May 15

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​Extra Help for Panic Disorder


Recovering from panic attacks may include talking with support groups, family, friends, a therapist, or your doctor. In most cases of anxiety, heart palpitations and chest pains have nothing to do with heart disease. However, you may have difficulty completely eliminating this fear until you have had appropriate diagnostic tests. Family and friends who are willing to read information on panic disorder can help in many ways:

  • Become thoroughly familiar with information about panic disorder and anxiety.
  • Do not tell people their fears are silly, that it’s “all in their heads,” or that they’re “not trying hard enough.” Instead, help them understand how an adrenaline rush can make symptoms feel so awful.
  • Discuss beliefs that will reduce concerns about symptoms of anxiety. Offer feedback that panic episodes are barely noticeable or information about other family members who have experienced problems with anxiety or depression. This can help people realize that an (inherited) sensitive temperament is a contributing factor.
  • Help relabel and reattribute symptoms when a person is not thinking clearly during a panic attack—“You may not have realized how stressful that visit from your mother was.”
  • Help people refocus on their breathing, something interesting in their surroundings, or silly trivia questions if sensations of panic start.
  • Do not constantly try to divert people’s attention to prevent panic, but encourage them to find out if panic will come and offer reassurance that you will help them refocus if it does.
  • Help people “flood out” anxiety by offering to “worry for them” in your silliest Mickey Mouse voice.
  • Encourage people to expose themselves to difficult situations and offer to go with them to help them through any panic that occurs.
  • Do not suddenly withdraw support, but find clever ways to gradually help people gain confidence in their independence after helping them refocus, float through, and face panic. Let them know you will be in another room, in the yard, at a neighbor’s house or following behind in your car in case you are needed.

FRIENDLY CAUTIONS

  • Avoid asking for help from friends and relatives who are pushy, disinterested, inept, or rigid. Attempts to involve them in your recovery or make them change will hinder you.
  • Do not argue with people who give you bad advice or try to make them understand. Let them know that you are glad they are concerned and just feedback what they are saying—”So you think it’s silly that I keep driving around the block and that by now I should be able manage downtown traffic. It must be frustrating for you to see me struggle and not be able to fix things for me.” Even if comments are cutting, respond to them as if they had been kind! Then find someone understanding with whom you can talk or write to yourself in a journal.
  • Watch out for friends and family who discourage recovery because they benefit from the limitations that panic places on your life. They may be afraid of losing you or need you to be “weak” so they can be strong. As you start to recover, they may become suspicious, jealous, accusatory, irritable, or even start to develop panic themselves!

NATIONAL NETWORKS AND SUPPORT GROUPS

If you are fortunate, you will be able to find one or two people who will give you assistance. However, this is not necessary. Many people do fine on their own or working with a therapist. You may also be able to find a support group in your community. There are national networks, web sites, and books that can offer additional assistance:

  • TERRAP (Territorial Apprehension) INC., 932 Evelyn Street, Menlo Park, CA 94025 (800-2-PHOBIA) offers a nationwide network for panic disorder and agoraphobia.
  • Anxiety Disorder Association of America, 6000 Executive Blvd., Suite 513, Rockville, MD 20852, Anxdis@aol.com (301-231-9350) has a newsletter and can provide information about therapists, research, and self-help groups.
  • Anxiety-Panic Internet Resource is a self-help network dedicated to overcoming and curing overwhelming anxiety: www.algy.com/anxiety/menu.shtml.
  • Treat Your Own Panic Disorder reviews self-treatment for panic disorder: http://e2.empirenet.com/~berta/.
  • General Internet sites and links: www.athealth.com/, www.cmhc.com.
  • Books: From Panic to Power by Lucinda Bassett (HarperCollins, 1997).

MEDICATION

Both antidepressants and anti-anxiety medications are commonly used in the treatment of panic disorder. Antidepressants such as Prozac, Zoloft, and Paxil increase serotonin levels in your brain, which makes problems less likely to happen without preventing them entirely. In mild cases, the herb, Saint-John’s-Wort has been shown to relieve both depression and anxiety. Anti-anxiety medication such as Xanax, Valium, and Ativan may prevent panic attacks and keep you from learning how to refocus or float through reactions. Refocusing and floating actually desensitize anxiety triggers. However, medication can be an important part of treatment when:

  • Depression is suggested by indecisiveness, withdrawal, and reduced concentration, energy, interest, and pleasure. Often, this is a physiological condition and with current medications, is more treatable than many other illnesses! An antidepressant may be necessary to “jump-start” your body’s chemistry so you can return to your usual level of functioning.
  • Reassurance is needed that you can take a pill if you are not able to reduce symptoms on your own. Knowing that you can take anti-anxiety medications will ease your mind enough to get through the worst moments of panic. Taking this medication when you are not actually experiencing panic can cause drowsiness. If taken during an episode, anxiety will “absorb” the medication and sleepiness will not occur.

PROFESSIONAL HELP

If thoughts of panic or memories of some of your episodes are overwhelming, a therapist can help you reexperience and “work through” your anxiety in the office setting. This can give you the confidence to know that you can diminish anxiety on your own. By exploring your first, worst, and most recent panic attacks with a therapist, you may discover the origin of your problem and make real strides in changing your reactions. Therapists can also identify and treat any depression, obsession, or social phobia that is contributing to your problems.


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