Question:
Hi Rita, In a way my anxiety attacks will never be completely under control. I have PTSD and the recurrent intrusive thoughts (which start a cycle of thoughts and feelings) which I get are the cause of a lot of my anxiety. There seems to be no way to stop them (a lot of doctors, some very good ones, have tried).
I take it you have tried therapy. I wonder what therapies you tried. Was *cognitve therapy* or RET among them? Philip – Hide quoted text — Show quoted text – The best that I can do is to either take enough medication so that the thoughts don’t bother me (like now) or use a "kicker" like nicotine to break the cycle temporarily so the anxiety doesn’t get to bad. One thought I have is that I’m going through this for nothing. Once my body/mind adjusts to the new benzo level the intrusive thoughts will have as much power as before. I tried explaining to the smoking doc about this and why I was different for her "normal" patients but she doesn’t understand. Few people and fewer doctors do understand about the multifaceted aspects of PTSD. Tried the patch but it gave me a bad rash. Wasn’t what I was using nicotine for anyway, gave me a steady dose when what I needed was occasional "jolts". Maybe I should just stay "benzo’ed out" and at least stay out of everyone’s hair. Thanks for the response, Larry L. Larry, you have my sympathy, my roomie (husband) and I stopped smoking January 15. I have PD, he doesn’t. Neither one of us had any problem because we used the patch. I didn’t have to up any of my benzo’s or Effexor….just used the patch. Neither one of us felt any side-effects at all, except for the normal one of wishing we could have a smoke here and there. Joe had a salty taste in this mouth, and said he had weird dreams, but he wore the patch all night, whereas I took it off before I went to bed. I used the gum when it first came out and it didn’t impress me at all. The reason is because I needed something that worked in my system without me having to think about it. With the gum, and I imagine the spray too, I would always be thinking, "should I take a hit now or wait a while? Do I really need it or will the feeling go away?" With the patch, you put it on, go about your business, and forget all about it I must have missed it, but did you give the patch a try? Or is there some reason you can’t use it? Hang in there, Larry, and my advise is use what works best for you….everyone is an individual. BTW, is your anxiety/panic disorder under control? If it’s not to the point where you want it to be, then maybe this is not the right time to stop smoking. One thing at a time, my friend. Rita I’ve learned… that I can’t choose how I feel, but I can choose what I do about it.
Response:
Margrove writes: [snip], ptsd like many anxiety problems isn’t solved by using a cookbook of some therapy or some drug or some specific method of nuking ones head and eliminating memories. The adversity that is the catalyst for these conditions and the preexisting characterological structures that are present to forment a disorder are all powerful issues and strong resistances to change. —–Which brings to mind the question: If an agoraphobic were suddenly to have a lapse of memeory, let’s say through a head injury, would that person still be agoraphobic, since they wouldn’t "remember" to be so?? – Kinder
Definitely YES. I.M.H.E. — mark brown
Response:
-Which brings to mind the question: If an agoraphobic were suddenly to have a lapse of memeory, let’s say through a head injury, would that person still be agoraphobic, since they wouldn’t "remember" to be so?? – Kinder
no they wouldn’t-I have seen a few cases of head trauma, brain surgery for cancer, etc where the patient forgot their phobias or anxiety and went on without them-the personality structures that support these disorders was still intact so it is possible that in time they would have developed some symptoms, but they all were middle aged or older and I couldn’t follow their course LM
Response:
If a blow to the head would work and I even lost the good memories I would most definitely opt out of that cure.
I sometimes wonder if ad meds are akin to a blow to the head-I know ect is. From what I have seen the anxieties didn’t develop as such but some belief systems of perfection or embarassment or what if thinking still did so it is possible that in time some symptoms of vague anxieties may emerge but I didn’t see this. My neuro friends report same.
Response:
basicalt
what spastic fingers do to words is amazing…sorry for the typos it is disgusting. ptsd like many anxiety problems isn’t solved by using a cookbook of some therapy or some drug or some specific method of nuking ones head and eliminating memories. The adversity that is the catalyst for these conditions and the preexisting characterological structures that are present to forment a disorder are all powerful issues and strong resistances to change. But one can change and one does all the time. It is a matter of finding the ways to effectuate changes that are more goal oriented. One may never forget the trauma, nor should they. But using loads of tools to learn how to deal with it and go past it is the goal. It is like chipping away at a big big rock that impedes your way. It may take very little swipes with a chisel or sledge hammer, but sooner or later you chip away enough of the stone to gain access to get past it. The stone remains but the hole in it allows passage. LM
Response:
Margrove writes: [snip], ptsd like many anxiety problems isn’t solved by using
a cookbook of some therapy or some drug or some specific method of nuking ones head and eliminating memories. The adversity that is the catalyst for these conditions and the preexisting characterological structures that are present to forment a disorder are all powerful issues and strong resistances to change.
—–Which brings to mind the question: If an agoraphobic were suddenly to have a lapse of memeory, let’s say through a head injury, would that person still be agoraphobic, since they wouldn’t "remember" to be so?? – Kinder
Response:
—–Which brings to mind the question: If an agoraphobic were suddenly to have a lapse of memeory, let’s say through a head injury, would that person still be agoraphobic, since they wouldn’t "remember" to be so?? – Kinder
Great question. I would like to know the answer to that also. Take care, Liz — Problems are only opportunities in work clothes. –Henry Kaiser
Response:
LM, that’s the trouble with combat related PTSD. There is (normally) no "one" trauma. It’s day after day of similar traumas, some more potent than others but many of them equal to that single one that causes PTSD in some and PA’s in many. Like a magic onion, you peel down to what you think is the core and "poof" you’ve got a whole new onion to peel. If you have never experienced an intrusive thought about how it smelled a few moments after your best friend was blown in two by a land mine then you have no idea of the power of these thoughts. Knowing why they are happening takes little of the sting out of them. I’ve tried a form of REBT and at least for me, it provided little help. Thanks though. If there is a better med with less side effects please tell me so I can inform my Pdoc. Larry L.
– Hide quoted text — Show quoted text – you are saying nicotine is somewhat anxiolytic for you or interferes with ruminating thinking? Nicotine does a few things to brain amines and if this is so for you then there are some more potent dopaminergic monoamine oxidase ways of obtaining a better response. as for all forms of new therapy ptsd is very similar to any anxiety disorder in the sense that the panic attack is anxiogenic and self traumatizing meaning it acts as a trigger event and then becomes the trigger and the result simultaneously just like a traumatic event in a physical or psychological sense. REBT has a good track record with this in terms of moving past the trauma philosophicaly-one is not cured but can accept deal with and manage ones anxieties to a pretty good degree. Log on to www.rebt.org and give a whirl LM
Response:
– Hide quoted text — Show quoted text – Margrove writes: [snip], ptsd like many anxiety problems isn’t solved by using a cookbook of some therapy or some drug or some specific method of nuking ones head and eliminating memories. The adversity that is the catalyst for these conditions and the preexisting characterological structures that are present to forment a disorder are all powerful issues and strong resistances to change. —–Which brings to mind the question: If an agoraphobic were suddenly to have a lapse of memeory, let’s say through a head injury, would that person still be agoraphobic, since they wouldn’t "remember" to be so?? – Kinder
My theory would be that it would redevelop. The loss of memory would trigger anxiety and then the predisposition for panic would come in to play leading to the learned behavior to avoid things that cause discomfort. If a blow to the head would work and I even lost the good memories I would most definitely opt out of that cure. Hugs Thought Provoking Kinder ( I liked your picture) Charla
Response:
. If you have never experienced an intrusive thought about how it smelled a few moments after your best friend was blown in two by a land mine then you have no idea of the power of these thoughts.
sure I do in ptsd fear structures are basicalt the key to dealing with the situation. Fear structures consist of a netwrok of memory that includes information about the stimuli the responses to the stimuli and meaning associated with both The structure is a system designed for escape or avoidance. In other anxiety disorders the anxiety becomes circumscribed so that one who is afraid of heights or elevations etc can escape the anxiety by avoiding the thing of height, but in ptsd in wartime one is in an uncontrollable scenario where the unpredictability of danger and the suddeness of trauma these events shatter the persons concept of what is safe or dangerous and how to discriminate between them. The fear memories become triggered continuously just like you remembering smells associated with violent acts of danger and the death of comrades and friends. This requires a very aggressive disputation of ones beliefs of tolerance to discomfort and stress-meaning, fairness, and order, self worth,anger all of these beliefs and self talk can be addressed systematicaly with a great deal of success. But it is dilligent and hard to stay the course since your memory and your response to it is fairly well habituated and possibly fueled by specific personality issues. I have had success with patients I rx-ed maoi’s and tca’s as well as ssri’s with benzos- I have also used combos of bupropion and tca’s or ssri’s when necessary-it really depends on the presenting symptoms and behaviors and the persons individual biology and genetics. I do not know what meds you have tried. I do know that meds with social support and a very well organized rebt protocol with a supportive and available shrink helps imeasurably.-Modifying pretrauma cognitive structures and post trauma responses is viable and possible prexisting inferential or personality issues not withstanding. all meds can affect the intrusive thinking and the free floating anxiety and panic attacks, slow down your hyper -responsiveness but none will change your avoidance if this is your main behavioral manifestation. hope this helps LM
Response:
Hi Rita, In a way my anxiety attacks will never be completely under control. I have PTSD and the recurrent intrusive thoughts (which start a cycle of thoughts and feelings) which I get are the cause of a lot of my anxiety. There seems to be no way to stop them (a lot of doctors, some very good ones, have tried). The best that I can do is to either take enough medication so that the thoughts don’t bother me (like now) or use a "kicker" like nicotine to break the cycle temporarily so the anxiety doesn’t get to bad. One thought I have is that I’m going through this for nothing. Once my body/mind adjusts to the new benzo level the intrusive thoughts will have as much power as before. I tried explaining to the smoking doc about this and why I was different for her "normal" patients but she doesn’t understand. Few people and fewer doctors do understand about the multifaceted aspects of PTSD. Tried the patch but it gave me a bad rash. Wasn’t what I was using nicotine for anyway, gave me a steady dose when what I needed was occasional "jolts". Maybe I should just stay "benzo’ed out" and at least stay out of everyone’s hair. Thanks for the response, Larry L.
– Hide quoted text — Show quoted text – Larry, you have my sympathy, my roomie (husband) and I stopped smoking January 15. I have PD, he doesn’t. Neither one of us had any problem because we used the patch. I didn’t have to up any of my benzo’s or Effexor….just used the patch. Neither one of us felt any side-effects at all, except for the normal one of wishing we could have a smoke here and there. Joe had a salty taste in this mouth, and said he had weird dreams, but he wore the patch all night, whereas I took it off before I went to bed. I used the gum when it first came out and it didn’t impress me at all. The reason is because I needed something that worked in my system without me having to think about it. With the gum, and I imagine the spray too, I would always be thinking, "should I take a hit now or wait a while? Do I really need it or will the feeling go away?" With the patch, you put it on, go about your business, and forget all about it I must have missed it, but did you give the patch a try? Or is there some reason you can’t use it? Hang in there, Larry, and my advise is use what works best for you….everyone is an individual. BTW, is your anxiety/panic disorder under control? If it’s not to the point where you want it to be, then maybe this is not the right time to stop smoking. One thing at a time, my friend. Rita I’ve learned… that I can’t choose how I feel, but I can choose what I do about it.
Response:
- Hide quoted text — Show quoted text – Rita, I’ve tried so many different things over the past 12 years, all with the VA. Up until this point the combination of Klonopin and Bupropion (Wellbutrin) has worked as well or better than anything else. I’m convinced that I will never quit "smoking" in the sense that unless someone comes up with something better than nicotine (in a replacement form) it is the only thing that seems to break the cycle with the least side effects. Trouble is that I’m to a large extent stuck with the VA. I’m 100% service connected disabled so I get the best they have to offer, sometimes it isn’t enough. Larry L. Hi Larry, I do understand because part of my panic came from a couple of early childhood incidents that traumatized me forever. I’m really thinking two things….first, if this doc doesn’t understand PTSD, then keep on looking until you find one who specializes in PTSD….I personally don’t think Klonopin is the drug of choice for what you have. But I’m not a doctor. Secondly, really, truly, is this the best time to put yourself under the stress of trying to stop smoking? My psych doc told me to wait at least a year until I tried again. But you have to do what’s best for you. I bet if you went to one of the Vet Hospitals you would find the doctor you need, or even to a veteran’s group. I wish you lived near me, because my psych doc is very familiar with this disorder and knows his meds. Rita sometimes all a person needs is a hand to hold and a heart to understand.
you are saying nicotine is somewhat anxiolytic for you or interferes with ruminating thinking? Nicotine does a few things to brain amines and if this is so for you then there are some more potent dopaminergic monoamine oxidase ways of obtaining a better response. as for all forms of new therapy ptsd is very similar to any anxiety disorder in the sense that the panic attack is anxiogenic and self traumatizing meaning it acts as a trigger event and then becomes the trigger and the result simultaneously just like a traumatic event in a physical or psychological sense. REBT has a good track record with this in terms of moving past the trauma philosophicaly-one is not cured but can accept deal with and manage ones anxieties to a pretty good degree. Log on to www.rebt.org and give a whirl LM
Response:
Philip, you name it and I’ve tried it (except ECT). It seems to be the flight/fight hard wiring that constantly reinforces the old memories and causes them to keep returning. They keep trying with "new" forms of therapy and I go along on the chance that someone will find the "key" or help me find it. My Pdoc’s have all given up on us. It’s meds now and forever. Larry L.
Response:
Rita, I’ve tried so many different things over the past 12 years, all with the VA. Up until this point the combination of Klonopin and Bupropion (Wellbutrin) has worked as well or better than anything else. I’m convinced that I will never quit "smoking" in the sense that unless someone comes up with something better than nicotine (in a replacement form) it is the only thing that seems to break the cycle with the least side effects. Trouble is that I’m to a large extent stuck with the VA. I’m 100% service connected disabled so I get the best they have to offer, sometimes it isn’t enough. Larry L.
– Hide quoted text — Show quoted text – Hi Larry, I do understand because part of my panic came from a couple of early childhood incidents that traumatized me forever. I’m really thinking two things….first, if this doc doesn’t understand PTSD, then keep on looking until you find one who specializes in PTSD….I personally don’t think Klonopin is the drug of choice for what you have. But I’m not a doctor. Secondly, really, truly, is this the best time to put yourself under the stress of trying to stop smoking? My psych doc told me to wait at least a year until I tried again. But you have to do what’s best for you. I bet if you went to one of the Vet Hospitals you would find the doctor you need, or even to a veteran’s group. I wish you lived near me, because my psych doc is very familiar with this disorder and knows his meds. Rita sometimes all a person needs is a hand to hold and a heart to understand.
Response:
Hi Larry, I do understand because part of my panic came from a couple of early childhood incidents that traumatized me forever. I’m really thinking two things….first, if this doc doesn’t understand PTSD, then keep on looking until you find one who specializes in PTSD….I personally don’t think Klonopin is the drug of choice for what you have. But I’m not a doctor. Secondly, really, truly, is this the best time to put yourself under the stress of trying to stop smoking? My psych doc told me to wait at least a year until I tried again. But you have to do what’s best for you. I bet if you went to one of the Vet Hospitals you would find the doctor you need, or even to a veteran’s group. I wish you lived near me, because my psych doc is very familiar with this disorder and knows his meds. Rita sometimes all a person needs is a hand to hold and a heart to understand.
– Hide quoted text — Show quoted text – Hi Rita, In a way my anxiety attacks will never be completely under control. I have PTSD and the recurrent intrusive thoughts (which start a cycle of thoughts and feelings) which I get are the cause of a lot of my anxiety. There seems to be no way to stop them (a lot of doctors, some very good ones, have tried). The best that I can do is to either take enough medication so that the thoughts don’t bother me (like now) or use a "kicker" like nicotine to break the cycle temporarily so the anxiety doesn’t get to bad. One thought I have is that I’m going through this for nothing. Once my body/mind adjusts to the new benzo level the intrusive thoughts will have as much power as before. I tried explaining to the smoking doc about this and why I was different for her "normal" patients but she doesn’t understand. Few people and fewer doctors do understand about the multifaceted aspects of PTSD. Tried the patch but it gave me a bad rash. Wasn’t what I was using nicotine for anyway, gave me a steady dose when what I needed was occasional "jolts". Maybe I should just stay "benzo’ed out" and at least stay out of everyone’s hair. Thanks for the response, Larry L. Larry, you have my sympathy, my roomie (husband) and I stopped smoking January 15. I have PD, he doesn’t. Neither one of us had any problem because we used the patch. I didn’t have to up any of my benzo’s or Effexor….just used the patch. Neither one of us felt any side-effects at all, except for the normal one of wishing we could have a smoke here and there. Joe had a salty taste in this mouth, and said he had weird dreams, but he wore the patch all night, whereas I took it off before I went to bed. I used the gum when it first came out and it didn’t impress me at all. The reason is because I needed something that worked in my system without me having to think about it. With the gum, and I imagine the spray too, I would always be thinking, "should I take a hit now or wait a while? Do I really need it or will the feeling go away?" With the patch, you put it on, go about your business, and forget all about it I must have missed it, but did you give the patch a try? Or is there some reason you can’t use it? Hang in there, Larry, and my advise is use what works best for you….everyone is an individual. BTW, is your anxiety/panic disorder under control? If it’s not to the point where you want it to be, then maybe this is not the right time to stop smoking. One thing at a time, my friend. Rita I’ve learned… that I can’t choose how I feel, but I can choose what I do about it.
Response:
Larry, I don’t have any advice, but I just want you to know how much I sympathize. I have some idea of how bad you feel right now. Quitting smoking is one of the hardest things to do, but you will never, ever regret it. Please believe me! These are the difficult weeks; it *will* get better. If you need motivation, visit http://www.getoutraged.com/p_spots.htm and view the ads about Pam Laffin. (The latest one is running on TV a lot these days.) Gruesome and unbearably sad. I hope you feel better soon, Larry. Hang in there, please! I’m saying a prayer for you the minute I post this message. Best, Anne —
Response:
Larry, you have my sympathy, my roomie (husband) and I stopped smoking January 15. I have PD, he doesn’t. Neither one of us had any problem because we used the patch. I didn’t have to up any of my benzo’s or Effexor….just used the patch. Neither one of us felt any side-effects at all, except for the normal one of wishing we could have a smoke here and there. Joe had a salty taste in this mouth, and said he had weird dreams, but he wore the patch all night, whereas I took it off before I went to bed. I used the gum when it first came out and it didn’t impress me at all. The reason is because I needed something that worked in my system without me having to think about it. With the gum, and I imagine the spray too, I would always be thinking, "should I take a hit now or wait a while? Do I really need it or will the feeling go away?" With the patch, you put it on, go about your business, and forget all about it I must have missed it, but did you give the patch a try? Or is there some reason you can’t use it? Hang in there, Larry, and my advise is use what works best for you….everyone is an individual. BTW, is your anxiety/panic disorder under control? If it’s not to the point where you want it to be, then maybe this is not the right time to stop smoking. One thing at a time, my friend. Rita I’ve learned… that I can’t choose how I feel, but I can choose what I do about it.
– Hide quoted text — Show quoted text – I’m still in a fog. Upped my Klonopin to 4 mgs a day to cut down on my need to use a nicotine replacement spray. It’s working, I could probably get by without the spray at all. Trouble is I’m not adjusting to the increased dosage well. Feel like my mind is locked down for most of the day. I won’t drive my car, no anxiety about it (no anxiety about much of anything at the moment), but I know driving would not be safe for me or others out on the road. Why can’t my doctors get together on this? I was doing fine on two and a half to three Klonopin a day and using the spray when I needed it. I was getting around fine and my head seemed as clear as normal (what ever that is). I feel like going back to smoking and cutting back on the Klonopin (slowly). I may kill myself in the long run (by smoking) but I don’t want to live like this much longer. Appointment to see my stop smoking doc on Wednesday. Going to be an interesting drive if my head doesn’t clear up better. I don’t think she understands my situation and hasn’t prescribed enough spray anyway (200 0.5mg sprays in a bottle, ten sprays a day (equal to 5 cigs) and one bottle a month. Do the math, end up 10 days short no matter how you count it). This isn’t doing anything good for my depression and my Pdoc is pissed off but can’t seem to do anything about it. Well, at least I’m getting plenty of sleep and maybe with a little more Klonopin (expect that’s what the smoking doc will tell me to do) I won’t care about any of this at all. Sorry for the rant, just feeling a little lost right now. Larry L.
Response:
I’m still in a fog. Upped my Klonopin to 4 mgs a day to cut down on my need to use a nicotine replacement spray. It’s working, I could probably get by without the spray at all. Trouble is I’m not adjusting to the increased dosage well. Feel like my mind is locked down for most of the day. I won’t drive my car, no anxiety about it (no anxiety about much of anything at the moment), but I know driving would not be safe for me or others out on the road. Why can’t my doctors get together on this? I was doing fine on two and a half to three Klonopin a day and using the spray when I needed it. I was getting around fine and my head seemed as clear as normal (what ever that is). I feel like going back to smoking and cutting back on the Klonopin (slowly). I may kill myself in the long run (by smoking) but I don’t want to live like this much longer. Appointment to see my stop smoking doc on Wednesday. Going to be an interesting drive if my head doesn’t clear up better. I don’t think she understands my situation and hasn’t prescribed enough spray anyway (200 0.5mg sprays in a bottle, ten sprays a day (equal to 5 cigs) and one bottle a month. Do the math, end up 10 days short no matter how you count it). This isn’t doing anything good for my depression and my Pdoc is pissed off but can’t seem to do anything about it. Well, at least I’m getting plenty of sleep and maybe with a little more Klonopin (expect that’s what the smoking doc will tell me to do) I won’t care about any of this at all. Sorry for the rant, just feeling a little lost right now. Larry L.
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