Dear Self: Stop panicking. You're not dying.
May 17, 2010 6:53 PM Subscribe
My anti-anxiety (wellbutrin and zoloft) meds are finally working! I feel an intense calmness I've never felt before. But because of a near-death experience, I associate that feeling with dying and it triggered a panic attack. When it happens again, how can I talk myself down from it without sacrificing the relaxed feeling?
I normally deal with panic attacks by explaining to myself exactly what's happening ("Something triggered your fight-or-flight response, which is why your heart is racing and blahblahblah"), and ("If you were dying, blahblahblah would be happening,") and then choosing to ignore the sensations. Kills the attacks instantly.
But I don't want to ignore the calmness I feel, because I've been battling anxiety a long time (not as a result of the NDE) and I'm thrilled the medication is working. I feel that fighting feelings of peacefulness is like taking a step backward, but when I didn't ignore the sense of tranquility, my reaction was basically, "I'm not dying because of [scientific evidence.]" "Wow, I feel amazingly calm!" "Oh crap, that means I'm dying!" "No, I'm not because of [factual evidence.]" "Hey, I feel incredibly calm right now!" "Oh crap, that means I'm dying!" Rinse and repeat.
How do I separate the serene feeling of "I don't feel physically tense and everything in my life is going well; I'm happy" from "I'm dying and my body is releasing whatever chemicals made me feel incredibly relaxed the last time I was dying!"
I can't afford therapy ATM, and this also isn't anything that messes up my daily life; it doesn't happen frequently and I'm the type of person that just ignores any freaking-out tendencies until I'm alone.
I normally deal with panic attacks by explaining to myself exactly what's happening ("Something triggered your fight-or-flight response, which is why your heart is racing and blahblahblah"), and ("If you were dying, blahblahblah would be happening,") and then choosing to ignore the sensations. Kills the attacks instantly.
But I don't want to ignore the calmness I feel, because I've been battling anxiety a long time (not as a result of the NDE) and I'm thrilled the medication is working. I feel that fighting feelings of peacefulness is like taking a step backward, but when I didn't ignore the sense of tranquility, my reaction was basically, "I'm not dying because of [scientific evidence.]" "Wow, I feel amazingly calm!" "Oh crap, that means I'm dying!" "No, I'm not because of [factual evidence.]" "Hey, I feel incredibly calm right now!" "Oh crap, that means I'm dying!" Rinse and repeat.
How do I separate the serene feeling of "I don't feel physically tense and everything in my life is going well; I'm happy" from "I'm dying and my body is releasing whatever chemicals made me feel incredibly relaxed the last time I was dying!"
I can't afford therapy ATM, and this also isn't anything that messes up my daily life; it doesn't happen frequently and I'm the type of person that just ignores any freaking-out tendencies until I'm alone.
Best answer: I get panic attacks, I take wellbutrin and cymbalta. When a panic attack hits, I react in the same way you do: I tell myself its an irrational response. And yeah, I can definitely overthink it, so then I get busy doing something, anything. If I'm in bed, I pick up a book and force myself to read at least two pages, and memorize them if I can with a little 'test' at the end. If it's during the daytime, I pick an activity - vacuuming, dishes - anything repetitive and calming but busy - and do that for a while. And if those don't work, then a good strenuous walk will completely cure it within a few minutes.
It helps.
posted by disclaimer at 7:48 PM on May 17, 2010
It helps.
posted by disclaimer at 7:48 PM on May 17, 2010
I can't afford therapy ATM
Whatever psychopharmacological treatment you're getting needs to be supplemented with 'talk-therapy' to help you learn tools for managing this kind of anxiety loop - based on your description of the effects this medication is having on you, you can't afford to not have therapy at the moment.
Look for a sliding scale clinic that will be within your budget.
posted by jardinier at 7:57 PM on May 17, 2010
Whatever psychopharmacological treatment you're getting needs to be supplemented with 'talk-therapy' to help you learn tools for managing this kind of anxiety loop - based on your description of the effects this medication is having on you, you can't afford to not have therapy at the moment.
Look for a sliding scale clinic that will be within your budget.
posted by jardinier at 7:57 PM on May 17, 2010
Best answer: Have you always had panic attacks? I had my one and only panic attack when I began taking Wellbutrin. I got off it immediately and no more panic attacks. You may want to review the frequency of your attacks with your doc.
posted by mokeydraws at 9:22 PM on May 17, 2010
posted by mokeydraws at 9:22 PM on May 17, 2010
Best answer: This is interesting, I have the same problem when I am very calm. Oddly, a piece of crystallized ginger or hard candy helps. Don't know why, but it works for me.
posted by fifilaru at 9:34 PM on May 17, 2010
posted by fifilaru at 9:34 PM on May 17, 2010
I also sometimes get anxiety attacks where my thoughts go in a mad looping tilt-a-whirl. What I do is carry around something to be a distraction: this game, or a deck of cards, or a pack of gum - something new and fun to focus on. It's essentially the same principle disclaimer described.
When therapy does become financially feasible it'll be worth making an appointment. In the meantime, you can keep a journal of when these attacks occur, what you eat, how much sleep and exercise you're getting, overall mood, etc. It's amazing what a month or two of observation can reveal.
Congratulations on finding medications that work for you!
posted by VelveteenBabbitt at 10:43 PM on May 17, 2010
When therapy does become financially feasible it'll be worth making an appointment. In the meantime, you can keep a journal of when these attacks occur, what you eat, how much sleep and exercise you're getting, overall mood, etc. It's amazing what a month or two of observation can reveal.
Congratulations on finding medications that work for you!
posted by VelveteenBabbitt at 10:43 PM on May 17, 2010
Nthing the above of talking to your doctor, perhaps trying therapy, and being aware that Wellbutrin can cause anxiety.
Okay, what about hypnosis? I've never tried it but I hear good things. If the above don't work maybe hypnosis could help your brain not to automatically associate feeling calm --> therefore I must be dying!
Frankly, I suspect the Wellbutrin but IANAD. Since you seem to be an intellectual type you might enjoy's William James theory about emotions being caused by physical sensations. I would tell the story but this Wikipedia link does it better (scroll down to the bear section):
http://en.wikipedia.org/wiki/William_James
Best of luck!
posted by ticketmaster10 at 10:54 PM on May 17, 2010
Okay, what about hypnosis? I've never tried it but I hear good things. If the above don't work maybe hypnosis could help your brain not to automatically associate feeling calm --> therefore I must be dying!
Frankly, I suspect the Wellbutrin but IANAD. Since you seem to be an intellectual type you might enjoy's William James theory about emotions being caused by physical sensations. I would tell the story but this Wikipedia link does it better (scroll down to the bear section):
http://en.wikipedia.org/wiki/William_James
Best of luck!
posted by ticketmaster10 at 10:54 PM on May 17, 2010
"I'm dying and my body is releasing whatever chemicals made me feel incredibly relaxed the last time I was dying!"
"No, wait! Actually this is amazing. These chemicals I've been eating seem to work a lot like the ones I made for myself during the NDE. And hey, I didn't die that time, even though the circumstances were much more extreme than they are now, and I won't die this time, and wow, I really like what these chemicals do. This feels good. It's so cool that this experience is also available without risking, you know, death! I wonder what music sounds like with a head full of this stuff?"
posted by flabdablet at 11:44 PM on May 17, 2010
"No, wait! Actually this is amazing. These chemicals I've been eating seem to work a lot like the ones I made for myself during the NDE. And hey, I didn't die that time, even though the circumstances were much more extreme than they are now, and I won't die this time, and wow, I really like what these chemicals do. This feels good. It's so cool that this experience is also available without risking, you know, death! I wonder what music sounds like with a head full of this stuff?"
posted by flabdablet at 11:44 PM on May 17, 2010
Best answer: Panic attacks are nearly always accompanied by hyper-ventilation (your stress level is so high you forget to breathe). Covering your nose and mouth with a fresh folded towel and breathing repeatedly into it slowly and somewhat deeply will alleviate the symptoms. Looks less silly than breathing into a bag which is what the paramedics will have you do if they come.
posted by Muirwylde at 2:33 AM on May 18, 2010
posted by Muirwylde at 2:33 AM on May 18, 2010
Hyperventilation is not forgetting to breathe - actually the opposite; you forget how to breathe, and end up breathing far too much far too quickly, getting rid of carbon dioxide faster than is good for you. The paper bag or towel rebreathing techniques slow down the rate of CO2 loss and get you back in balance again.
posted by flabdablet at 2:43 AM on May 18, 2010
posted by flabdablet at 2:43 AM on May 18, 2010
And of course it goes without saying that marijuana can cause paranoia, anxiety and panic attacks and especially if combined with medications mentioned (Zoloft and Welbutrin-Klonopin). In fact if you have a family history of mental illness, marijuana may be triggering psychotic or near psychotic episodes. Discontinue use of marijuana in that case and your symptoms should alleviate. Not everyone is OK smoking marijuana. Don't believe all the propaganda. People with a propensity toward psychosis may find the tendency exacerbated by marijuana use. Very scary but entirely avoidable.
posted by Muirwylde at 2:44 AM on May 18, 2010
posted by Muirwylde at 2:44 AM on May 18, 2010
Best answer: I've posted before about panic attacks. Panic attacks are physiological and psychological events. Treat the physiology with cold water on the face and Xanax if your doc recommends it. You may need prescriptions assessed, maybe changed. The affirmations you are already using help as well, and meditation and exercise as a regular thing, not during an attack should also help. Good luck.
posted by theora55 at 7:21 AM on May 18, 2010
posted by theora55 at 7:21 AM on May 18, 2010
Response by poster: I had no idea it may've been caused by the Wellbutrin! I've gotten some great advice, so I marked the ones that worked for me personally. I figured out that I only panic when I'm in a resting state, since that includes slow/relaxed breathing I'm not used to, and I fear it's the type of breathing indicating someone days/weeks before death. "Oh no, what if there were lasting effects from the accident that're slowly killing me or what if the combo of wellbutrin/zoloft is slowly killing me..." etc.
I did go to the ER during my first PA so I know all that's irrational.
I've tried almost (don't smoke haha) every suggestion and I'm hoping with consistent application I'll be able to remind myself of that more rapidly in the future.
posted by Autumn at 9:31 AM on May 19, 2010
I did go to the ER during my first PA so I know all that's irrational.
I've tried almost (don't smoke haha) every suggestion and I'm hoping with consistent application I'll be able to remind myself of that more rapidly in the future.
posted by Autumn at 9:31 AM on May 19, 2010
Best answer: If slow/relaxed breathing is an indication of being days/weeks before death, then I have been days/weeks before death on a regular basis for the last 48 years.
Try a little logic practice. The flip side of "If A, then B" is not "If B, then A"; it's "If not B, then not A".
In this particular case: even if you have experience to support the proposition that "if dying, then breathing is slow and relaxed", that experience does not support the proposition that "if breathing slow and relaxed, then dying"; the correct flip side is "if not breathing slow and relaxed, then not dying" which has nothing at all to say about the case when you are breathing slow and relaxed. Which is, incidentally, an excellent thing for anybody with anxiety issues to be practicing deliberately on a regular basis - it's a healthy and helpful breath meditation.
posted by flabdablet at 9:06 PM on May 19, 2010
Try a little logic practice. The flip side of "If A, then B" is not "If B, then A"; it's "If not B, then not A".
In this particular case: even if you have experience to support the proposition that "if dying, then breathing is slow and relaxed", that experience does not support the proposition that "if breathing slow and relaxed, then dying"; the correct flip side is "if not breathing slow and relaxed, then not dying" which has nothing at all to say about the case when you are breathing slow and relaxed. Which is, incidentally, an excellent thing for anybody with anxiety issues to be practicing deliberately on a regular basis - it's a healthy and helpful breath meditation.
posted by flabdablet at 9:06 PM on May 19, 2010
Response by poster: flabdablet, you are my hero! That's exactly the kind of logic that makes my brain actually listen to me.
posted by Autumn at 11:59 PM on May 21, 2010
posted by Autumn at 11:59 PM on May 21, 2010
One nice breath meditation I use fairly often is counting your heartbeats as you breathe in and out. If you lie flat on your back and relax, then open your lips just a tiny little bit as if you were sipping through a straw and start sucking in just a tiny trickle of air, you should fairly quickly become aware of two things: (1) your heart is beating and (2) you're not breathing in quite enough air. Deal with (1) by counting the beats, and (2) by opening up the back of your nose just a fraction so you get a little bit more coming in; you can shut your mouth at that point if you like.
The aim of the game is to count as many heartbeats as possible before your lungs are as full as you can possibly get them, and then count as many heartbeats as possible as you slowly let them empty.
posted by flabdablet at 7:51 AM on May 24, 2010
The aim of the game is to count as many heartbeats as possible before your lungs are as full as you can possibly get them, and then count as many heartbeats as possible as you slowly let them empty.
posted by flabdablet at 7:51 AM on May 24, 2010
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posted by amanda at 7:22 PM on May 17, 2010