![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Jackster on June 17, 2001, at 1:54:56
I am now at the stage where I realise that I am scared of seeing my PDoc. I have agoraphobia (with PAs) and he is really the only suitable person in town to deal with my problem. I had a kind of a 'meltdown' last Xmas where I had to change drugs (the Paxil had pooped out). I went through about 3 types (Imipramine, Celexa, Prozac) and was having terrible panic attacks by the time I started taking Prozac. I went back on the Paxil for stability. 4 months later I am in a steady job and feeling OK - although the Paxil wasn't working nearly as well - so decided to try Zoloft. Again I had really bad panic attacks on switching, but when I went back to see my PDoc for some solace in the fact that this was a common effect and that it would go away - the session went really badly. He asked if I was doing my breathing exercises (I hadn't - I felt it was a useless technique against drug induced panic attacks). He basically began saying that if I wasn't going to help myself he couldn't help me, and that I was obviously oversensitive to changing drugs. I got the feeling that I was just an annoying patient he couldn't get rid of. I ended up leaving the session in tears, saying that I just wanted some confirmation that the panic attacks were a side effect of starting the Zoloft and would go away. My partner was also there - and he said that it didn't seem to him that my PDoc was bullying me - so maybe I'm just being over sensitive. The thing is, I have followed his advice now - exercies, breathing techniques - so I must have taken some of it on board. But the Zoloft (at 50mg) isn't kicking in enough (is common to need at least 100mg). This means I need to see my PDoc again. I really don't want to, but am still miserable that my agoraphobia is still worse than before I ever started any drugs. I have visions of having to be babysat for the rest of my life. Any advice?
Jackie
Posted by Anna Laura on June 17, 2001, at 9:13:21
In reply to Scared of my PDoc, posted by Jackster on June 17, 2001, at 1:54:56
> I am now at the stage where I realise that I am scared of seeing my PDoc. I have agoraphobia (with PAs) and he is really the only suitable person in town to deal with my problem. I had a kind of a 'meltdown' last Xmas where I had to change drugs (the Paxil had pooped out). I went through about 3 types (Imipramine, Celexa, Prozac) and was having terrible panic attacks by the time I started taking Prozac. I went back on the Paxil for stability. 4 months later I am in a steady job and feeling OK - although the Paxil wasn't working nearly as well - so decided to try Zoloft. Again I had really bad panic attacks on switching, but when I went back to see my PDoc for some solace in the fact that this was a common effect and that it would go away - the session went really badly. He asked if I was doing my breathing exercises (I hadn't - I felt it was a useless technique against drug induced panic attacks). He basically began saying that if I wasn't going to help myself he couldn't help me, and that I was obviously oversensitive to changing drugs. I got the feeling that I was just an annoying patient he couldn't get rid of. I ended up leaving the session in tears, saying that I just wanted some confirmation that the panic attacks were a side effect of starting the Zoloft and would go away. My partner was also there - and he said that it didn't seem to him that my PDoc was bullying me - so maybe I'm just being over sensitive. The thing is, I have followed his advice now - exercies, breathing techniques - so I must have taken some of it on board. But the Zoloft (at 50mg) isn't kicking in enough (is common to need at least 100mg). This means I need to see my PDoc again. I really don't want to, but am still miserable that my agoraphobia is still worse than before I ever started any drugs. I have visions of having to be babysat for the rest of my life. Any advice?
>
> Jackie
Hi Jackie,First thing : posting from Europe, english is not my language; hope this mail makes some sense.
I've been suffering from panic attacks for years and i got rid of it (it took time but eventually subsided, vanished). I couldn't get out of the house alone whatsoever until to the last year.
I think SSRI or TCA are better then benzos: this is my personal opinion, even if it has been proved that SSRI and TCA leave you more margin/space " tfor you to react/fight back, I believe this is definitely positive : you might be suffering much more then on benzos, but benzos are kind of concealing/covering up your anxiety so that it gets worse as time goes by : this is because your brain gets used not working/reacting/managing with anxiety: if you pardon me the weird analogy being on benzos it's like not using a muscle; you do more excersing with AD, even if it does give you less relief. Do you know what i mean?
A thing it helped me was desensisation excercises: i.e. :facing a scary situation a bit at a time. Suffering from panic is actually having in the brain a nervous pathway
that shouldn't be there, that panic itself created and got enhanced over time. An example: all of a sudden you get scared of dogs. Every time you see a dog you get panic, o.k.? Now ther's actually a physiological difference between a not-scared-of-dogs person and you: a new nervous pathway has been created: an anxiety nervous pathway; Desensization is about "ereasing" that pathway little by little. If you're interested in it, a New-Zealand Pdoc, Doc. Falloon, wrote some material about it. He proved that it's effective for many people.
Another thing you might do it's just abrupt change. I think the first thing to do if you wish to follow that path is to investigate the root of your panic. Which kind of fear do you have? It's about getting totally insane or is that about dying? The first step then would be challenging those fears, both mentally and pshysically. I remember the challenge thing worked for me: my fear was death, then i tried to get prepared for death and not being scared about dying. Finally i managed not to be scared about that (to long to tell). And then i told to the panick monster: well, kill me then, i don't give a *****! And the panic went way, for years. The second time i had panic was after severe prolonged stress (found uot my ex-fiancee had AIDS). This time my panic monster got wiser : he knew i wasn't scared about death anymore, so he got me scared of madness instead. That was hard to treat man, because i've been actually psychotic back in 1993, my pdoc not being sure wether it was schizofrenia or not. I began thinking i was going to turn mad as soon as got on my early tirthies(usual deadline for that soecific kind of madness). I began thinking the worst scenario: my ex-fiancee dying and i getting crazy because of the pain (something like "splendor in the grass" movie sort of thing).
You know what helped me? I know this is going to sound weird but depression helped me, 'cause i become depressed again becasue of the stress, realizing i wasn't getting mad but just depressed. You know what? All of a sudden the panic went away and i was completely free to walk alone and going anywhere, catching trains and so on.
Thanks god the depression subsided because of AD. Right now i'm still taking them, still searching for a cure for my anhedonia.Best wishes and good luck
Anna Laura
Posted by rmshed on June 17, 2001, at 10:33:19
In reply to Scared of my PDoc, posted by Jackster on June 17, 2001, at 1:54:56
> I am now at the stage where I realise that I am scared of seeing my PDoc. I have agoraphobia (with PAs) and he is really the only suitable person in town to deal with my problem. I had a kind of a 'meltdown' last Xmas where I had to change drugs (the Paxil had pooped out). I went through about 3 types (Imipramine, Celexa, Prozac) and was having terrible panic attacks by the time I started taking Prozac. I went back on the Paxil for stability. 4 months later I am in a steady job and feeling OK - although the Paxil wasn't working nearly as well - so decided to try Zoloft. Again I had really bad panic attacks on switching, but when I went back to see my PDoc for some solace in the fact that this was a common effect and that it would go away - the session went really badly. He asked if I was doing my breathing exercises (I hadn't - I felt it was a useless technique against drug induced panic attacks). He basically began saying that if I wasn't going to help myself he couldn't help me, and that I was obviously oversensitive to changing drugs. I got the feeling that I was just an annoying patient he couldn't get rid of. I ended up leaving the session in tears, saying that I just wanted some confirmation that the panic attacks were a side effect of starting the Zoloft and would go away. My partner was also there - and he said that it didn't seem to him that my PDoc was bullying me - so maybe I'm just being over sensitive. The thing is, I have followed his advice now - exercies, breathing techniques - so I must have taken some of it on board. But the Zoloft (at 50mg) isn't kicking in enough (is common to need at least 100mg). This means I need to see my PDoc again. I really don't want to, but am still miserable that my agoraphobia is still worse than before I ever started any drugs. I have visions of having to be babysat for the rest of my life. Any advice?
>
> JackieJackie:
I had a doctor once who decided that he no longer wanted to treat me with benzodiazepines. So over a period of 6-8 weeks, he was tapering me down to nothing. I went through pure hell. As I was down to my last dose, I went over the edge. By the way, the doctor who made a decision for me was just an MD. I was lost not knowing where to go. I ended up going to a facility run by the county. Most of their patients get financial assistance from the county or state, but they accept anyone, regardless of your financial status or insurance coverage. I found that they housed many pdocs. I was lucky enough to find a good pdoc there. They were used to treating the worst cast scenerio, so treating patients with theraputic (sp) doses was a common issue for them. I was put on xanax for my panic attacks and anxiety. My panic attacks are and have been in remission for about 10 years. I refused to never again let a doctor decide when I was ready to go off a medication that worked. I never back down. I may not be my doctor's best patient, but then I am sure he has patient's who won't even take their medication as needed. Start looking for another doctor, it sounds to me as though your doctor is not listening to your needs. It sounds like he has decided to make his own decision regardless of your needs.
GET A SECOND OR THIRD OPINION.
Take Care.
Becky
Posted by mair on June 17, 2001, at 22:12:39
In reply to Scared of my PDoc, posted by Jackster on June 17, 2001, at 1:54:56
>Did the panic attacks you got when you first got on zoloft dissipate? If so and you want to try a higher dose to see if it helps, why can't you just call him/her on the phone? I've done that lots of times when I really wanted to avoid a more extended discussion. He probably has a plan for increasing you anyway.
Mair
Posted by JAMMER on June 18, 2001, at 8:42:57
In reply to Scared of my PDoc, posted by Jackster on June 17, 2001, at 1:54:56
> I am now at the stage where I realise that I am scared of seeing my PDocI have visions of having to be babysat for the rest of my life. Any advice? > Jackie
**********Jackie, I've had issues with Pdoc's before as well, so I ended seeing them, and found someone really willing to work with and help me, through referrals from friends and alternative medicine providors, not just my HMO PCP.....
My PTSD created panic attacks within me. For years, my dreams and waking up in sweats and panic was consuming me. I didn't even have to sleep. Just lying down triggered vivid imaginations and mental creations of non-occured events. My mind began racing, creating images of being victim and savior, through horrific battles.I was refered to try EMDR by two people I had learned to really trust. I meet with the woman who I was referred to, we talked, and the next sessions where EMDR exercises. It was incredible what I experienced, many old unresolved issues remembered, and not thought of for years, as well as very recent issues came out, and were discussed individually. Since then those PTSD induced senarios have all but ended. I sometimes still begin the creation of "awake dreaming". But I catch myself, and stop it by getting up for a while, concentrate on breathing which re-focuses the mind, Turn on the TV for a short time. I then return to bed and fall asleep normally. EMDR really made a big difference for me.
Yoga is also helping with anxiety. My job is very technical, difficult, and I work within a very high strung group of technical/engineering/scientist types. I've found going home for lunch and doing a 30-40 minute yoga session, alone, calms me greatly, allowing me to return to work without feeling like I'm losing it.
I've ended using AD's for now. Wanted to see how far I've come. I have made great advances, yet I'm finding I'm still depressed, and anxiety is still there, just over the fence, but I'm OK. I go for a re-assesment, and medication eval this week. If I need to return to some form of medication, I will, as I have found it does work/help. Effexor being the best I've tried to date, beyond the side effects.Talk with your pdoc again, and be certain where you stand with him/her, is he/she committed to helping you? and what are the real issues needed to be solved for the 2 of you to get back to helping you!! But, don't let yourself be pushed around, or abused...
Best wishes.
-James
This is the end of the thread.
Psycho-Babble Social | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.