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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4425
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hi I have a problem where i have sudden panick attacks, It

Resolved Question:

Hi
I have a problem where i have sudden panick attacks, It comes n goes unless im around family, usually happens when im alone and hungey. If that makes sense, every morning i wake up anxious and although im fighting i'd like to get some more advice, i dont want to live like this not wanting to get out of the house.

any advice? im not on any medication or seeing any therapist.
Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Z replied 10 months ago.

Dr. Z. :

Hello I believe I can help you with your concerns

Dr. Z. :

I am so sorry that you are going through these panic attacks, I can imagine how distressing this must be for you

Dr. Z. :

May I ask, for how long have you been experiencing these panic attacks?

Dr. Z. :

I will not lie to you, these are pretty severe panic attacks that can be cured and managed by non-medication means, but those means may take months of using therapeutic techniques, while the prescription medications may be more effective and faster for you

Dr. Z. :

The predominant non-medication techniques would be Cognitive Behavioral Therapy (CBT) and Exposure therapy. I can teach you some of the techniques of CBT and recommend a couple good CBT books, but I think for your severity you may want to consider a therapist's help. A therapist can also practice exposure therapy on you, where you are gradually exposed to the panic attack stimuli over time to help lessen your anxiety to it as you get used to it. This is best done by a therapist in a therapist's office.

Dr. Z. :

CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen, thus no more symptoms of a panic disorder

Dr. Z. :

So this link may help you, it contains a technique I use with patients 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 objective 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.

Dr. Z. :

In addition, these two worksheets are very good at helping lessen anticipatory anxiety and helping you focus on the big picture and the objective/positive thoughts and outcomes.

Dr. Z. :

Sorry I forgot the first link, here it is.

Dr. Z. :

Now the links for the first two worksheets that help with anxiety

Dr. Z. :

Also individuals with panic disorders also have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your anxiety better.

Dr. Z. :

These two books are also really effective in helping manage anxiety and panic

Dr. Z. :

This is a link for something called Progressive Muscle Relaxation that can help you create a long term calm by using muscle tension and release techniques, it can help manage your anxiety and panic better too and is very similar to meditation

Dr. Z. :

Now for the supplements, the St. Johns Wort is very effective, also Omega-3, Glutamate, and Valerian root can be added to increase anti-anxiety effects

Dr. Z. :

For medication, the use of an SSRI antidepressant, I would recommend Lexapro at 10-20mg or Zoloft at 150-200mg, in combination with the use of benzodiazepine (e.g Ativan, Xanax, and Klonopin) are effective in managing panic disorders.

Dr. Z. :

The benzodiazepines are usually effective within hours of use at calming you down and the SSRI antidepressant starts to be effective in 2-3 weeks of use and its maximum benefits are seen in 6-8 weeks.

Customer: Would u suggest to try natural techniques n ur worksheet or go strait to pills? Which I don't want
Dr. Z. :

Well since you do not want to take the medications, then I see no downside using the techniques and the natural supplements to help you. But if your find that these are not enough you may have to ask your primary care doctor to prescribe the medications for you as they will most definitely be effective for you.

Customer: Is this curAble that I will be able to travel again ? I try to dis regard
Customer: theregard the feelings if bring anxious I don't know how to stop it
Dr. Z. :

Yes this is definitely a treatable condition and with the techniques, books, and natural supplements it should gradually go away.

Customer: Should I continue with going to work as per normal I'm abit worried I would have it at work
Customer: and being a manager I'm worried colleagues might go what the hell!
Dr. Z. :

Well like I said the therapy techniques will take awhile to start being effective, you should start seeing benefits in 2-3 months and the maximum benefits in 9-12 months. The medications do work faster and can be temporarily used until the CBT techniques are enough to manage your panic attacks alone.

Dr. Z. :

So it is really your call if you should go to work or not, but I want to let you know that you will not see fast results with just the therapy techniques and supplements.

Customer: I understand but what would be the side effects of the drugs?
Customer: Should I also make any lifestyle changes thank you for this
Dr. Z. :

Well the side effects of the SSRI antidepressants are usually temporary and never permanent once off the medication. Here are a list of the most common side effects for you.

Dr. Z. :

Well you should definitely cut out caffeine and any other stimulants from your lifestyle. Try walking or exercising for at least 30 minutes a day as well.

Customer: Easy thank you for this
Dr. Z. :

Anytime, is there anything else I can do for you?

Customer: I will just copy notes n leave will seek therapy n ur recomendations
Customer: No I've been excellent with ur recommendations how can I save this chat
Dr. Z. :

Actually a link should be sent to your email of this chat, so that you will always have access to this chat

Dr. Z. :

Also you can bookmark this chat with this link

Customer: Thanks I've book marked it have a great day
Dr. Z. :

You have a great day as well, and best of luck with your treatment. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4425
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and 4 other Mental Health Specialists are ready to help you

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