Generalized anxiety disorder and panic disorder same, similar… different HELP?

One Comment

1. Shan says:

   August 8, 2010 at 6:04 am

   Untreated, inadequately, or ineffectively treated anxiety can lead to panic attacks. Anxiety: (1.) Generalised Anxiety Disorder: There is a saying in the mental health field: “if the only tool you have in your kit is a hammer, you tend to treat everything as a nail”. So it goes with doctors, and their prescription pads: handy, quick, and convenient, when trying to manage a large list of patients, with very limited time for each.

   With anxiolytics (anti-anxiety medication, such as Lexapro, or Paxil, which treat both anxiety and depression) you are only addressing the symptoms, and even then, often only temporarily, as your system becomes used to it, and you have to accept the risks of an increased suicide/homicide rate, aberrant behaviour, and side effects, such as possible sexual dysfunction (common), or weight gain. For those reasons, I recommend first trying the alternatives, (which only treat the symptoms, using supplements like inositol, and SAMe, or herbal remedies, such as c(h)amomile but the cause, as well) using the EMDR variant, EFT, and relaxation techniques. The anxiolytics/antidepressants will still be there, should the alternatives prove insufficient for you, but give them a tryout period of several weeks, first.

   See anxiety treatments, at ezy build (below) in section 6. Set yourself a specific time period for worrying about anything, (say; around three quarters of an hour, possibly when you get home, or after your evening meal, but not too close to bedtime) after which, resolve firmly to refuse to even entertain the thought of worrying again on that day: realise and accept that to do otherwise would be counterproductive to your mental health, and enjoyment of life. You will have had your “worry time” for the day, and can just write down any more thoughts that come to mind, and say to yourself: “Well, I’ll just have to worry about that tomorrow, won’t I?”. It is important to deal with a negative internal monologue (self talk), or mental process, such as disturbing thoughts, or images, by the process of (a): recognising it, and (b): challenging it immediately. When you notice something negative, such as: “I’m never going to get over this!” or: “Why am I always so pathetic/useless/such a loser?” or even: “I can’t do this/will never get over this!”, or a disturbing image, recognise that this is part of the mindset which will hold you back from progressing in your recovery. Having identified and labelled it, I first visualise a large “STOP!” sign, then I say to myself as forcefully as you can, even aloud in a big voice, if alone: “I know this tactic: GO AWAY FOR A WHILE !!!” You may want to use either: “ruse”, “ploy”, “game”, or “trick”, instead of “tactic”. In the case of an image, visualise a large “STOP” sign, or your preferred version. Some people go so far as to keep a wide rubber band in their pocket, then put it around their wrist, when they catch themselves backsliding, stretch and release it, as a method of reprogramming their mind sooner, but I don’t regard it as being strictly necessary. Remember to remove it, afterwards, if you use this method.

   Practice one of the relaxation methods on pages 2, 11, 2c, or 2i, daily, and when needed. Alternatively, give the EFT a good tryout, to see if it helps you. There is also a version for use in public places, (if you like, you can claim to have a headache, as you massage/lightly tap your temples, but you would then be restricted to subvocalising: saying it to yourself in your mind). Section 53, and pages 2, 2.q and 2.o at http://www.ezy-build.net.nz/~shaneris also refer: “Even though I sometimes suffer from anxiety, I deeply and completely accept myself.” Neurofeedback treatment for anxiety is increasingly becoming available. Herbal remedies, such as valerian, (which is not for use if depression is also present) passionflower, St.John’s wort, or arctic root are often effective, but the idea is (as with anxiolytic medication) to use them like water wings, or training wheels on a bicycle, providing initial support, and giving time for other treatments, such as therapy, and relaxation techniques, to take effect.

   (The following is a variant of EMDR therapy, which has been used successfully for those people suffering from Post Traumatic Stress Disorder, insomnia, and anxiety: it is easily learned, quick to use, yet can be very effective. It is easy to be dismissive of such a seemingly unusual technique, but give it a good tryout, for at least a few weeks, to see if it is effective in your case.). Prior to using either of the methods in the above paragraph, first sit comfortably, and take a deep breath. Then, without moving your head, move your eyes from the left, to the right, and back again, taking around a second to do so (say: “a thousand and one”: this takes approximately a second). Repeat this procedure (without the words, although you can count, subvocally, if you like) 20 times. Then close your eyes and relax. Become aware of any tension or discomfort you feel.

   Then open your eyes, and take another deep breath, and repeat step one, closing your eyes, and relaxing afterwards, in the same manner. Then, repeat the procedure one last time. Some people may find that this is all they need do. With experience, you may find that you can practise this in public, with your eyes closed, which greatly widens the window of opportunity for its use, and avoids attracting unwanted attention. I have found that the 2 – 3 minutes spent using the EMDR markedly reduces distractions to the relaxation process, and is repaid many times over. (2.) Fear: My standard post follows, but learn to identify, and confront your fears: a fear confronted is a fear reduced. If you don’t know what they are, write down 3 times, before going to sleep: “Tonight, in my dreams, I want to remember seeing what my fear is, when I get up”, and put it under your pillow. Then say it aloud 3 times, after lights out. It is important to summon as much desire as you are capable of, to more effectively communicate this to your subconscious mind. If this works, it should produce a response within 2 weeks; if not, you may not be remembering, so set an alarm to go off after, first, 3 hrs; next night 4; next night 5: have a pen & paper handy, and WRITE DOWN THOSE DREAMS!!! or, chances are, you will forget. Remember, the response may be metaphorical (figurative), rather than literal.

   There is a section on dream interpretation, here in Y!A, and view section 3 on dream interpretation, at ezy build (feel free to email me by clicking on my profile, but I am a lot better with interpreting dreams of males, than females) if you have any difficulty, but the idea is to, immediately after waking & writing down, question the characters inhabiting that dream, and note any thoughts, images, impressions, or emotions which result. Then use the confrontation method, in section 3, on recurring nightmares, at ezy-build. Take up a course in Tae Kwon Do, Kung Fu, or Tang Soo Do, etc., as much for the mental techniques you will learn, as the ability to face physical fear, which may well have a carry over effect in the dream state, at night, influencing your subconscious mind, and enabling you to tackle them head on (Some people can defeat them: it can help to call on friends, or others: “dream allies” to come to your assistance. I am still unable to, as yet, but I realise that all those figures are part of me, and the only thing to do is just keep fighting: persevere, and resist). Many people report reduced anxiety levels, after taking up yoga, and t’ai chi probably has similar benefits. More on these in the first 3 pages of section 2. ~~~ Panic: Advice from a published psychiatrist on controlled breathing. (1.) Get a clock, or watch with a second timer. (2.) Practise for 5 minutes, 4 times daily, until proficient. (3.) Take a small breath in, and hold it, for 6 seconds. (4.) Think to yourself: “RELAX”, just before breathing out. (5.) Try to feel a sense of releasing tension, as you breathe out. (6.) Breathe in for 3 seconds, then out, for 3 seconds. Try to make your breathing very smooth, and light, as you breathe in through your nose, and out through your mouth, or nose. (7.) For the next minute, continue to breathe in, and out, every 3 seconds. (8.) Go back to step 3, at the end of the minute, and proceed through to step 7, doing this for 5 minutes. Use this at the very first sign of a panic attack starting, or any time you feel anxious, or tense.