Stress Can Impair Memory

Ever blank out on an easy exam question? Blame it on stress. According to results of a study, stress can make it harder to remember facts and details stored in your brain. The finding suggests that memory might be impaired in a number of stressful situations besides exams, such as during job interviews and testimony on the witness stand, the study's authors explain. Dr. Dominique de Quervain, of the University of Zurich, Switzerland, and colleagues based the results on memory tests performed on 36 healthy adults. Participants were asked to memorize 60 German nouns that were displayed on a computer screen for 4 seconds each. Later they had to write down as many of the words as they could remember. In another test, the participants had to pick out the original words from a larger list of words. To test the effect of stress on memory, cortisone tablets or placebo ("dummy") pills were given at various times during the tests. Cortisone raises blood levels of cortisol, a hormone produced during stressful situations. One hour after treatment with cortisone, cortisol levels in saliva were comparable to levels caused by major physical or psychological stress, the authors report. After taking a cortisone tablet an hour in advance, participants were not able to remember as many words as they could after they took a placebo pill, according to the report in the April issue of the journal Nature Neuroscience. Despite its effect on memory, however, cortisone did not appear to impair any other mental abilities. The researchers conclude that stress may have a detrimental effect in stressful situations in which memory is important, such as exams, job interviews, combat and courtrooms. SOURCE: Nature Neuroscience

Panic Attack Help: Eliminating Panic Attacks

We know what anxiety and panic are, we know what the sources of anxiety can be, and we know how to cope with Panic Attacks when they strike, but now we need to know how to eliminate them altogether. This chapter discusses my ideas on how to "squash the mosquito" and eliminate panic attacks.

To eliminate our panic attacks we had to find out what was causing them. Basically, the build up of adrenaline in our body that was not used to fight or flee a given situation or circumstance that was found to be the primary culprit. It is these fearful, worrisome, or stressful situations and circumstances (lifestyle) that we have to eliminate, take control of, or change to stop the adrenaline flow and thus stop our panic attacks. Sometimes though, it really is not the situation or circumstance that is causing the adrenaline flow but rather it is the way we think about or deal with (psychological) a situation or circumstance that is causing the adrenaline to flow and that is what must be changed or controlled in order to stop our panic attacks.

To help illustrate, think about the Chinese Finger Trap game. It is not really a "trap" until you get caught in it. If we decide to put our fingers in the trap and cannot get them out, then the trap becomes a trap. How could we stop the trap from becoming a trap? We could eliminate the trap altogether by not purchasing it or by getting rid of the trap. We could choose not to play the game. We could learn how to beat the trap so that we did not get caught in it. We could change our thinking about the trap and realize that it is just a game and react to it as such. Or, we could seek out the advice of someone who is an expert at beating the trap or who has beaten the trap themselves and ask for their expertise. All of these things could stop the trap from being a trap. Since Panic Attacks are themselves like a trap we can use similar Strategies to eliminate Panic Attacks from our lives. We can use one of the following Strategies:

PANIC ATTACK ELIMINATION STRATEGIES

STRATEGY 1) AVOID OR ELIMINATE THE SOURCE
*Get rid of trap sources
*Avoid known trap sources
*Take away the fuel and the fire cannot burn

STRATEGY 2) CONFRONT OR TACKLE THE SOURCE
*Learn how to beat the trap
*Only thing to fear is fear itself

STRATEGY 3) TRANSFORM OR CONTROL THE SOURCE
*Change the way we think about trap sources
*You cannot control a TV show so change the channel

STRATEGY 4) SEE A PROFESSIONAL
*Ask an expert on the trap for help and advice
(SEEK OUT PSYCHIATRIC HELP, MEDICAL HELP, OR COUNSELING etc...)

What we will do next is take our Anxiety Attack Sources Chart (5) and go through some examples from each source category and show you how to eliminate your panic sources by one of the 4 Strategies mentioned in this chapter. After a few examples you should see a pattern develop as to how to deal with your sources of panic, whether they are on the chart or not. You will have to ask of each source, is this something that I have to avoid or eliminate from my life? Is this something that I have to confront or deal with differently? Is this something that I have to change or take control of in my life? or is this something that is beyond my own capability that I need to seek professional help for? Once you have determined what your source(s) are and what course of action needs to be taken, then all you have to do is figure out the best way to carry out that action. Hopefully, by following the examples listed you will have a good idea as to
what to do in any situation that you may face.


I. DIET:

The first category on the Anxiety Sources Chart is Diet. The old saying "you are what you eat" certainly is true. What you eat can have a great effect on your body and mind. Certainly you would want to do whatever it takes to make sure you are eating a balanced diet. By eating right your brain will be able to function better and this will help you to handle life better. You will be able to handle stress better as well, and thus deal more effectively with potential Anxiety sources.


EXAMPLE A)

From your Anxiety Sources Worksheet and Chart 5 you have determined that a source of your panic attacks is from drinking to much caffeine. You believe that caffeine is causing your heart rate to increase. What should you do? The answer to this is simple, you would have to use Strategy 1 and eliminate the source. You could try drinking caffeine free soda or decaffeinated coffee. You could also read the labels on all of your food to make sure you are not consuming caffeine in your food. You will have a headache from the withdraw effects when you first stop drinking caffeine, but they will go away after awhile and so to will your panic attacks. Make sure that any medicine you take to alleviate your headaches does not have any caffeine in it. When I found that caffeine was a contributing factor to my panic attacks, I reduced the amount of caffeine in my diet and this greatly reduced the number and severity of my panic attacks. You can see how easy this Strategy was, so let us go on to another example.

EXAMPLE B)

Perhaps you have determined that you have an alcohol problem and that maybe this plays a major role in your panic attacks. Strategy 4 would definitely be recommended in this case. Alcohol is a very addictive drug that requires professional help to try and overcome if there is a serious problem. If you even suspect that you have a problem you should seek out help at once. Panic attacks are probably the least of your worries if alcohol is what you think is driving your attacks. So please use Strategy 4 and seek out professional help. This step may not be so easy, so you might want to have some friends and family help you with this difficult battle. Let us now continue to the next source category the JOB.


II. JOB:

The second category of sources listed on the Anxiety Sources Chart come from the job. One thing to remember about your job and life in general is that "success is a journey not a destination." So many people have anxieties over whether or not they are successful. Strategy 3 is in order here because the source of our anxiety is our own way of thinking, we need to transform our thinking to that of as long we do our best and never give up we are always successful. This is discussed in a little more detail in the PSYCHOLOGICAL section of this chapter.

EXAMPLE A)

What if you have determined from your Panic Sources Chart that you are overloaded with projects to do at work and you do not ever have enough time to complete these projects. This is causing you to be stressed and is contributing to your panic attacks. Well you could use a combination of Strategies to deal with this source of anxiety. If you are in a position to do so you might want to try Strategy 1 and delegate some of your projects to coworkers or you could have your boss help you out. By doing so you would eliminate some of your panic sources.

You could also use Strategy 2 and prioritize you projects. Daily prioritization of your projects is essential in tackling them in an organized and efficient way. Writing down in order of importance your projects allows you to see them and realize that they are not an insurmountable task. As you complete one project you cross it off the list and continue on to the next project. Before you know it the list will be complete. Sometimes it is a good idea to do an easy project first to get one out of the way quickly. When you see an early success, tackling the rest of your projects will seem much easier and more possible. Sometimes you cannot just eliminate a source of anxiety altogether, like school or your job so you have to use Strategy 2 and tackle or confront these sources head on one at a time. When you get control on these seemingly overwhelming projects you then change them from a source of anxiety into a source of self esteem and pride.

Sometimes though, prioritization is not enough. For example, where I worked the projects kept coming and the hours I spent trying to accomplish them got longer and longer. My boss did not seem to appreciate the work I was doing. My wife and child never saw me, so I worried about them. I couldn't pursue personal interests outside of work since all of my time and energy was spent at work. I did not eat right. Things just snowballed and were not getting any better. My panic attacks became more frequent as tension at my job and in my life grew. Fortunately, my company is a large one and this enabled me to make a drastic move in order to deal with my sources of anxiety. I used Strategy 1 to the extreme. After some serious consideration, by using Strategy 1 I single-handedly wiped out multiple sources of anxiety in my life. I did this by transferring to another job within the company. This job was less stressful, had straight hours, and was one that I knew I could be successful at. I took a small pay cut as well, but my health and family were worth the move. The end result was nothing less than spectacular. Since eliminating multiple sources of anxiety, I have not had a single panic attack. Strategy 1 truly worked for me. You may find that you have multiple sources of anxiety emanating from one place, such as your job. You may want to consider whether or not to make such a drastic change in your life in order to improve your health and life. The choice is yours but for me life without panic attacks has been like being set free from a trap. I now have a boss that appreciates the work I do, I have straight hours, I see a lot more of my family, I get to pursue personal interests outside of work, and I feel successful at work. The pay cut has not really had a great impact in my life since I have been prioritizing my expenses and sticking to a budget. All in all, my life is much happier because I made this move to eliminate multiple sources of anxiety in my life. I hope this can work this well for you too. Let us look at another example of Anxiety Sources from the job category.


EXAMPLE B)

What if you have determined that the source of your anxiety is coming from poor relationships with your coworkers. Perhaps someone you work with is very difficult to get along with and nothing that you do seems to help the matter. This is worrying you and is causing you undo stress. The coworker does a good job, but your personalities just clash. In this case you could try Strategy 1 (if it were bad enough) and transfer to another department. If this is not possible Strategy 2 might be viable. You could try and confront your coworker and talk about the specific problem you are having. Focus on the problem and on finding a positive resolution. The key is to confront the problem and not to attack the person. By focusing on the problem in a positive light you don't make the situation worse by insulting or offending the person. Still yet, another Strategy you may want to try is starting a daily exercise routine. This could help you to burn some the extra tension you have away and help you to cope with the situation better. When a source of panic cannot be eliminated the best way to burn of the excess adrenaline is to exercise. Hopefully you can burn enough of the adrenaline away in your exercise, that your panic attacks would stop.


III. SCHOOL:

EXAMPLE A)

Today more and more emphasis and pressure is placed on getting high grades in school and on going to college. There is a lot of competition on standardized tests and for scholarship dollars. You may have found that some of your stress and worry are coming from this area of your life. Maybe poor grades of you or your child have you worrying excessively or maybe you are worried about upcoming tests. In this case you would want to try Strategy 2. The reason most people do poorly in school is due to lack of preparation or study. So you would have to attack this problem up front. This requires some work. In order for you to gain control over your grades you will need to take time and study. To do this you will need to learn how to prioritize your time to allow for study. You can use my Daily Prioritization Chart Workbook included with this manual to help you. On the chart you would want to make study a high priority and things like social events and television a low priority. If you continue to have trouble studying and with your grades after trying this, you may have to use Strategy 4. This means you should see a professional counselor or tutor. Whatever the case you will have to get organized and have a plan of action so that you can get prepared enough to do your best in school. Then and only then will your anxieties be reduced about school. When you are prepared for school you know you are in control and that you can do well. You may not be a straight A student but doing your best is what counts. When you do your best all of your energies are expended on the task and the likelihood of a panic attack happening is reduced. Let us now go to the next anxiety source category-The Family.

IV. FAMILY:

EXAMPLE A)

There are a lot of problems in families these days and the divorce rate is higher than ever. Single parent families are almost the norm in today's society. Many have multiple family problems that create anxiety about the future that drives panic attacks. From your Anxiety Source Worksheet and Chart you have found that your child's rebellious attitude is a source of your anxiety. Many parents today are to busy and to ill-equipped to deal with problems of this type effectively. To challenge a rebellious child head-on is a delicate matter to say the least. My suggestion is for each parent to deduce what the best course of action is in their individual case. A little love does go a long way and that may be all that is needed, but Strategy 4 is probably the best solution. A family Counselor has seen this problem before and is an expert in dealing with this in the most successful way. By confronting the problem through a professional you may gain some control of the situation and thus reduce your anxieties about your child. This in turn should help you to eliminate you Panic Attacks.

EXAMPLE B)

From your Anxiety Source Worksheet and Chart you have ascertained that a major source of anxiety in your life came from worrying about money problems in the household. You find that you are living paycheck to paycheck and that you do not know how you are going to pay all of your bills. To try and eliminate this source of anxiety you can try several elimination Strategies. Using Strategy 1 you can try and design a budget that will prevent you from getting into a situation where money is an overwhelming concern. This however, may require Strategy 4, the help of a professional accountant or credit counseling agency. If you are already in a tight situation you can use these same Strategies to get you out of it. Using Strategy 2 you could attack the problem and set some financial goals. You would want to make your goals attainable and write them down. For instance, maybe you would want to make a goal of paying off your credit card in six months. To do this you could make a budget with goals attached to it. You would follow this budget until your card is paid off. Again if you are not certain about how to make a budget you could seek the advice of a professional credit counselor. Making a budget and setting goals should help you gain control of the problem and reduce your anxiety. I This can be compared to driving your car. When you are out for a pleasant drive you roll down your window and feel great because you are in control and are free. However, when you are driving and you are late for work and you are caught in construction, you lose control and get stressed out. You are no longer free and are at the mercy of other traffic. Then driving becomes a source of stress and anxiety. When we lose control of our money we get the same way. This then is a source of anxiety and can drive our panic attacks. By using Strategy 2 and making a budget and setting goals we get control back and money no longer is a source of anxiety. Sometimes though a budget is not enough. We may need extra income to make ends meet. Then maybe you need to look at getting another job or look at securing overtime to help get a control over your bills. You still need to use Strategy 2 and deduce what the best course of action is to attack the problem. You need to organize, prioritize, and set goals. Another good thing to do is use Strategy 3 in this situation. You have to remember that money does not solve problems. If you were to suddenly come into some money your money problems might be solved but your focus would shift to other problems in your life such as health and family. Sometimes you have to transform your way of thinking and have the ability to see things in a broader perspective in order to eliminate your anxieties. This is easier said than done though and brings us to the final Anxiety Source category- The Psychological category.


V. PSYCHOLOGICAL

From the Anxiety Sources Chart you have seen some similarities in the way you think to those that are mentioned on the chart. If you tend to think the same way of those areas mentioned on the chart you may be your own source of anxiety. All of these ways of thinking: All or nothing, negative, paranoid, exaggerating, and obsessive/compulsive make everyday normal events seem to you worse than they are and thus can make you more stressed, worried, and fearful than you should be about life. This in turn makes your body react more often in the form of panic and thus you may have more panic attacks. To overcome this is difficult because it is in fact who you are and how you have been brought up. The best thing you can do is try Strategy 3 and control your thinking by stepping outside of yourself and recognizing when you are potentially thinking in an extreme way and by curtailing it at that point. Again, this is easier said than done so you may decide that you need help and that you need to see a professional using Strategy 4. A professional Psychiatrist can help you to change your way of thinking and deal with life better. If you are experiencing any of these extreme ways of thinking a visit to the psychiatrist may be the best thing you can do. Panic attacks may be the least of your problems if there is an underlying mental problem that needs to be addressed.



ANXIETY/PANIC SOURCES WORKSHEET EXAMPLE ANXIETY WORKBOOK PROCESS

* NOTE THIS WAS IN THE ORIGINAL MANUAL. YOU CAN USE A DAILY LOG AND FIND YOUR PANIC TRIGGERS. THEN DETERMINE WHAT METHODS TO USE TO DEAL WITH THOSE TRIGGERS.


STEP 1) USE ANXIETY SOURCES WORKSHEETS (OR KEEP A DAILY LOG OF YOUR OWN AND DETERMINE YOUR SOURCES) UNTIL A PATTERN DEVELOPS


STEP 2) COMPARE PATTERNS TO ANXIETY SOURCES CHART AND SEE WHAT CATEGORY YOUR SOURCES FALL UNDER


STEP 3) REFER TO PANIC ATTACK COPING AND ELIMINATION GRID FOR SUGGESTED ACTION ( OR USE YOUR OWN COMMON SENSE TO DECIDE WHAT IS BEST FOR YOU)


STEP 4) LOG SUCCESSFUL Strategies ON YOUR PERSONAL PANIC ATTACK TRIED Strategies GRID (REMEMBER WHAT HAS WORKED IN THE PAST)


STEP5) USE SUCCESSFUL PANIC ATTACK COPING AND ELIMINATION Strategies OFF OF PERSONAL GRID (OR ONES THAT YOU HAVE LOGGED PERSONALLY)


MY WORKSHEET/DAILY LOG EXAMPLE:

WHAT DID YOU DRINK TODAY?
1) I HAD 4 COLAS

WHAT DID YOU EAT TODAY?
1) HAD A BANANA
2) HAD A BAG OF PRETZELS
3) PIZZA
4) LEFT OVER SPAGHETTI

WHAT STRESSES AT WORK ARE THERE TODAY?
1) MORE FLIGHTS CANCELED DUE TO WEATHER
2) PAPERWORK BACKED UP
3) WORKED 9 HOURS
4) BOSS MAD BECAUSE HIS COMPUTER IS BROKEN AND BLAMES ME

WHAT STRESSES IN SCHOOL ARE THERE TODAY?
1) NA

WHAT STRESSES ARE THERE IN THE FAMILY TODAY?
1) WIFE MAD AT ME BECAUSE OF WORKING LATE
2) CANNOT VISIT PARENTS THIS WEEKEND

HOW IS YOUR MONEY SITUATION TODAY?
1) ALL BILLS PAID

IS THERE ANYTHING ELSE WORRYING YOU TODAY?
1) DID NOT GET TO SEE FOOTBALL GAME BECAUSE OF WORKING LATE

ARE THERE ANY EXTREME THOUGHTS THAT YOU HAVE HAD TODAY?
NA


CROSS REFERENCE YOUR ANSWERS WITH PANIC ATTACK SOURCES CHART 5

ARE THERE ANY REPEATING STRESSES OR PATTERNS NOTED FROM PAST LISTS?
1) CAFFEINE
2) LONG HOURS AT WORK
3) OPERATIONAL PROBLEMS AT WORK AND BOSS UNHAPPY
4) POOR DIET
5) NOT SEEING FAMILY ENOUGH IS HURTING FAMILY

Panic Attack Help: Coping With Panic Attacks

Knowing what you are dealing with is a key that allows you to attack panic at its source. You don't have to just shoot in the dark at something you don't understand. That is why you can succeed at eliminating your panic attacks. But before you can eliminate your panic attacks you will have to learn how to cope with them. This chapter discusses some ideas I have on coping with panic attacks and describes some coping Strategies that I have tried. Hopefully, they can help you to cope with your panic attacks as well as they have for me.

Knowing that your panic attack is not a heart attack or something that is going to kill you is a comforting thought in itself. In fact it is the first step in coping with panic attacks. To illustrate this point think of your panic attacks as if they were the Chinese Finger Trap. This is a game that you may have played with when you were a kid. With this game you would stick one finger in each end of a paper woven tube. When you would pull your fingers apart the tube would tighten around your fingers and your fingers would be trapped in the tube. The harder you pulled the tighter the grip of the trap became on your fingers. The trick to the game, in order for you to get your fingers out of the trap, was to relax and push your finger(s) inwards, then the weave of the tube trap would relax and loosen. When the weave loosened you could then get your fingers freed from the trap. The key to getting your fingers out was to relax and work with the trap and not against it.

When a panic attack strikes it is much like the Chinese Finger Trap. The more you fight the panic the more it tightens it's grip on you. When you fight the panic you can work yourself up into a frenzy which only worsens the symptoms of the panic attack. When the symptoms intensify you get more worried about the attack. As you get more worried about the attack the symptoms intensify more. As the symptoms intensify more you tend to get more introverted and focus more and more on the attack. This makes the attack seem even worse and it's grip tightens on you. So what is the key? You have to learn to relax and not fight the panic attack. In fact, you must do the opposite and work with the attack just like you would work with the finger trap. You need to relax and ride the attack out like a surfer rides a wave out, using the wave's energy to propel him forward and not resisting it. By relaxing and riding with the attack and using it's energy it can go by much quicker and soon releases it's grip on you just like the finger trap does. All of this sounds good but it is easier said than done. However, it is not impossible to do and this chapter is going to show you how to cope with panic attacks in this manner.

Once a panic attack strikes the Strategy you choose to cope with it is up to you. There are many techniques commonly used to cope with panic attacks but the results are different for each individual that uses them. In other words what may work for me might not work for you. What this chapter will do is list some coping Strategies that have worked for me. Then you should use the most effective coping Strategy for you anytime a panic attack strikes. Some will work better than others depending on the circumstances.

The coping Strategies described next basically try to get you through the attack as quick as possible by relaxing you and/or by helping you to ride the attack out. This is accomplished by diverting your attention away from the attack and yourself. You are not going to be able to stop the attack once it starts because the adrenaline is already running its course. The best thing you can do is ride the attack out by using the Strategies in this chapter. These Strategies follow the same line of reasoning as Lamaze. Basically the idea is that one's mind can only receive one thought or feeling at a time and no more than that, thus if you can divert your mind away from thinking about the attack it can no longer perceive the attack symptoms. It is a lot like your telephone. The telephone can only receive one signal at a time. When someone else tries to call they get a busy signal. The theory is that if your mind is concentrating on one thing hard enough and constant enough, anything else that tries to get through will get a busy signal (unless you have call waiting..ha ha). An example of this would be when you are daydreaming. When you daydream your mind wonders off and is completely emerged in thought and thus tunes out the rest of the world. Many students have been embarrassed when the teacher called on them to answer a question in class and they did not hear the question because they were daydreaming. So keep all of this in mind when you are trying these Strategies out. The idea is to do them completely and to put everything you got into them so that you can nullify the signals your brain is receiving from your panic attack. Someone once said that the middle of the road is the most dangerous place to drive, so don't try these Strategies halfheartedly because if you do the chances are that they will fail. Just as if you were to drive down the middle of the road, you would probably wreck and not reach your destination. Therefore, when you try these Strategies, to succeed, do them wholehearted.


REACT CALMLY
The most important thing you can do on the onset of an attack is realize what it is and that it is not going to kill you. By doing this you can react to it calmly. You know you are all right and that the attack will pass. You want to allow it to pass and you know that you have the Strategies available to you that will allow it to pass in the most direct route possible. The key is that you use a Strategy and that you use it wholehearted. Think and know that you will make it through the attack and then go onto your coping Strategy of choice. A calm reaction allows you to move forward in this process. The following are some Strategies you may want to try in order to help you cope with your panic attacks.



I BREATHING EXERCISE
To do this exercise lie down in bed and close your eyes. Once comfortable, count to 5 while inhaling a deep breath. Then exhale while counting to 6. Concentrate on breathing from your diaphragm. To ensure you are doing this place your right hand on your stomach and your left hand on your chest. When breathing make sure your right hand is moving and that your left hand is as still as possible. Doing this ensures that you are breathing from your diaphragm. Next sit up in your bed and repeat the inhale and exhale while counting. Then try standing up and repeating the exercise. Do this over and over, lying, sitting, standing, and counting. Take deep slow breaths with the count, making sure your right hand is moving. You might try playing soft music in the background to help with the rhythm. This may seem awkward at first but practice of this Strategy can turn it into a habit. I encourage you to practice this Strategy at least 5 minutes a day. When a panic attack strikes you shouldn't feel awkward and you can turn your full attention to your breathing. This should relax you and thus distract you from your attack. If done properly it should also reduce the amount of panic signals reaching your brain. This will allow you to ride out the attack, relax, and thus cope with it better.
Don't under-estimate the power of proper breathing. Breathing from the belly and not the chest allows the air to go deep into your lungs. This allows more oxygen into your system with less effort, thus your heart rate can decrease along with the number of times you have to inhale and exhale. So too your body is not as stressed to get the oxygen it needs. So, deep breathing alone can help eliminate some of the symptoms of a panic attack!

II MEDITATION
I know this sounds awkward at first but for this exercise I don't mean Yoga style meditation. Rather, I am simply suggesting taking an object, concentrating on it, and turning it over in your mind repeatedly. For example, if you have a candle at home, during an attack you could light the candle and concentrate on the image of the flame until it is the only thing that you can see. Hold that image in your mind as long as you can. After some time close your eyes but try to keep the image of the flame in your mind's eye. Hold the image as long as possible and turn it over in your mind. Make the flame your only thought. If you get distracted by outside noise try listening to soft music on some headphones to block out the distractions. If this exercise is done wholehearted, it should distract you from your attack and allow you to cope with it successfully. You should be thinking so hard about the flame that all other signals going to your brain should be blocked out. Still though, depending on your circumstances you may not be able to use this exercise, so you might want to try another Strategy. This exercise can be done with virtually any object. I chose the flame because it is easier for me to retain that particular image in my mind. Some people like to watch birds or clouds in the sky, some like to watch fish in a tank, or others like to watch a fire in a fireplace. The important thing is that you choose to meditate on something that is easy for you, so that this exercise can be successful for you in coping with your panic attacks. This Strategy should also help you to relax during an attack.



III MEDICATION
Not all panic attacks require distractions in order to cope with them. For instance sometimes the symptoms of panic attacks are the result of something you ate. I noticed that sometimes when I ate spaghetti I felt as though I was having a panic attack. This was probably due to some acid reflux in my esophagus. To help cope with this all I did was take some antacid. The antacid eliminated the symptoms almost immediately. If you have determined from you Anxiety Sources Workbook that your attacks come after eating a specific food you may want to try some antacid and see if this will help you to cope with your attacks better.




IV EXERCISE

You might want to try exercising as a coping Strategy during a panic attack. The idea is that if you concentrate hard enough on the exercise you will be distracted from the panic attack. Also, exercise should help burn off the excess adrenaline in your body that is causing the attack. I have used this Strategy more than once and have found it to be successful for me. All I did was go for a brief jog or brisk walk around the block during the onset of an attack. I ended up being so involved in the exercise that my attention was diverted from my attack, and thus I was able to ride the attack out and cope with it successfully. This coping Strategy may work for you as well. You don't have to do any fancy aerobics or have to have a fancy gym set in your house to do this Strategy either. When you feel an attack coming on, just try going for a fifteen minute jog or brisk walk, and by the time you get done your attack should be over.

V PERSONAL Strategies
A personal favorite coping Strategy that I found to be successful when a panic attack struck was taking a hot bath . I found the bath to be very relaxing and that the heat and sound from the water helped distract me from the attack. By being relaxed I was able to ride out my attacks easier. You might want to go back and try personal coping Strategies that you found to have worked in the past but try them a little harder to get better results. Some Strategies I have heard of include getting a massage, doing a hobby, praying, drinking cold water, or even snapping a rubber band on your wrist. I suppose all of these in one way or another could distract you from your attacks and/or help you to cope with them better. Some people take prescribed medication to help them ride their attacks out easier and/or to relax. If this works for you, you should probably continue taking your medicine. I know that the medications I was prescribed did not help me to cope with or ride out my attacks. If you have any coping Strategies you would like to share please feel free to write me at the same address you ordered this booklet from and maybe I can share those Strategies with others in future editions of this book.

VI. Strategies NOT TO TRY
Well, I have talked a lot about coping Strategies you should try to help you with your panic attacks, but before I continue I would like to suggest 3 things you should not do to help cope with your attacks. Due to their addictive nature and potentially harmful side effects, in my opinion the following items should not be used to cope with your panic attacks:
1) Alcohol
2) Cigarettes
3) Illegal Drugs

These things may seem to work for you but other more serious problems may result from taking them. So think twice about trying these out or in continuing to use these if they are a personal Strategy of yours. You now have the answer to the question of how to cope with Panic Attacks. Some coping Strategies are better than others and some work differently for each individual. Some Strategies shouldn't even be tried. But coping with Panic Attacks can be a lot like coping with mosquitoes. Coping Strategies can help us ride our panic attacks out, just as bug spray can help keep mosquitoes away for awhile, but these things don't eliminate the problem. You can use one coping Strategy after another and you can use bug spray again and again, but the problem is still there. Coping with Panic Attacks does help us though, and can make living with them easier; however, eliminating Panic Attacks from your life should be your goal. My next chapter describes Strategies that you can use in order to reach that goal and eliminate Panic Attacks from your life.

Panic Attack Help: Identifying The Sources Of Anxiety And Panic!

There are many sources of anxiety that can fuel our panic attacks. By identifying these sources we can through different techniques cope with and eliminate panic attacks. We will learn more about this in later chapters but for now we must focus on identifying the sources of anxiety in our lives that are triggering our panic attacks. Make no mistake about it, this is no easy task since these sources vary from person to person and from attack to attack. However, it is not entirely impossible to find these sources. They are there and if you dig deep
enough you can find them. The following describes my ideas on what the most common sources are and how to identify them in your life.

Basically, I have found that the primary sources of anxiety which I believe fuel panic attacks can be broken down into 2 areas. These areas are titled Lifestyle and Psychological. Lifestyle, covers the tangible things in our life and the way that we live that can be sources of anxiety. Psychological, covers the aspects of our personality and the way we think about life that can be sources of anxiety. Both areas have multiple source areas that fall under it which can fuel our panic attacks (SEE CHART 5). I truly believe that the circumstances of our life and/or the way we think about and handle our life can trigger our panic attacks. This is what is at the core of The Panic Sources Chart (5). Since the sources of anxiety that drives panic attacks are different for everyone, it would be impossible to capture all of the potential sources of anxiety on any single chart. This chart does not attempt to capture each individual source. Instead, this chart is organized to capture as many sources as possible by categorizing potential source areas not individual sources. This should make identifying the sources of anxiety in your life easier because the search area for your anxiety sources is narrowed down. It is a lot like an Index in a book. By using an index you don't have to read the whole book to find a specific word or subject because the index can tell you what page(s) to go to. This chart will show you what areas to look for the sources of your anxiety in. It is also flexible enough to allow you to personalize it if your sources of anxiety are not in any of the charted areas.

*Note this section does not try to identify sources of panic for PANIC DISORDERS such as AGORAPHOBIA or other PHOBIAS, rather it solely tries to identify the sources of panic that fuel the panic attacks related to those mentioned throughout this booklet that have no connection to PHOBIAS. Those suffering from PANIC DISORDERS such as PHOBIAS should seek the help of professionals. (SEE CHART 6)

I am confident though, that you can go to any of the categories or areas on this chart and find something that you can relate to in your life or way of thinking that may be a source of anxiety. If you are having a little trouble don't give up hope just yet.

This Chapter may take a little work and self-examination on your part to get through, but don't panic. I have tried to make this manual as short and easy to use as possible so that you do not have to worry or get stressed by reading it. Some books and programs about this subject seem so expensive and complicated that they can give you a panic attack just thinking about them. Hopefully this manual won't do this to you as we attempt to eliminate Panic Attacks from you life. So just because I mention things like work and self-examination try not to panic. I will try to make these next sections as easy and painless for you as possible.

To help you find the sources of anxiety in your life that are fueling your panic attacks I have provided the Anxiety Sources Workbook for you with this kit. This workbook is related to the Anxiety Sources Chart(5) and will aid you in determining your personal anxiety sources. After using this workbook for a while like a diary, you should be able to determine which anxiety source area(s) are driving your panic attacks. You should be able to see a pattern of events, eating habits, or pattern of thinking that is repeating itself over and over that is related to an anxiety source area on Chart(5). Perhaps you will see a pattern of anxiety sources that are not listed on the chart or maybe you will see a pattern of combinations of anxiety source areas from Chart(5). After using the workbook for some time you should be able to look at Chart(5) and use the records from your workbook to identify what is fueling your panic attacks. You do not have to be a genius to see the sources. If you think something is a source it probably is.

The following example workbook sheet is based on my life. As you can see I did not use big words or over analyze when filling out the workbook. I kept it simple and used a little self examination when filling in my answers. After several days a pattern of potential anxiety sources developed. Why don't you see if you can see the patterns.

Now that you have read my examples from the workbook, go ahead and list what you think the sources of my anxiety were, using Chart 5 as a reference.

TO SEE MY PERSONAL WORKBOOK EXAMPLE:CLICK HERE You can go ahead and list what you think my sources are on a piece of scratch paper at home.

From my example I found that job stress, long hours, poor diet and caffeine were the main sources of anxiety contributing to my panic attacks. In these examples these source areas were repeated on almost every sheet. If you saw the same pattern you should be ready and able to go on and use the workbook for yourself. So, before you go any further in this book go ahead and use the Anxiety Sources Workbook along with Chart(5). When you are comfortable that you have identified the anxiety source(s) in your life you may continue on with this manual to see how to cope with and eliminate your panic attacks.

Some of you may have already had a clue as to what was fueling your panic attacks, while some of you had to have your sources identified with the help of my Anxiety Sources Workbook. In either case you now know what these sources are and now have the key to coping with and eliminating your panic attacks. Knowing what you are dealing with is critical because it will help you to make informed and intelligent decisions in coping with and eliminating you panic attacks.

* NOTE IF YOU ARE STILL HAVING TROUBLE IDENTIFYING THE SOURCES OF YOUR PANIC ATTACKS, AT THIS POINT IT MAY BE ADVISABLE FOR YOU TO SEEK THE HELP OF A PROFESSIONAL.

With the question of what the sources of anxiety are answered we can now proceed to the next chapter which talks about panic attack coping Strategies.


CHART 5


ANXIETY SOURCES: LIFESTYLE & PSYCHOLOGICAL

LIFESTYLE


DIET
A) CAFFEINE
B) CHOCOLATE
C) ALCOHOL
D) JUNK FOOD


JOB
A) FIRED
B) LAID-OFF
C) DISCIPLINED
D) BAD REVIEW
E) POOR COWORKER RELATIONSHIP
F) POOR CUSTOMER INTERACTION
G) POOR RELATIONSHIP WITH BOSS
H) LONG HOURS
I) PERFORMANCE PROBLEMS
J)OTHER-
K)OTHER-


SCHOOL
A) UPCOMING TEST/EXAM
B) POOR GRADES
C) POOR STUDENT RELATIONSHIP
D) POOR TEACHER RELATIONSHIP
E) GIRLFRIEND/BOYFRIEND PROBLEMS
F) POOR ATHLETIC PERFORMANCE
G) OTHER-
H)OTHER-


FAMILY
A)SPOUSE RELATIONSHIP PROBLEMS
B)CHILD RELATIONSHIP PROBLEMS
C)MONEY PROBLEMS
D) DEATH/ILLNESS
E) OTHER-
F)OTHER-
G)OTHER-


MISCELLANEOUS
A)
B)
C)
D)



PSYCHOLOGICAL

I ALL OR NOTHING THINKING
*If you don't succeed at one
thing you are a total failure.
*One room of the house is dirty so
the whole house is dirty.

II NEGATIVE PESSIMISTIC THOUGHTS
*You are not worthy of good things.
*You fail to see the good things in life.
*You see the glass as half empty
not half full.
*You feel worthless.
*You don't take action because
someone else will do the job.



III PARANOID THOUGHTS
*You think everyone is out to get you.
*A disagreement with one person
means everyone is against you.
*Failure in one relationship means that
all relationships will fail
*You take criticism
as a conspiracy.


IV EXAGGERATING NEGATIVE THINKING
*You see a small black spot
on a white shirt rather
than see all of the white.
*One old driver cuts you off
so all old drivers are bad.



V OBSESSIVE/COMPULSIVE
*You are obsessed with washing
your hands. You have to clean and tidy
everything.

Panic Attack Help: What are Anxiety and Panic Attacks?

Well to see what Anxiety And Panic are let us first look at the BASIC dictionary definitions of these words.

ANXIETY:
PAINFUL OR APPREHENSIVE UNEASINESS OF THE MIND USUALLY OVER PENDING OR ANTICIPATED ILL, FEARFUL CONCERN OR INTEREST,ABNORMAL SENSE OF APPREHENSION AND FEAR MARKED BY TENSION, INCREASED HEART RATE, AND SWEATING. SELF DOUBT LACK OF SECURITY .


PANIC:
A SUDDEN OVERPOWERING FRIGHT, A SUDDEN UNREASONING TERROR OFTEN ACCOMPANIED BY MASS FLIGHT. SYNONYMS ARE: ALARM, DREAD, FRENZY, HYSTERIA, FRIGHT, AND TERROR.


What can we infer from these definitions? We can see that Anxiety is a feeling of fear, worry, or stress over something. While Panic is an intense response to fear, worry, or stress.

Fear is a feeling and can come in many forms. In fact worry and stress are very similar to fear. One can be afraid of getting into a fight or one can worry about getting into a fight. One can be afraid to lose his or her job or one can be stressed about losing their job. Panic is the response to these feelings in most cases. When confronted with a fearful situation the body will prepare itself to either fight or flee. Anxiety, fear, worry, and stress can trigger an adrenaline build up that puts the mind and body in a panic mode. This makes the heart beat faster in order to give the mind and body more energy to handle the situation being faced. This same reaction is found in a Panic Attack resulting in the same symptoms (SEE CHART 1). You may ask though, Why does Panic Attack happen at times of relaxation or at times when there is nothing to be fearful, worried, or stressed about? This has been what is called "Free-Floating" anxiety, because it seems to float around inside of us and can pop up at anytime, manifesting itself as a Panic Attack.

To describe this better, imagine that you're driving your car along a secluded road and your favorite song is playing on the radio. You are in no hurry to get anywhere, this is just a pleasant Sunday evening drive through the country. Suddenly, someone walks out in front of your car. Instantly you slam on the brakes and you swerve to miss them! You now find yourself alongside the road in a cold sweat and your heart is pounding out of control. Fear of hitting the person and of ruining your car triggered your body to produce adrenaline and panic. This in turn allowed you to react quickly so that you could react to miss the person. This also triggered the symptoms of a rapid heart rate, sweating, palpitations, tense muscles, and heavy breathing. Just as in this example, anytime you are in a fearful situation your body can produce adrenaline to allow you to react (fight or flee) quickly. Your body can also do this on a smaller scale during worrisome or stressful situations.

Now imagine that throughout the day that there are many little fears, worries, and stresses that you encounter but you did not necessarily react to these fears, worries and stresses. Inside your body was producing the adrenaline it needed to react to those situations. But because you didn't "Panic" or use the adrenaline during those situations, this adrenaline is floating around in you and is slowly building up in side of you. Imagine that this happened on a daily basis and no adrenaline was ever used up and no conclusion was ever reached for a lot of those fears, worries, and stresses you were faced with. Eventually, the adrenaline would have to manifest itself at some time. This manifestation is in the form of a Panic Attack and it can happen at anytime, even during times of relaxation. Its just like a balloon. You can blow a balloon up and then pinch the end of it with your fingers. You can hold the air in for a long time and keep the balloon inflated but sooner or later you will relax and let go of the balloon. When you do relax and let go, the air rushes out, rapidly deflating the balloon in a mad rush. Similarly, we can control our reactions to our anxieties, but when we try to relax and let go, the adrenaline inside of us rushes out of us in the form of a panic attack. Also sometimes we can over-inflate a balloon and it pops. We too can over-inflate and build up too much adrenaline and we then too can figuratively pop in the form of a panic attack. So you can see from these illustrations that panic attacks are simply a physical response to a build up of adrenaline in our body that was not used to react when we were faced with anxieties throughout our daily life.


Now that we know the answers to our first questions: what are anxiety and panic? and what are panic attacks? we need to know what source(s) of anxiety in our lives are triggering our panic attacks. Identifying these sources is the subject of my next chapter and is crucial in eliminating Panic Attacks

Panic Attack Help: Introduction & Doctors Visits

About 9 years ago in Dayton, Ohio I experienced my first Panic Attack (I did not realize what it was at the time.). I was relaxing on the couch, watching some television, and drinking some pop, when without warning my heart began to palpitate and beat out of control. I couldn't seem to catch my breath. It was really scary when the attack didn't go away. I thought to myself, "Could this be a heart attack? I am only 22 years old, how could this be happening?" I then went and woke up my wife and asked her to take me to the emergency room. I kept the car window down for fresh air as the attack persisted. The ride to the hospital seemed endless. The attack continued as we arrived at the hospital's main entrance.

In the emergency room the doctors seemed to be at a loss. They thought that maybe I was doing drugs and that this was causing my heart to race out of control. The tests that they ran for drug use all came up negative. They tested my blood to look for muscle damage from my heart which would indicate that I had had a heart attack. An x-ray of my chest was taken to see if there were any abnormalities with my heart or lungs. I was also hooked up to an EKG monitor to see if my heart was beating normally. After being monitored all night I was released and prescribed some pills to help me relax. The Doctors never told me what was wrong. The only thing that they confirmed was that I had Tachycardia, or a fast heart rate.

These attacks became a normal part of my life after that night. Most of the time the attacks struck after work when I was trying to relax. Soon though they started to happen at different times of the day. They even struck when I was on family outings. Sometimes I had trouble while driving since it was so hard to concentrate when my heart was racing. At other times my chest would hurt and pain would shoot down my left arm. Sometimes this pain was so bad that I had trouble lifting objects. I thought for sure that these attacks were the symptoms of a heart attack, yet the attacks always subsided and things would go back to normal.

After living several years with these attacks I decided to go and see my personal Doctor. I now lived in Cleveland and had a new baby son, and I really did not want my son growing up without a dad. Also, my coworkers over the years had suggested that I was experiencing Panic Attacks. I had never heard of Panic Attacks before, so I wanted to find out for sure what exactly was wrong with me and see if I could eliminate these attacks from my life. There were many questions that I wanted the answers to about these attacks. I am sure you would want to know the answers to these questions as well. The questions were as follows:

WHAT ARE THESE ATTACKS?
WHY ARE THEY HAPPENING?
WHAT IS THE SOURCE?
HOW CAN I COPE WITH THEM?
HOW CAN I ELIMINATE THEM?

By reviewing my personal struggle with Panic Attacks this web site will help answer these questions. The first place I went to look for answers was the Medical Profession. Let us see what the professionals had to say about my attacks and see if they could help answer any of the questions I had about these attacks in the next chapter.

AT THE DOCTORS OFFICE:

The symptoms of Panic Attacks (SEE CHART 1) are very similar to the symptoms of many serious physical ailments; therefore, if you have not done so already I strongly urge you to go see a doctor. Did you notice on Chart 1 all of the serious ailments that share the same symptoms of Panic Attacks? The doctor has the difficult job of diagnosing which ailment is causing your symptoms before you can be treated effectively. In order to narrow down the probable causes of your symptoms the doctor will have to do a "diagnosis of exclusion" which requires a lot of questions to be asked and a lot of tests to be performed. You will need a lot of time, patience, and money or insurance to go through this process. Your life is worth the effort though so you should make sure you do follow through and see your doctor. The following summarizes my experiences during my quest to find the answers to the questions I had about these attacks. This should give you a glimpse as to what to expect on your doctor visits during the "diagnosis of exclusion" process. Remember, even though this chapter will DISCUSS many of the tests you would probably have to go through at the doctors office,it is not intended to dissuade you from seeing your doctor and going through these tests yourself.

My first visit was to my personal doctor. The first thing that the doctor did was weigh me in. This was to see if I had lost or gained weight since my last visit. Then the doctor listened to my heart through a stethoscope. The doctor then asked me a series of questions. These questions were intended to help with the diagnosis process. The questions were similar to those that follow: * Note that my answers to the questions are at the end of the questions.



1) WHAT IS THE PROBLEM YOUR EXPERIENCING?...............,Chest Pain
rapid heart rate, difficulty swallowing.
2) WHERE WAS THE PAIN?.... Left lower arm and upper chest.
3) WHEN DID IT HAPPEN?...... Continuous for some time now.
4) WHAT WERE YOU DOING WHEN IT HAPPENED?....Relaxing.
5) WAS IT A SHARP OR DULL PAIN?........Sharp continuous pain.
6) HOW LONG DID IT LAST?..........Varies
7) HAVE YOU EVER HAD THIS HAPPEN BEFORE? IF SO DESCRIBE......Yes
8) HAS ANYONE IN YOUR FAMILY EVER HAVE HEART PROBLEMS BEFORE?..No.
9) DO YOU DO DRUGS?......No.
10) DO YOU DRINK ALCOHOL?.....Once in awhile.
11) DO YOU SMOKE?............No.
12) DO YOU HAVE ALLERGIES TO ANY MEDICATIONS?..No
..ETC............ETC...........ETC.........

After these questions were answered the doctor listened to my heart again. The doctor did not hear anything abnormal with my heart when listening to it. Next, the doctor took my blood pressure. My blood pressure was normal so the doctor decided to hook me up to an EKG Monitor or Electrocardiogram. This process involved taping tiny electrodes to my chest and upper abdomen. The electrodes measured electrical impulses from my heart beats and translated this information onto a graph. By looking at the pattern produced by the electrical impulses on the graph the doctor was able to determine whether or not my heart was beating or contracting normally. This was the last test that my doctor performed during this visit. All of the tests that were done indicated that I was in good health and none of the questions I had about my attacks were answered.

My doctor did not have enough information to make a diagnosis at this visit. Based on the answers to the questions that were asked about my symptoms my doctor decided that I should go see some specialists. The specialists the doctor wanted me to see were a Cardiologist and a Gastroenterologist. At the Cardiologist my doctor wanted me to get a Chest x-ray,complete blood work-up, stress test, and an echocardiograph with Doppler mapping. At the Gastroenterologist I was to have an Upper G.I. performed. Hoping that I would not have to go through all of those tests, I suggested to my doctor that I was probably just having Panic Attacks. The doctor really did not respond to my suggestion but did go on to prescribe some anxiety related medicines for me. These medicines were Pepcid and Lorazepam. These might be some of the medicines you are prescribed during your doctor visits, so before I go any further let me tell you a little bit about these medicines, as well as another medicine you may be prescribed during your visit.







PEPCID: ,
Is a FAMOTIDINE that is used to treat ulcers and ESOPHIGITIS ( inflammation of the Esophagus). Pepcid basically stops acid production in the stomach and allows ulcers to heal. I guess the Doctor prescribed this medicine because he thought I might have an Acid Reflux problem. In any case the Pepcid did not prevent my panic attacks from happening. Note: PEPCID was also prescribed to me in Dayton after I had my first Panic Attack.

LORAZAPAM: or ATIVAN
Is a BENZODIAZEPINE( The same family as XANAX ) and it is given to treat INSOMNIA or MILD ANXIETY. It works by suppressing brain activity and is like a tranquilizer. This drug did not help prevent my attacks either, in fact it made them worse since at the same time my heart was racing out of control the drug made me sleepy, yet I couldn't sleep because my heart was PALPITATING so much. That is one feeling I do not wish upon anybody!

VISTARIL:
Which is a HYDROXYZINE. This is a ANTIHISTAMINE drug used to treat hives or motion sickness, and in some cases mild anxiety. This drug made my mouth dry and made me drowsy but did not help prevent my panic attacks.



CHART 1

SYMPTOMS

a racing or pounding heartbeat

dizziness and lightheadedness

a feeling that you can’t catch your breath

chest pains or a smothering "heaviness" in the chest

flushes or chills

tingling in the hands, feet, legs, or arms

jumpiness, trembling, or twitching muscles

sweaty palms

or

a feeling of detachment from oneself



Some of these symptoms are also associated with more serious medical conditions such as:


HEART ATTACKS

ULCERS

MITRAL VALVE PROLAPSE

MUSCLE PULLS

TACHYCARDIA ARRHYTHMIAS

HERNIAS

ACID REFLUX

ASTHMA

PERICARDITIS

SHINGLES

ANGINA

NERVE ROOT PRESSURE


After the doctors visit I went and got my anxiety medicines from the pharmacy. I tried these medicines and found that they were not effective. So I decided that I had better set up appointments with the specialists that my doctor wanted me to see. Since I thought that the heart was more vital than the digestive system, the first specialist I thought that I should see was the Cardiologist. The Cardiologist could diagnose any heart related ailments that could have been causing my attacks. See Chart 1

My Initial visit to the cardiologist was much like the visit I had with my personal doctor. I was weighed, asked a series of questions, my heart was listened to, and my blood pressure was taken again. All of this indicated that I was in good health. At the end of the visit the cardiologist set up appointments to have all of the different tests prescribed by my doctor performed.

The first procedure I had done was the chest x-ray. This was done at the hospitals outpatient center. By looking at the x-ray the doctor could see any abnormalities in the size,shape or appearance of my heart. Also, the doctor could check for Pulmonary Edema (CALCIFICATION(CALCIUM DEPOSITS) IN THE ARTERIES). The doctor could also check for engorgement of vessels which could indicate previous heart failure.This procedure took about five to ten minutes to complete.The results came back in a couple of days and did not indicate anything abnormal with my heart.(Still no answers to my questions.)


The next procedure I had performed was a complete blood work-up.This procedure was also done at the hospital's outpatient center.The hospital labs were able to check just about everything in my blood from white blood cell count to thyroid production, and from sugar levels to phosphorus counts. They compared my results with those of normal blood counts to see if there were any abnormalities in my blood. When the results came back, the only irregularity found was a high phosphorus count. The cardiologist did not know how to interpret this and thought it to be of little significance.


The third procedure I had done was the echocardiograph. This basically was an ultrasound picture of my heart. It was very similar to the ultrasound my wife had when she was pregnant. A gel was put on my upper abdominal area and a transducer was moved over my chest area. The transducer emitted inaudible sound waves into my body. These sound waves were echoed back and translated by a computer to form a picture of my heart.This picture would reveal any structural defects my heart or surrounding blood vessels might have. The cardiologist could also measure blood flow and valve efficiency through Doppler mapping. Overall this test was the most interesting, since I was able to actually see and hear my own heart beat. The results from this procedure showed no abnormalities in my heart or surrounding vessels, except for a mild tricuspid insufficiency, which according to the doctor was of no clinical significance.

The last test I had to do for the cardiologist was the stress test. In this test I had to get on a treadmill and walk against increasingly harder resistance with an EKG monitor hooked up to me. During this process my heart rate and blood pressure were measured while under stress. The doctor did not find any irregularities with my heart during the course of this test. I did work up a sweat during this test and strongly recommend that you wear comfortable clothing if your doctor prescribes a stress test. I would also like to note that if you decide to do this test that it is done at your own risk.

Through all of these tests the cardiologist concluded that from the standpoint of my heart and cardiovascular system that I was in good health. After I suggested I was probably just having Panic Attacks the cardiologist recommended that I avoid caffeine, chocolate, and alcohol to help prevent future attacks. Since I didn't drink much and was already watching my caffeine intake this advice was not much help. After all of those tests I still did not have any answers. The good news was that my heart was okay and that I was not going to have a heart attack anytime soon, so I decided to make an appointment to see the other specialist my doctor wanted me to see, the gastroenterologist.

On my visit to the gastroenterologist I was weighed, asked the questions, and my heart was listened to again.(This process sounds familiar?) This time though, the doctor heard my heart skipping beats when he listened to it. Since my cardiologist did not mention anything about my heart skipping beats the gastroenterologist did not pay much heed to it. I was supposed to get an upper G.I. on this visit but that didn't happen. Remember from CHART 1 that Ulcers and Esophigitis have the same symptoms as panic attacks. Also, if you recall, along with my panic attacks I was having difficulty in swallowing. An upper G.I. would help the doctor see whether or not a digestive problem such as an ulcer was causing these symptoms and attacks. The upper G.I. would have given the doctor an x-ray of my digestive tract. Since the Barium used in this process reflects x-rays, a good picture of any abnormalities in the digestive tract can be seen. The gastroenterologist did not think this test was necessary because he thought another "test" would be better. This "test" , a rectal exam, was rather quick and was performed right in the office. Basically, it checked for blood in my feces which could indicate if I had an ulcer or another digestive tract problem. The test results showed no indications of any problems with my digestive tract. Since, the doctor felt confident that I did not have any digestive tract problems hedid not see a need to proceed with the upper G.I..

The doctor wasn't finished though, and wanted to try another procedure with an endoscope or gastroscope. This device is a flexible fiberoptic tool that allows the doctor to look at the esophagus close up. The doctor would place the device down the esophagus to do this.Once done, he could check for signs of inflammation caused by acid reflux from the stomach. Acid reflux could have accounted for my chest pains and difficulty in swallowing. After talking with the doctor, I opted not to do this test because even if I had esophigitis it wouldn't explain away my rapid heart rate and heart palpitations. Also, from what I understood there was not much in the way of a cure for esophigitis. To cure esophigitis I would have to change my eating habits and I did not see myself realistically doing that, thus I saw no need to proceed with the test. After I made that decision a brief check was made by the doctor for signs of a hernia. No signs of a hernia were found so I was given a clean bill of health by the gastroenterologist and my visit with him came to an end.

From anxiety drugs, to stress tests, to digestive tract examinations, I still had no answers to my questions about my attacks. Therefore, I concluded that my attacks were not a result of some serious physical ailment but must be from PANIC, as my coworkers had previously suggested. The good news was that I was not going to have a heart attack or die from stomach cancer and you probably aren't going to either. The bad news was that I had no idea what a Panic Attack actually was or what caused it. Through my personal experience with these attacks though, I have been able to come to an understanding of what I think these attacks really are and why they happen. The next chapter discusses these ideas and helps to answer some of the questions we had about these attacks.

Anxiety: The Script For Self Hypnosis

Give yourself some useful new instructions. You can hypnotize yourself if you put your mind to it. It' s not dangerous - you can't get 'stuck' under hypnosis or give yourself some harmful command. You'll just use the space given by deep relaxation to put some constructive thoughts where they'll do most good.

Start by lying on the floor or sitting in a straight backed chair, hands in your lap. If you have time, go through the foot-to-head relaxation. If time is short, do some breathing exercises to set the scene and put you in a calm and peaceful frame of mind.


The Script

Say to yourself, 'Everything I am doing makes me healthier, more relaxed, and more in control of my life. I will wake up immediately if I need to. When you feel comfortably relaxed, imagine sitting on a wooden bench in a beautiful garden, full of flowers. Bees are buzzing gently, and the sun warms your skin. At the end of the garden there's a gate. You walk through, noting the rough texture of the weathered wood as you push it open. Beyond it are steps leading down to a secluded beach, with waves gently lapping on the sand. You walk slowly down, feeling the coolness of stone. under your feet as you count the steps - one, two, three... at every step you feel more relaxed... four, five, six... deeply calm and relaxed... seven, eight, nine... your body is relaxed, your mind open to all the good that can come to you here... ten. You are on this beautiful beach, knowing you are perfectly safe and can leave whenever you want. Enjoy the peace and serenity. Nearby you see a wrought-iron seat facing the sea. You sit down and say to yourself, 'I am peaceful, happy and perfectly in control of my life. I easily cope with everything that happens.' Now pinch the fold of skin between thumb and first finger on your right hand (pinch your thumb if you're pregnant). From now on you can relax at will, simply by doing that and remembering this peaceful place. Repeat, 'I am peaceful, happy and perfectly in control of my life. I easily cope with everything that happens. I can relax at will, simply by pinching my right hand and thinking of this place.' When you're ready, return to the steps, knowing you can come back here any time you like. You will return to everyday consciousness as you count down, but will be able to relax at will. Count slowly down from ten, as you walk up the steps, starting to notice the everyday sounds around you. By zero you are back to everyday consciousness, relaxed and alert.


Getting started

You can do this without making a tape, but it's easier to follow spoken instructions - simply read out the script on this page. Speak in a slow, calm, rather monotonous voice and remember to leave pauses. You can give your self any suggestions you like on your secluded beach, but they must be positive, clear and harm-less. In an emergency, just say to yourself, 'One, two three, ready.' You can snap out of hypnosis instantly, but a brief wake-up formula reduces the jolt. If you find it hard to visualize, just do the counting many people find this equally effective. For deeper relaxation use 30 steps down to the beach instead of 10.


Sleeplessness

When you are wound up about stressful events that have occurred during the day, being unable to go to sleep is the final straw. When nothing seems to work, try this technique of self-hypnosis. It is worth learning it beforehand (read it over to yourself till you know it), then when you come to need it, it will be effortless. Lying down, close your eyes. Imagine a familiar image, say, for example, your bedroom (but keep your eyes shut). Say to your self: 'Nothing but this room exists.' Visualize all the different details that go to make up this room: the ceiling, the walls (are there pictures on them?), the floor (does it have a carpet or rug?), the windows (what are the curtains like?), the furniture dressing table, chest of drawers, wardrobe, the bed on which you are lying. In your mind work systematically from one end of the room to the other, from top to bottom. Then, one by one, wipe the image of each of these details from your mind, until everything has gone. You are left with absolute total emptiness. Concentrate on this void, with you in the middle of it, for a few moments. You will experience a feeling of relaxation coming from it. If you still cannot sleep, repeat the exercise several times. It's usually successful after only a few minutes of 'disconnection'.

Managing Anxiety: Determined Slow Talk

Here we are working on the feelings that accompany our peaceful, quiet determination. Inside this relaxation and peace are the other positive emotions: confidence, security, strength, power, assertiveness.

We want to grow those positive emotions until they are blooming boldly and brightly. What we are doing is solidifying those feelings into your emotional brain.

This is how "Determined Slow Talk" works:

1. First, we take slow talk and move it down even slower so that we can literally FEEL the determination, the strength, and the seriousness.

2. Then we use the DETERMINATION FACTOR to synergize these positive, quiet, peaceful, confident feelings of strength and power. It is easier to feel the determination and strength when you are using determined slow talk. (Again, notice that it's the feeling we're going after here.)

3. Third, we use the handout and/or statements you are working on and use "Determined Slow Talk" to sink them down to that emotional area of your brain where things become foundational, set in stone, automatic, and natural.

Determined slow talk has the power to allow you to FEEL the confidence, the strength, and the power to allow you to FEEL the confidence, the strength, and the power of your new thoughts and behaviour.

Remember, it is important that the statements, strategies, and beliefs become FEELINGS and these FEELINGS are rooted in your determination, your peace, your inner resources.

When you start to feel these things (even if it is only briefly) instead of just saying them, move on over into "determined slow talk" - because you are ready for your new thoughts to become permanently rooted in your brain... and for you to FEEL the difference!

Managing Anxiety Strategy: Slowing Down Deliberately

SLOW TALK ("CALM" TALK)

Strategy: Slow talk is nothing more than slowing your speech down very slightly. You are slowing down enough that you notice the change in your speaking rhythm. The change is so slight, however, that other people will not notice you have slowed down. Slow talk is nothing more than slowing your speech down very slightly. You are slowing down enough that you notice the change in your speaking rhythm. The change is so slight, however, that other people will not notice you have slowed down.

It is important to be as calm as possible while you are in the process of learning new ways of thinking and new strategies of acting. Remember that it takes 45-55 days of repetition before your brain starts to automatically use these strategies.

And notice that the only way your brain is going to be able to use these anti-anxiety strategies is if you are consistent and persistent and drop down these techniques into your brain over and over again... for the entire course of therapy.

The first benefit you may discover from using this technique is that it will be easier to remain calm and at peace while you do your therapy. The more you can slow talk the therapy into your brain, the easier and deeper it will get in.

As you become more familiar with the strategy and feel like you can use it in public, you will find it has great practical value in slowing you down so that you can begin to control your anxiety level. If you stay in slow talk mode, there is not much chance you can speed up, get the adrenalin pumping, and then become socially anxious. So, slow talk can prevent us from getting as socially anxious as we used to get.

Another benefit that people usually notice is that there is a slight relaxation while you're using slow talk.

Generally, as a deliberate result of slow talk, the muscles loosen up and are less tight, and many people feel a calmness or relaxation in the shoulders and upper back area where we tend to carry around much of our stress.

The more you have the ability to use slow talk, the more you will feel in control of situations. Slow talk is not something we want to do all the time, but while we are getting better, we want to be able to use this tool as an option to help us lower our social anxiety whenever we need to.

In public situations - the use of slow talk makes it easier to sound and be less anxious, and helps the words to come out more logically and clearly. High anxiety over real-world situations like this can be controlled by slow talk.

Now, please don't jump the gun. In your first week of practicing this technique, do not move this out into real-world settings yet. It is much more important to practice slow talk when you are by yourself. It is important to get it down deeply into your brain. It is important that you feel comfortable in doing it. You need to feel OK with slow talk before you ever try it out in a public situation.

So, generally, this first week, we ask you to practice slow talk for about ten minutes a day. You can read anything you want, but it generally helps to read something positive or inspirational. It isn't important what you read, the therapy is doing the slow talk. You are practicing the slow talk, not the material you choose to read.

One of our women worked in a large advertising agency where concepts and ideas were important, and she felt that no one paid her ideas very much attention. Every time she had a good idea, she would excitedly and quickly blurt it out, expecting other people to be excited, too. Instead, they just looked at her like she was weird, and they ignored her.

When this woman started using slow talk, she brought it to work with her. By this time, she was feeling comfortable with the process, and although some anxiety was involved, when it came her turn to share her new ideas, she switched over into slow talk and calmly and rationally gave her ideas to the assembled group. What happened next surprised her a great deal...

Once you learn to slow talk, you no longer will feel rushed and anxious, you can move on into your message sure you're staying calm and focused, and present a talk that everyone understands. In public, social situations like this, slow talk can be a very effective and powerful tool in decreasing anxiety and increasing clarity.

Almost everyone I've worked with has been able to pull a lot out of this technique. But keep in mind it takes practice first - when you're alone. When you do start to use this in public, we want to start out small - talking to one person, such as a friend or relative for example. We do not want to use slow talk in a gut-wrenching anxiety situation until we are ready for it.

It is important that we do things slowly, on a small scale, feel the success behind it at this point, and then move it up gradually to other situations.

And remember this is just one technique. We will be continually adding to these methods with each and every handout. Then, each and every technique will have the "synergistic" effect of strengthening the others.

The more you practice, the more results you will see.

The Cycle of Stress

Human beings have an innate response to real danger. It's often referred to as the fight-or-flight response, and it triggers the secretion of certain hormones along with an increase in blood pressure, breathing rate, metabolism, and muscle tension to help us fight or flee a perceived threat.

The problem today is that our bodies can't always distinguish between real danger and the pressures of modern life, such as juggling conflicting responsibilities, meeting deadlines, or dealing with traffic. As a result, some estimate that the stress response may occur 50 times a day in the average person.

People exhibit prolonged episodic stress in a number of ways: they become anxious, irritable, angry, withdrawn, or depressed. Over time stress can contribute to a variety of chronic health problems, such as high blood pressure and irregular heart rhythms that can put people at risk for heart disease. In fact, heart disease is the leading cause of death for women. Untreated, stress can also make it more difficult for people to stop certain behaviors, such as smoking or excessive drinking, or to implement lifestyle changes such as improved eating habits or regular exercise.

There is ample evidence now that the use of stress reduction techniques can dramatically improve the body's innate ability to take care of itself. In a recent study at the UCLA School of Medicine, 22 people with high blood pressure were taught various stress reduction techniques such as biofeedback, deep breathing, and the use of relaxation tapes. Seventy-three percent were able to keep their blood pressure under control with lower levels of medication, and over half were able to safely stop taking medication altogether. In a control group of 17 people who did not learn the relaxation methods, only one-third were able to reduce their medication levels.

A major part of the program at the Mind/Body Medical Institute at the Beth Israel Deaconess Medical Center in Boston is learning how to manage stress. In addition to practicing the relaxation techniques of meditation, deep breathing, and visualization, participants learn how to identify their automatic emotional and physical reactions to stress. Then they are taught how to break the cycle with these four steps:

• Stop: Don't let negative thoughts make the situation worse than it really is
• Breathe: Take several deep breaths to release physical tension
• Reflect: Focus your energy on the problem at hand
• Choose: Now you can choose the best way to deal with the situation

"After my last child i started to suffer from severe postpartum depression"

I am a 23 year old mother of three. After my last child i started to suffer from severe postpartum depression. I went to the doctor to discuss this with him( he was a doctor that I hadn't seen before, but my doctor was in a real bad accident and wasn't able to work), he didn't know a thing about me but prescribed me paxil. I started taking it because I thought it would help. Boy was I wrong. After two weeks of taking Paxil I started to experience real bad side affects, I couldn't move of the cough because if I stood up i got so dizzy I would fall, I felt like i was on a whole lot of drugs. Anyways I was at home alone one night with my three little boys and I got this horrible feeling come over my whole body, I felt almost paralyzed, i couldn't think, i was scared that I was going to die , I couldn't even talk, I phoned my husband to tell him to come home because I couldn't watch the kids but all I could say is come home, come home. he asked what was wrong but that is all that would come out of my mouth. It was the starriest thing that has ever happened to me in all my life. But to make a long story short i weaned my self of of it starting the next day. Please make sure your doctor knows your history, and you really try other help like counciling first, if that doesn't work then talk to your doctor, maybe paxil could work for you. I am not a doctor so i won't tell you not to take it because everyone is different and it could work very well for you. every thing said here is only my opinion and my experiences, and I just wanted to share them with you.

-- submitted by Reign, 23

"I started taking Paxil for postpartum depression"

I started taking Paxil in November 1999 for postpartum depression. I started feeling great right away and had no side effects. In January 2000 I tried to come off of it and had dizziness and nausea. My pharmacist told me to go back on it and to wean off of it. I went back on it (feeling better immediately) and decreased the doses as advised. It is February 28 and my last pill was last Wednesday. The dizziness and sick feeling is getting worse by the day. The dizziness has become so severe that I cant stop thinking about taking a pill to make it stop but I am determined to get away from it (I hope I win). My doctor and pharmacist assured me that this drug was not addictive and I would not have any trouble coming off of it. I trusted them both. This website is just what I needed. It feels good to know that this is real and not because of an underlying illness which is what I was told. I did not understand that if was not from withdrawal then why did taking a Paxil make the symptoms stop? I am wondering just how long the withdrawal symptoms last because I need to know what I am up against. I am desperate to get back to normal and enjoy my beautiful family without Paxil.

-- submitted by Jane, 32

"I have two months on Paxil, I can said that it works on me, it helped with my depression, mood swings and temper"

I have two months on Paxil, I can said that it works on me, it helped with my depression, mood swings and temper but on the side effects I feel very, very tired, I want to sleep all the time.I have also wet hands and some problems to sleep.

I am taking a 1/2 20 gms pill a day , I started with one pill daily, but it was too strong for me I was like a zombie! looking at all in gray color, with eyes of fish and with a dry mouth, looked to everything and said !bah!

I don't want to feel like that all the time! I feel better with out depression but this feeling is disturbing me now!

I read that some people here switched on Effexor Xr to avoid that lack of energy, is there anyone who have done this?

what is the dose that you are taking?

did you waited two weeks to clean your body from paxil?

Thanks in advance for your help and good luck!

--submitted by Carlos, 27

"I initially went on Paxil for severe social anxiety and panic disorder."

I initially went on Paxil for severe social anxiety and panic disorder. I responded to an ad in a magazine. My doctor put me on Paxil 2 weeks ago. I took 10mg for 1 week and increased to 20mg this last week. Eventually I will go on to 40mg. After reading this website I am very scared. I don't want to feel the anxiety anymore however, I don't want to feel sick like everyone else does. So far, I've felt as if I were in a daze. I feel like I am looking past everything as if you were trying to stare at one of those 3D pictures. I have muscle twitches in my arms and legs. I have difficulties focusing and my eyes are extremely sensitive to the light. I experience a floating dizziness all the time. Sleep comes easily and fast, however, when I wake up, it's really early (5-6am) and I am still exhausted but can't get back to sleep. My head feels foggy and my body aches. Will all this go away? I keep being told it will. Also, does anyone know the best time to take this drug? I am currently taking this at night and wonder if that is part of the problem. Anyone with similar symptoms or general info please e-mail me. I see my Dr. in 2 weeks and wonder if I should try something else? Good Luck everyone. I know I'll need it

-- submitted by Foxy1er, 21

"I have overcome the physical sickness of the withdrawals, I am dealing with the mental side of it now"

Well, I have been off Paxil going on 2 weeks now. That first week I felt like I was going to die. But GLORY TO GOD I feel normal again and I can't tell you how great that is! I'm not sleeping my days away. I actually look better.( not like a zombie ) I feel like I am dropping weight and that is awesome!!! I really feel for people on Paxil and are trying to come off. I was on for 2 years and once I made the decision to come off, I was fine until the withdrawals kicked in. It was a very sickening experience but I think I have made it through the worst. I have heard that it takes only a short period of time to leave your system but a very long time for it to rid itself from your body totally. Even though I have overcome the physical sickness of the withdrawals, I am dealing with the mental side of it now. I had a crying spell yesterday that lasted 30 minutes. I don't even know why I was crying but it felt good afterwards. I would like to tell all the people who are trying to come off to not give up. Middle way of your withdrawals, don't give in to Paxil. I thought about it, believe me but I felt as though I had come too far to go back. Just be strong and head strong that you are going to win this battle. I owe all my success to the LORD. Without him, I don't think I would have been physically or mentally strong enough to come off this medication. I still have a ways to go but I know I have got it whipped now. I will continue to keep you updated.

-- submitted by Ola, 31

"i started taking Paxil at 17 years old along with lithium for bi polar"

i feel better to know that i am not the only "prisoner of paxil". i started taking it at 17 years old along with lithium for bi polar. honestly, i don't remember any extreme changes in my mood, i know the lithium helped. paxil seemed to allow me to see the gray in situations, it sort of numbed me a little. it had less of a strong effect than any other meds i had been on so i continued to take it until about two weeks ago. i got off cold turkey, ignoring what the doctor said. i regret ever being on it. the way i feel now is horrible. pains inside my ears occur off an on, dizziness, sensitivity to sunlight, over emotional etc. but the side effect that is most bothering me is a continuous head buzz, like a headache, but it doesn't hurt. what is feels like is a sharp fast rush in my head, it sounds almost like a helicopter in the distance. it feels like a constant hangover, without the pain. they are these real strong waves in the top of my head that occur every five to ten minutes,strong at first and then they fizzle out. they are worse when i haven't eaten, or slept enough. they continue all day, i cant stand them it feels like im on acid almost. i keep thinking that maybe im pregnant but after reading some of the symptoms other people have had maybe it is paxil, i don't know, someone please tell me if there is anything NON ADDICTIVE i can take to feel normal again. emotionally im really not doing that bad in fact i feel a little better off of it, but i cant stand walking around everyday with a throbbing head. honestly it feels like your head feels when you are extremely over tired. someone, anyone, relate? i need to feel better.

-- submitted by yippyskippy, 21

"I took Paxil because I was having some problems coping with depression"

I began taking Paxil in October of 1999. I took it because I was having some problems coping with depression. At the time, I felt I was wise enough to ask the psychiatrist about any side effects Paxil might have. She pretty much assured me that the side effects were minor and, at worst, I may get some sexual side effects.

Anyhow, I took 10mg for the first 4 days (as she told me to go gradually onto it) and then I increased it to 20 mgs for my daily dose. I will say that it did calm me down but I think it did too good of a job as I was very detached feeling and showing little emotion at all.

While I was on Paxil, I did experience sexual side effects as well as muscle weakness/shakiness, was emotionally "blah" (almost zombie like I guess) and got some of the famous electrical "zaps" early on. As I got used to it, these effects were reduced to some extent but were almost always there. In fact, I started developing these muscle twitches/spasms in areas of my body as time went on (especially in one of my feet).

I decided about a month ago (after being on Paxil for over 2 months) that I did not want to continue as I didn't like the groggy, detached feeling I had and I was tired of the effects on my muscles. I went cold turkey (my doctor had advised me to wean myself off of Paxil and I didn't) for the 1st two weeks. I didn't have terrible problems but I had a dull headache and I felt less than normal.

The one thing that I did develope after a week of being off Paxil and continues to happen after about 3 weeks is that I get these involuntary muscle twitches. This is what bugs me the most (not painful or anything but a big nuisance). I have been searching for others who may have experienced this as well.... which is a big reason why I came to this website. I get these twitches all over but its really consistent near one of my eyebrows and it is so IRRITATING! They are like any normal muscle twitch that anybody experiences at one time or another in life but they are much more persistent and happen more than usual.

I am wondering if others have had these same involuntary twitches in their body after going off Paxil and how long it took for them to disappear (please tell me they eventually disappear!!). I would really welcome any Emails in response to this as it would be a big help. I have looked around and have seen that shaking/tremor is a withdrawal effect but I am not sure if muscle twitches are included in that "definition" so I want to hear from others who may have experienced this as I want to make sure this is a "normal" withdrawal effect.

With the exception of the muscle twitches, I feel like I have gotten over Paxil. I am not completely over it (it has been about 3 weeks off of it at this point) but I am hoping these twitches will eventually diappear.

I hope by giving my experience with Paxil will help others. I have felt alone at times and the muscle twitching has made me a little bit nervous that its not the medication and its something else wrong with me (although my parents and girlfriend tell me its clearly a withdrawal effect).

My advice is to anybody considering Paxil is to really weigh the pros and cons HARD. Personally, I will never go on any kind of Psych medication ever again in my life. I would rather fight through it with other means (like therapy) than to use a medication. This medication may work perfectly fine for some but it doesn't work for me.

Please Email me if you have dealt with muscle twitches from Paxil withdrawal. I need your support and advice if you can give it. Thanks in advance!

"Zoloft seemed to suck the life out of me so she then switched me to paxil"

In the spring of 1999 I ran a marathon. I had a few weeks of anxiety and went to my doctor to see if this was an effect of the race. She decided to put me on zoloft which was an absolute nightmare. Zoloft seemed to suck the life out of me so she then switched me to paxil. The change over to paxil was pretty quick and the side effects kicked in fast. I was constantly irritated and very moody.I tried to ram my best friends head into a golf cart after he made a comment about changing the dosage of my meds (paxil) because of my attitude. I can relate to almost all of the comments listed. I have gained 20lbs. in the last 8 months and its really playing with my head. I want to get off of paxil and decided to check on the side effects before doing so.I am glad I did. My dosage has been 10 mgs. all along and wonder if I will have the same side effects you all have listed. If anyone has any advise please e-mail me with your comments.

-- submitted by ssatkoske, 32

"I was so addicted to xanax which i was put on by my gp for anxiety disorder"

I've been on paxil for approximate 4months, I started on 20mgs.and was increased by therapist to 30mgs, this all came about in oct.99 I was so addicted to xanax which i was put on by my gp for anxiety disorder. I was on 2mgs of xanax a day. which is not that much but then i got used to it so I kept increasing my dose, I had got refills so often from my gp and other doctors that i would see. I crashed in oct. with an accidental overdose and placed in the psychiatric dept. I went through complete hell withdrawing from that crap, I had the shakes ,feeling of dizziness and sweating my head felt like i wasn't there it was so much hell i couldn't sleep and didn't have any support from my husband. It was so bad and i wasn't getting any better after about 3weeks in hospital and i had lots of therapist observing me,so i was proof that being taken of medication cold turkey was not successful. On the third week they put me on paxil to get me straightened out again. And within 2 days I was feeling totally normal, that should of been my q that this was another addictive med. but my therapist said it wasn't. After reading the other addictive paxil stories this scares me to tears and my heart goes out to you. I'm only 32 years old i don't want to be dependent on med. But I'm scared to go off this medication for fear of that terrible withdrawal. If there is anyone out there that this little note reaches I hope you will really educate yourself on the medication before you too will get addicted without knowing it. I'm a married 32 year old mother of 2 boys, and definitely not a drug addict. I thought. What I wouldn't do to be "normal" without medication.

-- submitted by Jim, 32

"NEVER take a cough suppressant called dextromethorphan with Paxil"

this isn't a story about my withdrawal i just want to alert all paxil user to the drug interaction from a common over the counter cold medication. i was warned by my pharmacist NEVER under any circumstance should you take a cough suppressant called dextromethorphan or DM. i was told paxil keeps the cough med from metabolizing in your liver where it builds to a lethal amount. if your cold med says DM DITCH IT QUICK. REMEMBER TO LOOK FOR ANYTHING WITH COUGH SUPPRESSANT. THE ONLY COUGH SYRUP OK FOR US TO USE IS A PRESCRIPTION ONE LIKE CODIEN. PLEASE TALK TO YOUR DOCTOR BEFORE TAKING ANYTHING.

-- submitted by KAREN, 27

"my only symptom being having trouble getting a deep breath"

Three days ago I was prescribed Paxil for anxiety...my only symptom being having trouble getting a deep breath. I was told to take 20mg in the evening with dinner. When I woke up the first morning I could not talk and breathe at the same time. I had been told it would take 2 weeks for the medication to take effect so I never even considered that Paxil was the cause. After about an hour I was fine. The second day I woke up feeling in a fog without the normal feeling in my right arm. As I sat on my bed my husband asked me if I was all right. I said not really. I quickly realized I could not talk and breathe at the same time again. Also, my hands were sweating. Next I had an attack of diarrhea. As I went downstairs afterward, I was literally shaking all over. This lasted for about an hour. I decided to go on-line to see what I could find out about this drug. Thank goodness for your stories. You saved me from what could have been a terrible mistake. I also do not like to take medication, preferring herbal remedies when possible. I am grateful to be able to learn the easy way - from all of you - that this is not the drug for me. THANK YOU

-- submitted by kmjmchugh, 39

"Paxil caused me to gain weight, and it causes me to not want to have sex with my husband"

I have been taking Paxil since I had my 2nd child in December of 1995. The recovery period from a C-section the 2nd time was tremendously different than the natural childbirth the 1st time. I also had a Colicky, cranky, never sleeping baby to deal with as well as a 18-month old. Since my 2nd baby had her days and nights reversed, she would not sleep at all during the night but would sleep from about 6:00a.m. until 11:00 a.m. This was her long sleep daily. I was spending all night awake and most of the day, so I quickly became very depressed. I was put on the Paxil for this and I saw results right away. However, this wonderful drug caused me to gain weight, and it causes me to not want to have sex with my husband. The weight gain isn't as much of a problem as the other. My husband could not deal with this at all. I tried going onto other meds but nothing works as well as the Paxil. When I am not on any medication I am extremely mean and evil. I want to throw things at my husband for almost nothing at all. He has to immediately get up when I ask him to do something or it puts me over the deep end. I would rather keep peace and harmony within my marriage and family so I keep taking the Paxil. If anyone has suggestions on the mood swings that I have when not on the Paxil I would love to hear them. The other meds that I have tried that do not work as well are Zoloft, Celexa, Wellbutrin, and Prozac.