Looking for Air

[Glass_Shadow]

My first post. I'm not sure whether I have a question. Not even sure I am in the right place. Just hoping someone is out there who understands.

I think I have panic attacks. No, I'm sure of it. In fact, I think I've probably had them all my life, and I'll be starting my 42nd trip around the Sun in a couple of months. It didn't get bad until a couple of years ago. I was having a rough time at work. I was expected to run the two departments each with more responsibility than any others in the facility. I was on call 24/365, was the only person who had worked every holiday for the last 5 years, and I couldn't tell you how many 24-hour and 36-hour shifts I had worked without a break. My boss was a walking ego. One day, I was trying to straighten my truck in the parking space and ended up denting a fellow employee's car. She had owned the car 5 days. I reported it to security and to her and to the insurance company. When I took her outside to show her the damage and apologize, suddenly the air was too thick to breathe. I ended up hyperventilating, hands and face started tingling, legs turned to rubber. They called an ambulance, but by the time it had arrived, I was breathing normally, and the only thing they could find wrong was that my pulse was a little elevated.

The security guard told my boss that I said I had blacked out. I don't remember telling him that.

A couple of weeks later I had another one. It just came out of the blue. Once again the air didn't seem to have enough oxygen.

After another week, it was happening every other day. Something new was starting, as well. Sometimes I would be sitting on the couch watching TV with my wife or maybe just going to check the mail, and all of a sudden I would be absolutely terrified. I didn't know what I was afraid of, but it was like being told that you probably wouldn't live until morning. An hour or two later, everything would be fine. Being afraid of nothing seemed silly.

I never believed in panic attacks. I always just assumed that it was an excuse to get out of work or to manipulate others. My opinion was rapidly changing, though.

I went to the doctor. He prescribed Wellbutrin. That helped at first, but after a while the "breathing fits," as I called them, came back. Eventually, I started studying Taoism and positive thinking. This was a huge change for someone who had been an atheist since he was a teenager. Things started getting better. A lot better. And, about 6 months later, I went off the Wellbutrin. I probably should have asked my doctor first, but I didn't feel the medicine was helping and I didn't really trust his opinion anyway.

A little over a year later, I changed jobs, took a HUGE pay cut, and ended up jumping out of the frying pan and into the fire. They put me, the new guy, as the head of a department that takes a couple of years to learn. My coworkers were resentful, to say the least. I had been free of the panic attacks for almost a year, and they came back with a vengeance. This time it was every day, sometimes as many as six in one day.

I am back on the Wellbutrin and my doctor added buspirone. I haven't hyperventilated since going on the new meds, but that is the only thing that has improved. Most nights, I wake up and worry to the ceiling over what might happen at work today. I lie there until I can't take it anymore, then get up and read or surf the Internet until it's time for my alarm to go off.

I called into work again today. I'm doing this at least once a month. The rest of the time, I force myself to go in. Yesterday was a really bad day. I couldn't do anything right. I was being asked to perform tasks that were about a year ahead of my learning curve, and every time I asked for help, the person seemed to take it as a personal attack. On the way to work, I started having an intense headache and a weird muscle spasm on the left side of my face. I thought I was having a stroke. I looked into the rear view mirror, but neither side of my face drooped. I woke up at 4:00 this morning and could not force myself to go in again today.

My wife is very understanding, but she has that look in her eyes that she is afraid I might lose my job.

I am wondering whether the buspirone is the problem. The doctor put me on only 15 mg twice a day, but I started having really bad headaches, and so he had me to cut the pills in half. This morning I got started doing some Internet research about buspirone. Dizziness, headaches, and insomnia are some of the symptoms. I have had severe sleep apnea for almost 10 years -- bad enough that before treatment I could fall asleep while talking or eating. So, insomnia is something difficult for me to wrap my brain around. Several of the websites also said that buspirone is ineffective for panic disorders.

I am seriously thinking about whether I should look for another doctor. Pills and "lose weight" seem to be his answer for everything. Plus, this wouldn't be the first time prescribed the wrong medicines for me. A pharmacist about hit the ceiling once when my doctor gave me two scripts that could not be taken together.

My wife has suggested that I see a counselor. There is a clinic close by, but I have heard a lot of bad things about it. Small towns don't tend to cultivate a wealth of psychiatric choices.

[rcohn20]

I understand how you feel-I actually just left a job last week due to the amount of anxiety it produced simply because I was doing the work of 3 people and working insane hours and weekends. You're not alone!
First-it's critical to go see a therapist-even if you have to drive an hour please find someone reputable! Search the Internet for someone who practices cognitive behavioral therapy-it will teach you how to prevent the anxiety and panic attacks.
Finally you need a better doctor-you need a psychiatrist who does this for a living-not just a general internist.
You can be helped-it doesn't have to be this way!

[Shyaamist]

WOW Glass~~~ I'm trying to decide if there is any possibility you are my husband! I really can't give you any advise because we are still trying to work through this together. Hubby suffers from anxiety attacks... but he is just realizing that is what they are. He gets chest pain, has major leg pain, and a very tight chest. He too will be sitting watching tv and all of a sudden it will hit him.

I on the other hand have general anxiety. I've only really ever had 2 or 3 panic attacks in the past 10 years. So I did some reading in some books that were shown to me and it helped me to understand what my husband is going through as well as myself. Sometimes I don't think he realized what I was going through until it started to dawn on him that he is having the same issues.

Does your wife understand what you are feeling? As a wife I can tell you that it is HEART BREAKING to want to be sympathetic to your husband at the same time worrying about how the bills will get paid. Hubby and I are both on different meds than you are, but I do know we react differently to meds. So it quite possibly could be your reaction to the meds.

I guess the best I can say is that I do understand where you are coming from! You are not alone! My brother is an alcoholic in recovery, and like him, I have learned that anxiety will never fully go away, ever. We just have to learn how to deal with it, be the master of it, and enjoy life. I am still trying to figure that part out.

~Good luck to you

[Glass_Shadow]

>>rcohn20 Thank you for the heads up about the cognitive behavioral therapy. I've been searching the Web most of the day for someone close and reputable. I'll start looking for that qualification, as well. I am sorry that you were forced to leave your job due to the stress. It seems there are a lot of people in the same situation. Sometimes I wonder why society has allowed itself to become something that makes so many people miserable.

>>Shyaamist I sympathize with both you and your husband. As I said, I never really believed in panic attacks, but I know now that they are very real. Yes, my wife understands how I am feeling. In fact, my wife is absolutely amazing. She's the reason I breathe. Here is another ironic similarity between your husband and I: I also have frequent chest pain and leg pain when sitting on the couch. My leg pain is an ache (about the same intensity as a toothache) next to the thighbone that builds and builds until my leg jerks. The ache goes away but immediately starts building again. I suffered a ruptured disk back in 2003, and I always attributed the leg pain to that. After reading your comment, now I wonder.

I wish all of you and your families the best. And thank you again for your kind words.

[trinidiva]

I take buspirone along with Zoloft. I start the buspar first, easing my way onto it. I am now taking 15mg, twice a day. I did get slight headaches, but you can take a motrin while taking buspar, and that feeling should go away within a few weeks. Of course, everyone is different, so if the headache persists, then you definitely want to speak to your doc again. You may need to try something different.
My doc also prescribed xanax so that I could take it as needed. Lately, my panic attacks have been at a minimum, so I haven't needed them. Let me tell you what has truly helped.....doing CBT, doing daily meditation ( I found an app for my phone, so I can do it anywhere), taking a Tai Chi meditation class and increasing my amount of exercise. I really feel much better. It's definitely work, but feeling good is worth it.

[PanicCured]

Let me break this down for you buddy! Knowledge is power!

There is never too little oxygen in the air. Hyperventilation symptoms are from breathing out too much Carbon Dioxide or CO2.

Why do we breathe? So we can get oxygen into our blood which will then circulate it and deposit it to our cells.

This is how your blood receives oxygen: Oxygen or O2 goes from the air, to lungs, to the blood. Each red blood cell carries oxygen. How does the oxygen go from the blood to your organs? By a partial pressure of CO2.

That means, there needs to be sufficient CO2 there, for the O2 to be released from the blood. Not enough CO2, the O2 can't be released as efficiently.

So..... when you breathe too much, what you are doing, is letting out too much CO2, which then actually causes less Oxygen to be released to your brain and organs. You get light headed and your nerves tingle, etc. So by overbreathing you are actually getting less oxygen, because your body does not need any more oxygen since its saturated anyway. You are letting out too much CO2, which inhibits O2 from being released from your blood to your organs and brain.

Ahhh we must learn to love Carbon Dioxide! Yes, Carbon Dioxide is good!

That means, that the less your breathe, the more oxygen your brain and organs are receiving.

When I discovered this, I felt I found gold. I was overbreathing all the time. Then I learned Buteyko breathing, and read this guy's book, Anxiety Free by Patrick McKeown and did the breathing exercises from the book and followed along with the MP3 and my anxiety went from a 10 to about a 5 in 5 days. I did a Skype call with him too. I have been shoving this guy's book down people's throats here for a while, and no, I do not receive any money from it.

Knowledge is power, and it would help everyone with anxiety to learn the basic physiology of it all to demystify what's going on. Nothing is worse than when you have all these symptoms and you have no idea where they come from. Once you know what it is, you are half way cured.

[Glass_Shadow]

Thank you for your comments.

>> trinidiva My GP started me out on 15 mg of buspirone twice a day, along with Wellbutrin. I wouldn't have known it was the cause of the headaches except that I forgot to take my morning dose one day, and I didn't get a headache. The next pill I took, though, it was back. My headaches last anywhere from 1 -2 hrs. They are not slight, though. It comes on all of a sudden, an intense pressure in my head, like I have been hanging upside down, and I can hear my blood coursing through my ears. It sounds like a sonogram: WOAM! WOAM! WOAM! I have wondered whether they are migraines. My mom had mild ones. I will try the motrin though.

>> PanicCured Thanks for the info. I knew that CO2 was involved, which is why people breathe into a paper bag, but I didn't know the exact relationship between it and the O2 in your blood. That makes a lot of sense. I will pick up that book, too. My wife and I both love to read. I have tried Wayne Dyer's books. That really helped, but lately the positive thinking is getting more difficult to sustain.

[PanicCured]

The book I referred you to is about how to breathe properly, and how to reverse hyperventilation syndrome to reset your breathing rhythm correctly. The guy who wrote it is this Irish guy, and I paid him $50 once for about an hour Skype session and he went over the breathing exercises with me. It comes with a mp3 that I used at least twice a day.

Here is an excerpt:


Healthy people have quiet and unnoticeable breathing. While they are resting, you cannot see or hear their breathing.
Quiet breathing ensures optimum partial pressure of carbon dioxide within your lungs, blood, tissues and cells. The release of oxygen from your blood depends on the presence of carbon dioxide.
Overbreathing causes a loss of carbon dioxide from your lungs, blood, tissues and cells.
This results in less oxygen being released from your blood into your tissues and organs. The more you breathe, the more your body is being starved of oxygen.
Breathing through your mouth, sighs, sniffing, noticeable breathing, hearing your breathing during rest or having a low Control Pause (explained later) indicates that you are starving your body of oxygen. Your brain is being starved, resulting in anxiety, depression and stress.
The calmer and quieter you breathe, the larger your blood vessels open, enabling better circulation and distribution of oxygen throughout the body, including the brain.
Oxygenate your brain—breathe less.
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Dilation of blood vessels and airways
Carbon dioxide relaxes the smooth muscles that surround the airways, arteries and capillaries.
With a normal breathing volume of 5 litres of air per minute, the partial pressure of carbon dioxide amounts to 40mmHg. Each 1 mmHg drop of arterial CO2 reduces blood flow to the brain by 2%.(2) In other words, oxygenation of your brain significantly decreases when you breathe heavily.
The heavier you breathe, the more you feed your hyperventilation or overbreathing related problems. Have you ever noticed that you get light-headed after taking a number of big breaths? Have you ever noticed being very tired in the morning after a night’s breathing through the mouth? How tired are you after a day’s talking? Do you notice that, as you get stressed, your breathing gets faster, resulting in a mental block and difficulty in making worthwhile decisions? Heavy breathing feeds anxiety and stress.
Overbreathing causes depression, stress and anxiety
Lower carbon dioxide within the blood causes a constriction of the carotid artery, the main blood vessel going to the brain. The extent of constriction depends on genetic predisposition but has been estimated by Gibbs (1992) to be as much as 50% for those with anxiety and panic attacks.(3) This finding is also supported by Ball & Shekhar (1997).(4)
Other researchers, including Balestrino and Somjen (1988)(5) and Huttunen et al. (1999),(6) have demonstrated that CO2 reduces cortical excitability. Cited in Normal Breathing: the key to vital health, “breathing too much makes the human brain abnormally excited due to reduced CO2 concentrations. As a result, the brain gets literally out of control due to appearance of spontaneous and
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asynchronous (‘self-generated’) thoughts.” Balestrino and Somjen (1988) in their summary directly claimed that, “The brain, by regulating breathing, controls its own excitability.”(7)
Dr Robert Fried, professor of psychology, states that “the first stage of chronic graded hypoxia (insufficient oxygen), which has repeatedly been shown in the case of chronic hyperventilation, is depression of mood and activity.”(8)
Cardiologist Claude Lum comments that “Hyperventilation presents a collection of bizarre and often apparently unrelated symptoms, which may affect any part of the body, and any organ or any system.”(9) He further labels hyperventilation syndrome as the fat file syndrome, noting that patients go from doctor to doctor in an attempt to get help for their symptoms. However, because chronic hyperventilation is overlooked in most instances, the patient might be told after a series of tests that there is nothing wrong with him or her, thus increasing the size of the patients’ file and further adding to his or her anxiety.
In the late Professor Buteyko’s words, “Exhaling Carbon Dioxide from the organism brings about spasms in bronchi, vessels and intestines, etc. This reduces oxygen supply, leading to oxygen deficiency, making one’s breath heavier, thus completing the vicious circle.”

[Glass_Shadow]

Thanks. I am going to the library tonight after work and see if I can find it.

[PanicCured]

Really? No man, they won't have it at the library. It was an ebook I bought with an MP3 download. Look here: http://www.patrickmckeown.net/books.php

[cabcom]

I know this all too well. My anxiety affects mostly my breathing. I think I can deal with every other symptom but that one. Super uncomfortable, but it helps knowing that my body don't need my help to breathe, so I have resolved to just take a back seat and allow whatever feeling or sensation to just have its fun.

[bajablue]

Glass, we have smiliar backgrounds around symptoms / work load / struggle to keep performaing at high level etc. My episodes, however, were 23 years ago. I understand everything you have said in spades. I would say unfortunately that you seem to be making a similar mistake (in hindsight) to one I made. Getting meds without getting therapy from a Psychologist. Did a Psychiatrist prescribe the Busbar and Welbutrin? Hope so. If not and it is from a GP, get to a Psychiatrist. You need Cognitive Therapy + meds (and statistically Buspar only works in 50 to 60% of those who take it and like an SSRI it must build up in your system)(and Welbutrin, though good for depression is known for causing increased anxiety in many patients - and I was one of them). Zoloft is what crushed my panic attacks plus about 2 years of Cog Therapy + Group therapy with other "Panic-tatics" + some Benzo use in rough patches. I did Bio-feedback and understand how to breath correctly now too. Get therapy from an experienced therapist.