Hi all,

Since being on Cipralex and working through my anxieties, I've realised that one of my main trigger symptoms is actually speaking or the anticipation of speaking. I thought back to the day of a huge initial panic attack 5 months ago where I was out for a walk in the freezing cold, tensed against the cold and anxious and I wanted to retch for the whole walk triggering the panic attack. This had never happened before in this manner but the person who I was with was chatting to me and I remember tensing my tongue tightly at the back to stifle heaving. This seems to have become one of, if not my main anxiety point now and I'm not sure how to relax it. Sometimes when I'm spoken to, I'll avoid certain words because they feel more likely to make me want to gag. Things like 'cool', 'car', 'can't', 'chocolate' etc all stimulate the part of my throat where the tongue seems to be tensed and 'onguard', this instantly leads to a rise in anxiety and makes me start working my throat. The problem is that as soon as someone speaks, my subconcious has already put my tongue into what my brain must think is a 'gag safe state' making speaking horrible and threatening to me. A very strange one I know and one I haven't read of before. I also find that when I concentrate hard for distraction, that part of my tongue and throat starts to feel a lot worse and I feel a despirate feeling in my throat which again sends the anxiety levels soaring and usually leads to a very painfull 'pill in the throat' feeling which makes my whole back and gullet ache. I've also noticed that opening my mouth wide (as if I were at the dentist) makes me want to heave because my tongue is in this state.

This is really the only problem stopping me from going out more, especially as work involves me speaking to lots of people over the phone and every day living involves verbal interaction to some degree.

Locking myself away as I am is doing me no favours but it's not that I fear going out and facing people, it's the fact that if I speak to them I know anxiety will rocket as I try and speak with a very sensitive throat.

I have a CBT assessment on Tuesday and am dreading having to speak to someone for a period of time. I'm going to take valium before I go to try and help relax the muscles in my throat.

Anyway, just airing this to see if anyone has any thoughts of ways I could combat this. I am already chewing gum and sipping water to make sure my throat stays as moist as possible (especially as the Cipralex dry my mouth so much).

Reading this back makes it sound so trivial but it's a terrifying feeling that is rocketing my anxiety levels.

Thanks for reading,

Mark