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  • BDD Moderators: Keif’ Richards | negrogesic

Meds for a) medical ptsd, b) panic disorder, or c) hyperadrenergic POTS

C

copium7777

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Apr 26, 2020
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411
I think this is a problem that's a combination of autonomic dysfunction and trauma from the medical system. That is, theres a contextual/psychological trigger but its also bc of autonomic dysfunction and sympathetic tone, which has an organic cause. I will now avoid going to doctors even when it's necessary or beneficial for me , because I've had such bad experiences that I fear them. I'm not looking for somethinf that heals rhe trauma overall, just something that helps wbthe acute symptoms like panic etc when in a doctor's office. The PTSD makes my hyperadrergic pots and white coat Hypertension way more intense. My bp is usually never high af home but is very high at doctors

I react badly to beta blockers but considering that alpha agonists may be more tolerable

Im trying to taper from benzos that im dependent on so benzos cant really help. I am just generally wondering if there are drugs for acute panic situations that are nor benzos or beta blockers.
 
I was on an SSRI called celexa. It is an older drug, made for depression and anxiety. Celexa is a long acting drug, meaning it has to stay in your system to work. I was on it for about a week when I realized my mood was more stable and I didn't have a lot of racing thoughts about stupid things like "What if we run out of water on planet?" Or "What if I'm at Walmart and someone tries to steal my baby?"

I have generalized anxiety, but for a brief spell I did have panic disorder brought on by domestic violence. It is the only drug that has ever worked for me, and my husband quite liked it as well.
 
Yes. I should've included more context but heres why therapy doesnt really help.

My medical ptsd is in some ways related to ongoing trauma (the trauma of being really sick and not getting adequate support from doctors, and getting treated badly by them) , and so it isnt something that is resolved that happened in the past.

Its hard to process a trauma when the trauma is ongoing.

In addition having very very small window of cognitive and physival energy makes it hard to really process things like this or heal from them, hence why for the monent, until i recover from my physical illnesses, im sort of looking for ways to medicate the symptoms

Also, I dont know many therapists who are very good with understanding chronic illnesses , many of them are uninformed about this topic and in some ways therapy can cause more harm than good if you have a therapist who doesnt understand what youre dealing with.

I also think while there are definitely psychological triggers for this panic response/ptsd, there are organic causes for the hyperadrenergic state that sustains them. For example, before i became Ill with POTS and ME/CFS and developed craniocervical instability, which caused all these autonomic issues in heart rate and blood pressure, i had similar levels of psychological stress and anxiety , and yet my blood pressure spikes were almost non existent. So i think its a combination of two things, an autonomic issue caused by something physical that causes sympathetic hyperadrenergic state, and then a psychological trigger that sets it off... but like i said i had anxiety beforehand without these kinds of bp spikes, so i think some of it is organic and hard to fix, that is why im looking at meds
 
So with regard to trauma and panic caused by my situation, its sort of like if someone was retraumatized every day but attempting to do therapy for it.

With the following analogy im not trying to say my situation is as bad, its just an extreme obvious example of a ptsd trigger and supposed to be analogous not homologous.
Say someone is in the midst of battle and encountering traumatic triggers such as bullet firing and people dying every day. In that case would it make sense for them to do therapy weekly , or to only bbe able to do that after they come home from war?

Again, i am not trying to offend anyone by saying my trauma is anywhere near a soldiers, i am just tryint 5o make an analogy. If i keep dealikg with a very traumatic situation in which the only way to deal is sort of get my head down and get through it, i am wary of the utility of any method of processing the trauma, until the trauma is gone.
 
Ok yes I get what you’re saying and I’ve been through it with drs also. As you know I too have a connective tissue disorder. What I know about it is that we have higher adrenaline running through our system therefore anxiety is unfortunately always there in the background. It’s about finding what helps with that. I’ve found the best thing helped me was getting my pain meds correct and also therapy that taught me how to deal with anxiety, recognise an anxiety attack and I have Benzos for when it gets to a stage I can’t talk myself out of it. Unfortunately you say you can’t take Benzos. Maybe there’s an online anxiety course you could try?
I forget which country you said you were from. For me I had to pay for a specialist to get the proper diagnosis and treatment plan. It was over £400 for one visit including flights but it was worth every single penny. Are you able to save for such an appointment. It would help you in more way than one, you’re paying for the best care so they are there to serve. It’s not like nhs drs who haven’t a notion what they are talking about if you get me. So it would help you realise that there are professional drs out there who will listen and treat you. You could also get specific meds for your condition that your normal dr wouldn’t think of.
 
Oddly prazosin made me feel worse. It actually made my heart rate faster which makes almost no sense. The only reason i could think of for that is that the adrenaline is compensatory for low blood volume, the body trying to use adrenaline to clamp down on the vessels and push around the remaining blood, vasoconstriction etc , so blocking adrenaline effect without increasing volume not work?
 
So you're looking for a substance that will help relieve severe anxiety and/or panic, but only for acute episodes of the same?

If this is the case, Benzodiazepines would be a pretty reasonable and practical choice. Outside of irresponsible and/or chronic usage, I think Benzodiazepines are amazingly and almost universally effective.

I get that this isn't an option for you. I'm going to throw out several possibilities, but please get back to us so we can have a dialogue. This is not an easy or predictable problem.

Gabapentinoids?

Cannabis or more likely Cannabidiol?

I would usually not say Alcohol, but a few quick drinks might reduce the intensity of your panic.

I dont feel that SSRI's or SNRI's are a good choice. I just dont think initiating a chronic treatment for an acute problem makes sense.

Please let us know more about your situation and what you have tried before I really start making suggestions.
 
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