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DrFee
DrFee, Psychologist
Category: Mental Health
Satisfied Customers: 437
Experience:  I help people overcome anxiety and enjoy life again.
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I have been having SEVERE anxiety attacks, and the worst ever

Resolved Question:

I have been having SEVERE anxiety attacks, and the worst ever happening a couple months ago, I would have up to a dozen a day if not more, and 3 almost level 9's for about a month. About a month ago I started to get a little better in regards XXXXX XXXXX having the attacks as often. I now can go through a day without having one, or maybe a small one, and having large ones once a week or so. I have a long history of agoraphobia, and in fact during this time was basically confined to my room. I need to go to the dr TOMORROW, for my obgyn appt and i just cant get out. I can barely walk next door, some days i can, I dont know how to get to my appt? I'm terrified that there is something bad wrong with me as i have heart palpitations, they were checked 5 and then 2-3 years ago but i keep thinking they are different and im terrified something is wrong with me. I dont want to be far away from home and have a bad palpitation. This appt is very far from home. Any advice? I take a benzo but i dont wish to take anything or add anything as I dont like medicines, they tend to react with me as I am sensitive to the tiniest dosage of even childrens benadryl.
Submitted: 2 years ago.
Category: Mental Health
Expert:  DrFee replied 2 years ago.

DrFee :

Hello! Please remember that my response is for information only, we are not establishing a therapeutic relationship.

DrFee :

I have 20+ years of treating anxiety disorders, so I hope that I can give you a little bit of direction, hope, and help!

Customer:

Thanks!

DrFee :

Have you ever been in Cognitve Behavioral Therapy (CBT) ?

DrFee :

Anyway, that would be a longer term help --but I'll focus on tomorrow for right now.

DrFee :

Anxiety is our body's warning system that DANGER is present --and the body is getting you read to either "fight" or "run away" from or to "freeze" in response to that danger.

DrFee :

The problem is, the body doesn't know the difference between real danger and perceived danger.

Customer:

Yes sort of, but the last time i was in therapy i had problems with my insurance and it went downhill from there

DrFee :

OK..we can come back to that in a bit.... An example of a real danger is if you were crossing the street and a bus was headed toward you.

Customer:

i feel like a bus is headed towards me all the time

DrFee :

You'd need to get out of the way -- FAST --which means you'd need your heart to pound.

DrFee :

Yes, you are perceiving danger all of the time

DrFee :

But your body does not know that there is no literal bus

Customer:

yes and there doesnt seem to be much in the way of help, no housecalls anymore so for the agoraphobic its hard to do

Customer:

I have tried different methods at home, lucinda basset, linden method etc, but i just cant do things on my own

DrFee :

Yes, it is very hard to do by yourself

Customer:

the problem is in the time of the bus i can NOT tell the difference, for instance when im about to pass out i REALLY AM about to pass out, then if say i take my meds, i later know that particular time was anxiety, but i cannot differentiate them

Customer:

as i do have a few heart arrythmias, whereas i dont really trust medical drs because i told them i had a certain arrythmia had read up on it after getting that feeling a certain palpitation and it was SVT to a T and they just said "oh you just have a history of palpitations" i asked and begged for them to look at my reports and they said they couldnt look at all of them, and i even gave them particular dates, and they found it, it was a brief episode but i was right, so i just dont have that confirmation if i go to the dr they say im fine, they usually dont even look at me because they know of my history of anxiety

DrFee :

Most people wait too long to take the anti-anxiety --since it takes 20 minutes to work, you really want to take it well before the anxiety hits...this is one of the problems of using an anti-anxiety instead of an antidepressant for anxiety.

Customer:

i take it 3 times a day every 7-8 hours

Customer:

but i have a fear of meds

Customer:

ive been taking this med for years hense the only reason i will take it

DrFee :

It doesn't sound like it's helping that much.

Customer:

well i always wanted to rely on myself and not the meds

DrFee :

That's understandable, and the meds are meant to be permanent, but an antidepressant could help get you to a level where you are able to learn how to control your anxiety without them --or be able to drive to a therapist's office regularly.

DrFee :

So --we have a few issues on the table here --

DrFee :

The one about the doctors can be very frustrating.

DrFee :

Did they tell you that you do need to be concerned about the arythmias (sp) ?

Customer:

well i havent been in a couple years to the heart dr, they really didnt tell me anything, one dr said he recommended a certain surgery and i said but i only had 3 under 1 minute, and then he agreed that i didnt have to have it, and dont think they were concerned with the duration of them, but i know it could always worsen, it could always go longer sometime and i wont be prepared

DrFee :

I think one thing that needs to happen --is to go back to the heart doctor (maybe take someone with you) and get some accurate information about that issue. It sounds like your fear is getting mixed up with what the real concern(s) are. If you can take someone, they can hear what the doctor is saying more objectively and also push the doctor to be more clear with you.

DrFee :

I would then put it in writing ---

DrFee :

Because as soon as you get anxious, you will forget --it's the normal thing to do!

DrFee :

Anyway, that's not going to help you for tomorrow, so let's talk about that.

Customer:

i do have it in my medical records but i get new symptoms everyday and never know whats anxiety and what the difference is

Customer:

i may have one feeling palpatation today a different one from yesterday

DrFee :

People who I've worked with before who have both real heart problems and anxiety problems have told me that they feel different.

Customer:

they themselves or the palpatations

Customer:

the ones with real heart problems or the anxious ones

DrFee :

I'm talking about people who have both issues --real heart problems and anxiety problems....

DrFee :

One time I had a woman with bad anxiety...went to the doctor a lot

DrFee :

Then suddenly the heart felt completely different --when she went back to the doctor she was dismissed.

DrFee :

So she got very assertive and they did test her again and there was an issue --but she told me that it was a help --because then she could

DrFee :

differentiate between her anxiety and the real heart issue....the anxiety no longer scared her after that.

DrFee :

So, the point being, she became more "critical" of what was happening in her body --and learned how to differentiate

DrFee :

But, some people are terrified of ALL body sensations.

Customer:

me included

DrFee :

I've had a number of pregnant women like that --any change, any feeling, was cause for panic

Customer:

i get scared if i get sleepy at a different time than usual like midday

DrFee :

So --your task then, is to learn how not to be scared --the sleepy feeling might be a good one to start with....

DrFee :

You have to say, "it's just a feeling. It doesn't mean anything." Even though you won't believe it for a long time.

Customer:

i keep trying that it just never sinks it

Customer:

everyone just gets frustrated in that they tell me that too

Customer:

feeling are feelings is all i ever hear

Customer:

to me i think yea and i have a heart attack no one will ever know

DrFee :

Is there any objective reason that you could have a heart attack in your mid 30s ?

Customer:

i dont get a huge amount of exercise, i eat very healthy tho

Customer:

my granny almost died in her 60's my mom had had high bp since she was my age

DrFee :

Do you have high bp?

Customer:

and has ended up in the ER several times not sure if they were anxiety or the start of heart attacks as they treated her for that

Customer:

only when i go to the dr, at home its pretty low unless i am in an extreme panic state

DrFee :

One of the other strategies is to stay in the "here and now." You've never had a heart attack. If you do, then you will deal with it then. You can't deal with something before it happens. Hopefully that doesn't sound cold, but it's true --I've seen countless people worry about every possible thing under the sun --and I've yet to see it help anyone.

DrFee :

And what worries one person, doesn't occur to another person. We "pick" what we worry about.

Customer:

and the times i have seen a therapist they demanded me to be on meds and when i refused they said basically there was not chance of me getting better

DrFee :

The only time I demand someone to be on meds is if they are suicidal ---

DrFee :

It would be much more of a challenge if you don't --

DrFee :

Another alternative would be to do Neurofeedback

Customer:

im just extremely scared and anxious, i have had depression believe me, but i can get my self out, as hard as it is, i usually manage to get myself through it,

Customer:

i've heard of biofeedback but neuro?

DrFee :

www.eeginfo.com --training your brain waves to function properly --like biofeedback only focussed on brain waves instead of muscle tension or skin temperature.

DrFee :

Non-invasive, no side effects

DrFee :

you attach little conductors to the scalp with paste --it just reads your waves and the brain learns how to function differently.

DrFee :

Pretty neat --and really helps a lot of people

DrFee :

I will also paste in some instructions for abdominal breathing for you --- but keep in mind, that relaxation is another body sensation --some people are scared of relaxation ---

DrFee :

4 x 4 BREATHING EXERCISE
This is called the 4 by 4 breathing exercise because you should practice it for 4 minutes 4 times a day to learn to do it well. If you are able, do this with your eyes closed, imagining a pleasant place. This is calming and designed to help you manage stress. There are two important things to learn about breathing:
1. Learn how to breathe from your diaphragm (from your tummy area) and make that pattern a part of your daily life.
2. Become skilled at shifting to diaphragmatic breathing whenever you begin to feel stressed.
Natural Breathing
1. Gently and slowly inhale a normal amount of air through your nose, filling only our lower lungs. Place your hands on your tummy so that you can feel it rising and falling with each breath. Count to 5 slowly as you do it.
2. Exhale slowly through your lips, counting to 5 as you do so.
3. Continue this slow, gentle breathing with a relaxed attitude, concentrating on filling only your lower lungs.
4. As you breathe, slowly repeat the word “relax” or “calm” or some other word which means the same to you.
If you have difficulty following the above instructions:
1. Lie down on a rug or your bed, with your legs relaxed and straight, a book on your tummy and your hands by your side.
2. Let yourself breath normal easy breaths. Notice what part of our upper body rises and fall with each breath. Rest a hand on that spot. If that place is your chest, you are not taking full advantage of your lungs. If the book is moving up and down, then, congratulations, you are doing it right!
Deep Breathing
Deep breathing is an extension of this normal process. With one hand on your chest and one on your abdomen, take a slow, deep breath, filling your lower lungs, then your upper lungs. When you exhale, let your upper lungs go first (causing your upper hand to drop), then your lower lungs (causing your lower hand to drop).
Reminder: Too many deep breaths, instead of natural breaths in a row, will produce a sense of lightheadedness. This is not harmful; just return to natural breathing.
Practice
Natural slow breathing and the deep slow breathing several times each day. Practice natural breathing for a period of at least 4 minutes, 4 times a day. The object is to train yourself to breathe from your diaphragm most of the time.

DrFee :

Lying down is easiest to do it properly....

DrFee :

sitting up a bit harder, standing harder yet...and it won't help with anxiety unless you have practiced it a LOT

DrFee :

and are truly breathing from you tummy NOT your chest or throat.

DrFee :

I would say to get to the doctor:

DrFee :

1. Tell yourself you do not HAVE to go, you can back out any time.

DrFee :

2. Stay in the "here and now" constantly --every step of the way you are allowed to turn around and go home

Customer:

you mean the long drive one tomorrow its like a 2-3 hour trip just to get THERE and i cant even get next door

DrFee :

Why are you seeing a doctor that is so far away?

Customer:

because im in a rural area and having gyno issues and my current dr doesnt seem to be able to get in touch with, which my current one takes about an hour to get to anyways, and has at least a 3 if not more hour waiting time,

Customer:

and the dr doesnt seem to be treating me

Customer:

and i am having issues

Customer:

have had issues in the past years and have had surgery etc, but now its just like i cant get anything done

DrFee :

Wow --I think that would be stressful for anyone --even without any anxiety issues!!!!

DrFee :

The waiting time alone ---

Customer:

i have asked repeatedly when i was barely able to get out for biopsies and i cant get one, and the dr tomorrow wanted me to have one years ago

Customer:

yea i managed a few weeks ago to have someone drive me there, well it was i guess a month ago, and got to the office and boom the waiting room was spilling out no parking spots and people were lined out the door

Customer:

i left needless to say

DrFee :

That is TERRIBLE --I don't know how anyone tolerates that!

Customer:

i just keep hearing im fine and i dont have a cycle and i have a history of problems when i dont have a cycle so basically i feel dismissed

Customer:

by saying im fine

Customer:

everyone ive talked to on here say i need a biopsy but i cant get my dr to give me one

DrFee :

I'm sure -- no explanation for a lack of cycle ?

Customer:

well i have no ovulation and pcos

DrFee :

Ah

Customer:

but never any concrete reasons

DrFee :

OK..I'm familiar with PCOS

DrFee :

Your surgery didn't help?

Customer:

oh ok, well my problem is i have a history of hyperplasia

Customer:

and had a d & c to im assuming confirm the diagnosis

DrFee :

I see --

Customer:

and i asked for a biopsy and dr said no, so i said well how often, they said oh about every year or so, its been FIVE YEARS

DrFee :

I see --so you really need to go. Is this doctor your only option?

Customer:

hes a trusted one of the family

Customer:

just not sure i can make it

Customer:

already feel like im gonna keel over

Customer:

in fact last time i saw him three years ago i couldnt do the exam i was so nervous and that was when i was doing really good with the anxiety i cant imagine now

DrFee :

Frankly, like I said, it sounds like an ordeal without the anxiety. Is someone taking you?

Customer:

yea i havent driven in a very long time

Customer:

last time i was that far away i had really bad heart palps

Customer:

thought i was going to have to go to the er

Customer:

but scared of er

Customer:

catch 22

DrFee :

Remember --being "far away" is a perceived danger --so your body is going to respond by speeding up your heart.

DrFee :

Your body thinks its' protecting you.

Customer:

im resenting that part of my anxiety

DrFee :

So --nothing bad is happening, the body thinks you need it!

DrFee :

Yes, I can understand that! But you'll need to try to tell your body "It's OK --I don't need you to do that! I don't need to run home!"

Customer:

but i dont like to be away from home when stuff like that happens i like to run home to bed, i was next door had a heart palp and thought i was going to pass out and it was just EXTREMLY scarey

DrFee :

Since you are not alone, nothing bad will happen. If you pass out, your friend will take care of you.

Customer:

also the last time i was down there something was wrong with my thyroid, it turned out ok, but it was almost non existant and they had me going 1000 miles or more in three days for testing in other state

Customer:

needeless to say i ended up in the ER

Customer:

they wanted to give me a huge amount of meds i think it was ativan i refused

Customer:

thats how terrified i am of meds

Customer:

i thought i was dying and refused anti anxiety meds

Customer:

and i have an extreme fear of passing out which intensifies around people, if im by myself doesnt seems as bad though still VERY scary

DrFee :

You really should address that issue --the meds can do wonders ---

Customer:

you mean like zoloft

DrFee :

The best thing that could happen, which probably won't, is if you did pass out in front of people --to experience something that's feared seems to help a LOT of people. Yes, Zoloft or similar drug.

Customer:

i actually have did that a few times, but it was like an instant blackout i fell into someone in a crowd

Customer:

always have a rebuttall dont i? im not much help i know

DrFee :

And what happened after that?

DrFee :

That's OK :)

Customer:

i was in high school, and then i tried going back to school again and did the same thing and they must of thought i was a liability as they made me go on homebound which i couldnt leave my room anyways

DrFee :

But --that's why therapy could be so useful --I stick with people and all of their rebuttals and protests until there's a breakthrough --but sometimes it takes months and months of weekly sessions (for the really tough ones).

DrFee :

You may (or may not) be able to find a therapist who will do Skype sessions --Psychologists in certain states are not allowed to do that, but other types of therapists with different licenses can.

Customer:

there just doesnt seem to be any hope for me ive had it so long and dont wish to add meds, i just cant see a future other than being trapped in the house conducting my merry way at home with sporatic times a couple time a year i can get out,

DrFee :

So what's worse? Meds or being trapped ?

Customer:

i definately dont want meds

Customer:

and trapped is about all ive ever known

DrFee :

OK --then you're going to have to pursue every other option ---

DrFee :

Skype therapist ---

DrFee :

Neurofeedback (which might be tough to find given your location)

DrFee :

Check out this website --- www.adaa.org

DrFee :

And see if there's any therapist anywhere near you on there.....

Customer:

and tomorrow?

DrFee :

I still say you have to have the freedom to bail at any time.....

DrFee :

Feeling trapped is a trigger than intensifies the anxiety.

Customer:

yes thats why i like walkins

Customer:

i dont like appts

DrFee :

Notice everything that triggers your anxiety ---I'll give you all of the categories....

DrFee :

External triggers --things perceived by senses (sight/sound/smell/taste), overstimulation (too much happening) Understimulation (waiting, boredom, traffic), florescent lights

Customer:

has anyone ever gotten better without meds?

Customer:

yea i can basically check all to those

DrFee :

Internal triggers --thoughts, feelings, images, body sensations, being too hot, tired, hungry...

Customer:

my dr thought i was nuts when i wore sunglasses because the florescent lights bothered me, he thought that was unheard of

Customer:

if i get tired it scares me silly

DrFee :

Yes, you can get better without meds, in fact meds don't cure anxiety -- NO! Florescent lights are a HUGE trigger!!!!

Customer:

i tried phone therapy and they just tried to get me better to get me out to get one meds, and in fact thats all they talked about which was a big anxiety mess for me

DrFee :

But it's like trying to play tennis without a racket...you could still play, but's it's now handball --a lot harder.

DrFee :

You need to find someone who is really patient if you are going to go the handball route....

Customer:

nobody seems patient with me, they including my family want me better now

Customer:

they think its nothing to go to the dr

Customer:

they say they have fear to going to the dr,

Customer:

but i dont think they have the fear that i have

DrFee :

Yes, I can understand that --they've watched you suffer a long time, and want you to be better ---

Customer:

they say i wont do anything for myself

DrFee :

Most people fear going to the doctor...but you have a fear of everything including feeling sleepy ---

Customer:

which is happpening as we speak

DrFee :

so it's fear compounded upon fear

DrFee :

From the conversation?

Customer:

no sleep part

DrFee :

Ah

Customer:

i have been in bed for two days, have had sinus and allergies and just didnt feel good

DrFee :

That's no fun!

Customer:

yea but to me its something serious wrong with me

DrFee :

You can choose to believe that or you can start to tell yourself "it's JUST allergies" You have to become a telemarketer with yourself --repetitive and annoying!

DrFee :

Telemarketers never take NO for answer, if you notice.....

Customer:

i had one this morning telemarketer repetitve and annoying guess i should have asked him for some advice huh

DrFee :

LOL, yes!

Customer:

:)

DrFee :

I'm glad you have a sense of humor --it can help you. ;)

Customer:

oh i laugh a lot but sometimes it gets me into trouble i laugh so hard i bout pass out and DO have heart palpitations

DrFee :

Have you ever asked a doctor about Beta Blockers? Also very good for anxiety, but not all doctors seem to know that.....

Customer:

i rarely have company so when i had co the other day i was a little nervous as i had been having more than usual attacks because of the heat, and i laughed and thought i was gonna pass out with heart palps

Customer:

actually i take one, twice a day, heart dr said i could take it 2-3 times a day 3 times a week but wrote it out for 30 days at a time,then i had a problem with my thyroid overactive and my family dr wrote me out 8 times the strength i wouldnt take it so fianlly i took half a tab twice a day

Customer:

so now instead of 150 pulse at dr its 120

Customer:

i asked the dr one day, (part of the reasons i just love going to the dr) my pulse was high, and i said is that gonna kill me? he said "well not today" i was like great

Customer:

at home my pulse is barely 60 usually unless i go outside and its kinda hot then it elevates

Customer:

i have a really big fear of heat, i dont tolerate heat very well, im fair skinned as you can get and completely not heat tolerant, i wish i could move to alaska, thats my kind of weather, or seattle, i like when it rains and not so bright all the time

DrFee :

Heat is very uncomfortable (as are a lot of bodily sensations) but the difference between being uncomfortable and panicked is the interpretation --just being miserable vs. "something bad is happening."

DrFee :

I do need to run now -- all I can do is encourage you to not give up. Keep in mind that the trip tomorrow would not be easy for many, many people without anxiety ---you want to remain as distracted as you can, talk to your friend a LOT...take something comforting with you (pillow, object, whatever) take snacks, drinks, etc... music

DrFee :

whatever piece of "home" than you can bring.

DrFee :

Bring something for the waiting room --- book, magazine, phone,

Customer:

ok thanks, XXXXX XXXXX do telephone therapy

Customer:

i can tell you two things that help me, and i dont know where to find it, i keep telling my husband its what i need but i dont get these two things, motivation and confidence

DrFee :

I wish I could with you, but I can't for 2 reasons --one it's part of our agreement at JA that we not solicit clients from the site, and two my particular state/license does not allow me to "see" anyone via phone out of state.

Customer:

gotcha

DrFee :

I can give you a possible referral though ----

DrFee :

Erica Lewis (NNN) NNN-NNNN/p>

Customer:

thanks :)

DrFee :

You're welcome --please feel free to let me know how tomorrow goes....

DrFee, Psychologist
Category: Mental Health
Satisfied Customers: 437
Experience: I help people overcome anxiety and enjoy life again.
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DrFee
DrFee
Psychologist
260 Satisfied Customers
I help people overcome anxiety and enjoy life again.