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Penny Rayas, MFT
Penny Rayas, MFT, Therapist
Category: Mental Health
Satisfied Customers: 394
Experience:  I have 20 years experience in the mental health field
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hi my name is XXXXX XXXXX i am 29 yrs old. I have severe panic

Customer Question

hi my name is XXXXX XXXXX i am 29 yrs old. I have severe panic disorder. I am taking klonopin 3x a day, seroquel er 100mg and just started taking vibryant. I have tried taking everything out there nothing seems help. Do you think this is the right combination? need help
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 2 years ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.


Josh, You are taking a heavy duty course of meds. The only ones not on your list are either Ativan or Xanax that are often prescribed. I have a feeling it is because the addictive potential for those two meds is so high that with your long term panic disorder, if you got help from one of them, you'd be trading in one problem for a worse problem.

So my question is: given that you are trying standard pharmacological treatment and it's not working, are you interested in behavioral treatment? That would be psychotherapy.

How long have you had these symptoms?

Was there trauma or abuse in your childhood? What about alcohol or dysfunction in your family when you were growing up?

Are you getting any therapy treatment right now? If so, what type? How is it going?

If not, when was the last treatment? What type of treatment was it? Was it helpful?

Any extra information that will help, feel free to share.



Dr. Mark

Customer: replied 2 years ago.

=No alcohol or drug related problems or trauma. My mother has a panic disorder. Mine started about 2 yrs ago. Nothing happened just out of the blue came on me. I started to have chest pain and I thought I was having a heart attack. I work 6 days a week as a coal miner and I don't have time behaviroal treatment. I have tried xanax but I no longer take them because I have found some improvement with the other medication that I am on but I still need help. I have tried talking to a therapist but he said he didn't know where the problem was coming from.

Customer: replied 2 years ago.
Relist: Answer came too late.
Expert:  Penny Rayas, MFT replied 2 years ago.

Hello there and thanks for asking JA. I think you may not find a reason why you have panic attacks because in your case it is inhereted. Usually panic attacks are symptoms of an anxiety disorder. I would like to ask if there a certain situation that triggers those attacks. Can you tell me a bit about the last time you had one where you were and what were you doing? To reduce your panic attacks keep a journal of when they happen what were your thoughts just before you had one. Usually you can feel the anxiety building in your body. Anxiety is characterized by excessive, exaggerated negative thoughts and worry about everyday life events with no obvious reasons for worry. People with symptoms of generalized anxiety disorder tend to always expect disasterand can't stop worrying about health, money, family, work, or school. In people with GAD, the worry often is unrealistic or out of proportion for the situation. Daily life becomes a constant state of worry, fear, and dread. Eventually, the anxiety so dominates the person's thinking that it interferes with daily functioning, including work, school, social activities, and relationships.

I think you are on the right type of medication I see my clients with anxiety and depression being on those medications very often. There several ways to help yourself learn how to reduce your anxiety that leads to panic attacks. One way is deep breathing and progressive relaxation techiques.

 

  • Lie on your back, close your eyes.

  • Feel your feet. Sense their weight. Consciously relax them and sink into the bed. Start with your toes and progress to your ankles.

  • Feel your knees. Sense their weight. Consciously relax them and feel them sink into the bed.

  • Feel your upper legs and thighs. Feel their weight. Consciously relax them and feel them sink into the bed.

  • Feel your abdomen and chest. Sense your breathing. Consciously will them to relax. Deepen your breathing slightly and feel your abdomen and chest sink into the bed.

  • Feel your buttocks. Sense their weight. Consciously relax them and feel them sink into the bed.

  • Feel your hands. Sense their weight. Consciously relax them and feel them sink into the bed.

  • Feel your upper arms. Sense their weight. Consciously relax them and feel them sink into the bed.

  • Feel your shoulders. Sense their weight. Consciously relax them and feel them sink into the bed.

  • Feel your neck. Sense its weight. Consciously relax it and feel it sink into the bed.

  • Feel your head and skull. Sense its weight. Consciously relax it and feel it sink into the bed.

  • Feel your mouth and jaw. Consciously relax them. Pay particular attention to your jaw muscles and unclench them if you need to. Feel your mouth and jaw relax and sink into the bed.

  • Feel your eyes. Sense if there is tension in your eyes. Sense if you are forcibly closing your eyelids. Consciously relax your eyelids and feel the tension slide off the eyes.

  • Feel your face and cheeks. Consciously relax them and feel the tension slide off into the bed.

  • Mentally scan your body. If you find any place that is still tense, then consciously relax that place and let it sink into the bed.
  • Toe Tensing

    This one may seem like a bit of a contradiction to the previous one, but by alternately tensing and relaxing your toes, you actually draw tension from the rest of the body. Try it!

    1. Lie on your back, close your eyes.
    2. Sense your toes.
    3. Now pull all 10 toes back toward your face. Count to 10 slowly.
    4. Now relax your toes.
    5. Count to 10 slowly.
    6. Now repeat the above cycle 10 times.

    t. Deep breathing is a great way to relax the body and get everything into synchrony. Relaxation breathing is an important part of yoga and martial arts for this reason.

    1. Lie on your back.

    2. Slowly relax your body. You can use the progressive relaxation technique we described above.

    3. Begin to inhale slowly through your nose if possible. Fill the lower part of your chest first, then the middle and top part of your chest and lungs. Be sure to do this slowly, over 8 to 10 seconds.

    4. Hold your breath for a second or two.

    5. Then quietly and easily relax and let the air out.

    6. Wait a few seconds and repeat this cycle.

    7. If you find yourself getting dizzy, then you are overdoing it. Slow down.

    8. You can also imagine yourself in a peaceful situation such as on a warm, gentle ocean. Imagine that you rise on the gentle swells of the water as you inhale and sink down into the waves as you exhale.

    9. You can continue this breathing technique for as long as you like until you fall asleep.

    Guided Imagery.

    1. Lie on your back with your eyes closed.

    2. Imagine yourself in a favorite, peaceful place. The place may be on a sunny beach with the ocean breezes caressing you, swinging in a hammock in the mountains or in your own backyard. Any place that you find peaceful and relaxing is OK.

    3. Imagine you are there. See and feel your surroundings, hear the peaceful sounds, smell the flowers or the barbecue, fell the warmth of the sun and any other sensations that you find. Relax and enjoy it.

    4. You can return to this place any night you need to. As you use this place more and more you will find it easier to fall asleep as this imagery becomes a sleep conditioner.

    5. Some patients find it useful to visualize something boring. This may be a particularly boring teacher or lecturer, co-worker or friend.
    Penny Rayas, MFT, Therapist
    Category: Mental Health
    Satisfied Customers: 394
    Experience: I have 20 years experience in the mental health field
    Penny Rayas, MFT and 3 other Mental Health Specialists are ready to help you
    Customer: replied 2 years ago.
    is it normal to feel like you are going crazy
    Expert:  Penny Rayas, MFT replied 2 years ago.
    Yes for someone with extreme anxiety most people feel like they are going crazy, but they are not. This is part of the worry your anxiety is talking. When it happens please use the deep breathing method and say to yourself. This is my anxiety talking. I am safe and nothing wrong will happen. My mind is just playing tricks on me. Try to change activties on that moment and try not to think. Watch a funny movie take a walk and take deep breaths, relax your body.
    Customer: replied 2 years ago.

    I feel like i am going to die are do something bad like i am not in control

    Expert:  Penny Rayas, MFT replied 2 years ago.
    I am sorry about you feeling like that. Often people who have panic attacks do believe that something bad is going to happen and they are going to die. I want your to write those thoughts in a journal and then write the opposite thoughts many times such as I am a healthy man and everything is going to be ok. Write that down many time and repeat it even if you don't believe it. Keep dowing that and correct the thought that comes in your mind tell yourself I am going to be fine. Please also talk to your psychiatrist he may be able to give you a different medication that will keep you calm. Try working out, walking and yoga also it reduces stress.
    Customer: replied 2 years ago.
    thank you so much you have been very helpful i live in grundy va not alot of doctors to choose from
    Expert:  Penny Rayas, MFT replied 2 years ago.
    good luck to you. I suggest that you buy the book When panic attacks. It is a great book.

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