zjmc
03-07-16, 03:15
Hello,
First time posting all though I've read this board and various others over the years. I wanted to share my struggles with panic disorder. Any advice or input would be greatly appreciated. I would also like to share my more recent successes in the hope they may help others. Apologies that it is a VERY long read, I've been thinking about doing it for some time.
I've been suffering badly from large panic attacks and GAD for the last 14 years (now 31). They seemed to start randomly when I was around 17 years old towards the end of high school. I would get light headed, feeling as if I would faint. My heart would race and hands tremble. Excessive sweating and difficulty focusing. Both mentally and trying to focus on my surroundings. During these first few months I thought I was dying and surely I was having a heart attack. On one of these occasions my father drove me to the emergency room to get checked out. This is when I first heard of panic attacks.
After my first hospital visit my local GP prescribed Paroxetine. Apart from an initial increase in anxiety and panic attacks I didn't really notice any changes, positive or negative. I continued to have daily panic attacks and constantly felt some form of background anxiety. It was a low dose of paroxetine and I went on and off over a year or so (I know, not recommended). I eventually stopped taking it and continued to focus on ignoring my anxiety for many years. I would only talk about it with my parents and even then I was very vague. I did a lot of reading and was hoping for a quick fix but I was generally too anxious to actually try anything which might help my anxiety. I used alcohol as a coping mechanism even while knowing the rebound effect would increase my anxiety significantly.
I continued like this until approximately two years ago. I managed to start a successful career and was fine in most aspects of my life from the outside. I had started sharing my experiences with some closer friends who tried to understand. Seemingly randomly my panic attacks started to worsen after a work trip to Hong Kong. I had some difficulty with heights and being in a professional environment having to act 'normal' was painful. Enclosed rooms, tall buildings, bridges, trains etc would always exacerbate my symptoms.
Arriving back in Australia I decided it was time to finally try to treat my anxiety again. I read some books with little success. An online course through a local University (CBT based). Again, little success. A large part of my lack of success I would attribute to my motivation and commitment to the exercises. I found it difficult to practice the exercises and continued drinking excessively (mostly on weekends but flowed over into week days at times). I went to a new local GP and I requested trying the medication route again.
I started on 10mg Lexapro. I was hopeful after reading a lot of the positive reviews (purposefully ignoring any negative ones). It seemed ok, but no real difference. Then one night I had one of the biggest panic attacks I had so far. I was very used to them as I still had them almost daily. This one started differently. Looking back it feels like I had sleep paralysis (I sometimes got it, usually linked to sleep deprivation). I awoke with the feeling I get when I have sleep paralysis but it didn't go away. I was incredibly dizzy and started dry reaching uncontrollably and was unable to breath. An ambulance came and took me to hospital. Everything checked out fine and they said it was just another panic attack. There was an onsite Psychiatrist who suggested upping my dose to 20mg and seeing a Psychiatrist and a Psychologist.
Seeing my Doctor once I was able to leave the house (this took some time as I was experiencing major agoraphobia) I received a referral to Pysch and Pysch! Also battling agoraphobia again I managed to make it through my first appointments with each. With great difficulty. This started what would be my worst period of my life related to anxiety. I'll cover this part very briefly but there was a lot of medication, and changing medication.
The Psychiatrist upped my dose of Lexapro to 20mg. There was no noticeable change to me. After approximately two weeks of this I was removed cold turkey and tried on Imipramine. I had left over Xanax (which I previously would only use for flying in small doses) which I was instructed to use to help with the transition. The lower doses didn't do anything and I was soon on the maximum dose. I had unpleasant side effects (weight gain, hallucinations at night, troubles with vision, increased panic etc). After this I was prescribed Sertraline (Zoloft) and was to start after tapering off Imipramine max dose in two days. Again, using Xanax to cover increased anxiety during the transition.
I can't recall the starting dose of Sertraline but shortly I was up to 200mg. Alongside this I was prescribed 80mg of Propranalol (beta blockers). I had various side effects from one, or both of these I'm not sure. Increased anxiety, dizziness, hypotension (dizzy when standing up), sweating, decreased sex drive (harder to finish) etc. I couldn't sleep now and the Psychiatrist prescribed Lorazepam (Ativan) for sleep. This continued until approximately 2 months ago. I was drinking more and more which was beginning to have an impact on my personal and professional life. I was taking 200mg Sertraline, 80mg Propranolol and 3-4mg of Lorazepam daily. Well nightly in the case of Ativan. My diet was terrible (takeaways), I rarely exercised and it was hard to do anything. After everything over the years I didn't really have any depression. This really only started when I went onto Zoloft. I had made some previous attempts to taper off the Ativan unsuccessfully. Very unpleasant withdrawal symptoms. I continued seeing the Psychiatrist and Psychologist for 1-2 years, weekly or fortnightly. Unfortunately this was around 2-300 AUD per visit for no benefit.
Something in me finally clicked. I met a new girlfriend who was understanding and supportive (has also had issues with anxiety in the past). Upon doing a lot of self reflection I realised I had hit rock bottom, or at least close to it. I decided now was the time to try once and for all to come off my medications. I took some extended leave from work as I had built up quite a number of sick days and annual leave over the years. I factored in some remote work also as I could still function to some degree and my type of work allows it (management doesn't quite agree with the idea though generally). My key focus was to get off the Ativan as this was what I was most nervous about.
What follows is what I have been doing to taper based on what I have felt comfortable with. I wouldn't recommend others following it and that you should put a plan together with a medical professional. I understand it is faster than what is generally recommended but I wanted to utilise the time I had away from work as best as possible. I was in a safe environment with people around me who would support me. Over a period of two weeks I went from my 3-4mg a night for sleep to 1mg. This wasn't easy, but not as difficult as I thought. During this same time period I stopped all drinking and smoking and started exercising. Exercise at first was walking then I finally joined a gym. Which I actually went to...Diet also changed for the better having very minimal takeaways and enjoying home cooked meals. The next two weeks were more difficult.
I stayed on 1mg for approximately a week, maybe slightly less before dropping to .5mg for approximately a week. This was by far the hardest part, but again not as hard as I thought it would be. Anxiety increased, agoraphobia was rather intense but I pushed myself to go out for exercise when possible. I took Circadin (melatonin) for sleep, 4mg. I managed to sleep each night eventually. I would sweat a lot and was physically sick for a few days. Dizziness was also rather extreme along with my emotions being up and down. This thankfully seemed to pass rather quickly. I began to feel better and more motivated. I could concentrate better than I had in a long time and this pushed me to continue making changes. I'm not sure how much can be attributed to the various changes I made at once, but it was all positive. The thing I had been fearing and putting off since getting on Benzo's now seemed mostly conquered. My next goal was to get off the Sertraline.
Now I'm only about 2-3 weeks into my Sertraline taper. Each day I am improving though. I still haven't had a drop of alcohol, or a cigarette. Going to the gym three times a week and walking on the off days. Some occasional sport thrown in as well. I've gone from 200mg to 100mg in that time frame and as of tomorrow I'm looking to drop to 75mg. I'm basing my taper on how I'm feeling and I know that it can take longer than 2 weeks per dosage drop to begin to feel the true side effects. In saying that my mood is greatly improved. My hands no longer shake. I am still having significant dizziness but it no longer throws me into a panic as much. More of an annoyance. In fact most of the side effects are annoyances now, not debilitating. I'm continuing to remain positive all though some days are harder than others. Removing the stress of work has been a great help, I don't think I could have performed my job effectively and tapered off to where I am now. If anyone is interested I will continue to post updates as I continue to come off the remaining medications. Beta blockers will be last but that doesn't concern me too much. I think if I can stop drinking, Benzo's and smoking so far, the rest should be relatively easy (I hope). I'm eager for this cloud and haziness, lethargy and regular fatigue to continue lifting so I can focus on my life again. Career, future etc. I'm sure I left a lot of pieces out, and if anyone actually made the effort to read this I'm sure they would be happy it's finally over and no more typing from me :P
First time posting all though I've read this board and various others over the years. I wanted to share my struggles with panic disorder. Any advice or input would be greatly appreciated. I would also like to share my more recent successes in the hope they may help others. Apologies that it is a VERY long read, I've been thinking about doing it for some time.
I've been suffering badly from large panic attacks and GAD for the last 14 years (now 31). They seemed to start randomly when I was around 17 years old towards the end of high school. I would get light headed, feeling as if I would faint. My heart would race and hands tremble. Excessive sweating and difficulty focusing. Both mentally and trying to focus on my surroundings. During these first few months I thought I was dying and surely I was having a heart attack. On one of these occasions my father drove me to the emergency room to get checked out. This is when I first heard of panic attacks.
After my first hospital visit my local GP prescribed Paroxetine. Apart from an initial increase in anxiety and panic attacks I didn't really notice any changes, positive or negative. I continued to have daily panic attacks and constantly felt some form of background anxiety. It was a low dose of paroxetine and I went on and off over a year or so (I know, not recommended). I eventually stopped taking it and continued to focus on ignoring my anxiety for many years. I would only talk about it with my parents and even then I was very vague. I did a lot of reading and was hoping for a quick fix but I was generally too anxious to actually try anything which might help my anxiety. I used alcohol as a coping mechanism even while knowing the rebound effect would increase my anxiety significantly.
I continued like this until approximately two years ago. I managed to start a successful career and was fine in most aspects of my life from the outside. I had started sharing my experiences with some closer friends who tried to understand. Seemingly randomly my panic attacks started to worsen after a work trip to Hong Kong. I had some difficulty with heights and being in a professional environment having to act 'normal' was painful. Enclosed rooms, tall buildings, bridges, trains etc would always exacerbate my symptoms.
Arriving back in Australia I decided it was time to finally try to treat my anxiety again. I read some books with little success. An online course through a local University (CBT based). Again, little success. A large part of my lack of success I would attribute to my motivation and commitment to the exercises. I found it difficult to practice the exercises and continued drinking excessively (mostly on weekends but flowed over into week days at times). I went to a new local GP and I requested trying the medication route again.
I started on 10mg Lexapro. I was hopeful after reading a lot of the positive reviews (purposefully ignoring any negative ones). It seemed ok, but no real difference. Then one night I had one of the biggest panic attacks I had so far. I was very used to them as I still had them almost daily. This one started differently. Looking back it feels like I had sleep paralysis (I sometimes got it, usually linked to sleep deprivation). I awoke with the feeling I get when I have sleep paralysis but it didn't go away. I was incredibly dizzy and started dry reaching uncontrollably and was unable to breath. An ambulance came and took me to hospital. Everything checked out fine and they said it was just another panic attack. There was an onsite Psychiatrist who suggested upping my dose to 20mg and seeing a Psychiatrist and a Psychologist.
Seeing my Doctor once I was able to leave the house (this took some time as I was experiencing major agoraphobia) I received a referral to Pysch and Pysch! Also battling agoraphobia again I managed to make it through my first appointments with each. With great difficulty. This started what would be my worst period of my life related to anxiety. I'll cover this part very briefly but there was a lot of medication, and changing medication.
The Psychiatrist upped my dose of Lexapro to 20mg. There was no noticeable change to me. After approximately two weeks of this I was removed cold turkey and tried on Imipramine. I had left over Xanax (which I previously would only use for flying in small doses) which I was instructed to use to help with the transition. The lower doses didn't do anything and I was soon on the maximum dose. I had unpleasant side effects (weight gain, hallucinations at night, troubles with vision, increased panic etc). After this I was prescribed Sertraline (Zoloft) and was to start after tapering off Imipramine max dose in two days. Again, using Xanax to cover increased anxiety during the transition.
I can't recall the starting dose of Sertraline but shortly I was up to 200mg. Alongside this I was prescribed 80mg of Propranalol (beta blockers). I had various side effects from one, or both of these I'm not sure. Increased anxiety, dizziness, hypotension (dizzy when standing up), sweating, decreased sex drive (harder to finish) etc. I couldn't sleep now and the Psychiatrist prescribed Lorazepam (Ativan) for sleep. This continued until approximately 2 months ago. I was drinking more and more which was beginning to have an impact on my personal and professional life. I was taking 200mg Sertraline, 80mg Propranolol and 3-4mg of Lorazepam daily. Well nightly in the case of Ativan. My diet was terrible (takeaways), I rarely exercised and it was hard to do anything. After everything over the years I didn't really have any depression. This really only started when I went onto Zoloft. I had made some previous attempts to taper off the Ativan unsuccessfully. Very unpleasant withdrawal symptoms. I continued seeing the Psychiatrist and Psychologist for 1-2 years, weekly or fortnightly. Unfortunately this was around 2-300 AUD per visit for no benefit.
Something in me finally clicked. I met a new girlfriend who was understanding and supportive (has also had issues with anxiety in the past). Upon doing a lot of self reflection I realised I had hit rock bottom, or at least close to it. I decided now was the time to try once and for all to come off my medications. I took some extended leave from work as I had built up quite a number of sick days and annual leave over the years. I factored in some remote work also as I could still function to some degree and my type of work allows it (management doesn't quite agree with the idea though generally). My key focus was to get off the Ativan as this was what I was most nervous about.
What follows is what I have been doing to taper based on what I have felt comfortable with. I wouldn't recommend others following it and that you should put a plan together with a medical professional. I understand it is faster than what is generally recommended but I wanted to utilise the time I had away from work as best as possible. I was in a safe environment with people around me who would support me. Over a period of two weeks I went from my 3-4mg a night for sleep to 1mg. This wasn't easy, but not as difficult as I thought. During this same time period I stopped all drinking and smoking and started exercising. Exercise at first was walking then I finally joined a gym. Which I actually went to...Diet also changed for the better having very minimal takeaways and enjoying home cooked meals. The next two weeks were more difficult.
I stayed on 1mg for approximately a week, maybe slightly less before dropping to .5mg for approximately a week. This was by far the hardest part, but again not as hard as I thought it would be. Anxiety increased, agoraphobia was rather intense but I pushed myself to go out for exercise when possible. I took Circadin (melatonin) for sleep, 4mg. I managed to sleep each night eventually. I would sweat a lot and was physically sick for a few days. Dizziness was also rather extreme along with my emotions being up and down. This thankfully seemed to pass rather quickly. I began to feel better and more motivated. I could concentrate better than I had in a long time and this pushed me to continue making changes. I'm not sure how much can be attributed to the various changes I made at once, but it was all positive. The thing I had been fearing and putting off since getting on Benzo's now seemed mostly conquered. My next goal was to get off the Sertraline.
Now I'm only about 2-3 weeks into my Sertraline taper. Each day I am improving though. I still haven't had a drop of alcohol, or a cigarette. Going to the gym three times a week and walking on the off days. Some occasional sport thrown in as well. I've gone from 200mg to 100mg in that time frame and as of tomorrow I'm looking to drop to 75mg. I'm basing my taper on how I'm feeling and I know that it can take longer than 2 weeks per dosage drop to begin to feel the true side effects. In saying that my mood is greatly improved. My hands no longer shake. I am still having significant dizziness but it no longer throws me into a panic as much. More of an annoyance. In fact most of the side effects are annoyances now, not debilitating. I'm continuing to remain positive all though some days are harder than others. Removing the stress of work has been a great help, I don't think I could have performed my job effectively and tapered off to where I am now. If anyone is interested I will continue to post updates as I continue to come off the remaining medications. Beta blockers will be last but that doesn't concern me too much. I think if I can stop drinking, Benzo's and smoking so far, the rest should be relatively easy (I hope). I'm eager for this cloud and haziness, lethargy and regular fatigue to continue lifting so I can focus on my life again. Career, future etc. I'm sure I left a lot of pieces out, and if anyone actually made the effort to read this I'm sure they would be happy it's finally over and no more typing from me :P