Dear Doctor: A Doctor Answers Your Questions
Return to the main Dear Doctor page
Coping with panic attacks
Dear Doctor
I was recently diagnosed as having depression. That’s bad enough, but I’m having awful anxiety and panic attacks. I’m scared to go out of the house and just can’t cope with going shopping in the supermarket.
I’m taking antidepressants, but they don’t seem to have helped the anxiety and panic attacks. Is it normal to feel like this? I thought depression was just low mood.
What can I do to get through this, as it’s disrupting my whole life and I’m having trouble coping?
Danny
Dear Danny,
I can well understand why you are struggling to cope with the burden of having symptoms of both Anxiety and Depression. It is very common to have both problems at the same time. Most people with Depression will also have unpleasant Anxiety symptoms and many will have these symptoms badly enough to be diagnosed as having Generalized Anxiety Disorder or Panic Disorder.
Fortunately, antidepressants generally have an “anxiolytic” effect; that is they tend to reduce the symptoms of anxiety, as well as having an antidepressant effect. These effects typically take 2-4 weeks to kick in. If you've already been on your antidepressant for a couple of weeks, I'd strongly encourage you to return to your GP. Since leaving the house is difficult at present, it would be sensible to ask a friend or relation to go with you.
Your doctor may be able to help in various ways, for example:
- by adjusting your medication
- by helping you to identify stresses in your life that may have contributed to your illness and advising on ways of reducing these stresses
- by looking for any “triggers” that cause your panic attacks and helping you to identify ways of avoiding them
- by advising you on changes in your life style that would help you to reduce your anxiety
- and he or she may also be able to give you specific advice on relaxation techniques or put you in touch with an agency providing this form of help.
Sometimes, when Anxiety and Panic problems are persisting, a course of counselling or psychological help might be beneficial and your doctor will also advise you on this.
Anxiety often causes physical symptoms such as tiredness, palpitations, sweating and pain (usually from muscle tension). These symptoms can be severe and greatly increase your Anxiety, as you grapple with the additional worry that you may have some serious physical illness. Don't be frightened to discuss them with your doctor.
You will wonder what you can do yourself to help reduce your levels of anxiety. The following suggestions may help:
- avoid drinks that contain caffeine such as cola, coffee and tea
- drinks such as hot chocolate or chamomile tea can be useful to relax you, particularly at bedtime
- if you are a smoker, try hard to reduce the number you smoke – nicotine, like caffeine, is a stimulant drug
- do not self medicate with alcohol, or other sedative drugs, to help you relax or get to sleep – this is a very dangerous pathway
- try to keep to a regular daily routine of tasks to be done, meals, time in bed etc
- even though you may feel tired, try to take regular exercise – perhaps somebody could go for walks with you and, if you like swimming, this is particularly relaxing
- look regularly at the things you've got to do and try to set a reasonable plan for what you can manage each day – consider which are the important tasks and which ones can be left
- be open about your feelings with anybody close to you – sharing your problems with another person is very important.
Anxiety and Depression are very real illnesses and not just a failure to cope, as some people wrongly believe.
Fortunately, they are very treatable and, however bad things seem at present, with appropriate help there is every prospect that you will make a full recovery.
Yours sincerely,
Gerry McPartlin
Getting Help With Anxiety: Useful Organisations
- No Panic Helpline 0808 808 0545 (10am – 10pm) http://www.nopanic.org.uk,
- Royal College of Psychiatrists 020 7235 2351 http://www.rcpsych.ac.uk/, has useful information about Anxiety and Panic and how they can be treated.
- Stresswatch Scotland 01563 570886 http://www.stresswatchscotland.org
Further Reading
Self-Help for your Nerves by Claire Weekes (Angus and Robertson).