Hi all,

Lately I've been having bouts of panic attacks that wake me up in the middle of the night or very early in the morning. The first round a few weeks ago was quite bad (a temporary scrip for Zyprexa helped calm it down), but I'm in the middle of the latest one now. For the last five days, I wake up at 5 or 6am feeling okay, but then something startles me into a mild panic attack (elevated heart rate, pit in my stomach w/nausea, feeling shaky and uneasy) and I can't go back to sleep.

The problem is, the physical symptoms hang around, and as they start to subside, another minor panic attack usually hits and sends them through the roof again. So I spend all day on this rollercoaster, which is utterly exhausting and makes me feel like I'm barely keeping it together all day, every day. It's really wearing me down, and being stuck in my home without a job (I live in a major city in the US where COVID-19 is still running rampant) isn't making things any easier.

In all honesty, I've only recently started taking the non-medication parts of lessening anxiety seriously (journaling, meditating, getting outdoors, exercise, cutting down on caffeine and sugar, etc.). I used to rely solely on my meds (225mg Effexor, 100 mg Lamictal, with the occasional .5mg Xanax when things get really bad. I also take Lopressor for heart palpitations).

My main question is: how long does it usually take for these efforts to start making a noticeable difference in improving your panic and anxiety? And in the meantime, what do you do to keep from absolutely losing it?

Thank you all in advance for any guidance.