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Is It Really Panic? And How Do We Get Help

Question:

My son had a severe panic attack when he was riding in a car. He was in front of the school where he had been assaulted as a student approximately 10 years previously. He has not been able to leave the house since that time. He is being seen by a social worker from the mental health organization. A psychiatrtist ordered medication for him which doesn’t seem to help. when he asked for a change in medication, he was told that the psychiatrist doesn’t make house calls.” How can we get some assistance?

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  • Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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Answer:

Sometimes I get a letter that just drives me up a wall. Yours is one of those letters because of the seeming failure of the medically dominated healthcare system to treat appropriately that is described therein. The suggestion here is one of a particular kind of anxiety disorder – either a traumatic stress reaction (along the lines of what is called post-traumatic stress disorder), or a phobia (similar to agorophobia (“fear of the market place”). Post-tramatic stress is suggested because you are describing a severe anxiety reaction which took place in the setting of a previous assult (I’m assuming this was a violent assault), and in the context of severe avoidance behavior (not being able to leave the house for 10 years). Agoraphobia is suggested because that particular phobia is all about becoming housebound in response to panic attacks that leave a person feeling that no place is safe. In either case, medication should not ever have been the primary treatment modality. What is suggested treatment-wise is cognitive-behavioral psychotherapy for anxiety. Possible adjunctive therapies might involve medication for anxiety, and EMDR (a type of therapy specialized for treating tramatic stress). Cognitive-Behavioral therapy for Agorophobia is very well studied and has a high success rate, and has the added bonus of having no side effects and being non-addictive (some anti-anxiety medications are highly addictive). Feel free to consult the directory of Cognitive-Behavioral therapists available at AABT’s website (the Association for Advancement of Behavior Therapists), for a referal.

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Comments
  • Anonymous-1

    Dear Dr. Dombeck,

    Thank you soooo much for this site and trying to provide help to so many invisible faces. I briefly reviewed some of the topics. These are so hard and difficult to seek help for. They are complicated, embarrassing and loaded with social stigma. I've got to do my part and I'm working on it. My request to you is, can you take these comments to the psychiatry societies so they can apprepreciate the gravity of these issues? I know they can't fix them but if they can help other pscychiatrist, psychologist and the general public understand that most people are good, kind people who are victims of the worse kind. There mind has turned on them and become their worst enemy. And they don't know how to fix it. One thing I think the psychiatry community needs to show is that everyone has a little bit of "crazy". And the degree is based on a lot of factors. We must increase compassion for these illnesses and provide more research to helping find cures.

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