Anxiety resources?
October 12, 2015 11:07 AM   Subscribe

My niece has anxiety - panic attacks, etc. I feel like I am not up-to-date on anxiety/panic attacks or how to deal with them - can you recommend any resources that I can read or look into?

She has been in therapy before, and isn't currently due to her choice, but we're open to her going back. (And so is she, but I hesitate to start something right before she sees the psychiatrist.)

She has an appointment with a psychiatrist (I think she also has ADD, as it runs in the family, and I want someone qualified to manage her medications), but not until mid-November.

She has difficulty discussing her panic attacks or anxiety with us, says she disassociates, has full blown panic attacks, gets really anxious about certain things (currently mostly schoolwork and discussing of such, but we've tried to keep things pretty calm around the house).

She was on a medicine for her panic attacks, but it knocked her out, and since she is currently having them at school, she has stopped taking it - it was only taken when she was actually having one. She has recently been prescribed lexapro (daily) by her previous GP, in the hopes that will help with them while still allowing her to function and attend school/do schoolwork.

I realize that anxiety and panic attacks don't present the same for everyone - I have had a panic attack in the past, but do not have them frequently. I am just hoping to get some tools and knowledge in order to deal with this and better understand it before the doctor appointment in November.
posted by needlegrrl to Health & Fitness (12 answers total) 7 users marked this as a favorite
The Anxiety and Phobia Workbook has lots of information and practical exercises on dealing with panic attacks. Behavioral techniques may be helpful, as adjusting to Lexapro can take a few weeks.
posted by papalotl at 11:22 AM on October 12, 2015

I just read about this new app that can help some people communicate with those around them during a panic attack.
posted by The Underpants Monster at 11:26 AM on October 12, 2015 [1 favorite]

I had panic attacks in my late teens and one thing that I think would have been helpful (if it had existed at the time) is therapy via Skype rather than in person. For me, sitting in the therapist's office talking was almost unbearable. It's good to get exposure to get comfortable with something, but if your niece is really struggling, that might be a helpful place to start (if she feels comfortable at the therapist's office, obviously disregard). I took medicine but didn't find it that helpful. Exercise, though (especially cycling) was really helpful.
posted by three_red_balloons at 11:39 AM on October 12, 2015

If you don't have a therapist in mind, the psychiatrist should be able to recommend one who would suit your niece's particular needs.
posted by griphus at 11:41 AM on October 12, 2015 [1 favorite]

Echoing griphus, you could always contact the psychiatrist for a therapist recommendation. They often have working relationships with specific therapists and keep each other updated. I would think it would only be helpful for your niece and the psychiatrist to have a month plus head start with the therapy side.
posted by cecic at 11:50 AM on October 12, 2015

I have frequent panic attacks like what you're describing.

One thing that helps me is people leaving me alone. The best thing is when whoever is around just says, "It looks like you're panicking, so I'm going to go away, I hope you feel better." Because I look terrified, people sometimes try to hang around and comfort me, but this is rarely effective, and the resulting social awkwardness often makes me feel worse.

Exercise is also helpful, especially stretching my upper body. When I feel really bad, it's the last thing I want to do, but if I can force myself, it's extremely helpful.

Taking care of others is also really good, because it makes me stop thinking about my own fears. It really helps me when, say, my wife needs me to do some chore, or my dog needs a walk. At first it feels burdensome, but if I can start, the panic attack often subsides.

Anything involving seeking comfort or soothing does not work for me. It seems to reinforce my sense of helplessness. One exception is seclusion from people's voices, which are a sort of trigger for me.

posted by andrewpcone at 11:55 AM on October 12, 2015 [1 favorite]

Mindfulness techniques can help for some people. I have mentioned this before, but my GP recommended the book/CD Real Happiness by Sharon Salzberg for my anxiety attacks and I found it very helpful. Also, it can be helpful to just do something distracting to "short-circuit" your anxious thoughts--a small chore or task around the house, for instance, or taking a walk around the block, watching a brief video, or making a cup of tea. Speaking of tea, she can try avoiding caffeine as I've found it to make my anxiety worse.

Building from andrewpcone's comment above about needing to be left alone, I think it's also helpful to figure out what you personally need from others during an anxiety attack and get good at communicating that. My experience is that it's down to personality whether someone wants to be left alone, physically comforted, verbally comforted, given advice, distracted, to hear similar experiences from friends and loved ones, and/or to hear a joke or something else that lightens their mood. It's been helpful for me to get used to saying "right now I don't think advice would help, but do you think you could give me a hug?" and similar.
posted by capricorn at 12:27 PM on October 12, 2015

I'm a therapist. I often recommend the aforementioned Anxiety and Phobia Workbook -- it's a great resource for both information and activities/treatments.

I'm obviously biased, but I would also strongly encourage you to start seeking out a therapist now rather than waiting. There's no real reason to wait until she sees a psychiatrist, and it will likely take some time to find a therapist who's taking new clients, who has availability at a time that works, etc. Working on anxiety (and dissociating and ADHD, if appropriate) with both medications (psychiatrist) and behavioral techniques (therapist) is generally recommended as the best course of action.
posted by jaguar at 1:08 PM on October 12, 2015

There is a newly proposed spectrum disorder centering around anxiety/panic that I think is worth looking into:
A high rate of association between panic disorder and four domains of physical illness has been documented by researchers. Their new study could alter how physicians and psychiatrists view the boundaries within and between psychiatric and medical disorders.

"Patients who appear to have certain somatic disorders -- illnesses for which there is no detectable medical cause and which physicians may consider to be imagined by the patient -- may instead have a genetic propensity to develop a series of real, related illnesses," says Dr. Coplan, an expert in neuropsychopharmacology.

The researchers found a high correlation between panic disorder, bipolar disorder, and physical illness, with significantly higher prevalence of certain physical illnesses among patients with panic disorder when compared to the general population.

"Panic disorder itself may be a predictor for a number of physical conditions previously considered unrelated to mental conditions, and for which there may be no or few biological markers," explains Dr. Coplan.

In the study, published in the Journal of Neuropsychiatry and Clinical Neurosciences, the researchers proposed the existence of a spectrum syndrome comprising a core anxiety disorder and four related domains, for which they have coined the term ALPIM:

A = Anxiety disorder (mostly panic disorder);

L = Ligamentous laxity (joint hypermobility syndrome, scoliosis, double-jointedness, mitral valve prolapse, easy bruising);

P = Pain (fibromyalgia, migraine and chronic daily headache, irritable bowel syndrome, prostatitis/cystitis);

I = Immune disorders (hypothyroidism, asthma, nasal allergies, chronic fatigue syndrome); and

M = Mood disorders (major depression, Bipolar II and Bipolar III disorder, tachyphylaxis. Two thirds of patients in the study with mood disorder had diagnosable bipolar disorder and most of those patients had lost response to antidepressants).

For example, joint laxity was observed in 59.3% of patients in the study compared with a prevalence of approximately 10% to 15% in the general population; fibromyalgia was observed in 80.3% of the subjects compared with approximately 2.1% to 5.7% in the general population; and allergic rhinitis was observed in 71.1% of subjects, whereas its prevalence is approximately 20% in the general population. ...
As far as I have been able to find out, no definitive therapeutic approach has been established, but I think aerobic exercise will turn out to have significant benefits.
posted by jamjam at 1:36 PM on October 12, 2015 [6 favorites]

This book helped my niece a lot a couple of years ago. I think she was 9 or 10 then.
posted by CrazyLemonade at 2:05 PM on October 12, 2015

histamine intolerance is worth investigating. That and celiac. Tackling these 2 issues made a world of difference for a family member.
posted by egk at 2:24 PM on October 12, 2015

A lot of anxiety stems from worrying about the future. This both bad and good, because you can imagine what will go good and you can imagine what will go bad.

When I was a kid (aka teenager or young adult), I read a lot of books. In between time, I had chores. So, I was always active, whether through my own endeavors or my parents. Further in between that, I played with toys, and to top it off, we watched TV. On Saturday mornings, and then again Saturday evening and yet again, Sunday evening.

I never remember any anxiety over school work. But I do remember anxiety at school, over some boys, who used to torment me. Just picking fun, but it was enough for me to leave school and trot down to my dad's office, which was just below the school, to complain over my ill treatment. Having grown up with brothers, I was primed to complain over boys being wicked.

So if she is an introvert type, maybe it's not the school work but the school environment you should be exploring, before she sees the doctor. I had a similar experience with my daughter, in 5th grade, would you believe it, boys being bullies. I had to go to the school principal, because lo and behold, the teacher had them write things on the blackboard like Bart in the Simpson, but them calling my daughter a little bitch or worse, he was like "oh, that's nothing," in Fifth grade.

So I posit to you that she may be experiencing something else other than school work, but some sort of social problem, because I gather you are intelligent, therefore, your niece is very intelligent, but may not want to talk about what is really going on there. Bullying or shaming, etc. Because being stupid never stopped anyone, but being bullied has stopped a lot of people. I would adjure you to not medicate her for something that is going on at her school that is causing her anxiety, but to first address the environment she is in, and see if looking at that helps her, before you treat her as a mentally ill person. Sometimes, our bodies tell us things, and sometimes, adults may not see what is truly going on, unless we look at the situation and question why is this happening to my child?

Just my 2 cents. I understand anxiety and I understand kids, and it feels like she may be a great little person except for her environment and she may be reluctant to talk about it because of something going on at the school.
posted by Marie Mon Dieu at 4:13 PM on October 12, 2015 [1 favorite]

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