How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask DrFee Your Own Question

DrFee
DrFee, Psychologist
Category: Mental Health
Satisfied Customers: 437
Experience:  I help people overcome anxiety and enjoy life again.
Type Your Mental Health Question Here...
DrFee is online now
A new question is answered every 9 seconds

I have had anxiety since I was a child. I am 42 now, and within

Resolved Question:

I have had anxiety since I was a child. I am 42 now, and within the last year it has become worse. when I first awake in the morning I have high levels of anxiety along with rapid heartbeat, cold sweaty hands, dry mouth with an occasional dizzy spell, and feelings of being confused and out of touch with reality these symptoms usually last two to three hours. And by the afternoon I crash with terrible feelings of depression. Every now and then I begin to feel too happy for no reason. Then the cycle starts all over again. I have been prescribed Zoloft 100 mg for about four years it does seem to work most of the time and levels me out but, it does not seem to prevent the random panic attacks. I recently found out this runs on both sides of my family. Can Zoloft be supplemented with additional medication to help prevent the panic attacks?
Submitted: 1 year ago.
Category: Mental Health
Expert:  DrFee replied 1 year ago.

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

 

I have 20+ years treating anxiety disorders as a Psychologist. Most of my clients take some form of medication, so I've worked with a lot of Psychiatrists over the years. Zoloft is one of three SSRI antidepressants that has been approved by the FDA specifically for the purpose of blocking panic attacks (the other two are Paxil and Prozac). So --your choices could be

1) Talk to your psychiatrist about switching to one of the other 2 if the Zoloft isn't blocking your panic attacks

2) Undergo other forms of therapy (I'll discuss this in a minute)

3) Supplement with Neurofeedback (which may help block panic attacks) http://www.eeginfo.com/

 

 

4) Many people take an anti-anxiety in addition to the antidepressant --However --they are not useful for blocking panic attacks, they are useful for lowering anxiety levels (which of course can help prevent a panic attack). You could talk to your doctor about this possibility, but from what you describe, the panic attack comes out of the blue and surprises you. That's too late for an 'as needed" anti anxiety, you need some warning in order for that to be useful.

 

Which is why I recommend therapy --specially Cognitive Behavioral Therapy (CBT) with someone who specializes in anxiety disorders. Here is an excellent site for reading more about anxiety and it's treatment (as well as for finding a therapist): http://www.adaa.org/

 

 

Anxiety is our body's signal that it believes danger is present, and the body prepares itself to either fight, run away from, or flee from that danger. If we have to get out of the way of an oncoming bus, it is quite useful to be able to move quickly. The problem is that the body does not know the difference between "real" danger such as a bus, and "perceived" danger --which can be triggered by so many other things including ---thoughts, feelings, memories, images, bodily sensations (even relaxation triggers anxiety for some people, but also being too hunger, hot, or tired, or effects of medication). "Overstimulation," which can occur when too much is happening and "Understimulation," (not enough is happening such as waiting, traffic, et) are also triggers. Anything external (sight/sound/smell/taste --as well as flourescent lights for some) can trigger an internal trigger and also cause anxiety.

 

Many people describe panic attacks as "coming out of the blue," or "occuring randomly," but I actually disagree that they truly come out of the blue. I strongly believe that there is always a trigger, no matter how quick or subtle that trigger might be.

 

So--given that....a first step to overcoming anxiety is to be able to identify what trigger(s) are happening in each situation and dealing with the trigger(s). Like I've mentioned, this can be difficult, because they can both happen rapidly, be chained together, and be subtle. Tired eyes from contact lenses is a great example of a super subtle trigger --I've seen this a few times, where a person's eyes get tired, the thought occurs, "I can't see," and panic ensues.

 

So -- CBT therapy can help by examining the interplay between beliefs, emotions, behavior, and feelings in one's body when in a particular situation. Intervention in one area will affect the entire system. With CBT one does a lot of work with identifying beliefs and making counter or alternative beliefs to the irrational ones. These are then tested out in real life situations in the form of "experiments." It is a highly effective approach for working on behavioral change. You can read more about it here: http://www.mindovermood.com/ and here www.nacbt.org/whatiscbt.htm

 

A first step in CBT is to learn how to rate your anxiety. The higher your anxiety the more difficult it is to address. You should start to rate your anxiety on a scale of 1-10, where 10 is a panic attack. You need to intervene at a 5 --anything at the 2-3 level ought to be tolerable. It takes some time to be able to identify triggers, but you can start rating your anxiety today --start by doing it at random times, like right now.

 

If your panic attacks are "random," it might be a challenge for you to start catching your anxiety before it is panic. Start rating your anxiety regularly, 3,4,6 times a day at random times. Then ask yourself, "What was just happening," that either helped you be calm or was triggering anxiety.

 

I hope that these thoughts will give you some ideas about a next step for you to take --either talking to your doctor about your meds, Neurofeedback (which helps re-train brain waves that are not working optimally), or therapy to specifically target the anxiety.

 

There's lots of good information and tools available for you to conquer this problem and get it under control.

 

Warm Regards,

 

Dr. Fee

 

 

DrFee, Psychologist
Category: Mental Health
Satisfied Customers: 437
Experience: I help people overcome anxiety and enjoy life again.
DrFee and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 

Related Mental Health Questions