going back to work and decreasing benzodiazepine

[jothenurse]

I hope to be going back to work, maybe starting at the end of next week. I have a panic disorder. My boss said for the first couple of weeks if I just want to work a few hours each day that would be fine, then go back to full time.
I have been on a medical leave for about two and a half months and of course I am very nervous about going back. I am in a management position and have lost about 20 pounds. How have you handled going back to work? I know staff will be commenting on my weight loss, and questions of how are you doing, though not all know why I was off work. Most will know it was due to stress because at that time, my boyfriend and I decided to not live together but still see each other, then he had a heart attack, and then my Mom broke her arm and ended up in the nursing home that I work at for a short time - I was also trying to work full time. But - not everyone knows I have a panic disorder.
The other thing - has anyone tapered off of benzodiazepines before? I am on Ativan - for the last few months - but at a fairly low dose according to my psychiatrist and the pharmacist. I was taking for a little while 1 mg in the morning and 1 mg at noon. I never seemed to need any more after that for the rest of the day, or very infrequently. I have decreased the noon dose to .5mg, for the last 5 days and that seems ok. Today I am trying to decrease the morning dose to .5mg, and continue with a .5 mg in the morning and a .5 mg at noon, especially seeing that I will be going back to work and will be nervous. The 1 mg dose in the morning makes me sleepy and dizzy, so would prefer to get that to a.5 by the time I go back to work. The pharmacist said that I do not need to worry about rebound/or big withdrawal problems (like seizures) because I never was on that much of the medicine. But I am still scared. Any suggestions?

[jothenurse]

Does anyone have any suggestions?

[andrew]

Hi Jothenurse,

It sounds sensible to gradually reintroduce yourself back into work, see how a few hours a day feels to you. You might feel a little anxious about going back, just take your time. Good luck.

Sorry Ive no meds suggestions, maybe you'll find some in the meds section of the forum. You asked about rescue remedy in another post, its a herbal product meant to calm anxiety.

You take care .. andrew

[jothenurse]

Thanks for your reply.

[Vixxy]

Hi Jo. When I was first struck down with panic attacks many years ago I had a very understanding employer (M&S).
After a few months off they allowed me to come back for 2 hours a day, then 3 hours, then gradually I increased it up to my old hours. It really helped me to know I wasnt pressured to stay there for the full day.
In regards to your weight loss, I've had a few comments about how healthy I look..... seems stupid seeing as I lost so much weight! But hey, if people want to just see the good in my weight loss they can carry on and ill pretend Im doing it on purpose!
Just tell them you were too busy to eat if you dont want to go into it. Or my usual is to just tell everyone what happened when I first see them, so they wont feel the need to keep asking later.
Im so happy youre feeling ready to go back to work!

[jothenurse]

Thanks for the suggestions. Sometimes I feel like I should go back (my leave is up in a few weeks) and sometimes I don't know how well I will do. The first two weeks I can go in part-time. My therapist thinks that getting back to work may help to help me stop ruminating about all my panic/anxious symptoms. But, I am trying to gain weight (which isn't happening yet), but I sure don't want to lose anymore. They were commenting on my weight loss before I took the leave, I can imagine what they will think now.

[andrew]

Hi again Jo,

Its hard to guage with anxiety how well you will do when you return to work and it is sensible to start part time.

Do you think you are ready to return to work? Also, did work stress contribute to your anxiety/panic symptons?

I am not sure that going back to work to help you stop 'ruminating' is a good reason, you should only return if you are able.

Try not to worry about what other people think about your weight, as long as you are happy is all that matters.

take care .. andrew

[jothenurse]

My Medical FMLA is up on June 8th, so I really probably need to go back and try it or else my job will not be there. I am a Director of Nursing. In the United States there is a law that you can have 12 weeks of medical leave if signed by an MD. I am the type of person who was always busy - very stressful job, which probably doesn't help the situation. But, I have an excellent reputation as a DON, and that's why the therapist feels that getting back into some routine may help.

[andrew]

Hi Jo,

I understand you need to give work a try. It might be a good idea to come up with a plan to try and lower your stresses at work and maybe include more relaxing activities in your leisure time.. take care

[jothenurse]

My feelings of unreality have been worse - they really bother me. Any suggestions on dealing with those?

[andrew]

Hiya, explain them better, it might help.

Listen to music that you know and like. Do anything physical that requires you to concentrate on it. Try anything artistic or creative that you enjoy.

take care .. andrew