New Meds

It's been awhile again. I wish I could report that my absence between posts meant things are improving, but that's not exactly the case.

As you may remember, I have been taking Xanax to help me during "panic" situations. According to my doctor, Xanax is supposed to a "band-aid" medicine, to get you over a temporary hump until you feel better.

Well, my temporary hump has turned into a long, straight road. I was taking the full dose of Xanax three times a day (the maximum my doctor prescribed) to help me tolerate every day's challenges. If I didn't take my dose, my panic symptoms would return. I started a three-times-a-day regimen to help get things under control. It worked, but it's been going on too long.

So, my doctor has placed me on an anti-depressant called Celexa, which has a fairly good success rate for helping people with panic disorders. I have been taking it for a week and dealing with the annoying side effects, such as stomach pains, insomnia, hot flashes and increased anxiety (isn't that the kicker?).

The side effects should wear off in another week, and then I should start seeing results (and taking less Xanax) within another two weeks. I am remaining optimistic about Celexa because of its high success rate.

On the therapy front, I am enjoying a wonderful 30-minute meditation/visualization CD created by a local therapist. It really puts me at ease, especially when I feel those panic symptoms coming on. And I am really focusing on "slowing down," which is helping a lot!

I will keep you posted on the Celexa treatment. Thanks for stopping by!

Feeling better

I have been negligent on my posting to this blog. When I started it, I thought it would be something I would post to every day or two, but life has kept me busy.

Overall, I am feeling better. I am now taking my medication on a six-hour interval throughout the day. I started this regiment about 10 days ago, and I only had one (small) panic episode. I managed this episode successfully with breathing exercises and mindful thinking.

I am not sure how much longer I will continue this medicinal regiment, but I will give it several weeks and see how I feel.

Additionally, I've tried to slow down and not rush myself. I don't streak through yellow lights; I try to get ready for work at a slower pace; I make lists to help me remember.

And I can't forget Time. It's been several weeks now, and I am guessing that time will heal these wounds too.

Thanks to everyone who stops by and leaves a message of support. It's nice to know people are out there.

Simple Meditation and Relaxation by Joel Levey and Michelle Levey

Simple Meditation and Relaxation
By Joel Levey and Michelle Levey
Completed August 30, 2008

I needed a book that would begin my journey of self-healing through meditation and relaxation techniques. I stumbled across Simple Meditation and Relaxation at my local library. It's a square book with wide margins. Something about the design of the book drew me from the other meditation books that I checked out. Sometimes, you can tell a book by its cover!

Simple Meditation and Relaxation discussed five different types of meditation and devoted a chapter to each one: concentration, mindfulness, reflective, creative and heart-centered meditations. Each one is the foundation for the other, and as a beginner, I reread the concentration and mindfulness chapters twice (maybe even three times). There are also sections about how to dedicate time to meditate and what other resources are available to learn more.

This book has taught me some wonderful breathing exercises that I can use during a meditation period or simply while driving in my car. It showed me that my mind is in constant motion - and not necessarily in a good way. I worry too much about the past and the future, without focusing on the now. It was an insightful lesson.

I would highly recommend Simple Meditation and Relaxation to people interested in learning more about meditation, especially if you're a beginner like me. ( )

Just breathe....

I am almost done with Simple Meditation and Relaxation by Joel and Michelle Levey. This has been an enormously helpful book for me. I will write a formal review once I complete it, but I wanted to share some breathing exercises that I learned from this book.

Count to Ten

This was hard for me at first. I would lose my focus before I reached the mid-way point. The idea is to breathe in (thinking good thoughts) and then breathe out (ridding bad thoughts) for a count of ten. It requires a lot of concentration, but I am getting better at it.

As I improve, I am adding a focus on my tailbone at the top and bottom of each breath. It's trickier than it seems!

The Nine-Part Breath

This breathing exercise requires that you inhale through one nostril then exhale through the other (taking turns) for a count of three.

Left nostril, inhale; Right nostril, exhale

Left nostril, inhale; Right nostril, exhale

Left nostril, inhale; Right nostril, exhale

Right nostril, inhale; Left nostril, exhale

Right nostril, inhale; Left nostril, exhale

Right nostril, inhale; Left nostril, exhale

Then breathe in though both nostrils for another three times

While inhaling, imagine your body being filled with a white light (positive energy). And while exhaling, imagine a reddish gas leaving your nostrils, taking all of the negative energy with it.

This one also requires a lot of concentration but is easier than counting to ten.

What are your favorite breathing exercises?

A New Warning Sign

Typically, I know a panic attack is coming on because my breathing becomes labored, and I feel a tightness in my chest that spreads to my throat.

But this week, I kept feeling something else: a restless, uneasy feeling that made me want to flee from the room. It wasn't a panicky feeling necessarily - but something unsettling that I felt deep within my gut. As I felt this sensation, my breathing stayed normal and there was no tightness in my chest. I was not sure what was wrong. I remember reading about the "flight" response, and when the second episode of uneasiness hit me, I decided to take a Xanax and do some breathing exercises. Sure enough, it took care of this weird, uneasy feeling.

And so I guess I now have two warning signs of panic.

I googled the flight response and found this interesting passage on the Anxiety and Panic Disorder Center of Los Angeles's Web site:

What happens to the body during a panic attack?

When the brain perceives a threat or danger, messages are sent to a section of your nerves called the autonomic nervous system (ANS) which then activates the adrenal glands in the kidneys to secrete chemicals, such as adrenaline and noradrenaline, which key up the body for fight or flight. The autonomic nervous system is divided into two sub-sections called the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system is the actual system that releases energy and prepares the body for action. The body then typically restores itself back to normal after a period of time by the parasympathetic nervous system, which acts as a kind of stabilizer.

For people who are prone to anxiety and panic attacks, their parasympathetic nervous system, or their ability to restore their body back to normal after experiencing a stressor, does not seem to function properly. Hence, people who suffer from anxiety and panic attacks have a faulty parasympathetic nervous system, which for some unknown reason malfunctions in its ability to restore the body back to a normal state. The sufferer then remains keyed up simply because there are high levels of free-floating adrenaline in the body that have not burned off yet. For some it lasts for hours, for others it can last for days.

It's always reassuring to me to know that there are chemical reasons for anxiety. For me, chemical means it can be altered, studied and treated. But, like with an chemical, it requires experimentation and patience. I am hanging there...

My Book Finds

My therapist suggested I learn some more about mindful thinking and meditation. I thought the best place was to look in the library for Buddhist texts that may instruct me on these techniques. For a small library, I think I hit the jackpot and checked out the following books:

• The Art of Happiness by His Holiness the Dalai Lama
• The Beginner''s Guide to Insight Meditation by Arinna Weisman and Jean Smith
• How To Practice: The Way to a Meaningful Life by His Holiness the Dalai Lama
• Simple Abundance: A Daybook of Comfort and Joy by Sarah Ban Breathnach
• Simple Meditation & Relaxation by Joel Levey and Michelle Levey

Now, mind you, I have only two weeks to read these books (not going to happen!), so my goal is to skim through them and figure out which one(s) can help me. Then, I will renew or purchase accordingly.

So far, I discovered that Simple Abundance is a book of daily entries, filled with inspirational stories or messages. I ordered a copy from Bookmooch and that should be coming in the mail soon (so, cross one off the pile!).

I usually write book reviews on my completed reads, including non-fiction, so I will post my reviews on The Anxiety Journal too.

It's really not surprising that I turn to books during a time like this. Books help me stay calm by learning. I suspect that's what makes me a bibliophile!

My Current Treatment

Isn't it true that the best place to start is at the beginning?

Over the past several weeks, I have been experiencing panic attacks with the classic physical symptoms: chest tightness, fullness in my throat, tingly sensations in my extremities, the flight response and general, gut-wrenching fear.

I believe (as do my medical professionals) that my panic attacks are a result of a recent injury called costochondritis, which is the inflammation of the cartilage in my rib cage (sternum). The pain from costochondritis is much like a heart attack. My initial cardiovascular tests were fine, so my doctor knew I was not having a heart attack, but she couldn't figure out what was causing my pain and other symptoms.

After a trip to the ER, which was a scary adventure, I was diagnosed with costochondritis. I was relieved to have a diagnosis finally, but the Panic Train had already left the station. And it's been spinning around the Brain Track ever since.

I have been taking Xanax to help me. Without a doubt, when I feel the chest fullness coming on (my first sign of a panic attack), I reach for Xanax. I take half of a pill, and within 20-30 minutes, I feel fine. If I wait too long before taking Xanax, then the other panic signs come on, and Xanax has a harder time "fixing" my symptoms.

What frustrates me is that I would like to utilize non-medicinal methods to allay my panic attacks, but so far, nothing has helped. Only Xanax. My therapist assured me that this is okay. Just like it will take my rib cage 6-8 weeks to heal, so too will my brain need time to recondition to a less panicky state.

Patience, it seems, will be an important part of my treatment plan.

I have, however, found great solace in music. And thanks to a wonderful fellow book blogger who sent me music that helps her relax, I have some nice selections in my iPod to help me relax through music.

What's next? I will be going to therapy every two weeks. I will continue with the Xanax. And I will be reading more about mindful thinking and relaxation techniques.

I am especially interested in mindful thinking because I believe it will not only help my panic attacks but also help me to control my other life stressers. Before my health issue, my life cup was right at the rim, and when another stresser came along, my cup runneth over. I have to keep that level down a notch or two - to allow some buffer for those inevitable life stressers that will come back into my life.

Blogging about my anxiety will help too. Thanks for stopping by and reading. You are part of my therapeutic journey, even in this small way.