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Q.I feel very offended that I should have to go and see a psychiatrist or a psychologist. They are for people who have a mental illness. I have anxiety and panic which is not a mental illness and I am not some sort of weak person.
A.We always strongly recommend that people with an anxiety disorder see a mental health professional, either a psychiatrist and/or a psychologist. Seeing a mental health professional is not a sign of insanity. Anxiety disorders are the most common mental health problem in the country, and many psychiatrists and psychologists are trained in this area. When we have a physical problem we prefer to see a someone who specialises in that particular area. So it is with anxiety disorders. Most of us need to see a mental health professional. You are right you are not weak, nor is anyone who has an anxiety disorder. Nor are people who have a major mental illness.
Seeing a professional who is trained in anxiety disorders can mean the difference between a full or incomplete recovery. It is important that people with anxiety disorders understand mental illness per se. Our own biases and fear only helps to perpetuate the stigma and shame many people feel if they have a mental health problem and the fear, stigma and shame won't change until we as individuals change our perception about mental illness/mental disorders.
Q. I was first diagnosed with panic disorder about three years ago and I have since developed agoraphobia. I would be grateful for a referral to a CBT therapist as close to my location as possible. I have been on Xanax for almost three years and over the past two months I have managed to reduce the dose .
I didn't suffer any significant withdrawal symptoms at first but at the moment I am still going through hell. I am waking in the early hours of the morning with over-breathing, rapid heartbeat, nausea and uncontrollable shaking. Needless to say I am presently averaging about fours hours sleep per day.
The panic attacks and level of anxiety have increased markedly. I have discussed Valium replacement (and subsequent taper) with my doctor but I am fearful of introducing another benzo into my system. Further, there are conflicting views on equivalent doses. . I have previously tried to switch to a number of anti depressants but I couldn't tolerate the changeover. I believe (having done some research) that it was wrong to abruptly stop the Xanax and immediately introduce a new medication. Anyway I shall battle on with hope that CBT works for me.
A. In regards to your medication : The guidelines for the prescribing of any of the tranquillisers is for 2 - 4 weeks only. The tranquillisers, including Xanax can be addictive and some people may become addicted within four weeks. Xanax is one of the short acting tranquillisers. With the short acting ones, if people do become addicted they may have withdrawal symptoms every 4 to 6 hours. Withdrawal includes anxiety and panic. The federal government recommends people on the short acting tranquillisers transfer over to the equivalent dose of Valium and once stabilised slowly withdraw the Valium. Valium in a longer acting drug and prevents the 4 - 6 hour withdrawal. You MUST NOT simply stop taking these drugs. This can be very dangerous. You need to speak with your doctor and slowly withdraw the drug under medical supervision. This also applies to any transfer and withdrawal from Valium.
We realise you are feeling uncomfortable about changing to Valium, but it can really assist you in the Xanax withdrawals. The referral we have given you has the conversion rates and he has assisted many of our clients in this.
Anti depressants work differently to the benzos and they can take up to six weeks to work.
As you begin to practice your CBT skills you will find they will be of benefit to you.
Q. I read your question about positive thinking and how it is only short-term. I've just had a quick read of your site so my question may be answered somewhere on your site but will have to come back due to time constraints!
how do you overcome or replace negative thoughts?
a) do you avoid, ignore or refuse to listen to them?
b) do you learn to gradually accept them?
as a) to me seems to brush them under the carpet so to speak and you may end up fighting the thoughts which of course will only increase the anxiety/panic.
b) accepting thoughts that are not true doesn't seem completely rational and may end up trying to cover anxiety and panic pretending it's ok, nothing to worry about. so is there another way or is a) or/and b) both viable in certain ways?
A. Great question! Let's take this a point at a time:
'how do you overcome or replace negative thoughts?a) do you avoid, ignore or refuse to listen to them? or b) do you learn to gradually accept them? '
'a) to me seems to brush them under the carpet so to speak and you may end up fighting the thoughts which of course will only increase the anxiety/panic.'
This is exactly right
'b) accepting thoughts that are not true doesn't seem completely rational and may end up trying to cover anxiety and panic pretending it's ok, nothing to worry about.'
True. It is learning to see why there is nothing to worry about.
'so is there another way or is a) or/and b) both viable in certain ways? '
Neither a or b is viable! It is learning to see why there is nothing
to fear/worry about. Many of us have recovered by learning to lose our fear
of panic attacks and in learning to see how the anxiety symptoms are being
created. We use a mindfulness technique which teaches people to see how
their thoughts create their experience. When people can see this, they (a)
begin to lose their fear, (b) see they have a choice in what they think
about (c) exercise that choice.
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