Posted by:
Gay Philosopher
(
)
Date: June 28, 2012 07:41PM
Hi Rander,
I suffer from anxiety, too. When I had a medical problem when I was 22 and suffering incredible and unrelenting pain, I started having panic attacks. The problem resolved itself, but the panic attacks continued, and I was diagnosed with panic disorder. After taking Xanax, and imipramine, for about nine months, it all went away, I stopped taking the meds, and I returned to normal.
Three years later, my grandmother died. Exactly two weeks later, I had a spontaneous panic attack. No one can understand the terror unless they've experienced a full-blown panic attack themselves. I tried meds again, but couldn't continue taking imipramine because it caused tachycardia, so I settled for Klonopin and Paxil, an imperfect but workable combination. Four years later, I stopped taking both, and I was fine for three or four years. Subsequently, I've suffered from generalized anxiety disorder. It waxes and wanes. I don't need meds, but still occasionally take a low dose of Klonopin occasionally.
My panic attacks were spontaneous. They weren't preceded by gloomy thoughts or anything unusual at all. That's what makes them so scary. Generalized anxiety, on the other hand, is of much lower intensity and of an anticipatory nature. ("Something bad is going to happen. Watch out.") It's not that thoughts create anxiety or panic, so much as thoughts can fan the flames. Anxiety is, by definition, emotional, and panic attacks are the part of the brain known as the amygdala freaking out. (It's a bit more complicated than that, but good enough here.)
Some of us are unfortunately just a lot more primed for anxiety than others. To treat the panic attacks, I recommend that you try two things: first, Xanax. The moment that you feel one coming on, take 0.5 or 1 mg, and that will shut it down, although it takes about 20 minutes. Xanax is only really effective at shutting down panic attacks. To keep the flames down, add some Klonopin--0.5 or 1 mg. That will take care of you for a few hours, and hopefully for an entire day. But taking Xanax and Klonopin is problematic. Over time, Xanax tends to stop working as your body becomes habituated to it. Klonopin can have the same tolerance effect. You tend to need to keep taking more and more to get the same effect. This is bad, because you could get to the point where Xanax simply doesn't work anymore against panic attacks (although it could take months to reach that point).
So, you need a long-term drug. Usually, psychiatrists prescribe SSRI drugs, such as Prozac, Paxil, Pristiq, Lexapro, or Viibryd. Viibryd would be great if it works for you. It doesn't seem to cause fat gain, or have any sexual side-effects. (The others inhibit one's ability to have an orgasm, and tend to make one sleepy and fat, to be honest.)
The idea is to take an SSRI, give it eight weeks to work, and take Xanax and Klonopin meanwhile. Once the SSRI begins working, you'll stop having panic attacks. Then, you can stop taking Xanax, keep taking Klonopin, gradually lower your dose of Klonopin until you're only taking the SSRI, and after a year, say, stop taking the SSRI to see what happens.
Alongside all of this, see a psychotherapist and try cognitive-behavioral therapy (CBT), or any other therapy that you feel comfortable with. If you combine the drug approach with the psychotherapy, you'll have the best chance for getting better. I strongly advise not waiting on this. Please see a psychiatrist, and find a psychotherapist, right away.
Regarding your specific thoughts, everything that you've expressed is perfectly rational. Your post is very eloquent and says some things better than I ever could find the words for. Like you, I also desperately wanted answers to the big questions in life. I thought that if I had them, and they were the answers that I wanted, that everything would be all right. I could stop worrying.
I've learned, over time, that no amount of reassurance will ever be enough. What we really need is ongoing support. You're lucky to have your fiance. I personally believe that your panic attacks are *amplifying* thoughts that you've always had. This is where psychotherapy can help. It won't change the human condition. We will all die one day. However, it can help you to recognize distortions in thinking (i.e. unlikely and unreasonable thoughts) and challenge them and give you comfort.
Regarding atheists, believe it or not, most of them are no worse off than true believers. They don't fear or think about death more than true believers. They see the same amount of suffering that you do. Sometimes they experience the same pain that you do. But they react differently, because their brains are wired differently. People like you and me got unlucky in that way. We have a problem with the way that our brains are wired. It causes unwanted and unhelpful anxiety.
If it were possible to take a pill and eliminate anxiety altogether, any fear about a god not existing or about injustice and suffering, or the possibility that there is no afterlife would simply go away, and people would go on living their lives. Unfortunately, no magical pill like that has been invented yet, so we have to do the best that we can. And for you, that means drugs and psychotherapy, and a supportive environment.
Anxiety tends to transform itself. In your case, it has done so, leading to cutting yourself. That just makes it all the more urgent that you find a good psychiatrist and get on an SSRI right away. I promise you that you will be able to find help, and you will get better. Please take the first step right now.
Once you're on the right meds, and in psychotherapy, the stress--and make no mistake that panic attacks create a lot of stress--that you're under will decrease, dark thoughts and possible suicidal ideation will go away, and you'll return to normal.
You're going to be all right. Take the next step, and keep us abreast of how you're doing.
Best Wishes,
Steve