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In Part 3, I will talk a little more about my experiences with medication, and how things are going now: The rest of the story, if you will. Click for Part 1, Part 2 and Part 4.
Again, please note: I am not a therapist and I cannot guarantee that what worked for me will work for you. I hope you can learn a thing or two from my experiences, and that some of my tips will help you keep anxiety and panic at bay. If your experiences are debilitating, I recommend you talk to both a medical doctor and a therapist to get to the root of the problem.
How about some statistics?
"Panic disorder affects about 6 million American adults and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited....
Early treatment can often prevent agoraphobia, but people with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders, responding in most cases to certain kinds of medication or certain kinds of cognitive psychotherapy, which help change thinking patterns that lead to fear and anxiety." From the National Institute of Mental Health
As I mentioned in Part 1, my doctor prescribed me two anti-anxiety medications in January 2009. The one that I could feel working was the Ativan, because it's meant as a quick-acting sedative. For the first two weeks, I took it every day, especially at night to ward off the 3 a.m. adrenaline rushes. However, there is a risk of dependence with Ativan, and it was important to use it only sparingly.
So, I stopped taking it at night and focused its use only on acute situations where my own tools weren't working, and the occasional preventative dose before going into a possible triggering situation. By March, I wasn't taking it at all. In fact, the last time I took one even as a preventative was before taking my first plane ride after the big attack, in May. A few minutes after boarding, I realized I didn't need it.
By April, I was starting to feel like myself again. I had more energy, I was eating better, sleeping better and even starting to put weight back on (darn it). I was still shaky and experiencing side effects from the medication, but was getting back to my old routine. Unfortunately, we had to put down our sick kitty that month, and it was devastating to us after four months of cancer treatment and high hopes of her recovery. It was a big stressor. But at the same time, it was also like a fresh start for me, mentally.
Like clockwork, I decided to start tapering off my main medication, an SSRI, at the six-month mark in July. These medications have powerful side effects at the beginning, and I did not want to go through that again, so I very gradually reduced the dosage a few milligrams at a time.
Here are some of the more pronounced side effects I experienced:
Coughing and asthma
Nightmares and night sweats
And a few others
I want to make it clear that SSRIs are no fun. Your body gets used to them after a couple of months, but some of those side effects, like the coughing and asthma, lingered the whole time I was on them.
By October, I was finished, and had experienced no side effects through the tapering process.
And believe me, I had plenty of anxiety about going off the medications. "What if I have to go to the hospital again?" "What if I'm really crazy and need to be on meds my whole life?" "What if...?" Here's how I addressed those questions, with the help of my doctor and therapist.
1. Although I was still in the process of developing my tools to help me both prevent and manage panic attacks, I realized that it was unlikely I would get to the point where I would need to go to the emergency room again, with all the work I had done to change my thinking and lifestyle. But I also knew the hospital was there if I needed it, which was actually a comforting thought.
2. The issue of "crazy" was harder to deal with (and I realize this is not a PC word, but these are real fears I had). Do I have a mental illness? Is my brain messed up? What does it all mean?
The truth is, I just don't know the answer to those questions, but I do know that if, in the future, I need to go back on medication, it doesn't make me a bad person, or a weak person, or a failure.
I've put a lot of pressure on myself in my life to be "perfect" and "strong" and "together" and "tough." Now I see where that pressure led me, when I tried to power through difficult times instead of taking the time and space to deal with them. I am who I am. I'm imperfect and I'm human, and that's life.
I'm glad and grateful that I don't need medication to "keep it together" as it stands right now. And maybe I'm lucky, too. But it's not worth worrying about or dwelling on.
I wrote this blog post last February, about setbacks. Here's what I said then:
"Sometimes we overcome a physical or mental challenge only to be faced with setbacks. We believe we've left the problem in the dust only to have it return at a later date, maybe unexpectedly, or maybe triggered by a similar situation that created the first challenge.
I want to let you know that you can overcome it again! You beat it once, and you still have the skills and determination to beat it again.
It's scary to feel like you're not in control of your mind or body. It's scary when the feelings in your body and the thoughts in your mind seems to override all logic.
Don't give up, and don't give in. Get support if you need it. You're strong, you're powerful, and setbacks are only temporary. Keep fighting and you'll see what I mean."
I was writing this to myself as much as I was writing it to you, my readers. I was taking on the challenge of positive thinking and self-care, knowing that I was down and the only way to go was up.
Even as I felt fully myself again and mentally as strong as ever, the process of writing this series started out with a big setback two months ago, when I tried to incorporate some content about my car accident. I had a very intense emotional reaction to what I was writing, and I couldn't even look at it for three weeks, hence my decision to leave that part out of these blog posts!
Sure, there's a possibility I could have panic attacks again. I had a 19-year reprieve, for goodness sake. They came back, and how could I have known that would happen? I certainly can't predict the future.
But I've done everything this past year to concentrate on living the life I want, staying healthy, staying positive, and not letting this experience drag me down into some permanent dark, sad place. I've remained focused on growing my business and helping others grow as speakers and entrepreneurs, which also has kept me from constantly dwelling on my own problems. And I know I'm not the only one who has ever gone through something like this, and that there are much worse problems I could have.
I've had great support from my doctor and therapist, and from my family and friends, with no judgment and no (visible) shock or horror!
I don't ever again want to experience what I went through in 2009. But if I do find myself ramping up to a panic again, I hope that everything I've learned will have prepared me to deal with it and move past it. I'm not fragile, I'm not delicate, I'm not broken.
I hope that, by sharing my story with you, that you will feel inspired to take the necessary steps to start your own process of managing your anxiety and panic. If there's nothing else you do, please talk to someone. Therapy doesn't have to be permanent, but if you don't do something about your anxiety, it will not go away on its own, and may become a permanent part of your life.
Thanks for reading and feel free to share additional tools and resources in the comments!
See Part 4 here, one year later!
Overcoming Panic, Anxiety, & Phobias: New Strategies to Free Yourself from Worry and Fear
Mayo Clinic Panic Disorder site
Mayo Clinic Cognitive Behavioral Therapy site
Related blog posts
Thought Trap #8: Emotional Reasoning
Avoiding public speaking intensifies your fear
Don't panic, plan it
Being willing to feel good
Setbacks are only temporary
Visualization is for the body as well as the mind