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Ask Dr. Z Your Own Question

Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4414
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Doctor Z- This is sort of a follow up question after yesterday

Resolved Question:

Doctor Z- This is sort of a follow up question after yesterday and if I wasn't struggling so much this evening I promise I wouldn't be asking you and bugging you yet again...and I am definitely calling tomorrow and getting back in therapy. Anyway I have been have just this extreme amount of anxiety for several hours now. I usually can handle it when this happens but it's so out of control right now it is making me feel physicallly ill. I can't really do the thought record because I'm not really having any negative thoughts. This is just relentless though to the point I'm feeling desperate for relief, I just need to know what I can do..
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

DoctorZ :

Hi, and you do not have to worry about asking too many questions, I am here for you, so you are definitely not bugging me at all

DoctorZ :

So the anxiety is really severe for you right now, has it ever been like this before for you?

Customer:

Not usually this bad, and usually it doesn't last this long

DoctorZ :

Well so the thought record I gave you is a part of therapy that I subscribe to called Cognitive Behavioral Therapy which states that the thought comes before the emotion, so with this theory there might be some overwhelming thought causing your emotion

DoctorZ :

But that doesnt help us necessarily because the anxiety may be too severe to "think straight"

DoctorZ :

Have you tried doing activities that are pleasurable and relaxing for you?

Customer:

Well I tried reading but I couldn't sit still to hardly do anything, and that's even with the Adderall which I sometimes forget to take, and I haven't really been able to watch tv either

DoctorZ :

What about a jog or swimming? Something to get your energy going

Customer:

I was feeling like I didn't want to leave the house it was so bad so I haven't been out at all today

DoctorZ :

I understand, anxiety can be very severe. There are breathing exercises can lower your heart rate to help calm the anxiety down. Yoga is also a good technique for relaxation.

DoctorZ :

Or meditation if you are familiar with that

Customer:

I have never done any meditation myself, my breathing is like I keep holding my breath but I'm not trying to

DoctorZ :

Okay I want you to take a deep breath, I mean as deep as you can (you are a swimmer so you must have great lung capacity) and then let it out. Keep repeating until you feel a little more calmer

Customer:

ok

DoctorZ :

Here is a good link for the deep breathing and other relaxation techniques

Customer:

ok I am already feeling a little better, that works quickly

DoctorZ :

Yes it does, it is a simple technique, but it lowers your heart rate so that you are not feeling a lot of the physical effects of anxiety

Customer:

I'm still doing it as I type, it really is relaxing, my stomach doesn't hurt as much either

DoctorZ :

I am glad it is working. These techniques will help you calm your anxiety when you are having these episodes, and therapy will help with the root cause so that these anxiety episodes become less and less severe and less frequent

Customer:

It was just weird because it really didn't start until the middle of this afternoon but I was feeling ok before that, nothing even happened

Customer:

I kept thinking it would go away but it didn't

DoctorZ :

Sometimes anxiety attacks happen spontaneously and they can be severe like you had

Customer:

I forgot to mention I took extra Intuniv and that wasn't even helping, it didn't even make me tired

DoctorZ :

It would have went away eventually, but the relaxation techniques hasten the process by making them go away faster.

DoctorZ :

Intuniv is for ADHD so it would not have helped for anxiety usually

Customer:

I feel like I wasted a day and now it's already going to be Monday

Customer:

oh i thought it did

DoctorZ :

You didnt waste a day, you just learned some good relaxation techniques

Customer:

true I did :)

DoctorZ :

So that is a positive that will help for a long time

Customer:

Thanks for that

DoctorZ :

So I know you mentioned seeing your psychiatrist later in the week, you may want to ask about a benzodiazipene medication for anxiety. These are great for anxiety attacks, but you do get physically dependent on them, which is the downside to them

Customer:

I usually forget to take meds if anything, so I would probably not be as likely to get addicted I would guess

DoctorZ :

That may be true, but medications work more effectively for you if you take them regularly and Im pretty sure you know that. A good way to remember to take your medications is to set an alarm on your watch or phone

Customer:

could the anxiety med be taken just as needed? yeah i keep thinking i need to set alarms on my phone, esp for the adderall because i have to remember that one 3 times a day

DoctorZ :

An alarm will help especially with the adderall. The benzodiazepine medication is usually fast acting, but most psychiatrists want it to be taken regularly. There is also a medication called gabapentin (its a hypnotic) that can be used as needed, and its off label use is for anxiety

DoctorZ :

Also gabapentin is not physically addictive

Customer:

Oh ok that's cool, so maybe i will ask about that one

DoctorZ :

I do not think it would hurt to try it

Customer:

Yeah I don't want this to interfere with having to go to work, because right now I still feel like hiding

DoctorZ :

I understand your feelings. The combination of the relaxation techniques, therapy, and the medication will help you a lot so that the anxiety is no longer as severe

Customer:

That would be great because today really was bad and I don't want to have to go through this again

DoctorZ :

I know you dont and no one wants to, it will get better. You are starting to feel better from doing the relaxation techniques, so you know now the anxiety is not permanent

Customer:

yeah thats true, its not half as bad now with the breathing that I'm still trying to be aware of and I think just talking about it has helped

DoctorZ :

That is good, I am always happy to help make you feel better

Customer:

I didn't tell anyone earlier because people who don't have it don't understand, at least the people i know don't

DoctorZ :

It is a tough situation because you are right, those who do not have severe anxiety do understand its effects on people. Mental health is still a mystery to most people

Customer:

yeah which is why I tell no one about the adhd or anything unless i have to, like i did have to tell work

DoctorZ :

I understand, but sometimes opening up to people and letting them in to help you can increase your support system so you do not have to feel alone. But only with people you trust

Customer:

That makes sense, I usually try to do things alone, I always have

DoctorZ :

We cannot do everything alone, sometimes it takes greater strength to ask for help then to do it alone.

Customer:

That I believe, asking is hard, it was hard enough to ask you even

DoctorZ :

I know, but I am here for you to help you. And your friends care for you and would be there for you too

Customer:

Yes they would, you're right, it's just embarassing...but like you said it takes greater strength to ask

DoctorZ :

So far you have taken the right first steps, you asked me for help, you are going to see a therapist. These are good first steps, so you are on the right track

Customer:

Yes, it feels like I am :)...thank you so much for everything again

DoctorZ :

Anytime, I am always here to help. You never have to think that you are "bugging me" because you never will. I am just happy helping you

DoctorZ :

And you know you can ask me anything or if you just want to voice your concerns with me at anytime and I will get back to you as promptly as I can.

Customer:

That is really good to know, just knowing that makes me feel better

DoctorZ :

No problem. Good luck with your therapy appointment tomorrow :)

Customer:

thank you I am looking forward to it :) have a good night

DoctorZ :

Good night

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4414
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you

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