Overcoming Panic Disorder: Seeking Effective Treatment Beyond Medication

I was diagnosed with panic disorder by the hospital?

Hello, I had a few instances of hyperventilation before my military service, but I didn't think much of it since it only happened once or twice.
However, during my service, I experienced severe anxiety and insomnia, often sleeping only 1 to 2 hours a night and waking up frequently, which led to very light sleep.
I had no such issues before my service.
Eventually, it worsened to the point where one day I woke up feeling like I couldn't catch my breath.
I was extremely anxious during roll call, my heart was racing, which caused me to hyperventilate, and I was sent to the hospital.

I used to be able to drink coffee and tea without any problems, but from that point on, consuming either would cause severe palpitations.
Later, I visited a military hospital where they conducted a full examination but found no abnormalities.
Eventually, I saw a psychiatrist at the military hospital, but instead of discussing my condition, they just prescribed medication.
My situation improved somewhat, and I stopped taking the medication two months before my discharge without any issues.
Now, it has been four years since my discharge, but two years ago, while driving, I suddenly experienced hyperventilation again.
Since that day, I have been unable to stay home alone and fear going out.
Whenever I am alone, I feel very anxious and cannot live normally.
I then went to Chang Gung Memorial Hospital in Keelung, where they prescribed me six medications to take three times a day.
However, whenever I took those medications, I would become drowsy.
Although my condition improved slightly, I still felt very anxious whenever I drove on the highway or went to remote areas.
If I stopped taking the medication for 2 to 3 days, the panic would return.
Last month, I visited the psychiatric department at Taipei Veterans General Hospital, where I had a CT scan of my brain.
The doctor prescribed me Xanax, which I also have to take three times a day.
I feel the same way with this medication as I did with the ones from Chang Gung; if I don't take the medication, I start to feel very anxious.
I still don't dare to drive on the highway or go to the mountains or remote places.
My family has advised me against taking these medications, fearing the side effects and potential long-term issues.
Recently, I heard that hypnosis can treat this kind of condition without relying on medication.
I would like to ask you what I should do now and if there are any good psychiatric treatments or hypnosis therapies in Taipei or Keelung.
I do not want to visit hospitals that only prescribe medication without improving my condition.

Xiao Wei, 20~29 year old female. Ask Date: 2004/11/07

Dr. Chen Wenke reply Psychiatry

Hello, Xiao Wei.
From your clear description of the situation, I can confidently tell you that you are experiencing what is known as panic disorder, which is fundamentally an anxiety-related condition.
Medications for anxiety can certainly help improve this type of disorder, and your past experiences have indeed reflected that.
However, is there any other way to manage this besides taking sedatives? The answer is yes, but I must emphasize that even among two individuals diagnosed with panic disorder, their responses to medication and the severity of clinical symptoms can vary significantly.
Therefore, treatment should be tailored to your specific situation to determine what is most effective.
I must say that although you may not prefer solely medication-based treatment, pharmacotherapy is still very important (because it is effective).
Do not deny or avoid this fact.
Of course, other methods can also be beneficial for treatment, including the use of antidepressants and psychotherapy.
Clinical reports indicate that a combination of medication and psychotherapy is more effective than using either treatment modality alone, so you might want to consider this approach.
In Taipei, many hospital physicians often have limited time to discuss due to the high volume of outpatient cases.
However, I can recommend that you visit Dr.
Jan Chia-Chen at Taipei Municipal Zhongxing Hospital, as he has good experience in treating panic disorder.
Give it a try.
As for hypnosis, I believe there is considerable variability among hypnotherapists.
Unless absolutely necessary, I do not recommend this treatment approach.
Wishing you well.

Reply Date: 2004/11/07

More Info

Overcoming panic disorder can be a challenging journey, especially when medication alone does not seem to provide the relief you seek. Your experience with panic attacks, especially in high-stress situations like military service, highlights the complexity of anxiety disorders and the need for a multifaceted approach to treatment.
Firstly, it is important to recognize that panic disorder often involves a cycle of fear and avoidance. When you experience a panic attack, the body's natural response is to enter a state of heightened alertness, which can lead to hyperventilation and feelings of being unable to breathe. This can create a fear of future attacks, leading to avoidance behaviors, such as not wanting to be alone or avoiding certain situations like driving on highways. Understanding this cycle is crucial in addressing your symptoms.

While medications like Xanax can provide immediate relief for anxiety and panic symptoms, they are often not a long-term solution due to potential side effects and the risk of dependency. It is understandable that you are concerned about the long-term use of these medications, especially given your family's apprehensions about their side effects. Therefore, exploring alternative treatment options is a wise decision.

Cognitive Behavioral Therapy (CBT) is one of the most effective non-pharmacological treatments for panic disorder. CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to anxiety. Through CBT, you can learn coping strategies to manage panic attacks when they occur, as well as techniques to gradually face and reduce your fear of certain situations. This approach can empower you to regain control over your life and reduce the reliance on medication.

Another option you mentioned is hypnosis. While research on hypnosis for panic disorder is limited, some individuals find it helpful as a complementary therapy. Hypnosis can promote relaxation and help individuals access their subconscious mind to address underlying fears and anxieties. If you are interested in this approach, seek a qualified professional who specializes in hypnotherapy for anxiety disorders.

Mindfulness and relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, and meditation, can also be beneficial. These practices can help you manage anxiety symptoms in the moment and reduce overall stress levels. Regular practice can enhance your ability to cope with panic attacks and improve your overall mental well-being.

Additionally, engaging in physical activity can be a powerful tool in managing anxiety. Exercise releases endorphins, which can improve mood and reduce stress. Finding an activity you enjoy, whether it's walking, jogging, or yoga, can provide both physical and mental benefits.

Lastly, consider seeking a second opinion from a different mental health professional if you feel that your current treatment plan is not effective. Look for a psychiatrist or psychologist who takes a holistic approach to treatment and is open to discussing various therapeutic options beyond medication.

In summary, overcoming panic disorder requires a comprehensive approach that includes therapy, lifestyle changes, and possibly alternative treatments like hypnosis. By actively participating in your treatment and exploring various options, you can find a path that works for you and leads to a more fulfilling life. Remember, recovery is a journey, and it is okay to seek help along the way.

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