Still in agony..

[Krissy1816]

After my whole up and down roller coaster with paxil, (which I started for panic disorder) I was told here on this forum that I was tapering too fast and instead of being on disability I should go back to work and that I need to go back to a dose that was comfortable to me..and after I stablize to try tapering again but much slower..

But my problem is I went back up to 20mgs, half of my original dosage, and went back to work. I've been back to work for almost 2 weeks and every morning I wake up and drive to work and have a panic attack..I get so sick and cant get out of my car and finally give in and take some xanax. Not only am I having a panic attack before work everyday but I went to the movies with some friends and had an anxiety attack before the movie and had to go to the bathroom and take another xanax to calm down. And before that I went to the mall with my sister and had such a bad Panic attack I threw up three times and we had to leave..It's been years since I've had to deal with these panic attacks and never so severe before..and I have so many fears.

I'm afraid that i'm losing my life all over again to the panic and that if I continue to get off paxil that I'll end up becoming addicted to xanax because i'll have to many panic attacks..or end up not able to even work..but I know if I dont get off paxil completely that I may never be able to have kids for fear or something going wrong, and i'll be stuck with all the nasty side affects forever..and the worst thing is that every doctor I talk to seems to think that the only way to keep my panic attacks down and away is to stay on medication and increase it, or switch meds! I dont know what to do.I'm so torn and so afraid of what to do..

[carolyn]

Hi Krissy! {{{HUG}}} Welcome to the site!

There are a bunch of us here who have panic disorder and can definitely relate to your situation.

The trick to living with the panic attacks is to learn to accept them and "treat" them without medication as you taper.

Have you done any sort of Cognitive Behavior Therapy? I really recommend it -- it literally changed my life with regards to my panic attacks.

If therapy is unavailable to you, or too expensive, check out www.controllinganxiety.com for some of Claire Weekes' work. She's highly recommended on this forum and the techniques on that website are free.

BTW, movies are a total panic trigger for me, too. I haven't been to a movie comfortably in 15 years. My therapist used to call my husband and tell him to make me go to a movie just to face that fear. I can sit through them now but I still don't like them much. I prefer Netflix. But I CAN go to a sporting event and have fun, which used to also give me panic attacks (hint for either: sitting near the aisle instead of in the center of the row can really help).

I also was really scared of the thought of having kids someday because "what if something goes wrong" or just the thought of my body giving me new/different sensations. But now, a year after weekly sessions of CBT for 6 months, I'm really looking forward to getting pregnant once I'm off of Paxil.

Anyway, now I'm blathering. WELCOME!!!

[been there done that]

There is a quick fix for lowering stress it is called tapping I am not sure how or works or why but it can be found online. Just search tapping. There are other names for it but I can't recall them now it may help you it is available now adn works quickly. I am not saying it is all you may need but it is a start.
At the end of the day you are one that has live with this so make your own decisions it could be that half your original dose is not enough I am sure others more familiar with tapering will chime in soon. One thing I know for sure taking the other meds to get thru the day is not the answer no sense being addicted to two drugs and it happens quickly with these.
I suspect you need a higher dose of paxil to get stable and a slower taper there is also the idea that you could say no to movies and shopping and do something more calming like a bath quiet walk until your system calms down. Good luck.

[carolyn]

Originally Posted by been there done that

I suspect you need a higher dose of paxil to get stable and a slower taper there is also the idea that you could say no to movies and shopping and do something more calming like a bath quiet walk until your system calms down. Good luck.

Nah, my guess is still that the main problem at this point is the panic attacks. Since that's what she originally went on the Paxil for, that's the main thing she'll have to look at (it's different for those of us who went on Paxil for panic, as opposed to the tons of people who wound up with panic attacks *because* of Paxil).

Saying no to situations that give us panic attacks actually makes things worse in the long run because our brains learn to associate the situation with panic. It's how agoraphobia starts (or is cemented) for those of us with panic disorder.

Now, I'm not saying that everyone with panic disorder should make themselves miserable all the time just to plow through it! I've said no to things many times because my anxiety levels were just too high.

But for specific triggering events, like going to the movies, it's really important to keep going and prove to the lizard brain that the movie isn't going to kill us....and believe me, I've spent more time than I want to admit to freaking out/sobbing/thinking I was going to die in movie theater bathrooms. But it DOES get better, even without meds/with lower doses!

If Krissy had said that she's experiencing a ton of withdrawal symptoms (zaps, flu symptoms, akathesia, etc etc etc), I'd think, sure, maybe increasing the dose would help. But this, I think, is really just getting to the bottom of the panic attacks and learning to deal with them as a part of her.

(Er, sorry, Krissy, for talking about you like you're not here! )

[been there done that]

FYI I have had agraphobia anxiety to the point of puking my guts out been there is not just a title. I know where she is but regardless of all that she did go back to only a half dose this could be a temporary problem I am not saying she should not address this from many angles at once but forcing herself into more painful and distressing situation to train her reptilian brain is not my idea of a good idea not. What is the point at the end of the day? All these things can be faced and dealt with after she has found a sound base and some peace. imho
Whatever we say on here she is the one who has to live with her choices being sound enough to make good choices is part of this too. Please find some peace so you can approach this from a position of strength in some respect. Find what comforts you and do it.

[Betsy]

Krissy,
I'm sorry you are having such a hard time. I think you may have misunderstood about the "going back to work" thing. If you are referring to what Scotty said on your other post, I think she meant that it may take you longer to taper off of the paxil than a short term disability might be. I don't think she meant for you to go back, just to be aware that it may take longer than you expect to get off the med, depending on how your body responds.

So, you've been back on 20 mgs for about 8 days now and things are feeling worse than they were at the 10 mgs? Is that correct? This can be difficult because the chemically induced anxiety can be as hard or harder than the original anxiety.

Carolyn recommended the controllinganxiety.com site. That is a good start. Also, CBT. David Burns is the author of a great CBT book, "The Feeling Good Book". it's great for CBT. However, I have just purchased a newer book of his called "When Panic Attacks", that has even more comprehensive information about CBT an other tools you can use to help alleviate anxiety, that are not as extensive in "The feeling Good Book". So, I'd suggest his "When Panic Attacks" book.

I do not completely agree with Carolyn about continuing going to places that
trigger intense anxiety. When things are bad for me I avoid those things for a time, which is what Dr. Claire Weekes suggests. Yes, you could still go to a movie, but choose carefully what kind of movie. Avoid anything that is intense or scary. I avoid political and religious discussions even, if those would be a trigger for you. I even avoid the news on TV! Avoid caffeine, alcohol, tobacco, they too can contribute to anxiety. However, if you use them regularly, stopping them all at once isn't a good idea either.

Dr. Weeks talks about relaxation and meditation and how it calms your body and nervous system. I think staying away from those things while you desensitize your body is a helpful thing. It takes a few weeks to begin getting the full benefit of relaxation and up to two months of doing it daily to desensitize your body. However, that is when you are not dealing with med withdrawal. But it can still be very helpful.
Maybe, for you, 15 mgs. might have been a better place to increase to. maybe the jump from 10 to 20 was more than your body was ready for. This crazy med can even cause the very symptoms we take it to get rid of, it's in the literature with the prescription. It's so hard to know and so hard to choose. Everyone really only knows what has worked for them. We each have had to experiment a bit to see what works for us. I tend to be someone whose body reacts differently, mostly in a negative way, than most on this site. But, remember there is hope, and you will find a way. Please keep posting and letting us know how you are doing and what is happening with you. Hopefully, Scotty will see your post and get back to you. She's the "resident expert", and has great suggestions.

I'm sorry this has been so hard for you. We all feel for what you are going through, and I know how tough my version of what you are going through was for me.

Listen to the audios on the website and see how that feels to you. If you'd like more info on the relaxation, I'd be glad to give you what info I have.

Take care, hugs to you,
Betsy

[Iksfreundin]

I'd say the increased anxiety is from dropping almost 40 mgs in less than 5 months. It seems possible that you might be someone who will have some increased intense anxiety on dose changes, down OR up. I know I faced a lot of anxiety, and it forced me to learn intense coping strategies, since I pooped-out on 40 mgs and had been on 60 mgs before (and was crippled by side effects as well). I knew there was no chance I was going to be able to go up in dose for any real amount of time, and I'd been on a ton of stuff without being helped. So I had to choose the anxiety and move forward.

You have to learn coping strategies and ways to get through the panic, or you won't be getting off paxil or any other drug. It's very simple. You have to have the tools to control or leash the panic, because, if you don't, you're going to end up on drugs over and over. It's really a choice, because there's no quick fix. I'm still in therapy after two years to continue learning ways to deal with panic when it arises, and I have read several books and done workbooks and everything else to keep working towards pushing back the panic.

I had severe limiting agoraphobia through about half of my paxil taper. I went way too fast at the beginning and it plagued me the rest of the taper - I think this because I did a cold turkey attempt many many years ago and I only got sicker and sicker as the months went on, so I believe it is just the way I react to going off too fast. I managed to finish school, but afterward I spent many months unable to get more than a few miles from my home. I remember my first few trips to my therapist; she was less than seven miles away, but I had to stop two or three times to catch my breath and talk myself out of severe panic and terror. It should have taken me 10 minutes door to door, and it took me a half hour (or more) regularly.

I'm telling you all this, because it's a thing of the past for me. It felt impossible for a long time, but intense care for myself and real work got me off the drugs (all of them) and into a new life. But you have to commit to work on yourself.

[Betsy]

Good point, Tara,
There are so many ways to see things and I'm glad you posted for her.
Betsy

[AussieGirl]

Krissy

Panic attacks can be so disabling its true.

What strategies to date have you learnt or are you trying for your panic attacks?

Some of the posts already on this thread may help you too.

Let us know what you are curretnly doing and many here I am sure can say what works for them.

Like Carolyn and others I know all too well what you are going thru and want you to know you are NOT alone and you CAN get life more manageable again. CBT helped me immensely too.

Claire Weekes and Bronwyn Fox ( googol both if your not familiar) have excellent books to help those of us with Panic disorder too.

Keep us posted

Hugs Michaela

[scotty]

Originally Posted by Betsy

Krissy,
I'm sorry you are having such a hard time. I think you may have misunderstood about the "going back to work" thing. If you are referring to what Scotty said on your other post, I think she meant that it may take you longer to taper off of the paxil than a short term disability might be. I don't think she meant for you to go back, just to be aware that it may take longer than you expect to get off the med, depending on how your body responds.

That's exactly what I meant. Short term disability isn't going to give one enough time to wean off successfully. Which is why it's important to find a weaning schedule that allows you to have a life at the same time.

Originally Posted by Iksfreundin

I'd say the increased anxiety is from dropping almost 40 mgs in less than 5 months. It seems possible that you might be someone who will have some increased intense anxiety on dose changes, down OR up.

Excellent point. It may require going higher than the 20mg to get things under better control.Resuming can also take time to start working again....it's been less than a month since you restarted.

[carolyn]

Originally Posted by been there done that

but forcing herself into more painful and distressing situation to train her reptilian brain is not my idea of a good idea not. What is the point at the end of the day? All these things can be faced and dealt with after she has found a sound base and some peace. imho

The point is whether the panic attacks are because of Paxil or because of the panic disorder. The way to deal with panic disorder is very different than the way to deal with isolated panic attacks (or any other symptom) that exists solely because of Paxil.

If Krissy had come on and said "I've never had panic attacks before but now, since changing my dosage, I have them whenever I go to a movie," I'd agree with you 100% that, OK, stay away from movie theaters during the taper.

Not everything is *caused* by Paxil. At the end of the day, we all have to deal with the issues that brought us to Paxil in the first place, and that's what I'm offering advice about.

[nickels]

As someone who also suffers from panic disorder, I have to agree with Carolyn here, staying away from every day things that cause you panic tend to make the situation much worse.

In Krissy's case, it seems as though normal daily activities are giving her panic, and avoiding these things make it much harder to get over the panic hurdle. Avoiding work, or stores or shopping will just fuel agoraphobia...this coming from someone who has experienced it prior to paxil. There is a difference between dealing with withdrawal related panic and panic disorder...the hard part is distinquishing the difference for the person who has had both.

For things that are avoidable, it might be beneficial to ease up on it until you at least stabilize, which is something I think that has to be taken into consideration here. When you are in such a sensitive state, anything can be a trigger to a panic attack...especially if you are already prone to them...but I'd resume doing these "optional" things once your feeling stable. Krissy, you are only back up in dose for a week or so, this probably isn't enough time for the paxil to start working again. Give yourself some time to stabilize before definitely going back up to 40mgs or dropping again.

I really feel your pain b/c when I made a few large drops my anxiety and panic came back much worse than before. However, once I stablilized, I then began a slow taper, and I was able to work full time and get thru my daily activities...and even a few of my panic inducing ones (ie:the dentist). I think the extreme anxiety you are feeling now is a combo of the fluctuating doses and the original anxiety. Look into the books and websites that everyone mentioned above...and if you can, find a therapist who specializes in CBT.

I know its really scary, where you are right now...but it does get better, I promise.

[anjillian]

Have you tried Bach Rescue Remedy? I found it to be helpful when i had panic attacks. It's homeopathic and you just put a few drops on your tongue with a dropper and in a few minutes you feel much calmer.

I don't know much about Xanax because i've never taken it. I think it's a good idea to try the natural stuff instead of getting addicted to Xanax. A slow taper is the best as well with paxil, to avoid any unnecessary ill's.

Try not to drink coffee or any bigtime stimulants. I got on paxil for panic attacks so i totally hear where you are coming from. They are annoying and sometimes disabling but there are ways to control them.

[Rachelina]

It's only been 8 days since you went up to 20 mg. It can take as long as 6 - 8 weeks to get stable when you go up in dose. So just hang in there, give it more time and hopefully you will feel better in a few weeks. You are going to make it through this!

[scotty]

Originally Posted by carolyn

The point is whether the panic attacks are because of Paxil or because of the panic disorder. The way to deal with panic disorder is very different than the way to deal with isolated panic attacks (or any other symptom) that exists solely because of Paxil.

If Krissy had come on and said "I've never had panic attacks before but now, since changing my dosage, I have them whenever I go to a movie," I'd agree with you 100% that, OK, stay away from movie theaters during the taper.

Not everything is *caused* by Paxil. At the end of the day, we all have to deal with the issues that brought us to Paxil in the first place, and that's what I'm offering advice about.

Well put. Even in withdrawal I worked with Ryan on non drug approaches to his anxiety within the limits of his withdrawal symptoms.

[Krissy1816]

Thank you all so very much for all the advice and input. I guess you are all right, all our bodies are different and have different ways to heal. I definitly will look into all the books that were suggested, and try the CBT. I'm lucky enough to have very understanding friends, and bosses. and I'm very lucky to have found you all. I dont feel quiet so alone. I have another appt. with my doctor tomorrow so we will talk about my options there, and I will keep trying to push on and through the darkness. Thank you all again, you are all such inspirations to me! Thank you!

[scotty]

Krissy...you're never alone!

[Betsy]

I also had panic attacks prior to paxil, and at the time I continued to do all that I had to do. I drove my kids to a private school everyday, I went to church on Sundays, I went to family activities and all the activities that having 5 children require. My 24/7 anxiety never let up. I slept maybe 2 - 4 hours a week and paced the floors, and scrubbed the floors and toilets and sinks and carpets the other night hours in the week, in an effort to get away from the anxiety, trying to get my mind off it. But it didn't work.

I do know that my continuing to keep going was good for me. I didn't get "agoraphobic" in the traditional way, because I forced myself to keep going. I found I was miserable wherever I was, so I may as well be miserable other places as well as at home. So, I do admit that going is helpful.

Having said that, Dr. Weekes talks about how taking the necessary time to heal and desensitize your body is beneficial. When my withdrawal is acute, I avoid those things that trigger more anxiety, as a preventive measure. When my body gets tense, it triggers that adrenaline rush, and causes my body to be sensitized again, and repeats the anxiety cycle. So, FOR A TIME, I avoid specific things, knowing I will go back to them again soon.

The technique you are talking about is referred to as "Flooding" and does work for some types of anxiety when you are at a stage where it is helpful. For me, I have found that a combination of techniques is what is most helpful. And even when I avoid specific things, I still am going to church and going grocery shopping, going to my childrens' ball games doing service activities, driving myself 35 to 45 miles to get to everything I have to do. I live in a rural community and I have to drive to docs and stores and the school is even 20 miles away. Even with my pounding heart and sometimes with having to push away the suicidal thoughts, the skin burning and underlying buzzing, telling myself all the while, it will all work out, things will improve. And believe it or NOT! Those times I hardly talk to people....I know, no one on here can imagine Betsy NOT TALKING! But that is what I do also. My friends see me and say "How are you, you haven't called, you've lost weight, are you having anxiety trouble? I can't even tell by the way you look." Eventually, using these techniques as well as the relaxation, things start to calm and improve and get better over time. But I still avoid intense, scary movies and the news, including political and religious discussions, things that will kick the adrenaline button.

When I prepare for a taper, that is just part of my preparation along with my relaxation and exercise. Always keeping in mind, I'll be able to do some of these things again. Scary movies I just have never liked and realize they don't have to be a part of my life, but that is just a personal preference thing. I just offer it as a method of coping while tapering. We all do have individual circumstances, that is so true, and what works for me may not work for everyone. And situational avoidance during specific tapering times has been helpful for me. I hope that clarifies what I meant to be saying. Someday I hope to get over this "Hating to be misunderstood". I know that was a big part of my anxiety in the past and that is why I TALK SO MUCH!! LOL Please laugh with me, will you all!
Betsy

[nickels]

I understand exactly what you are saying Betsy...b/c I too, am in a way, a "functioning panic attacker"...meaning, I still go thru the daily routines and things that NEED to be done, all while feeling terrible anxiety and dread. However, anything that is outside of my routine which is optional, has usually fallen into my agoraphobia category...meaning, I avoid these things and become panic stricken at the thought of doing them.

When I was tapering, I also would avoid certain activities when I felt it would just be too much, b/c I knew the added stress and worry would be a set back for my panic...even if it was withdrawal panic. For example, during my very last drop, I had to cancel a dentist appt b/c I was feeling awful and I didn't want my withdrawal symptoms and panic to imprint a bad experience in my mind...which would have negated some of my improvement.

In a way, I'm glad that I continued to do the necessities b/c I could have seen myself with larger issues if I hadn't...and that is why I'd recommend that to others in similar situations. I'm working on doing the "extras" now, and I'm looking foward to feeling better.

Sorry for the thread hijack Krissy...I'm glad you are moving foward! We know what its like, you are not alone.

[Songbird]

It can take several weeks to feel significantly better after updosing, and more weeks to really stabilise. At this point, just try to trust that you will improve and feel better soon. It is true that panic disorder and w/d panic are different, however the Claire Weekes techniques should be helpful for either.