Okay so I thought I would say a few
words about medications for panic disorder. The typical medication prescribed for panic
disorder are benzodiazepines (xanax, klonopin, etc) and SSRI/SNRIs (prozac,
zoloft, etc). Benzos act on your brain and basically calm down your brain
if it is overexcited and your neurons are firing way too much. They act
pretty quickly, within minutes, and so people like to take these when they feel
a panic attack coming on because it will lessen or stop the attack. When I have taken these in the past I could almost feel them slowing my brain down. SSRIs are pretty complicated
so I won't get into the mechanism of action but these are antidepressants and
keep you in a "happier" basal state, I guess, so that you aren't as
prone to feeling anxiety on a daily basis. You take them regularly every day. SSRIs would be considered more
of a long term, in-the-background sort of thing whereas a benzo is short-acting
and would be taken at the onset of a panic attack to achieve instant
results.
I think both of these medications are
great, and they have their purposes with other medical problems. But not
ours. Our problem is essentially a fear of the fear response. To
get over this you need to prove to your brain that this fight-or-flight
response is NOT something to be scared of. But if you are someone that
pops a xanax every time you have an attack you are telling your brain "Yes,
amygdala, this is a VERY scary and dangerous situation, so I am going to take this pill and make it go away". You are confirming to your amygdala that there was in fact a
dangerous or scary event going on. This is the opposite of what you want
to do.
Think about it: what is so scary
about a panic attack? It is the fear of death, of going crazy, of having
something terribly wrong with you, of passing out. If you are having an
attack and you take a xanax and then your attack goes away....guess what - you
just confirmed that you were having a panic attack and it is not some life
threatening illness. It means that you are not going to die, you are not
going crazy, you do not have anything terribly wrong with you and you are not
going to pass out. This, if anything, should give you all of the
confidence in the world to go out there and power through a panic attack and
start to retrain your amygdala.
If you have been on medication for a while I know it will be very scary to get off of it. But if you want to get rid of this disorder for good,
you have to show your amygdala that a panic attack is nothing to be afraid of. And unfortunately you can't do that with medication as a security blanket.
I have being researching about panic disorder and reading your blog, I found your post very helpful. Prozac can be used to treat major depressive disorder and panic disorder.
ReplyDeleteThanks for your comment. You are right that prozac is prescribed for panic disorder, it is one of the SSRIs. The point that I was trying to make in this post is that while you can take prozac for panic disorder and it will make the panic attacks lessen or go away, it is not a cure. As soon as you stop taking prozac, the panic attacks will come back at full force. While some people might consider this a treatment for the disorder, I do not. To treat panic disorder, I personally think that you need to understand the disorder, learn to handle panic attacks and retrain the amygdala. This is the way to truly overcome panic disorder.
ReplyDeleteI have been on a steady diet of low dose Benzo (Klonopin) and SSRI for about a year and a half, and you're absolutely right-- I'm terrified of going off the medication; I can honestly say I've never missed a dose. My mind believes that if I am on the medication the panic attack can't get me-- and that is calming in itself. I continually tell myself that I need to get off the medication-- but it is so hard to give up that security blanket. Like any addiction, I say..."maybe tomorrow."
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