Question: I have been speaking to a therapist and she suggested medicine. I have panic attacks, I do not go outside in public, I do not even want to get out of bed some days. I can't sleep at night, and there are all kinds of thoughts that go through my head what do i do?
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Laura NP
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Tuesday, May 25, 2010
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Dear Shelby,
It sounds like you may have some anxiety symptoms and some depressive symptoms. I do want to mention the importance of the sleep-wake cycle. It sounds like you are having trouble falling asleep and then having trouble waking up...probably because you aren't falling asleep until late. I would definitely recommend a sleep medication. People are amazed by how much better they feel once they have a regular sleep pattern. I would prescribe ambien for you for sleep. You may find that the ambien is enough to curb your racing thoughts as you fall asleep. I think the most effective therapy for your type of anxiety is CBT (cognitive behavioral therapy). There are often groups or day programs you can attend at your local hospital's outpatient psychiatric services. Group therapy would help. And, the CBT will help you gain insight into what triggers a panic attack as well as ways to extinguish panic before it starts. I would also target the depressive symptoms with an antidepressant. But before prescribing an antidepressant, I would want to hear a little more about your history. It may be that an antidepressant might make your racing thoughts worse. So to sum it up, you should try to reset your sleep-wake cycle, go to bed at the same time each night and wake up at the same time each day. Also try the ambien. Look into joining a CBT group or day program with the main focus of CBT to target your panic and social anxiety. Thoroughly review your history of symptoms, especially the racing thoughts, with your prescriber before trying an antidepressant. Good Luck and let us know how you are.
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