Panic attacks - use meds or not?

[Forrest Gump]

I’m afraid this will be a long post due to complicated circumstances. Please correct me if I should shorten it down to just symptoms, in case I have misunderstood the rules at the forum.

I'm a 40-year old guy living in Thailand since two years back. About two months ago, after having felt a pressure on my chest for about a week, I went to the hospital to check it up. After extensive tests they found a problem with my heart and recommended some meds. I was told not to worry, that my heart is strong but it's safer to eat the meds, keep a healthy diet and so forth. Despite my doctors assurance that I was gonna be fine, I got very worried.
After that, I went through a very difficult time where really bad things happened to me. I don't want to go into any details as this a public forum, but among the outcomes was that I quickly had to find a new apartment and that I needed to get a new visa. (To get a new visa, one must leave the country and apply for the visa in another country). During all the difficulties, I started to have some serious panic attacks. I have never had panic attacks before, only a couple of depressions in younger years. The first time I got a panic attack, I rushed to the emergency at the nearest hospital, convinced that I had a heart attack. Most of the nurses did not speak any English, and my Thai is not yet up to par, so it was a terrifying experience trying to explain my symptoms. They kept me overnight on a heart rate monitor and released me the day after, stating that my heart was fine and that my problem was anxiety.

After that I started having panic attacks every day. I had a huge pressure on my chest, often lasting for a whole day but coming and going in intensity. I also had stabbing pains in my chest, back, arms and legs, a strange sudden coughing, headaches and tooth aches. When the attacks where in full intensity, it was like someone was flushing hot water through my entire system. A terrible, terrible fear and an alarming sense that I have to run away from something. By reading on this forum, I was somewhat calmed and started to understand the panic attacks. But it was close to impossible to convince myself that I was not having a heart attack, since I actually do have a problem with my heart. On two more occasions I could no longer calm myself and had to go to the hospital, convinced that I had a heart attack. Same result, after checking ECG, blood pressure and blood, they concluded that my heart was fine.

After about a month I had to leave Thailand to get my new visa and went on a four day trip to Laos to apply there. This was one of the worst times, I had frequent panic attacks, I even found myself standing in line at the Thai Embassy holding my queue ticket in hand, convinced that I was having a heart attack but trying not to go the hospital because I could not lose my queue ticket... If I did, I would have been forced to stay longer in Laos than I had money to. Afterwards, I rushed to the nearest hospital and once again – my heart was fine.
That whole day was as terrifying as it was off the wall crazy. Imagine this guy standing in line with his ticket, sweaty palms and shaking all over thinking he’s having a heart attack while trying to look somewhat orderly for the very strict procedures at the embassy. Life sure puts you in strange places.
By this time I was also broke. All the hospital bills had eaten away at my savings and a friend that owed me a substantial amount of money could unfortunately not pay me back. Problems were stacking up – it’s one thing to have difficulties in your home country, but a whole other one to battle these things when your home is on the other side of the earth. Where I live in Thailand, just the idea of getting to a hospital quickly is a joke. You could be stuck in traffic for hours and even the ambulances don’t get through.

Back in Thailand again the panic attacks continued. At some point I simply could not believe that my chest pain was only related to the panic attacks, so I went for another visit to the hospital. This time they said that I have a problem with my gallbladder that is causing the stabbing pains I my chest and pains under the ribs. What do you know… This was three days ago and I’ve been on medication for this since. The pain is a bit better, but the panic attacks continue relentlessly.

Now… I have been given medication for the panic attacks: Xanax. Half a 0,25 mg tablet, twice daily. I’ve been taking them a couple of times, but tried to avoid them at all costs since I’ve read that they are highly addictive. Should I ignore the warnings and start eating these on a daily basis? I’m pretty much incapacitated right now because of the panic attacks and frequent anxiety. I’m thinking that “tomorrow I’ll be alright”, but it just continues. I’m considering leaving Thailand and moving back home, because we have free healthcare there and a lot of things would be easier. But I really love to live in Thailand, and I have fought dearly to be able to live here.


Any thoughts would be deeply appreciated.

[Insomniac]

Its hard to give advice on that one. I am taking seroxat at the moment. At first I took St John's Wort which really helped. Then unfortunately my husband lost his job and we were worried about losing our home. The PAs got worse and I ended up going to the doctor.

My doc was lovely (and in this country luckily for me free) and advised that I could take seroxat. Now I have heard all that stuff in the news about how terrible it is and told her I was concerned. She said that she has other patients who would be unable to leave the house without it and on a small dose it makes a big difference.

It certainly did make a difference to me. This site is the other things which helped, and having counselling through my doctor surgery. I believe the meds helped me stay in control of my emotions a bit more so I was able to listen and take in what my counsellor said. I have practised lots of self help stuff mainly from this site, which my counsellor said sounded like a good place. The breathing exercises where you inhale for a slightly shorter time than you exhale, e.g. breathe in for count of 4, then out for count of 6 (or whatever you can manage) really helps with the physical symptoms and brings your oxygen & adrenaline back in control making you feel less dizzy and panicky. Also I find distracting myself is helpful. If I can't do it myself I involve my husband. He's a big help and seems to understand when I just need to chatter about stuff to keep my brain distracted. When I stop thinking about the panic it eases off, which over time has convinced me that I am in control.

Even though I still get times now when I feel panicky, I believe I can get it back under control. I am in the process of coming off my meds slowly now. But I do believe they helped me in the first instance. You don't have any problems with taking meds for your heart problem or gallbladder, and the panic is just another illness. Its an illness like any other. Meds work for some people and not for others. If you feel they will help you get better, go for it and try not to give yourself a hard time.

When I first suffered with depression and then also with anxiety, I used to blame myself. Letting go of the self-recrimination has really helped my recovery.

Sorry for the long post(!) but I find it easier to explain what I mean. I can't just say yes go for it or whatever without saying why!

I do hope you start to feel better soon.

[bel25]

It's difficult to say as everyone finds their own way of coping. Personally i've never used medication to treat mine- when i first went through it i was never offered meds by doctor and saw a therapist once. As i didn't use it the first time i've never wanted to go on meds as i'm afraid of addiction (if i go on them i'll be scared to come off them incase PA come back) and plus i've survived up until now without meds so when i get offered them i refuse and use therapy, breathing techniques and exercsie to cope instead.
Good luck with it all :-)
xxx

[Forrest Gump]

Insomniac: Thanks for sharing, it really helps to read other peoples experiences. I've been trying the breathing exercises, they do help from time to time. Distraction is something that I personally feel is helping me the most. When the panic comes, I just get up and start doing something else. Many times it's helping. The panic does not go away, but distractions seem to keep it at a manageable level.
You've got a good point in that I'm already using meds for the other issues, so why not one more? It's just that I normally avoid medication unless absolutely necessary, and now I'm already on three different medications. I'm getting what I think is various side effects from the meds, and they add to my panic attacks. Xanax is of course supposed to be the remedy of that, but I'm just worried about the sum of it all.

bel25: Thanks, I'm kind of leaning towards not using meds. Maybe I should just give it some more time.

For the past day I've had all sorts of weird symptoms. Bloated stomach, a very weird sense of my chest expanding. Pains that seem to travel around my body. All of a sudden, my leg hurts. Then the side of my chest. Then my wrist, then my shoulder and then my gums. It hurts for a couple of minutes, and then after some time hurts somewhere else for a couple of minutes. It's very frightening, but I try my best to deal with it. After all, I'm still here. It's really, really hard though to be convinced that you are going to die about five times a day. How does one cope with that? (Thinking out loud there, I know it's not an easy one).