How embarrassing....

[Benjammin69]

OMG!

I just had a panic attack at my therapy session :-( it was my like 20th session so it's not like I'm new there but I had a setback in my depression/anxiety 2 weeks ago and I've just started citalopram 10mg - I've never had these types of panic attacks :-( even 2mg diazepam done nothing. Any advice on how to avoid these/stop these ASAP!

[Panicer]

Hi Benjammin

Sorry to hear about the panic attack, I know exactly where you're coming from because the same thing happened to me yesterday (http://www.nomorepanic.co.uk/showthread.php?t=195214&page=2) at a group therapy CBT class. Looking on the positive side as the therapist and the rest of the group said to me, "if you're gonna have a panic attack what better place to have one" :) I felt embarrassed at first but the therapist said she's seen hundreds and all the group had obviously been through them or they wouldn't have been in therapy, so now I'm fine with it.

As for why, as far as I understand a lot of Anti Depressants and particularly SSRI's like you're on can initially raise you're anxiety levels, so this may well be just a blip. If it doesn't get any better, like I also experienced then you can be prescribed another AD instead. I've just changed from Fluoxetine to Mirtazapine 7 days ago for just that reason.

Next time you're at therapy I'd suggest you just talk through what happened with your therapist and if they continue have a word with your GP about changing the Citalopram.

[Benjammin69]

Thank you for replying, I'm absolutely appauled with myself can't believe it, she said exactly the same and we did a mindfulness activity I would have just grabbed the diazepam if I was at home :-( I'm on 30mg mirtazapine already :-(

Never had a physical panic attack before :-(

[Panicer]

Hi again

Yes they are absolutely terrifying the first time round, I was convinced I was dying ended up in an ambulance and spent 4 hours in A&E. I think purely because I was on my own and had no idea what it was. Now I know what to expect they are by no means fun but at least I know I'm not dying, as do you and I promise that if they do come again they will get easier and pass quicker. Just remember no matter how bad it is they can, as I'm sure you know already, never hurt you! Holding on to that one thought has got me through several.

Here's another tip I've tried if you're having a full blown attack and just can't think straight.. All mammals have something called the “mammalian diving reflex (http://en.wikipedia.org/wiki/Mammalian_diving_reflex)” that forces the parasympathetic nervous system (PNS (http://en.wikipedia.org/wiki/Parasympathetic_nervous_system)) to kick in, which functions to relax and calm us down.
This reflex is activated by icy cold water (i.e., not freezing) on the face. In particular, the icy cold water must hit the parts of the face just below the eyes and above the cheekbones for the dive reflex to be activated. The idea is when in an extremely heightened state of anxiety:




Fill a bowl/sink with icy cold water
Bend/lean over
Hold your breath
Put face in icy cold water for 30 seconds
Make sure that area underneath eyes/above cheekbones (most sensitive part of the face) feels the icy water


This surprisingly simple technique can calm you down almost immediately and allow you to start thinking straight.

[Benjammin69]

Thank you I will be in the bath all day tomorrow

P.s - in icey water lol

[Tea87]

Panicer, I have never heard of that reflex before! That is so weird because I suffer from anxiety and panic attacks and I basically carry an ice pack with me everywhere I go. If I ever feel overwhelmed like I am about to have an attack I use the ice pack all over my face and it immediately calms me down! So your description is very interesting to me. Benjammin perhaps you could give an ice pack a go as it is more portable? It has "saved" me soooo many times, the problem is I can't really go shopping and just whip it out half way through because then people would stare at me and make my anxiety worse, but it is great to use in situations where you are with people who sympathize with what you're going through (therapy, friends,family etc).