Advice needed please

[danxiety]

Hi there, I'm new to this forum. I've been suffering from panic attacks since I was 16 (am 27 now) I'll get mild attacks from time to time but it won't affect my day to day life. Every now and then I'll have a big attack and it'll give me severe anticipatory anxiety where I'm afraid to do anything or I'll trigger another one off. My last blip happened two years ago and lasted a few weeks then I was pretty much back to normal. I had another big one two weeks ago although this time I'm sure it's worse. I'm having attacks every day and frequently getting borderline full blown attacks, almost freaking out.

Now I will admit I'm probably not helping myself as I drink a lot at the weekend (I have social anxiety and like to feel relaxed when I'm on a night out) This also means I don't get enough sleep which I know doesn't help my anxiety. It's mainly a fear of attacks though, they rarely come out the blue.

In regards to medication and therapy I started taking citalopram and receiving CBT when going through a bad phase 8 years ago and it really helped me. I have stopped taking the meds from time to time because of laziness and to see if it made any difference. I asked to change to sertraline (50mg) last year because I though citalopram wasnt doing a decent job anymore. I've been taking that on and off and took it again a few days before that attack two weeks ago. They don't seem to be doing anything.

I have contacted Talking Therapies and to my dissapointment they can only provide group lectures or computer counselling where I read through modules and they conduct a telephone review every two weeks. Fat lot of good that will do. They said it was because of my problems so I guess 1 to 1 intensive treatment is given to people that are more in danger? If the computer thing doesn't work then they progress to 1 to 1 apparently. But because my anxiety and panic is so bad I can't wait that long. Should I switch anti depressants and ask to be put on anti anxiety meds like diazepam? What's interesting is on drugs.com it says they usually prescribe 50mg for depression and 25mg for panic disorder so maybe it was too high of a dose at first?

[zen10]

Hi Dan. You probably don't want to hear this but the heavy drinking might be a major catalyst.

I say this because my experience is really similar to yours in terms of having had spats of panic on off since i was 18.

I would drink heavily on Friday because I was out with friends and then probably on Saturday to avoid the anxiety and panic feelings that come from my hang overs. This would mean that I wouldn't really sleep all Sunday night causing major anxious feelings leading to panic, which would then spill over to Monday because of the lack of sleep and possibly Tuesday.

I sat and thought about how I was going to control my anxiety and my panic, I thought about all of the occasions when I get these feelings and basically concluded that it is always a lot worse after drinking. I've quit drinking now for 7 weeks and my acute experience of panic has drastically reduced and my day to day anxiety has also massively massively died down.

I'm not saying quit drinking for ever, but quit for a while and still go out with your friends, this will get you out of the drunk then anxious cycle and it will also help to gradually improve your confidence that you can be around people without drinking. I honestly never thought I would be able to be around drunk people without drinking myself, but i've been out loads since stopping and had a really good time. Then woken up so happy that I didn't have to feel hungover and anxious, it has given me bags of confidence.

I read Alan Carr's easy way to control your drinking for a bit of advice.


Sorry to focused on the alcohol but it is an area that I'm currently working on and thought the advice might be useful.

[xvolatileheart]

Could you clarify how regularly you are taking the sertraline? SSRIs do not work if they aren't taken daily. They also take at least 2 weeks to get properly into your system and up to 8 weeks to take full effect. If you're missing days or taking breaks, it will not be working.