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Finally... => Life Advice => Topic started by: sonerohi on January 16, 2011, 04:43:00 pm

Title: Battling panic attacks
Post by: sonerohi on January 16, 2011, 04:43:00 pm
Thread title is a huge clue in.

Basically, I suffer from panic attacks a lot, when socializing. The times I don't have attacks are small groups of friends, one on one conversations, meeting new people in the presence of friends, and a few others. Basically, it seems to me like ratios. I have always been heavily introverted, but I got along despite that. Now though, it seems like if I can't isolate and sort of remove myself, then I just break down.

Recently, I was at a lock in at school, and was having a great time. I was in a group of fifteen, out of a crowd of 400 or so. I had met everyone in my group and was getting along with them and opening up just as much as I do when chatting with my best friends. I felt really great about the situation and was laughing and dancing, and just all of a sudden got hit. I felt nauseous, heart rate shot up, got tunnel vision, felt faint, my extremities hurt, and I just felt cold inside and miserable all of a sudden. I am thinking (speculating with all my inner Internet doctor) that my heart condition, an unusually bad coronary artery fistula, may be compounding the situation.

Dear B12, my questions, based on this ( and a previous lock in that went exactly the same way), are several in number and are as follows. How do I fight the attacks once they happen? How do I distinguish the effects, like faintness and such, from what is being caused by the panic attack and what is my heart acting up in response to the attack? How do I socially maneuver into smaller groups to help prevent these instances?

To answer my own questions, so you guys know what I do and do not know, I'm editing here.
When an attack happens, I usually just sit down, breathe slowly, and try to make small talk with friends to help calm me down, and also get lots of cold water.
I have no clue how to distinguish the two, since a lot of what they cause in a person are the same, although the high heart rate from a panic attack will induce a heart flare-up thing (since attack is taken). They sort of feed into each other, because while I know the panic attack is mental and not real danger to me, the heart issue is, and since I can't tell what is what I get afraid, which heightens the panic attack, and the increased blood flow from that heightens my heart flare up.
The best I have for the social tactics to prevent this are to keep going to these lock ins. I have had panic attacks at the last five and intend to go to the next one still, to keep fighting it til it doesn't happen.

Advanced apologies if formating or reading flow are terrible, if you think my OP is terrible please tell me.
Title: Re: Battling panic attacks
Post by: Darvi on January 16, 2011, 04:51:48 pm
Dear B12, my questions, based on this ( and a previous lock in that went exactly the same way), are several in number and are as follows. How do I fight the attacks once they happen? How do I distinguish the effects, like faintness and such, from what is being caused by the panic attack and what is my heart acting up in response to the attack?
When in doubt, consult a doctor.
Quote
How do I socially maneuver into smaller groups to help prevent these instances?
When the group becomes too big, jus' tell them that you'd like to leave. Or try to pretend that you're not actually in the group. That's what I do when there's too many people around. Go for a short walk. You know, spend some time being introvertive (is that actually a word?).
Title: Re: Battling panic attacks
Post by: ChairmanPoo on January 16, 2011, 04:53:40 pm
You should go to a professional and get it treated. IIRC social phobia is treated with a combination of ansiolithics, antidepressants, and controled exposition and group training.
Title: Re: Battling panic attacks
Post by: smigenboger on January 16, 2011, 05:41:26 pm
How do you fare doing extended activities when not around people? Dancing and being generally exertive could make your coping ability go down. The people I know with anxiety say they can cope much better earlier in the day and when fully rested and alert.
Title: Re: Battling panic attacks
Post by: The Merchant Of Menace on January 16, 2011, 08:13:41 pm
Hmm...
My personal way of dealing with panic attacks is to get away from people and isolate myself as much as possible.

If you have some form of mantra it may help as well, just thinking "everythin is fine" or something to that extent.
Aside from that, I, personally, can't do much else to deal with them.
Title: Re: Battling panic attacks
Post by: Bouchart on January 16, 2011, 08:54:41 pm
Just avoid large groups of people whenever possible.
Title: Re: Battling panic attacks
Post by: Heron TSG on January 16, 2011, 10:32:37 pm
You must not fear.
Fear is the mind-killer.
Fear is the little-death that brings total obliteration.
You will face your fear.
You will permit it to pass through you and over you.
And when it has gone past you shall turn the inner eye to see its path.
Where the fear has gone there will be nothing.
Only you will remain.
Title: Re: Battling panic attacks
Post by: Grakelin on January 16, 2011, 11:26:14 pm
Fear cuts deeper than swords

see with your eyes, hear with your ears
Title: Re: Battling panic attacks
Post by: Tellemurius on January 17, 2011, 12:45:22 am
my father has rare panic attacks but they are fucking weird (he roams around the house at night periodically walks into our rooms and peer out the windows). ask your doctor for anxiety pills for emergencies.
Title: Re: Battling panic attacks
Post by: scriver on January 17, 2011, 04:33:52 am
My personal way of dealing with panic attacks is to get away from people and isolate myself as much as possible.
Just avoid large groups of people whenever possible.
These are both terrible, terrible advice. The only thing doing this will accomplish is reinforcing the condition, and will also put you in the risk-zone of developing social phobia and the like. Obviously, avoiding a problem does not deal with it.

If you don't want, can or think it's necessary  see a counsellor or therapist or something like that, I can only advice you to keep doing what you seem to be doing now; Keep pushing yourself into the kind of situations that triggers the attacks. Going to these "lock ins" (what is that, by the way?) seem like good idea, especially since you appear to have fun at them the rest of the time. You're body should get the hint eventually. If you've got the determination to do so, maybe make up some sort of plan so you can't make up excuses or procrastinate as easily. And while it doesn't appear so from your OP, I'll still add that if you feel ashamed, nervous or vulnerable about your panic attacks and having them in front of friends/how people will react to them, then telling your friends about how you want to fight them might ease those feelings somewhat. Having people understand what you're going through is always helpful.

Other than that, some "lighter" form of therapy or counselling could be helpful, if only because they most likely have experience with these kind of things and can give you advice and tools to help yourself, that you cant get from other people (as reliable, at least).
Title: Re: Battling panic attacks
Post by: The Merchant Of Menace on January 17, 2011, 04:35:32 am
Yah, I'm already terrified of people, ergo, panic attacks whenever I'm near them, and I did state that it was my personal way of dealing.
Title: Re: Battling panic attacks
Post by: Vector on January 17, 2011, 06:59:12 am
Going to these "lock ins" (what is that, by the way?) seem like good idea, especially since you appear to have fun at them the rest of the time.

I nearly drowned when I was 3.  My mother made me put my face into bowls of water in the kitchen, hand on the back of my neck, over and over again.  I took swim lessons for years, until I started crying every time they tried to get me to dive into a pool.  I failed the swim test in high school, despite being perfectly able to swim, due to panic attacks--automatic ones, endured with no sense of fear, even as I was forcing myself to keep moving.

When I went to college, I could still hardly wash my face with a wet washcloth.  I just started gasping.

If you're having panic attacks, forcing yourself into the most difficult situations will often just give you more panic attacks.

In the case of fixing my fear of swimming, I started with just standing in the shower, before getting my face closer and closer to the water, running water over the back of my head and into my face, and finally keeping myself calm as I ran water more and more directly onto my face itself, just standing there feeling it without trying to wash or do anything but control my breathing.  Nowadays, I can get a little water up my nose and all over my mouth without much trouble.  My brain will quietly tell me "Vector, you are drowning," to which I can tell it "No, I am not drowning" and everything moves on this way.  I was even able to swim last summer without any fear at all, because I took a year to slowly make progress.  All of the quick exposures the world had ever offered me just made me more and more frightened, as I started sinking below the surface, again and again, with my desperate efforts to stay afloat.


I'm sure you can understand what the metaphor is, here.  Take little steps.  Don't just force your way through it with the idea that it is "Hurr manly" or something like that.  I'm not saying that you should spend all your time isolated--I've done that, and it was bad.  But work up to it.  Find your limits, acclimate yourself to those limits, and move on while being kind to yourself.  If you need a psychologist to help you with that, then go for it.  But for goodness' sakes, don't just keep pushing yourself up against the wall unless you've already tried some other things.  You've "failed" 5 times.  Isn't that enough to show you that you should see how a different tactic works out?
Title: Re: Battling panic attacks
Post by: scriver on January 17, 2011, 09:45:38 am
Vector, the way I see it, going to these lock ins might be more similar to your shower therapy than having your mother pressing your face into a bowl of water (What the hell gave her the idea that would be helping anyway? It's just outright cruel). He said he had no trouble spending time with small groups of people and friends, so trying to expand the "safe" zone to slightly bigger social happenings would be the next logical step. As long as he have friends around him, and have fun (except for or despite the attacks), of course. If these "exercises" increases anxiety rather than the opposite, of course he should step down a notch and try something less taxing. All I wrote in the above post was under the assumption that he was in fact ready to face these kind of situations. Maybe I should have been a bit more clear on that.
Title: Re: Battling panic attacks
Post by: Darvi on January 17, 2011, 09:53:03 am
Vector, the way I see it, going to these lock ins might be more similar to your shower therapy than having your mother pressing your face into a bowl of water (What the hell gave her the idea that would be helping anyway? It's just outright cruel). He said he had no trouble spending time with small groups of people and friends, so trying to expand the "safe" zone to slightly bigger social happenings would be the next logical step. As long as he have friends around him, and have fun (except for or despite the attacks), of course. If these "exercises" increases anxiety rather than the opposite, of course he should step down a notch and try something less taxing. All I wrote in the above post was under the assumption that he was in fact ready to face these kind of situations. Maybe I should have been a bit more clear on that.
Exactly. Baby steps. And, as I said, step out if you get too uncomfortable.
Title: Re: Battling panic attacks
Post by: sonerohi on January 17, 2011, 12:55:16 pm
Thank you for the tips everyone. You guys have no idea how comforting it is to get the reinforcement provided here.

@Vector: I am already going to a therapist, and was considering bringing this up at my next appointment, but will definitely do so now. I didn't really realize panic attacks could be reinforced into behavior, but now I do and am taking steps. I'm not going to go all 'herp derp testosterone mangrit' on the issue, but I will keep at it, and a change in tactics probably is necessary.

@Tellemarius & Chairman: I'll be talking to my therapist about the necessity of medications, but are there any you would recommend me asking about?

@Scriver & Darvi: Thank you two for kind of encouraging me to keep at it. As I've said, my approach might change up but this will be solved.

@Scriver: A lock in at my school is a sort of hodge podge of stuff. Kids from every high school in the district can sign up and attend, and we all come in on a Friday evening and then they lock the building. We do a lot of peer counseling sort of stuff, along with drug awareness and prevention, but we do it in a goofy and fun way. It is an amazing bonding experience, and gets pretty emotional.
Title: Re: Battling panic attacks
Post by: Tellemurius on January 17, 2011, 01:07:46 pm
hypertension drugs i don't know really what my father uses but i think they use the same stuff for ADHD and ADD ie. speed.
Title: Re: Battling panic attacks
Post by: scriver on January 17, 2011, 02:03:00 pm
@Vector: I am already going to a therapist, and was considering bringing this up at my next appointment, but will definitely do so now. I didn't really realize panic attacks could be reinforced into behavior, but now I do and am taking steps. I'm not going to go all 'herp derp testosterone mangrit' on the issue, but I will keep at it, and a change in tactics probably is necessary.
Telling your therapist is a good idea, yeah. I'm a bit surprised that you hadn't already, if you've already got one.
Title: Re: Battling panic attacks
Post by: sonerohi on January 17, 2011, 02:06:26 pm
Well, my meetings with her are spaced out pretty far, and when I saw her last I had only had one instance, which we discussed a little but ultimately dismissed. When I see her next I'm updating her on the other ones and telling her the seriousness of it.
Title: Re: Battling panic attacks
Post by: smigenboger on January 17, 2011, 04:03:45 pm
Well, my meetings with her are spaced out pretty far, and when I saw her last I had only had one instance, which we discussed a little but ultimately dismissed. When I see her next I'm updating her on the other ones and telling her the seriousness of it.
Anti-anxiety medications are controlled substances, and with the way ADHD and anti-anxiety medication is often abused and sold, people are hesitant to prescribe it. They get more hesitant the younger you are. I would not recommend Xanax, or other high-dose fast acting anti-anxiety medications. I'd instead recommend low-dose ones such as Librium so that you don't develop a dependency, gain a high tolerance, and don't get a high and a low point from taking it. It's also safer to prescribe, since it's much harder to abuse. I don't know how young you are, but nevermind you're in high school, don't drink anyway.
Ask if it would be better to have a low dose constant effect medication instead of a situational one, since it could just mask the symptom and not help you get over it.

Just about everything anyone's said on this thread, mine included, can be contradicted by someone else's opinion. What works for you may not work for someone else. Even on here some people are saying it's bad to remove yourself from the cause, and that it's bad to 'push on through' anyway. Take everything with a grain of salt.
Title: Re: Battling panic attacks
Post by: scriver on January 17, 2011, 04:22:16 pm
Well, my meetings with her are spaced out pretty far, and when I saw her last I had only had one instance, which we discussed a little but ultimately dismissed. When I see her next I'm updating her on the other ones and telling her the seriousness of it.

Ah, it's seems I jumped to conclusions again. For whatever reason I presumed you had been going for some time, but looking back I can't see any reason for thinking so.
Also, thanks for the explanation. Forgot to say that.
Title: Re: Battling panic attacks
Post by: ChairmanPoo on January 17, 2011, 04:52:36 pm
ADD are not treated with antidepressants, but with amphetamines (or alternatively, with atomoxetine, which has the added benefit of not being dependence-inducing). As for xanax and librium, both are short-term benzodiacepines, and AFAIK they're be pretty much interchangeable (in class we were recommended alprazolam in this context, but this is likely because it's more widely prescribed overall rather than it being inherently better or worse). They're only suitable for the beggining of the symptoms, though.  For long term treatment, selective inhibitors of serotonin recaptation were recommended.
Title: Re: Battling panic attacks
Post by: Vector on January 17, 2011, 04:58:49 pm
Vector, the way I see it, going to these lock ins might be more similar to your shower therapy than having your mother pressing your face into a bowl of water (What the hell gave her the idea that would be helping anyway? It's just outright cruel). He said he had no trouble spending time with small groups of people and friends, so trying to expand the "safe" zone to slightly bigger social happenings would be the next logical step. As long as he have friends around him, and have fun (except for or despite the attacks), of course. If these "exercises" increases anxiety rather than the opposite, of course he should step down a notch and try something less taxing. All I wrote in the above post was under the assumption that he was in fact ready to face these kind of situations. Maybe I should have been a bit more clear on that.

Ah-ha, I was mostly thinking that there had to be an interim step between "small groups of people and friends" (which, to me, means about 5-8 people, tops) and "400 people in a locked area that you can't get away from and are probably making a lot of noise."

I'm not even socially anxious, but I am pretty shy (internally)--and the latter of those two would be very difficult for me to deal with.  If this is the interim step, then yeah, he should probably focus more on slowly introducing himself to that particular situation.  I figure it'd probably work better to focus on calming down whatever makes him uncomfortable, though, before he moves on to whatever terrifies him. 
Title: Re: Battling panic attacks
Post by: smigenboger on January 17, 2011, 05:46:41 pm
ADD are not treated with antidepressants, but with amphetamines (or alternatively, with atomoxetine, which has the added benefit of not being dependence-inducing). As for xanax and librium, both are short-term benzodiacepines, and AFAIK they're be pretty much interchangeable (in class we were recommended alprazolam in this context, but this is likely because it's more widely prescribed overall rather than it being inherently better or worse). They're only suitable for the beggining of the symptoms, though.  For long term treatment, selective inhibitors of serotonin recaptation were recommended.
I didn't know anti-depressants were being abused like amphetamines were, but I'm sure they are. In high school it seemed like there was always someone trying to sell their ADD meds and high test painkillers.

Huh I thought librium was different. Perhaps I was just recommended low dose tablets several times a day than one big pill when needed. Did you say SSRI's are recommended? I thought that was for depression, though a few doctors said the meds can overlap.
Title: Re: Battling panic attacks
Post by: scriver on January 17, 2011, 05:56:35 pm
Ah-ha, I was mostly thinking that there had to be an interim step between "small groups of people and friends" (which, to me, means about 5-8 people, tops) and "400 people in a locked area that you can't get away from and are probably making a lot of noise."

I'm not even socially anxious, but I am pretty shy (internally)--and the latter of those two would be very difficult for me to deal with.  If this is the interim step, then yeah, he should probably focus more on slowly introducing himself to that particular situation.  I figure it'd probably work better to focus on calming down whatever makes him uncomfortable, though, before he moves on to whatever terrifies him. 
I agree with that. It's always hard to give advice with the vast Internetian Void separating us, though. So perhaps caution would be for the best.
I also admit that my firdt post was a bit of a gut reaction to people saying he should semi-isolate himself or avoid  the issue. Made me go a little "No don't do THAT!" and perhaps come on a bit too strong for ghe opposite direction.
Title: Re: Battling panic attacks
Post by: ChairmanPoo on January 17, 2011, 06:02:37 pm
But ADD meds aren't antidepressants, but amphetamines, and thus quite subject to abuse. As for SSRI's, they're used for other things besides depression, yes, or so were we told. Social phobia, generalized anxiety, OCD (in this one triciclicals are the first choice, according to my notes). In particular, what my notes say about social phobia is that benzodiacepines should be used short-term only because of dependence risks, and that long term MAOIs and SSRI's should be used. I added a little parenthesis saying "recurrence risk" to MAOIs, I dont know if it applies to SSRIs too.
Title: Re: Battling panic attacks
Post by: sonerohi on January 17, 2011, 07:32:54 pm
Well, I'm already on Focalin for ADD, but that is my only med currently. I can confirm that it is an amphetamine.

@Vector: I can handle maybe 50 people at a time, so long as I know names and it isn't the whole judgmental first meeting. Of these 400 in the lock in, I know maybe 170-200, but the whole of us only assembled for listening to speakers and stuff, which I was handling ok. It was when we broke down into our designated discussion groups, of about 15 (of which I knew 6 well enough), that I just started freaking the fuck out. 
Title: Re: Battling panic attacks
Post by: Tellemurius on January 17, 2011, 08:15:00 pm
they use speed for anxiety medication becuase the same reason for ADD and ADHD, it (supposedly) calms the person down.
Title: Re: Battling panic attacks
Post by: ChairmanPoo on January 17, 2011, 08:55:22 pm
ADD patients have a neurotransmitter disorder which results in certain attention-related parts of the CNS being less active than they should. Amphetamines can correct this (to an extent, at least). They're certianly not routinedly used as anti-anxiety medication in people without ADD.
Title: Re: Battling panic attacks
Post by: Vector on January 17, 2011, 09:59:08 pm
@Vector: I can handle maybe 50 people at a time, so long as I know names and it isn't the whole judgmental first meeting. Of these 400 in the lock in, I know maybe 170-200, but the whole of us only assembled for listening to speakers and stuff, which I was handling ok. It was when we broke down into our designated discussion groups, of about 15 (of which I knew 6 well enough), that I just started freaking the fuck out.

Then it seems like the real problem is meeting new people (specifically: issues with feeling judged, which you should talk to your therapist about), not just being around people in the first place.  For that, I suggest coffee shops or other hangouts where you don't know folks, or just striking up conversations with classmates you've never talked to.  Trust me, lots of practice helps =)
Title: Re: Battling panic attacks
Post by: Neonivek on January 18, 2011, 01:02:46 am
I have problems with stress too for the most part because I always feel the need to worry about every little thing and I always suspect that at any moment my friends won't like me anymore because of the way I act or acted or something I said or even for no reason.

My friends think it is totally rediculous for me to be stressed around them and that those are the times I am supposed to be relaxing rather then tensing up.

If isn't that pleasant to analyse everything you do and wonder if because of something you did or didn't do will make someone you like, dislike you. Heck I dislike being disliked and I have felt pretty bad being disliked by people I generally dislike.

I guess I am too accomidating...

Though that is only one of the things that stress me out to the point of losing it. I think for someone who stressed a lot, it is genuin work not to be stressed. I am going to work on my friend stress and relax a bit more everyday.