Situational panic attacks

[Stuz]

Hello fellow sufferers!

I've been experiencing panic attacks for about 10 months now. I've had them in various situations- driving, work meetings, trains, planes, restaurants, in queues, theatre. Lots of places!! Its a daily battle using CBT techniques to try and rationalise the physical sensations to try and prevent panic attacks occurring.

For a while I felt I had it under control but in the last couple months the regularity of attacks have become a real problem at work and I have decided to try an SSRI. All these situations trigger panic symptoms and I'm finding my world becoming smaller, so must try all available options. So I'm 18 days in to taking 50mg of sertraline (zoloft).

Does anyone get panic attacks only in specific situations rather than randomly? As I've had several attacks in meetings at work and driving on motorways these two situations almost guarantee my anxiety skyrocketing. Leading up to meetings I feel the anxiety scale raise from 1/10 to 7/10, to literally 9/10 as i walk in the meeting room. Then inevitably 10/10 and I have to flee! Same with driving, the closer I approach the motorway the anx rises up. Also if I'm driving and there isn't anywhere to pull over, or going over a bridge, through a tunnel, this makes me panic too. I've had attacks on trains and the underground too that peaked the second the doors shut.

Its crazy as I know there is no reason to panic and that i've been in these situations a million times but now my brain sees them as a threat. On the few occasions I cope I find getting angry with the panic and telling it to give me the worst its got helps dissipate it. Being passive and not fighting it is the key to success but its so difficult.

The feeling of not being able to escape seems to be the common feature of the situations I fear. Like going to the theatre and sitting in the middle of a row, or having a one-on-one conversation with someone where it'd be rude to just walk off.

Anyway, as I said I'm on sertraline now which sometimes feels like its having an effect. I'm standing my ground with the panic more often now although it still feels absolutely dreadful and leaves me drained.

Its such a messed up situation as its causing me problems at work and socially with friends and family. Apart from my wife no-one knows I have panic attacks - if I leave the room I tell them I just feel sick. Its a such a weird turn of events in life, 10 months ago I was fearless and "normal", now I'm showing signs of agoraphobia, risking my job/livelyhood and taking an SSRI.

Mindfulness meditation, no alcohol (i used to drink a lot), daily exercise and the SSRI are hopefully going to be my saviour!

But anyway, the purpose of the thread - do you repeatedly have panic attacks in specific situations, if so what are yours and how to do you cope?

Thanks
Stu z

[dorabella]

I can identify with every thing you have said here . It's basically fear of being trapped in situations / places you cannot get out of easily if your anxiety gets out of control. For me it is the following:

behind the wheel on a motorway if there is nowhere to pull over

being stuck in a traffic jam with idiot drivers tailgating me

having to hold myself together in the middle of all day meeting sessions where you cannot just get up and walk out

the chair at the hairdressers or the dentist

being on a train that has no opening windows and has few stops on route where I can get off

London Underground - absolute no-no these days - being underground and trapped in a metal tube

being stuck in the middle of a row in a theatre - I always get tickets at the end of a row and at the back of the auditorium where I can slip out unnoticed

being tied to fixed times and appointments - I instantly want to cancel them as soon as I have made them

not being able to get home at the end of a day to my own four walls - agoraphobia in short

I could go on and on with this but you get what I'm on about. There are a lot of us with similar problems on this forum. When you say these things out loud you feel daft but the fear is very real at the time. But that is what this site is so good for - rationalising your fears with others who understand.

[Brunette]

I'd recommend telling your boss at work if you can.

Once you "come clean" it's one less thing to worry about. Somewhere in there, fear of "being found out" will be contributing to your panic.

Also, you may well be more on track with dealing with your panic attacks than you think you are. If you can dial down actual anger to the point of being dismissive (yeah, so what, you're a panic attack, big deal, you don't bother me) then that's pretty much taking the power out of it.

The other stuff you're doing is all good too. If you haven't already, give up caffeine too as that won't help you.

All the best.

[Stuz]

Thanks Dorabella and Brunette for your replies

Dorabellla - do you take any medications or undergone CBT for this?

Brunette - I taken your advice about coming clean with work, its also something I have been thinking about for a while. I've let my immediate manager know I get panic attacks and will have a meeting with him about it next week (im on leave at the moment).

thanks

[koala]

I also fear situations i can't easy flee from. some of my fears are:

-long journeys away from home, especially driving on motorways or unfamiliar roads or relying on public transport
- going to the theatre /cinema (i can only go if i can sit at the end of a row)
- restaurants/ eating out
- going to someone's house if i don't know them very well
-meeting new people in general
-eating in front of people who don't know me very well

Still learning how to cope in these situations.

[GingerFish]

I used to get panic attacks in these situations -

*going into town
*waiting in waiting rooms
*waiting in queues
*going into supermarkets (I still get a tad panicky sometimes in there but nowhere near as bad)
*while getting my hair done at the hairdressers
*having to call someone other than friends/family
*going on a plane, even just being in the airport

[dorabella]

Stuz - I did take SSRIs in the past when I was at my worst but these days I just grit my teeth and bear with it.

I find that panic always follows a pattern and I know that I am going to panic in some situations. Mostly it is the anticipation that makes me panic - the reality for the most part is fine. Sounds ridiculous but I have to wind myself up by imagining the worst that might happen in order to find that it doesn't. That's anxiety for you.

CBT is well worth doing. I did a few months of it years ago and still remember the rational thinking exercises I was taught. It really only teaches you common sense reactions to panic and dealing with situations that frighten you. However, sometimes we just need to be reminded to think rationally sometimes - that's all.

Hope you find this useful.

[Stuz]

Hi GingerFish - you said used get panic attacks. Do you no longer have them? If so, what was the turning point for you - medication, CBT, something else?

Thanks Dorabella

[Brunette]

I don't have them any more either.

I never had any meds or therapy I just read a couple of books, gave up caffeine and looked after myself -made sure I didn't take on too much, got enough sleep etc. I just "got" the whole thing about acceptance really quickly and put it into practice.

They subsided after about four months.