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    How i feel
    bre786 posted:
    My anxiety makes me feel like i am dying. I cant breathe, my chest hurts, i cant concentrate. All of the symptoms that i have are just terrible. Its worse because i have people telling me that i need to be on medication and people telling me that i dont need the meds. I believe that some people just dont understand. They do not know what this feels like, and they r trying to tell me that in dont need the medication?!. then i have my doctor telling me that i need the meds and i need them because they will help me. If they are going to help me why are people telling me not to take them? I know when i was on the hydroxizine that i helped me soo much that soon it was gone and i had no anxiety attacks. and when my uncle died it came back. I am so confused and i dont know what to do!!!!!!!! should i do what my doc. says or what people tell me because they dont think that i need the meds.
    Patricia Farrell, PhD responded:
    It's never an easy decision regarding whether or not to take medication and only you can make that decision. You've indicated that, in the past, one particular medication had helped but that these dreadful feelings returned after the death of your uncle. The fact that this did happen after a very stressful event leads me to think that it is a reaction rather than a long-term effect.

    There really is a third choice here and it's not whether to take medication or not to take medication, but to consider short-term cognitive therapy to learn new ways to deal with stressful situations. I always believe that the more conservative approach is the one that should be tried first and this is something you need to consider.
    AKB26 responded:

    I have had panic attacks off and on for over 20 years. When they happend I feel exaclty as you descibed. It is horible. Sometimes it is so bad I go to the hospital, because my chest hurts so much and I feel like I am looing grip on reality. After 15 years of every know type of therapy in the US and Switzerland, five years ago I concluded that my condition is genitic, and no amount of counseling will help. In my case I take an SSRI every day and Xanax when I feel realy anxious. Even this has not prevented the attacks, just reduced them to about once evey 9 months to a year. I know a lot of people with panic disorders, and most of them have an event that triggers their attacks. I think in this cases counseling works to a point. My attacks seam total random.

    It sounds like your are fortunate that your panic is triggered by cognitive thoughts and might be treated with counseling. In my case medication is the only thing that works.
    JeffMedStudent responded:
    There are really two issues you raise here.

    First, the issue of whether people "understand" what it's like to have anxiety. The fact of the matter is that there will be a good number of people who have never felt pathologic anxiety before and as a result will not be able to empathize with people who do feel pathologic anxiety. It's not that they don't care about you, nor is it that they are lying to you. Rather, it is that it literally isn't in the realm of things that they view as being possible mental/psychological occurrences in themselves so they can't fathom them occurring in another person. It's important for you to expect and accept that a certain number of people just will not believe your anxiety to be real let alone the need for medication to be real. It's not your fault, it's not their fault, it's just the way it is.

    Second, the issue of whether the medication is working for you. I don't have much experience with hydroxyzine specifically, but if it was working for you before, then it was working for you. No need to question it. There is also a component of the "placebo effect" with ANY medication (for psychiatric or physical purposes). The point is if it works, it works. Now, if with the stressor of your uncle dying (I'm really sorry, by the way), took your anxiety to the next level, the hydroxyzine alone may not be adequate to get you through this phase, and you may need something additional... but no need to question whether hydroxyzine worked previously... you yourself said it did.

    An additional point, which you may want to bring up with your psychiatrist or psychiatric-issue-managing physician is whether it might be appropriate to introduce a more sustainable long-term treatment plan that incorporates a medication from the SSRI or SNRI class. Anxiolytics like hydroxyzine are meant more for acute (short-term) relief of severe anxiety. While it may still have a role to play in your treatment regimen, you might do well to have a 24-hr anxiety-modulating agent like, as I mentioned, an SSRI or SNRI.

    I hope you are able to find a treatment option that you can feel confident "works" for you. As importantly, I hope you are able to truly realize and accept that some people just won't understand what you are going through with your anxiety, and that is okay.
    rosmonen replied to AKB26's response:
    I believe I have the same experience like yours, but how did you come to the conclusion that it is genetic and how is your SSRI doing? Are you experiencing any side effects? I took Prozac for six months and then stopped it and am taking 0.5 mg Xanax daily, I am coping somehow but I am still living in anxiety and panic..I am worried about taking Xanax permanently even at 0.5 mg daily, friends tell me it may cause seizures.
    JeffMedStudent replied to rosmonen's response:

    It's interesting that you would have taken Prozac for six months, stopped it, and then gone directly to a benzodiazepine. Typically if one SSRI isn't working adequately, a psychiatrist will try a different SSRI and/or will add on an augmenting agent like aripiprazole.

    It is important for people to realize that, in a general sense (this is not specific medical advice for any individual), benzodiazepines are meant to be used to relieve acute extreme anxiety, not to treat anxiety in the long-term. Many articles have been written on the adverse effects of long-term benzodiazepine use. A Wikipedia article synthesizes some of the current knowledge:

    It is of course better to be on benzodiazepines then to be experiencing acute severe anxiety. However, ideally, you'd want to work with your psychiatrist to find a way to manage your anxiety long-term with an SSRI/SNRI or any other agent you might agree upon together.

    As always this advice is based only on my own experience and knowledge of the field. It is NOT meant to replace that of your health care providers.
    Ermak42 replied to mmjulie50's response:
    Ignorantly discouraging someone to not take their medications as prescribed by a physician is irresponsible and dangerous. While Jesus may have you under his "heel", it is not appropriate for you to suggest others stop their medical treatments until a qualified and hopefully literate physician recommends otherwise. You are obviously neither of those.
    WillT responded:
    Hi bre786:

    It always makes me wanna scream when I hear about "friends" who deem themselves sufficiently competent in medicine to advise what I "need" and "don't need"! Especially the Luddite types, who fear anything modern or scientific. Loons!
    Psychotropic medications have kept me alive these last 20 years - after finding an expert shrink to figure out the right drugs and best dosages for me.
    Not all anti-anxiety/psychotic/depression meds are good for every person. It's all very fluid, that's why you need to get to a specialist in psycho-active meds. Sounds like you're dealing with a GP at present time? Go higher up the food chain. My experience has taught me that GPs just aren't competent in matters psychiatric.
    Get a referral to a well-known, popular shrink. Here in Canada we have a handy website for rating doctors: Patients have built up a vast database of ratings and personal lilkes/dislkes of doctors. Very useful when shopping for a good doc. Barring that kind of assistance in finding a good shrink, ask around - call up local mental health organizations, groups etc to ask form some highly recommended names of shrinks in your area. Not ALL psychiatrists are good or useful. I'd even say that 90% of them are charlatans working the system by spinning through as many patients as possible every day to maximize their billings.
    Find a GOOD psychiatrist. Then tell your GP you'd like a referral to this exact doctor - nobody else. So you might hurt your GP's feelings, tough. It's YOUR health!
    About meds: I sometimes hear horror stories about powerful anti-psychotic drugs that are just too powerful and addictive. Seroquel comes to mind as the drug I hear most about. Also there was a drug called Zyprexa - supposed anti-psychotic that actually made people FAT, FAST! Many patients were made diabetic from this drug, and the manufacturer, Eli Lily Co. ended up settling a class action lawsuit for more than $1 billion!! I had a close call with Zyprexa. I gained unwanted weight, but I did not turn diabetic.
    I'm just saying, everything is a series of decisions you have to make: the right doctor, the right medication(s). <Sometimes it takes more than one med to do the job.
    In summary: don't listen to your know-it-all friends. Locate a trusted psychiatrist. Get on good meds. It could be the difference between a reasonably good life and an intolerable life. It's your play!
    Good Luck!
    2goodhealth responded:
    I think that you have to do what you believe is right for you, in conjunction with a professional therapist.

    Having said that, I do believe that it is important to address the underlying issues that are causing anxiety and panic attacks, for anyone. Medications do help, but I do think they are **one** part of the solution. As Patricia Farrell pointed out, cognitive therapy can be used, as well. We can all learn to reframe our reactions to events, and learn relaxation and stress reduction techniques.

    That means that at some point, some people, but not all, will no longer need to take anxiety meds. Whether or not you do or don't is up to you and your therapist.

    Have you asked your friends why they are concerned about your medication usage?

    However, if I had a friend who drank 4-6 cups of coffee per day, and then complained of anxiety attacks and went on meds, then I'd probably suggest they cut out the caffeine, and take up yoga, and try going off of the meds after a bit of time. (I'm not saying you do that, it is an example of when and why I would express my concern to someone.)

    My concerns with "head meds" relate to all of the side effects that can lead to other problems (weight gain ==> obesity ==> diabetes; sexual dysfunction ==> relationship problems), and so forth.
    efkelly2 responded:
    I feel you. You need the meds just like I do. My parents told me not to take them for religious reasons and theyre idiots. I cant concentrate either and it interferes with my daily life. Go with what YOU feel is right. You have to take responsibility for YOUR decisions because you're smart and worth it.

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