Therapy for anxiety / panic disorder?

[Tacori E-ring]

ame, sorry you had a negative experience. Ethical therapists believe in short term therapy unless you have a chronic/severe issues. Doesn't feel good to feel taken advantaged of. In the future behavioral therapist do not care about the past. You might feel more comfortable with that style. Gestalt is also "here and now." I prefer that since you can talk about past issue but more about how it effects you today, not about reliving the past. Just some ideas if you ever want to try talk therapy again. I use CBT on myself with my own anxiety issues. I am happy to show you how to use a "thought record" sheet if you think it may help. You can download them.

 

[diamondseeker2006]

Oh my gosh. Antidepressants can trigger bipolar??? That is alarming (not for me but for a family member).

Yes they can. Usually its bipolar II ("soft"). This is why meds are not the way to go UNLESS suicidal or becoming nonfunctional for work or family.

Also, you cannot take meds 'forever' and the long-term effects are completely unknown for many of the meds.

The book is excellent.

The reason it is alarming is that the person was eventually diagnosed with bipolar, also. Severe. Cannot work. Meds do not work for long at all. Endless horrible cycle.

Will look into the book but it may not help since they are already years into meds.

DS - I hope you come back to this thread. I do not know if this will be helpful, but it was eye-opening for me. I also have a family member diagnosed with bi-polar, which began after a 5 day treatment of IV steroids for another medical condition. She was treated with lithium for years. She was never quite right (meaning that she still had a lot of symptoms, perhaps toned down, but a lot interpersonal issues, I guess you could say), and she always wanted to discontinue the drug, and sometimes did, with disastrous consequences (required hospitalizations.) During one of these hospitalizations, they switched the lithium to lamictal, and there has been a huge difference in symptoms. She tolerates the med much better. She also takes some other mood stablizers. And, then, a few months later, she developed another serious condition as a result of the years of lithium use. Her levels were not measured for many of the years that she was on the drug. It is not clear to me whether the psychiatrist did not order the blood work, or if she was non-compliant, but I think it was not being ordered. All of this is to say -- has your family member tried different combinations of these drugs? If he or she has always been on the same core drugs, maybe it is time to look into other combinations of drugs? ALSO, I am currently dosing out all of my family member's medications into weekly pill containers. I think a lot of her issues in the past with meds have been related to her accidentally skipping doses. I hope you find something useful in here.

Thank you. lovesvintage! My family member took Lithium for a little while, but then he was switched to Seroquel which works relatively well without the concerns of Lithium. He also has depression and anxiety meds. He has had to change depression meds every couple of years because they always lose effectiveness. He recently had a few months of depression and the doctor reduced Effexor and added some Wellbutrin which helps boost dopamine. Don't know how that is going to work out yet. I would say that the only thing that he has taken long term is the Seroquel, which really helps him sleep, and an anxiety medication of which he uses a small amount normally but takes more if he has more severe anxiety. The anxiety medicine was switched a couple of times, but he finally settled on the one that worked the best and worked the longest. He plans to go see another doctor soon for another evaluation of his meds and other options.

 

[VapidLapid]

my own experience, so individually specific.

Keep away from antidepressants...unless you need them. The thing is they are a bitch to get off of later, and you may feel that you have only deferred dealing with your misery sources, unless you really have a neurotransmitter imbalance, which you may not actually know until much later, in which case I say, we live in the post-post-modern world and you do not have to suffer!!!

For short term treatment and or as needed treatment I find klonopin is an excellent adjudivant. The next generation of Mother's Little Helper, but regardless of it's pop culture iconography , useful. Anxiety and panic are usually short term, and dont require daily maintenance meds.

 

[tmot14]

Hi OP. I also work in mental health (psychiatric NP) so can shed a little light. Many mental health professionals are trained in the same styles of therapy. Obviously a PhD or PsyD will have longer and possibly more intensive training, but that doesn't automatically make them more qualified. Current research indicates that therapy success isn't so much linked to the credential or style of training, but to the kind of rapport you build with a therapist. Sometimes it takes seeing a few different people to see who "clicks." That's not always the easiest thing to do during a stressful, anxiety-ridden time in your life, but it's worth taking the time to find the right person.

Also, meds are not always short-term for anxiety. If you have a more generalized anxiety, then daily meds can be useful and truly life enhancing. I've seen many patients who report drastic improvement after beginning a small daily dose of citalopram. But yes, primary care doctors can be very quick to prescribe without having a lot of foundation in mental health diagnoses or treatment, so be cautious. Best of luck to you.

 

[missy]

Oh my gosh. Antidepressants can trigger bipolar??? That is alarming (not for me but for a family member).

Yes they can. Usually its bipolar II ("soft"). This is why meds are not the way to go UNLESS suicidal or becoming nonfunctional for work or family.

Also, you cannot take meds 'forever' and the long-term effects are completely unknown for many of the meds.

The book is excellent.

The reason it is alarming is that the person was eventually diagnosed with bipolar, also. Severe. Cannot work. Meds do not work for long at all. Endless horrible cycle.

Will look into the book but it may not help since they are already years into meds.

DS - I hope you come back to this thread. I do not know if this will be helpful, but it was eye-opening for me. I also have a family member diagnosed with bi-polar, which began after a 5 day treatment of IV steroids for another medical condition. She was treated with lithium for years. She was never quite right (meaning that she still had a lot of symptoms, perhaps toned down, but a lot interpersonal issues, I guess you could say), and she always wanted to discontinue the drug, and sometimes did, with disastrous consequences (required hospitalizations.) During one of these hospitalizations, they switched the lithium to lamictal, and there has been a huge difference in symptoms. She tolerates the med much better. She also takes some other mood stablizers. And, then, a few months later, she developed another serious condition as a result of the years of lithium use. Her levels were not measured for many of the years that she was on the drug. It is not clear to me whether the psychiatrist did not order the blood work, or if she was non-compliant, but I think it was not being ordered. All of this is to say -- has your family member tried different combinations of these drugs? If he or she has always been on the same core drugs, maybe it is time to look into other combinations of drugs? ALSO, I am currently dosing out all of my family member's medications into weekly pill containers. I think a lot of her issues in the past with meds have been related to her accidentally skipping doses. I hope you find something useful in here.

Thank you. lovesvintage! My family member took Lithium for a little while, but then he was switched to Seroquel which works relatively well without the concerns of Lithium. He also has depression and anxiety meds. He has had to change depression meds every couple of years because they always lose effectiveness. He recently had a few months of depression and the doctor reduced Effexor and added some Wellbutrin which helps boost dopamine. Don't know how that is going to work out yet. I would say that the only thing that he has taken long term is the Seroquel, which really helps him sleep, and an anxiety medication of which he uses a small amount normally but takes more if he has more severe anxiety. The anxiety medicine was switched a couple of times, but he finally settled on the one that worked the best and worked the longest. He plans to go see another doctor soon for another evaluation of his meds and other options.

DiamondSeeker, I hope you don't mind me chiming in here. Seroquel can be a great medication but if your family member has not been made aware I want to let you know it can potentially cause cataracts. Please make sure he/she is having regular eye exams. I would suggest every 6 months just to make sure they don't suffer this particular side effect from the medication. Of course all meds have potential side effects but I have seen more than a fair number of patients develop cataracts on this med. A high percentage of my patients are on psychiatric meds so I feel comfortable in sharing this info with you as this is from my personal experience seeing patients on this medication.

 

[House Cat]

Oh my gosh. Antidepressants can trigger bipolar??? That is alarming (not for me but for a family member).

Yes they can. Usually its bipolar II ("soft"). This is why meds are not the way to go UNLESS suicidal or becoming nonfunctional for work or family.

Also, you cannot take meds 'forever' and the long-term effects are completely unknown for many of the meds.

The book is excellent.

The reason it is alarming is that the person was eventually diagnosed with bipolar, also. Severe. Cannot work. Meds do not work for long at all. Endless horrible cycle.

Will look into the book but it may not help since they are already years into meds.

DS - I hope you come back to this thread. I do not know if this will be helpful, but it was eye-opening for me. I also have a family member diagnosed with bi-polar, which began after a 5 day treatment of IV steroids for another medical condition. She was treated with lithium for years. She was never quite right (meaning that she still had a lot of symptoms, perhaps toned down, but a lot interpersonal issues, I guess you could say), and she always wanted to discontinue the drug, and sometimes did, with disastrous consequences (required hospitalizations.) During one of these hospitalizations, they switched the lithium to lamictal, and there has been a huge difference in symptoms. She tolerates the med much better. She also takes some other mood stablizers. And, then, a few months later, she developed another serious condition as a result of the years of lithium use. Her levels were not measured for many of the years that she was on the drug. It is not clear to me whether the psychiatrist did not order the blood work, or if she was non-compliant, but I think it was not being ordered. All of this is to say -- has your family member tried different combinations of these drugs? If he or she has always been on the same core drugs, maybe it is time to look into other combinations of drugs? ALSO, I am currently dosing out all of my family member's medications into weekly pill containers. I think a lot of her issues in the past with meds have been related to her accidentally skipping doses. I hope you find something useful in here.

Thank you. lovesvintage! My family member took Lithium for a little while, but then he was switched to Seroquel which works relatively well without the concerns of Lithium. He also has depression and anxiety meds. He has had to change depression meds every couple of years because they always lose effectiveness. He recently had a few months of depression and the doctor reduced Effexor and added some Wellbutrin which helps boost dopamine. Don't know how that is going to work out yet. I would say that the only thing that he has taken long term is the Seroquel, which really helps him sleep, and an anxiety medication of which he uses a small amount normally but takes more if he has more severe anxiety. The anxiety medicine was switched a couple of times, but he finally settled on the one that worked the best and worked the longest. He plans to go see another doctor soon for another evaluation of his meds and other options.

DiamondSeeker, I hope you don't mind me chiming in here. Seroquel can be a great medication but if your family member has not been made aware I want to let you know it can potentially cause cataracts. Please make sure he/she is having regular eye exams. I would suggest every 6 months just to make sure they don't suffer this particular side effect from the medication. Of course all meds have potential side effects but I have seen more than a fair number of patients develop cataracts on this med. A high percentage of my patients are on psychiatric meds so I feel comfortable in sharing this info with you as this is from my personal experience seeing patients on this medication.

I have been taking Seroquel for 9 years and no one has ever told me this. Thank you! My vision is doing strange things over the past two years.
Is the cataracts caused on its own or is it a complication of diabetes? I always attribute most of the serious side effects of Seroquel to be related to the huge weight gain and diabetes it causes. I didn't gain a lot weight with it, so I always felt safe. I am slowly beginning to learn that its side effects can reach much farther than just complications of weight gain and diabetes.

 

[rubybeth]

Hi OP. I also work in mental health (psychiatric NP) so can shed a little light. Many mental health professionals are trained in the same styles of therapy. Obviously a PhD or PsyD will have longer and possibly more intensive training, but that doesn't automatically make them more qualified. Current research indicates that therapy success isn't so much linked to the credential or style of training, but to the kind of rapport you build with a therapist. Sometimes it takes seeing a few different people to see who "clicks." That's not always the easiest thing to do during a stressful, anxiety-ridden time in your life, but it's worth taking the time to find the right person.

I totally agree with tmot. My husband is becoming an LMFT (Licensed Marriage and Family Therapist) and I would say mainly ignore the credential letters after someone's name and find someone whose area of expertise is anxiety disorders who you like. My husband is great with people who have anxiety (me being one of them!), though you might not immediately think of a Marriage and Family Therapist as someone to see when you have anxiety. I also think CBT would be beneficial.

I also have to add that my own experience with medications was that, while initially they seemed to help (both Zoloft and Wellbutrin), eventually I couldn't tell a difference between taking them and not (except with Zoloft I got headaches when I would forget to take it, so not fun). I eventually figured out that exercise (getting my heart rate up, weights, etc.) helped me more than the meds, so have been doing that for years. It's been a very long time since I've had a panic attack. Best of luck to you!

 

[Sunstorm]

It does get much worse with age, I think it is due to the fact that many people experience several episodes of trauma in their lives which can set off really bad episodes of panic reactions or generalized anxiety, depression. First time I tried without any treatment whatsoever but I ended up doing very badly and got help from my father and went on antidepressants for years but today I would not recommend that. They simple did not work for me.

I also tried several types of antianxiety medication and by far the best experience I have had with Xanax SR, only the slow release formula. It does tend to help a great deal. I have unfortunately had a lot of trauma in the last three years of my life and recently worse. When things get better for periods, I wean myself off to minimum dose but I always take it, when things are very bad I up the dose and go down later. Magnesium IS really good but if you have a more severe case it may not be enough. Homepathy only knocked me out but did not work. Xanax SR helps me stay active, only helps with the severe anxiety and it does seem to help depression as well. Other types had very bad effect on me.

I think that many techniques and alternative methods work but in some cases when the chemical balance of the brain is off, again they may not be enough but I would recommend many other things like psychodrama sessions alone and in group, they worked well for me and perhaps a private psychologist. It may be worth looking into what set it off or caused it to worsen.

Many require initial hospitalization and when it is possible at a private clinic or someplace it may be a good idea as many of these drugs can have severe effects and some are only present in the beginning. I took Cipralex but I have found that it can in fact make anxiety worse and they will tell you that too that especially in the initial weeks or two it does make anxiety much worse to the point that it is unbearable. That is why they prescribe antianxiety drugs along with it but in my experience Cipralex causes more severe mood swings, highs that are great but also episodes of strange reactions, even aggression and can make people suicidal, I was not but I did not like how it made me feel and act for short periods of time, no problems coming off of it.

I too do not believe in most therapists but some alternative therapy can actually work, my private psychodrama was combined with massage like love sessions which were great. I still did not feel that it was the answer, ultimately ithas not proven to be. I think most the time the answer is within us, we just have to find it, until then a temporary Xanas SR can help greatly but it is a highly addictive medicine that is somewhat difficult to wean oneself off.

I do not believe in sleeping pills at all, nor even the best ones worked for me well. In addition to my Xanax (not taking a high dose even now but higher than before), magnesium in the morning and in the evening, as well as antihistamines for the night can greatly help.

Xanax is much less addicitive and much more even level as far as effects go when taken in the SR version. It can be taken for up to 2 mgs without side effects like diminished memory. For short periods it may be prescribed in even higher doses. Most the time people should not take more than 1 mg a day. I do not. Depends on how bad is your condition. Hope you get better.

 

[NOYFB]

I know I posted earlier, but wanted to chime in again and let you know that I've been taking Ativan on a daily basis for about a year now and it's made a tremendous difference in my life and my overall well-being. I'm approaching menopausal age, and my anxiety/stress levels have been through the roof. Ativan has truly been a lifesaver for me. Without it, I'm not a very pleasant person to be around.

I've been on different anti-depressants over the years and getting off of them was hell. I finally realized that I wasn't necessarily depressed, just anxious all the time.

Not to say that daily meds are for everyone. Some people only need them on a PRN basis. Unfortunately, I'm not one of them.

 

[Sunstorm]

I agree with Rubybeth that most antidepressants stop working after a while and the fact is that your body gets used to them and in order for them to work again you have to up the dose but you can only go up so much. I also noticed no difference at the end when I took cipralex (escitalopram) and I stopped it right away, no problems there. I also think that antidepressants do not really let you deal with the problem you are experiencing, they make you feel great no matter what but the anxiety still remains and they give you odd highs when you should not be experiencing them. It is better to grieve and deal with pain unless it is severe and when it is, taking low dose antianxiety meds is the answer. They allow you to sleep and not be miserable but you will still experience and feel what you should be feeling.

If it is not severe anxiety like I have from PTSD then you may not need medication at all and alternative therapies, magnesium, etc. may work great, I wish I did not have to take meds now and things like exercise and other stuff could work but sadly that is not always the case in every life situation and for all people.

 

[packrat]

The weather is getting nicer..do you have a stress reliever like gardening or anything you could do? Being in the dirt and out in the fresh air is hugely beneficial to our moods and general well being. I can tell a big difference when winter drags on, once the geese come home and things start to green up, I feel happier automatically and just ache to get back into my yard.

 

[diamondseeker2006]

Oh my gosh. Antidepressants can trigger bipolar??? That is alarming (not for me but for a family member).

Yes they can. Usually its bipolar II ("soft"). This is why meds are not the way to go UNLESS suicidal or becoming nonfunctional for work or family.

Also, you cannot take meds 'forever' and the long-term effects are completely unknown for many of the meds.

The book is excellent.

The reason it is alarming is that the person was eventually diagnosed with bipolar, also. Severe. Cannot work. Meds do not work for long at all. Endless horrible cycle.

Will look into the book but it may not help since they are already years into meds.

DS - I hope you come back to this thread. I do not know if this will be helpful, but it was eye-opening for me. I also have a family member diagnosed with bi-polar, which began after a 5 day treatment of IV steroids for another medical condition. She was treated with lithium for years. She was never quite right (meaning that she still had a lot of symptoms, perhaps toned down, but a lot interpersonal issues, I guess you could say), and she always wanted to discontinue the drug, and sometimes did, with disastrous consequences (required hospitalizations.) During one of these hospitalizations, they switched the lithium to lamictal, and there has been a huge difference in symptoms. She tolerates the med much better. She also takes some other mood stablizers. And, then, a few months later, she developed another serious condition as a result of the years of lithium use. Her levels were not measured for many of the years that she was on the drug. It is not clear to me whether the psychiatrist did not order the blood work, or if she was non-compliant, but I think it was not being ordered. All of this is to say -- has your family member tried different combinations of these drugs? If he or she has always been on the same core drugs, maybe it is time to look into other combinations of drugs? ALSO, I am currently dosing out all of my family member's medications into weekly pill containers. I think a lot of her issues in the past with meds have been related to her accidentally skipping doses. I hope you find something useful in here.

Thank you. lovesvintage! My family member took Lithium for a little while, but then he was switched to Seroquel which works relatively well without the concerns of Lithium. He also has depression and anxiety meds. He has had to change depression meds every couple of years because they always lose effectiveness. He recently had a few months of depression and the doctor reduced Effexor and added some Wellbutrin which helps boost dopamine. Don't know how that is going to work out yet. I would say that the only thing that he has taken long term is the Seroquel, which really helps him sleep, and an anxiety medication of which he uses a small amount normally but takes more if he has more severe anxiety. The anxiety medicine was switched a couple of times, but he finally settled on the one that worked the best and worked the longest. He plans to go see another doctor soon for another evaluation of his meds and other options.

DiamondSeeker, I hope you don't mind me chiming in here. Seroquel can be a great medication but if your family member has not been made aware I want to let you know it can potentially cause cataracts. Please make sure he/she is having regular eye exams. I would suggest every 6 months just to make sure they don't suffer this particular side effect from the medication. Of course all meds have potential side effects but I have seen more than a fair number of patients develop cataracts on this med. A high percentage of my patients are on psychiatric meds so I feel comfortable in sharing this info with you as this is from my personal experience seeing patients on this medication.

Oh my gosh, Missy! Ugh!!! Thank you!