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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4888
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hi...I am a therapist who herself suffers from panic attacks.

Resolved Question:

Hi...I am a therapist who herself suffers from panic attacks. I take PaxilCR 37.5mg and 1 mg Ativan for breakthrough panic...lately, I just feel so anxious and so afraid that the panic is going to just consume me. I have been doing a lot of deep work lately with and EFT practitioner and I am also dealing with several significant losses over the past couple of years....do you have any advice as to better ways to treat my panic besides the meds I have described to you. I have been on Paxil for 14 years. thank you.
Submitted: 12 months ago.
Category: Mental Health
Expert:  Dr. Z replied 12 months ago.

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am so sorry that you are going through panic attacks, I can imagine how distressing that is for you

DoctorZ :

Now you mentioned using EFT and Talk therapy. Is this talk therapy have a Cognitive Behavioral Therapy (CBT) focus? CBT, as I am sure you are familiar with, is very effective in helping lessen the symptoms associated with panic attacks.

DoctorZ :

Also while I know that you do not want more medication, but after 14 yeas on the Paxil, it is possible that your body adapted to it and it is no longer effective, that could be a discussion with your psychiatrist that you may want to explore too

Customer:

yes, just began using CBT....my worst fears are having panic attacks in traffic ( feel like I can escape) and sometimes I have them in my sleep...which are terrifying to wake up to.

DoctorZ :

Well CBT does take some time for it be effective, but I am glad that you have started to use it. It usually takes around 2-3 months to start seeing benefits from CBT and then another 6-12 months for maximum benefits. It takes time to retrain your brain, this is why it is a gradual approach.

DoctorZ :

Also I can teach you a couple good CBT techniques that can be helpful for you too if you would like. And I would also like to show you about Progressive Muscle Relaxation (PMR).

Customer:

don't know if I can endure another 2-3 months. sure, I am open- tell me more.

DoctorZ :

Well the PMR exercises can work quicker than that if you want. But here is the CBT techniques that can be beneficial for you. This technique I use with patients is called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more positive and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

Customer:

so...you think the paxil may have lost it efficacy ?

DoctorZ :

In addition this worksheet helps to come up with alternative thoughts to prevent a panic attack that you think may happen

DoctorZ :

And this worksheet will help retrain your coping mechanisms to help you

Customer:

my panic attacks often don't have preceeding disturbing thoughts, they just come upon me very quickly.

DoctorZ :

It is possible that after 14 years the Paxil has stopped working. Your body is a remarkable machine that can adapt to these medications, I would ask to get reevaluated by your psychiatrist and while you do not need to add medications, but maybe make a subtle switch to another medication may help you if in fact the paxil did stop working

DoctorZ :

I know that you may not think you have any preceding thoughts before the panic attacks, but typically there is some trigger that invokes a thought, even in the subconscious.

DoctorZ :

Here is a link to PMR that can help relax your body and that can help you create a long term calm by using muscle tension and release techniques.

Customer:

Are you familiar with medications that have a high success rate in treating panic disorders.......yes, the thought comment is true....with exception for when I am sleeping.

DoctorZ :

Well you are dreaming, so something may be triggering your subconscious, we all do not remember our dreams in REM sleep. Lexapro is very successful at treating panic attacks. And sometimes when Paxil stops working Effexor can be successful as well.

Customer:

do you know of any panic hotlines....I often get them during the night and often feel better if I can call someone. Hate to bother friends and family.

DoctorZ :

Also since you are looking for all alternative therapies then what you have tried so far, have you considered EMDR therapy?

DoctorZ :

There might be local panic hotlines in your area, what is your city and state so I can look for you?

Customer:

I am doing EFT...similar to EMDR...it is a form of tapping on energy meridians while doing scripts related to issues that create disturbance and discomfort for you. I have been using technique intensively for several months with much success...however, when I am in a full blown panic attack, the tapping is difficult to do.

Customer:

I live in New Jersey

DoctorZ :

The PMR will help in a full blown panic attack, I recommend you practice it. And it can also help prevent panic attacks too. Let me check for you in New Jersey, give me a couple minutes.

Customer:

I am familiar with the Panic & Anxiety workbook by Bourne...that is where the pmr is from...need to pull out that resource again.

Customer:

thank you for checking in nj

DoctorZ :

So you can try this number if you would like 1-866-202-HELP. They do not give a lot of information on it, but I know that it is at least not a suicide hotline (it seems most hotlines are for suicide, abuse, or addictions)

Customer:

yes, I know this one...it is a "leave a message" line...I am looking for something that will actually bring you to a live person...ok, thanks for your help.

DoctorZ :

Okay well let me keep on looking for you for a second and see if I can find anything. In my community they have a crisis hotline, but most jurisdictions do not have them

Customer:

I know...it is unfortunate. DrZ...you have been helpful and I am a very resourceful person ( when I am not having a panic attach ) : ) I can google and check my area as well...thought you might know because you do this for just answer.

DoctorZ :

Well this crisis hotline is not in your area, but they do provide short term intervention that may help you if you wish

DoctorZ :

1-800-309-2131

Customer:

thank you. take care.

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4888
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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