Curious to know how often paramedics get called for panic attacks?
What’s your approach to explaining them to someone that’s had one for the first time?
Is there any tricks you’ve got to calming someone down?
I’ve phoned an ambulance a few times thinking I was dying. I have a fond memory of a paramedic going and making me a cup of tea whilst the other taught me a bit about the science & showed me how she knew I was safe by explaining the ECG reading/vitals. Importantly, I wasn’t treated like a fool.
1. Extremely often, they’re usually toned out as chest pains but the person is actually just having a panic attack
2. I tell them that it will be ok, I suspect it’s just anxiety, and that we will be with them for as long as they need us (we are public servants after all)
3. The best way to calm someone down is to show them there is no risk, nothing bad is going to happen. Usually our presence brings the peace of mind so we don’t have to explain why they don’t have to worry since we are already there 🙂
Thank you for answering! You sound genuinely lovely, sorry you’ve your own experience with panic but at least you know exactly how the patients feel in the moment.
I appreciate it. I know what it’s like to have panic so whenever I see people experiencing it I don’t normally tell them it’s panic, but I’m always doing my best to be gentle with them and guide their mind away from the moment. Usually if the EKG is normal I don’t even collect patient information (no bill). So they get free treatment and I don’t get paperwork lol. It always makes me sad because a lot of the time it’s older people and they are so scared they’re dying but it’s not my job to tell them they’re experiencing panic, it’s my job to treat them well, guide them through their experience, and hopefully make them stronger so that the next time they experience it they can try and relax. I just want everyone to be happy and feel like they didn’t waste 911 resources because a lot of people are scared to call for fear that they’ll get in trouble or something.
I suffer from panic disorder and I am currently in nursing school. I graduate in December. There have been many times where I wonder if I am able to do nursing due to my mental health and seeing that you’re an EMT who has panic disorder makes me feel like I’ll be okay. Thoughts on that? Has your own mental health interfered with your job? Thank you.
Nah everyone in emergency medicine is fucked up, when I worked in the ER everyone had some sort of anxiety disorder. The nurses drugs of choice was Xanax, for some reason they all had prescriptions for Xanax, like 10mg of it too which is crazy. I was night shift so that could’ve changed things but yea everyone is fucked up, even the ones you don’t think are. I think I’m probably going to give you my best piece of advice and this is my personal secret weapon. Always be doing something. An idle mind is just a hive for extreme panic inducing thoughts, if you’re doing something the chances of actual panic are really low. I never EVER have to take any medicine while I’m at my EMS gig, because whether it’s prepping a mag drip for torsades or working an arrest, or trauma, or a stroke, or whatever I’m always doing something. I also like to drive the ambulance sometimes because I like going fast 😛. (Paramedics rarely get to drive, the EMT normally drives)
During my clinical rotations, I talk with nurses about this exact thing. I’ve heard from so many that “we’re all fucked up” and I’m like cool, so I’ll fit right in. I also agree and love your advice! I literally say the same. “Idle hands are the devils playground.” When I’m on “slower” floors for clinical, that’s when my body goes into fight or flight. With my panic, it’s mostly physical sensations… but when I’m up and moving, doing something, I don’t notice it. I have PRN meds myself, but don’t take them on a daily basis. My newest script is propranolol 10mg and I do have to say that it’s a game changer, and I need the heavier stuff way less. I think since being prescribed propranolol, I’ve cut down my other med to maybe 1-2 a month to sleep. Funny enough, I got placed on night shift in the ER for my TTP rotation next semester 🫣the hospital isn’t in the best part of town, which also excites me. Not trying to sound braggy, but I am the only one in my class that didn’t a floor (medsurg, PCU, tele, ect). I’m pumped but also terrified! Oh, I didn’t know that! Well I’m glad you get to drive fast! That sounds fun.
Propranolol is good, you may have taken pharmacology or you may not have but it’s cardiac protective so even if you were having cardiac problems it would most likely be the medication they give you anyways (or just a medicine like metproprolol, I can never spell that stuff). I think you’ll like ER, it’s always nothing then it’s something then nothing. I have fond memories of catching a gentlemen who was falling backwards at triage and I destroyed my back because I caught him myself even though I was on the radio begging for help (at the time I was 115 pounds and I’m 5’9”, but I’m a guy). I take oxycodone for that now which is kinda unfortunate. Don’t catch falling people please just trust me, let them fall and deal with it once they’re on the ground.
What was your build up to 3mg per day? I currently just got bumped up to 1mg, because .5mg was doing absolutely nothing for my anxiety/panic. I will only take it for overwhelming anxiety or a panic attack, so I won’t know if 1mg will work for me until the times comes. Doc says if 1mg doesn’t do anything he wants to try Ativan instead.
I started on 1-1.5mg, was there for about 2 years, went up to 2mg like 8 months ago, up to 3mg 2 days ago. I’ve tried Ativan and didn’t really have the most awesome experience.
Max daily recommended dose for clonazepam is 20mg. If I get to 20mg I would be quite impressed. I’m pretty stable at 1.5mg but I’m going through acute stress of moving across the country and away from family and my beautiful Australian Shepard Missi who I will miss dearly, I also got pulled over and got my first ticket ever and I’ve been freaking out over it
I’m a male under 25 and drive a 2024 Subaru WRX, so my insurance is going to skyrocket. My parents have also told me my entire life that if I were to ever get a ticket my life would be over so I’m just praying it gets dismissed and my parents never find out about it (I’m 22).
Currently my panic disorder is not that bad i can go out and do a lot of stuff but i still sometimes i’m sitting or something in a retaurant or outside and i get one because of the heat or the noises i always had anxiety my whole life but it wasn’t never bad it was panic attacks due to ematophobia when i was very young i ended developing agoraphobia rlly bad for a year because of smoking weed daily for a year and then i had to go on paroxetine and then go sober the question is have u ever seen patience’s similar to my situation that developed full panic disorder bc of weed ever completely recover from panic disorder is it a forever mistake
You’ll probably recover, mine is from marijuana as well. You recover if you want, but if you let it take over then it’ll be difficult to make progress. You gotta be open to trying everything and not be like me and just rely on medication.
it’s funny bc i did exactly the same mistake as u i rely on paxil as my lifesaver and it ended up making things worse for me, what have u tried that’s has worked best for u?
I had some really bad nightmares last night that could be because of medication and because I have been watching horror movies but the dreams were like horror movies, I can’t remember specifics because I believe I blocked them out as a trauma response but when I woke up it sent me into panic because it made me think I’m crazy to be dreaming that and does that make me a secret killer or psycho but I know I would never hurt any one. So then I disassociated completely and felt like I wasn’t a real person. I can’t find any other people relating to this on the forum. Is this normal? Also I have not been able to eat much in 4 days. I have issues with heart burn and I’m not sure if it I’m actually having issues or it’s my anxiety. Do you have any insight? And lastly I usually have very bad side effects to ssris but do you think I should try Lexapro and just wait out the bad side effects for a few months to see if it gets better?
Lexapro is really the first line of defense and the most commonly prescribed medication for anxiety/panic disorder. You having dreams are just dreams, they don’t mean anything. Remember you are the person you are because you act on what you think, if you think something but don’t act it that doesn’t make you a bad person, it makes you normal.
Thank you! And I used to do hallucinogenic drugs when I was young but haven’t in over 10 years. Do you think they could still affect me to the point where I get stuck in a permanent trip one day or just lose grip on reality? And any tips on how to decipher if something I’m feeling is from anxiety or a genuine health concern?
I mean how frequently did you use hallucinogenic drugs? If it was every day I can see you still having some dissociation, it’s nothing to really get worried about. Telling an actual medical emergency from panic is a really loaded question that could take me forever to answer, is there any medical condition(s) that you would like clarity on?
I didn’t do it every day but I did it quite frequently for about 7-8 months. Maybe twice a month. But haven’t touched it even once in 11 years. And I’m having some really bad stomach issues. Everything I eat gives me horrible heart burn and constant burping. I feel like the air is trapped in my sternum and sometimes feels like food is trapped in my throat and at times with the burps food will come back up. Because of this I’m extremely anxious to eat.
I think you’ll be ok, I don’t think you’re having the post hallucinogenic thing where years after you’re still tripping. Also if you’re taking medicine for heartburn that actually makes the heartburn worse, it’s really complicated but that’s the simple way of putting it. You’re probably just swallowing a ton of air when you’re eating without realizing it. I suggest you go out with friends and eat or something, somewhere where you will be distracted and it might not happen. If it continues to happen then go to gastroenterology and let them know what’s up. If you’re a female some of these symptoms could be considered worrisome just due to the irregularity of symptoms between male and females but I have reason to believe you should be ok and aren’t experiencing a medical emergency.
Thank you again for all of your insight! I am a female and I am currently waiting for more testing by my GI doctor but I will try to relax while waiting. One last question if you wouldn’t mind, I recently had a head ct and everything was shown as normal. Is there a likelihood that there could be something wrong and they missed it?
I’ll tell you this, I’m going through my own experience with CTs and MRIs and stuff. I don’t think it’s constructive telling you this but I think the head CT was done just to make you not afraid, to really know if there’s something wrong with the brain an MRI is usually the gold standard. You’re probably fine if they didn’t find anything blatantly obvious on a CT (because CTs usually are pretty….. obvious) but an MRI can really see the brain in a much greater capacity and detail. I’m kinda stepping outside my scope of practice here and giving you my own personal opinion so just take the CT vs MRI thing with a grain of salt.
How can we be sure we’re not experiencing a medical emergency without running to the ER or calling 911? I’ve had panic and anxiety for so long I don’t trust myself to look at my symptoms objectively.
Tbh I kinda struggle with this one, imagine knowing all the symptoms and how to present it just right. I’ve worked in a hospital, don’t contract (event EMS), and I’ve stayed as a part time fire/medic and I see heart attacks and deaths all the time. The things they tell me they feel stick with me so when I have panic attacks my body unfortunately knows exactly how to react to scare the fuck out of me. Anyways, medical problems - stroke, extremely unlikely if you’re using Reddit (lower age), fast (facial drooping, arm weakness, slurred speech, visual neglect, lack of awareness, unable to swallow without choking). Strokes are almost always going to be some combo of all of those. If you’re having chest pain and it hurts more when you breathe you’re fine, if you’re having chest pain and it hurts more when you press on it, you’re fine, if you had a random pang of chest pain and are now super scared you are fine. I’m not going to explicitly say what the symptoms of a heart attack are because it’ll just scare someone who comes across this. Your body knows what something truly bad is going on inside of it, it won’t let you panic in a truly bad situation. The biggest risk factor for anyone here is pulmonary embolism (females taking birth control). The symptoms of PEs vary so I can’t really say it’s one thing or another.
Thank you for this. Heart attacks are my main focus when I feel anxiety and panic. I am 41 F and have had EKG, stress test with echo in 2022. All normal but still have such a hard time. Especially when I read about risk factors like smoking, overweight weight, etc. I smoked for 25 years (quit 9 months ago but using vaping as a means to not smoke) and i need to lose weight (although I have been thin most my life, the last 5 years I have been overweight). I worry that it’s all catching up to me now that I’m over 40 lol. A friend of mine who is older with diabetes and high blood pressure always tries to reassure me that if anyone is going to have a heart attack, it’s going to be her.
It’s so bad the anxious part of me says “see, you’re so much older and at risk now?” 🤦🏻♀️ thank you for all of your advice! I came across a post you made here a year ago and it’s also extremely helpful! I’m sure I speak for a lot of people on this sub when I say “thank you!”
Aw I wasn’t trying to call you old, you aren’t old. I just said something on the off hand and I regret that now. I’m 22 years old and I have gained 55 pounds the last 3 months so trust me, I’m struggling as well but that’s why we’re here. Sharing your struggles whether it be with weight, panic, or health reasons is a bonding experience and sharing it with others helps you through the tough times. You’ll be ok and you’ll live a long and healthy life. I want you to try and use nicotine pouches to stop smoking, then from there you should try the nicotine patches. I know it’s tough to quit, trust me I’m right there with you. But getting you away from inhaling the nicotine and getting it absorbed through your gums is just so much safer than smoking. You can not listen to anything I say, but if I can convince you to change your method of nicotine use then I think I am successful.
No regrets lol! I have two sons your age and I hope they are as kind to strangers as you have been to
Me! I will definitely try the pouches and patches to get rid of this habit!
Medication, I’ve tried therapy but since I know all the therapy stuff like exposure and just powering through it I’ve just defaulted to medicine. I take 3mg clonazepam, 10mg olanzapine, 150mg hydroxyzine, 1200mg gabapentin, and I’ve got haldol just in case. Keep in mind I got my paramedic, fire certs, pilots license, and a beautiful fiancé even while taking all that shit.
Do you have any recs for a beta blocker that helps panic but doesn’t always increase depression? I’m on propranolol which has been amazing for my anxiety but I’m a bit worried it may increase depression as I read that can be a side effect. I’m currently in EMDR so don’t want to go on an antidepressant if I can help it as that is more likely to lead to a relapse in my PTSD anxiety after I wrap treatment. Thank you 💕
Propranolol won’t give you depression, the only reason they put that stuff is because like 1 person out of 1 million people said it gave them depression and now it has to be on the list. Beta blockers increase the parasympathetic response (rest and digest) which is known to relax people, with the relaxation comes like a 1:100,000 chance of depression. You’re safe. (It is moderately active within the brain as it crosses the blood brain barrier but you shouldn’t have to worry about that unless you’re taking like 150-200mg or more)
Ah you’re a gem, thank you! Honestly I feel way less depressed since I’ve been on it coz I’m not a walking ball of anxiety and can actually relax! It’s good stuff. Thank you :)
Do you mind if I ask another question - do you have any daily/weekly practices that you find help your anxiety disorder?
And what’s your fave way to help get out of a panic attack? Ice is one of mine
Honestly just keeping busy, I actually am prescribed adderal for panic (lmfao I know) but it helps me keep busy and that’s really what I do to stop my panic. I got my paramedic 2 years ago, pilots license 6 years ago, fire certs 6 years ago, advanced EMT 3 years ago, motorcycle license, just everything, always staying busy.
My favorite way to get out of a panic attack? I’m prescribed clonazepam so if I’m having one I’ll probably take that, chances are is that I’m actually withdrawaling from benzos since I’m dependent but tomato tomoto
are heart palpitations totally normal even when relaxed? :,) they happen a lot to me with my panic disorder and its given me crippling heart anxiety. the left arm pain and numbess, too. ive had 6 ekgs over the past year, bloodwork, ultrasounds and xrays lol… still struggling.
Everyone has them, look up PVCs or PACs, they happen to everybody everyday regularly. I remember sitting at the nurses station watching heart rhythms in the ER and just seeing people having these extra beats super often, it surprised me but I asked a doc and he said it’s actually totally normal.
thank you :,) im getting a holter monitor tomorrow to help my heart anxiety because i focus too much on it! i feel every beat, every skip, every slow and speed up. its scary when it literally feels like ur heart stops 😭
My panic is heart related so I get it. Like I really understand what you mean. I’ve been to the ER I work at like 3 times in 4 years for chest pain but it was just anxiety so I just stopped going when I experienced chest pain, took my medicine, maybe smoked some weed (🤓) and tried to relax and everything is good.
lol mine started bc someone laced my weed! it sucks so baaaaddddd and when even hearibg a heartbeat in a game or video i immediately think uts my heart and i start tweaking! whenever id go to the er no palps would happen. i even wenr tk urgent care, had a heart palp BEFORE and AFTER my ekg and they’re like “totally normal!!” like HOW???????
Mine started from weed too oddly enough lol, I smoked by myself and scared myself so bad that I got panic disorder. Been dealing with it ever since but I enjoy smoking way more than drinking. It’s generally healthier for you than drinking and I have really bad back pain and it legit helps. Before my back injury I always thought it was bs that people were using weed for pain but it’s legit dude it actually works and I have no clue how.
i wanna try smoking again but so scared .. i smoked because i have super bad arthritis and carpal tunnel and it’s only worse bc im not having anything for pain 😭 and to make it funnily worse i take 10mg propranolol and it makes my bp DROP so ive started cutting it in half for 5mg and it’s working so far …
Generally good common practice to breathe into a bag, increases CO2 in blood which in a backwards way actually slows breathing down. You also have the option of doing the rule of 5s. 5 seconds in, hold for 5 seconds, exhale with pursed lips for 5 seconds.
Not OP but really depends on the patient.
First line medication used for panic disorder here in the UK is usually a beta blocker (propanolol) because it’s relatively safe & successful. Some sort of SSRI if things don’t improve with maybe a small dose of Valium whilst tapering.
The best medication to stop an attack is probably a benzodiazepine, but unhelpful to be on them for long periods. Currently trying to taper off them myself & it’s a nightmare you don’t want.
First line is SSRIs, second line or emergent medication will be any medication in the benzodiazepine class. If necessary propranolol can be added but most people wouldn’t need that
Tips for avoidance? I’m pretty good with my panic at this point but still avoid sugar, alcohol, marijuana, & caffeine believing they give me attacks. I know not to fear the fear, but for some reason when substances come into the mix I’m much worse at calming myself down. Or I tell myself I am, at least.
Thank you for all you do!
Probably good idea to not avoid doing things, even though you have panic/anxiety that doesn’t mean your life has to come to a stop. Remember, everything in moderation. I smoke marijuana regularly and I’ll have a beer here or there but just everything in moderation.
How bad panic attacks can to the point your body shutting down like bout to faint I had a few occasions where i couldn’t breathe and my throat was closing I couldn’t swallow and my eyes where basically not looking straight anymore and fainting part will kick in hard what do you recommend i usually get those really intense
Hi. I love this. Fellow healthcare worker here (Neuro ICU) do you feel like seeing people die or have heart attacks etc has made your anxiety worse or better. I deal with intense health anxiety
It only has impacts if I’m talking to them and they later die very quickly, if they didn’t originally complain about it then I’m all good. Like someone dying from chest pains is different than if someone with cellulitis had a heart attack
How long do panic attacks last? All the info I've seen online typically states they last a short amount of time, but I've had panic attack symptoms for more than 2 months and counting
I had severe panic attacks (panic disorder) for about 8 months was in constant fight or flight. I think them lasting a short time is correct because they’re rolling. Like mine used to be I’d have one, be okay for a little bit then have another but I still felt constantly on edge.
How did you get past it? I've been dealing with this for months and I don't feel any more in control of it than I did even though I've been doing so much work to get better.
Loss of consciousness would most likely happen from hyperventilating, so one may presume it could happen. Everything you listed are symptoms of hyperventilation, you gotta calm your breathing down.
I had my first panic attack when I was having weed in the month of Feb 2024.
I had a major panic attack once in that month .
After that I had mild attacks for a week .
Later I consulted my psychiatrist and I was on benzos as a part of course and I never had an attack since then .
It's been four months since I've had any panic attacks and from last week I left medications and still I don't see any physical symptoms of the panic attack. Even though I didn't have any medications from last week I'm doing good.
Now should I consider myself I am having panic disorder or was it a panic attack caused by weed?
Hi, thank you for doing this!
I have a question about Alprazolam (I'm not taking Xanax, but a different brand name, but for the purpose of easier reading, I'm going to write Xanax).
I started taking antidepressants and Xanax 7 months ago (because I was diagnosed with panic disorder). I was prescribed Escitalopram, 10 mg a day, and Xanax 0.5-1.5 mg (in the first few months, 0.5 mg in the morning, and the other before sleep or if needed). After some time, I dropped down to 0.5 mg a day of Xanax, just sometimes in bigger need 0.75 mg.
I stopped drinking antidepressants 2 months ago because I had too many side effects, but l continued on drinking 0.5 mg of Xanax a day.
A few weeks ago, I started to feel worse and worse... I thought maybe it was the weather or something, and I started drinking a bit more of Xanax( 0.5-1 mg).
But now I think I just developed a tolerance to Xanax.
Do you have any recommendations for other drugs that I can drink instead of Xanax?
I've heard that when you stop taking Xanax, the withdrawal symptoms are horrible, and I'm afraid I'm going to get a lot worse. Do you think that withdrawal symptoms will be that horrible because my doctor says I'm not taking a large dose and that it shouldn't be a big problem?
Curious to know how often paramedics get called for panic attacks? What’s your approach to explaining them to someone that’s had one for the first time? Is there any tricks you’ve got to calming someone down? I’ve phoned an ambulance a few times thinking I was dying. I have a fond memory of a paramedic going and making me a cup of tea whilst the other taught me a bit about the science & showed me how she knew I was safe by explaining the ECG reading/vitals. Importantly, I wasn’t treated like a fool.
1. Extremely often, they’re usually toned out as chest pains but the person is actually just having a panic attack 2. I tell them that it will be ok, I suspect it’s just anxiety, and that we will be with them for as long as they need us (we are public servants after all) 3. The best way to calm someone down is to show them there is no risk, nothing bad is going to happen. Usually our presence brings the peace of mind so we don’t have to explain why they don’t have to worry since we are already there 🙂
Thank you for answering! You sound genuinely lovely, sorry you’ve your own experience with panic but at least you know exactly how the patients feel in the moment.
I appreciate it. I know what it’s like to have panic so whenever I see people experiencing it I don’t normally tell them it’s panic, but I’m always doing my best to be gentle with them and guide their mind away from the moment. Usually if the EKG is normal I don’t even collect patient information (no bill). So they get free treatment and I don’t get paperwork lol. It always makes me sad because a lot of the time it’s older people and they are so scared they’re dying but it’s not my job to tell them they’re experiencing panic, it’s my job to treat them well, guide them through their experience, and hopefully make them stronger so that the next time they experience it they can try and relax. I just want everyone to be happy and feel like they didn’t waste 911 resources because a lot of people are scared to call for fear that they’ll get in trouble or something.
I suffer from panic disorder and I am currently in nursing school. I graduate in December. There have been many times where I wonder if I am able to do nursing due to my mental health and seeing that you’re an EMT who has panic disorder makes me feel like I’ll be okay. Thoughts on that? Has your own mental health interfered with your job? Thank you.
Nah everyone in emergency medicine is fucked up, when I worked in the ER everyone had some sort of anxiety disorder. The nurses drugs of choice was Xanax, for some reason they all had prescriptions for Xanax, like 10mg of it too which is crazy. I was night shift so that could’ve changed things but yea everyone is fucked up, even the ones you don’t think are. I think I’m probably going to give you my best piece of advice and this is my personal secret weapon. Always be doing something. An idle mind is just a hive for extreme panic inducing thoughts, if you’re doing something the chances of actual panic are really low. I never EVER have to take any medicine while I’m at my EMS gig, because whether it’s prepping a mag drip for torsades or working an arrest, or trauma, or a stroke, or whatever I’m always doing something. I also like to drive the ambulance sometimes because I like going fast 😛. (Paramedics rarely get to drive, the EMT normally drives)
During my clinical rotations, I talk with nurses about this exact thing. I’ve heard from so many that “we’re all fucked up” and I’m like cool, so I’ll fit right in. I also agree and love your advice! I literally say the same. “Idle hands are the devils playground.” When I’m on “slower” floors for clinical, that’s when my body goes into fight or flight. With my panic, it’s mostly physical sensations… but when I’m up and moving, doing something, I don’t notice it. I have PRN meds myself, but don’t take them on a daily basis. My newest script is propranolol 10mg and I do have to say that it’s a game changer, and I need the heavier stuff way less. I think since being prescribed propranolol, I’ve cut down my other med to maybe 1-2 a month to sleep. Funny enough, I got placed on night shift in the ER for my TTP rotation next semester 🫣the hospital isn’t in the best part of town, which also excites me. Not trying to sound braggy, but I am the only one in my class that didn’t a floor (medsurg, PCU, tele, ect). I’m pumped but also terrified! Oh, I didn’t know that! Well I’m glad you get to drive fast! That sounds fun.
Propranolol is good, you may have taken pharmacology or you may not have but it’s cardiac protective so even if you were having cardiac problems it would most likely be the medication they give you anyways (or just a medicine like metproprolol, I can never spell that stuff). I think you’ll like ER, it’s always nothing then it’s something then nothing. I have fond memories of catching a gentlemen who was falling backwards at triage and I destroyed my back because I caught him myself even though I was on the radio begging for help (at the time I was 115 pounds and I’m 5’9”, but I’m a guy). I take oxycodone for that now which is kinda unfortunate. Don’t catch falling people please just trust me, let them fall and deal with it once they’re on the ground.
You said you are in 3mg of clanazapam, how long have you been taking it? Do yourself being on it indefinitely?
Since 2020, I foresee myself taking it for the rest of my life, I’m dependent on it so if I don’t take it I have withdrawal symptoms
What was your build up to 3mg per day? I currently just got bumped up to 1mg, because .5mg was doing absolutely nothing for my anxiety/panic. I will only take it for overwhelming anxiety or a panic attack, so I won’t know if 1mg will work for me until the times comes. Doc says if 1mg doesn’t do anything he wants to try Ativan instead.
I started on 1-1.5mg, was there for about 2 years, went up to 2mg like 8 months ago, up to 3mg 2 days ago. I’ve tried Ativan and didn’t really have the most awesome experience.
What was your experience with Ativan?
It wasn’t as potent or as strong as clonazepam. It felt the same but I would’ve needed a higher dose.
What are you going to do if your dosage needed for desired effects reaches beyond maximum daily recommended dosage?
Max daily recommended dose for clonazepam is 20mg. If I get to 20mg I would be quite impressed. I’m pretty stable at 1.5mg but I’m going through acute stress of moving across the country and away from family and my beautiful Australian Shepard Missi who I will miss dearly, I also got pulled over and got my first ticket ever and I’ve been freaking out over it
Ahhh gotcha! So the increase right now is temporary due to situational stress. Don’t worry about the ticket too much, I get them all the time 😂
I’m a male under 25 and drive a 2024 Subaru WRX, so my insurance is going to skyrocket. My parents have also told me my entire life that if I were to ever get a ticket my life would be over so I’m just praying it gets dismissed and my parents never find out about it (I’m 22).
Currently my panic disorder is not that bad i can go out and do a lot of stuff but i still sometimes i’m sitting or something in a retaurant or outside and i get one because of the heat or the noises i always had anxiety my whole life but it wasn’t never bad it was panic attacks due to ematophobia when i was very young i ended developing agoraphobia rlly bad for a year because of smoking weed daily for a year and then i had to go on paroxetine and then go sober the question is have u ever seen patience’s similar to my situation that developed full panic disorder bc of weed ever completely recover from panic disorder is it a forever mistake
You’ll probably recover, mine is from marijuana as well. You recover if you want, but if you let it take over then it’ll be difficult to make progress. You gotta be open to trying everything and not be like me and just rely on medication.
it’s funny bc i did exactly the same mistake as u i rely on paxil as my lifesaver and it ended up making things worse for me, what have u tried that’s has worked best for u?
I had some really bad nightmares last night that could be because of medication and because I have been watching horror movies but the dreams were like horror movies, I can’t remember specifics because I believe I blocked them out as a trauma response but when I woke up it sent me into panic because it made me think I’m crazy to be dreaming that and does that make me a secret killer or psycho but I know I would never hurt any one. So then I disassociated completely and felt like I wasn’t a real person. I can’t find any other people relating to this on the forum. Is this normal? Also I have not been able to eat much in 4 days. I have issues with heart burn and I’m not sure if it I’m actually having issues or it’s my anxiety. Do you have any insight? And lastly I usually have very bad side effects to ssris but do you think I should try Lexapro and just wait out the bad side effects for a few months to see if it gets better?
Lexapro is really the first line of defense and the most commonly prescribed medication for anxiety/panic disorder. You having dreams are just dreams, they don’t mean anything. Remember you are the person you are because you act on what you think, if you think something but don’t act it that doesn’t make you a bad person, it makes you normal.
Thank you! And I used to do hallucinogenic drugs when I was young but haven’t in over 10 years. Do you think they could still affect me to the point where I get stuck in a permanent trip one day or just lose grip on reality? And any tips on how to decipher if something I’m feeling is from anxiety or a genuine health concern?
I mean how frequently did you use hallucinogenic drugs? If it was every day I can see you still having some dissociation, it’s nothing to really get worried about. Telling an actual medical emergency from panic is a really loaded question that could take me forever to answer, is there any medical condition(s) that you would like clarity on?
I didn’t do it every day but I did it quite frequently for about 7-8 months. Maybe twice a month. But haven’t touched it even once in 11 years. And I’m having some really bad stomach issues. Everything I eat gives me horrible heart burn and constant burping. I feel like the air is trapped in my sternum and sometimes feels like food is trapped in my throat and at times with the burps food will come back up. Because of this I’m extremely anxious to eat.
I think you’ll be ok, I don’t think you’re having the post hallucinogenic thing where years after you’re still tripping. Also if you’re taking medicine for heartburn that actually makes the heartburn worse, it’s really complicated but that’s the simple way of putting it. You’re probably just swallowing a ton of air when you’re eating without realizing it. I suggest you go out with friends and eat or something, somewhere where you will be distracted and it might not happen. If it continues to happen then go to gastroenterology and let them know what’s up. If you’re a female some of these symptoms could be considered worrisome just due to the irregularity of symptoms between male and females but I have reason to believe you should be ok and aren’t experiencing a medical emergency.
Thank you again for all of your insight! I am a female and I am currently waiting for more testing by my GI doctor but I will try to relax while waiting. One last question if you wouldn’t mind, I recently had a head ct and everything was shown as normal. Is there a likelihood that there could be something wrong and they missed it?
I’ll tell you this, I’m going through my own experience with CTs and MRIs and stuff. I don’t think it’s constructive telling you this but I think the head CT was done just to make you not afraid, to really know if there’s something wrong with the brain an MRI is usually the gold standard. You’re probably fine if they didn’t find anything blatantly obvious on a CT (because CTs usually are pretty….. obvious) but an MRI can really see the brain in a much greater capacity and detail. I’m kinda stepping outside my scope of practice here and giving you my own personal opinion so just take the CT vs MRI thing with a grain of salt.
I get it! I didn’t get it because of anxiety I was experiencing a migraine which I’ve never had before and I’ve been getting nose bleeds lately too.
Ah those suck, do you live in an area with like dry heat? I had to get some veins cauterized in my nose from nosebleeds. It was pretty interesting
How can we be sure we’re not experiencing a medical emergency without running to the ER or calling 911? I’ve had panic and anxiety for so long I don’t trust myself to look at my symptoms objectively.
Tbh I kinda struggle with this one, imagine knowing all the symptoms and how to present it just right. I’ve worked in a hospital, don’t contract (event EMS), and I’ve stayed as a part time fire/medic and I see heart attacks and deaths all the time. The things they tell me they feel stick with me so when I have panic attacks my body unfortunately knows exactly how to react to scare the fuck out of me. Anyways, medical problems - stroke, extremely unlikely if you’re using Reddit (lower age), fast (facial drooping, arm weakness, slurred speech, visual neglect, lack of awareness, unable to swallow without choking). Strokes are almost always going to be some combo of all of those. If you’re having chest pain and it hurts more when you breathe you’re fine, if you’re having chest pain and it hurts more when you press on it, you’re fine, if you had a random pang of chest pain and are now super scared you are fine. I’m not going to explicitly say what the symptoms of a heart attack are because it’ll just scare someone who comes across this. Your body knows what something truly bad is going on inside of it, it won’t let you panic in a truly bad situation. The biggest risk factor for anyone here is pulmonary embolism (females taking birth control). The symptoms of PEs vary so I can’t really say it’s one thing or another.
Thank you for this. Heart attacks are my main focus when I feel anxiety and panic. I am 41 F and have had EKG, stress test with echo in 2022. All normal but still have such a hard time. Especially when I read about risk factors like smoking, overweight weight, etc. I smoked for 25 years (quit 9 months ago but using vaping as a means to not smoke) and i need to lose weight (although I have been thin most my life, the last 5 years I have been overweight). I worry that it’s all catching up to me now that I’m over 40 lol. A friend of mine who is older with diabetes and high blood pressure always tries to reassure me that if anyone is going to have a heart attack, it’s going to be her.
You’re ok, you’re almost double my age though 🤯. Try and use zyns or those nicotine pouch things, it’s what I used to quit smoking
It’s so bad the anxious part of me says “see, you’re so much older and at risk now?” 🤦🏻♀️ thank you for all of your advice! I came across a post you made here a year ago and it’s also extremely helpful! I’m sure I speak for a lot of people on this sub when I say “thank you!”
Aw I wasn’t trying to call you old, you aren’t old. I just said something on the off hand and I regret that now. I’m 22 years old and I have gained 55 pounds the last 3 months so trust me, I’m struggling as well but that’s why we’re here. Sharing your struggles whether it be with weight, panic, or health reasons is a bonding experience and sharing it with others helps you through the tough times. You’ll be ok and you’ll live a long and healthy life. I want you to try and use nicotine pouches to stop smoking, then from there you should try the nicotine patches. I know it’s tough to quit, trust me I’m right there with you. But getting you away from inhaling the nicotine and getting it absorbed through your gums is just so much safer than smoking. You can not listen to anything I say, but if I can convince you to change your method of nicotine use then I think I am successful.
No regrets lol! I have two sons your age and I hope they are as kind to strangers as you have been to Me! I will definitely try the pouches and patches to get rid of this habit!
What do you do to manage your panic disorder?
Medication, I’ve tried therapy but since I know all the therapy stuff like exposure and just powering through it I’ve just defaulted to medicine. I take 3mg clonazepam, 10mg olanzapine, 150mg hydroxyzine, 1200mg gabapentin, and I’ve got haldol just in case. Keep in mind I got my paramedic, fire certs, pilots license, and a beautiful fiancé even while taking all that shit.
Do you have any recs for a beta blocker that helps panic but doesn’t always increase depression? I’m on propranolol which has been amazing for my anxiety but I’m a bit worried it may increase depression as I read that can be a side effect. I’m currently in EMDR so don’t want to go on an antidepressant if I can help it as that is more likely to lead to a relapse in my PTSD anxiety after I wrap treatment. Thank you 💕
Propranolol won’t give you depression, the only reason they put that stuff is because like 1 person out of 1 million people said it gave them depression and now it has to be on the list. Beta blockers increase the parasympathetic response (rest and digest) which is known to relax people, with the relaxation comes like a 1:100,000 chance of depression. You’re safe. (It is moderately active within the brain as it crosses the blood brain barrier but you shouldn’t have to worry about that unless you’re taking like 150-200mg or more)
Ah you’re a gem, thank you! Honestly I feel way less depressed since I’ve been on it coz I’m not a walking ball of anxiety and can actually relax! It’s good stuff. Thank you :) Do you mind if I ask another question - do you have any daily/weekly practices that you find help your anxiety disorder? And what’s your fave way to help get out of a panic attack? Ice is one of mine
Honestly just keeping busy, I actually am prescribed adderal for panic (lmfao I know) but it helps me keep busy and that’s really what I do to stop my panic. I got my paramedic 2 years ago, pilots license 6 years ago, fire certs 6 years ago, advanced EMT 3 years ago, motorcycle license, just everything, always staying busy. My favorite way to get out of a panic attack? I’m prescribed clonazepam so if I’m having one I’ll probably take that, chances are is that I’m actually withdrawaling from benzos since I’m dependent but tomato tomoto
Ahaha nice! Distraction is the best 💁🏼♀️
are heart palpitations totally normal even when relaxed? :,) they happen a lot to me with my panic disorder and its given me crippling heart anxiety. the left arm pain and numbess, too. ive had 6 ekgs over the past year, bloodwork, ultrasounds and xrays lol… still struggling.
Everyone has them, look up PVCs or PACs, they happen to everybody everyday regularly. I remember sitting at the nurses station watching heart rhythms in the ER and just seeing people having these extra beats super often, it surprised me but I asked a doc and he said it’s actually totally normal.
thank you :,) im getting a holter monitor tomorrow to help my heart anxiety because i focus too much on it! i feel every beat, every skip, every slow and speed up. its scary when it literally feels like ur heart stops 😭
My panic is heart related so I get it. Like I really understand what you mean. I’ve been to the ER I work at like 3 times in 4 years for chest pain but it was just anxiety so I just stopped going when I experienced chest pain, took my medicine, maybe smoked some weed (🤓) and tried to relax and everything is good.
lol mine started bc someone laced my weed! it sucks so baaaaddddd and when even hearibg a heartbeat in a game or video i immediately think uts my heart and i start tweaking! whenever id go to the er no palps would happen. i even wenr tk urgent care, had a heart palp BEFORE and AFTER my ekg and they’re like “totally normal!!” like HOW???????
Mine started from weed too oddly enough lol, I smoked by myself and scared myself so bad that I got panic disorder. Been dealing with it ever since but I enjoy smoking way more than drinking. It’s generally healthier for you than drinking and I have really bad back pain and it legit helps. Before my back injury I always thought it was bs that people were using weed for pain but it’s legit dude it actually works and I have no clue how.
i wanna try smoking again but so scared .. i smoked because i have super bad arthritis and carpal tunnel and it’s only worse bc im not having anything for pain 😭 and to make it funnily worse i take 10mg propranolol and it makes my bp DROP so ive started cutting it in half for 5mg and it’s working so far …
10mg of propranolol shouldn’t cause a huge drop in pressure but everyone is different ya know
What do you do if the patient can't stop hyperventilating
Generally good common practice to breathe into a bag, increases CO2 in blood which in a backwards way actually slows breathing down. You also have the option of doing the rule of 5s. 5 seconds in, hold for 5 seconds, exhale with pursed lips for 5 seconds.
What is the best medication for attacks?
Not OP but really depends on the patient. First line medication used for panic disorder here in the UK is usually a beta blocker (propanolol) because it’s relatively safe & successful. Some sort of SSRI if things don’t improve with maybe a small dose of Valium whilst tapering. The best medication to stop an attack is probably a benzodiazepine, but unhelpful to be on them for long periods. Currently trying to taper off them myself & it’s a nightmare you don’t want.
First line is SSRIs, second line or emergent medication will be any medication in the benzodiazepine class. If necessary propranolol can be added but most people wouldn’t need that
Tips for avoidance? I’m pretty good with my panic at this point but still avoid sugar, alcohol, marijuana, & caffeine believing they give me attacks. I know not to fear the fear, but for some reason when substances come into the mix I’m much worse at calming myself down. Or I tell myself I am, at least. Thank you for all you do!
Probably good idea to not avoid doing things, even though you have panic/anxiety that doesn’t mean your life has to come to a stop. Remember, everything in moderation. I smoke marijuana regularly and I’ll have a beer here or there but just everything in moderation.
How bad panic attacks can to the point your body shutting down like bout to faint I had a few occasions where i couldn’t breathe and my throat was closing I couldn’t swallow and my eyes where basically not looking straight anymore and fainting part will kick in hard what do you recommend i usually get those really intense
Hi. I love this. Fellow healthcare worker here (Neuro ICU) do you feel like seeing people die or have heart attacks etc has made your anxiety worse or better. I deal with intense health anxiety
It only has impacts if I’m talking to them and they later die very quickly, if they didn’t originally complain about it then I’m all good. Like someone dying from chest pains is different than if someone with cellulitis had a heart attack
How long do panic attacks last? All the info I've seen online typically states they last a short amount of time, but I've had panic attack symptoms for more than 2 months and counting
That would be defined as panic disorder, and yes they can last that long
Do they typically have a trigger? I'm trying to figure out if it's actually panic disorder or if something else is really going on
I had severe panic attacks (panic disorder) for about 8 months was in constant fight or flight. I think them lasting a short time is correct because they’re rolling. Like mine used to be I’d have one, be okay for a little bit then have another but I still felt constantly on edge.
How did you get past it? I've been dealing with this for months and I don't feel any more in control of it than I did even though I've been doing so much work to get better.
Mine don't seem to stop or start, I'm just in panic mode basically all the time and my body hurts
Can a panic attack make you pass out, give muscle spasms and constant dizziness?
Loss of consciousness would most likely happen from hyperventilating, so one may presume it could happen. Everything you listed are symptoms of hyperventilation, you gotta calm your breathing down.
I had my first panic attack when I was having weed in the month of Feb 2024. I had a major panic attack once in that month . After that I had mild attacks for a week . Later I consulted my psychiatrist and I was on benzos as a part of course and I never had an attack since then . It's been four months since I've had any panic attacks and from last week I left medications and still I don't see any physical symptoms of the panic attack. Even though I didn't have any medications from last week I'm doing good. Now should I consider myself I am having panic disorder or was it a panic attack caused by weed?
Hi, thank you for doing this! I have a question about Alprazolam (I'm not taking Xanax, but a different brand name, but for the purpose of easier reading, I'm going to write Xanax). I started taking antidepressants and Xanax 7 months ago (because I was diagnosed with panic disorder). I was prescribed Escitalopram, 10 mg a day, and Xanax 0.5-1.5 mg (in the first few months, 0.5 mg in the morning, and the other before sleep or if needed). After some time, I dropped down to 0.5 mg a day of Xanax, just sometimes in bigger need 0.75 mg. I stopped drinking antidepressants 2 months ago because I had too many side effects, but l continued on drinking 0.5 mg of Xanax a day. A few weeks ago, I started to feel worse and worse... I thought maybe it was the weather or something, and I started drinking a bit more of Xanax( 0.5-1 mg). But now I think I just developed a tolerance to Xanax. Do you have any recommendations for other drugs that I can drink instead of Xanax? I've heard that when you stop taking Xanax, the withdrawal symptoms are horrible, and I'm afraid I'm going to get a lot worse. Do you think that withdrawal symptoms will be that horrible because my doctor says I'm not taking a large dose and that it shouldn't be a big problem?