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Panicking Boyfriend

Question:

Hello-I’m 22 and my boyfriend is 31, who is diagnosed with anxiety/panic disorder. He has had this for 6 years and nothing seems to be improving. Medications, cat scans, therapy…it has just gotten worse. Is it normal for them to last for 6 hours at a time? For 4-5 days? He’ll have good days and then a long stream of bad days. It’s impaired his driving and jobs. I have been very patient and sensitive to his needs…but how can I tell if he is “over-exaggerating” (not that he is)? His pulse is normal during the attacks, although, one occasion it was very slow. Currently, he is on PaxilCR and Ativan. I don’t see a difference and it’s been about 6 months on these. (he’s been on several medications over the years.) He is wanting to give up on help and work. I just don’t know what to do…Thank you for your time and advice. It is greatly appreciated.

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Answer:

I’m thinking there are at least two issues to deal with in your short letter. The first has to do with the nature of panic disorder – could it really be this severe and treatment resistant? – and the other has to do with your own frustration. The answer to the first question is that panic disorder really can be this severe and disabling, although it would seem likely that your boyfriend has perhaps more than just simple panic disorder going on. It is also entirely possible that your boyfriend is exaggerating his symptoms so as to get attention and care. If the latter is the case, the manipulation could be intentional or relatively ‘unconsciously’ motivated; there is no simple and reliable way to tell. Government agencies responsible for disability payments will sometimes commission psychological testing in an effort to separate out real disabilities from malingering patients, but this type of response would seem inappropriate to your situation.

You suggest that many therapies have been tried with little positive effect. I wonder if one of those therapies has been cognitive behavioral therapy for anxiety and panic. Cognitive therapies are known based on scientific study to be among the most effective treatments for anxiety and panic problems. If cognitive therapy has not been tried, it should be considered.

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p> It doesn’t take much reading between the lines to recognize that you are frustrated with this situation and more than a little suspicious of your boyfriend’s condition. You’re working hard to support this man but aren’t sure if you are being taken advantage of and manipulated in the process. It may be a good idea for you to get some support for yourself to help you to figure out your feelings better. After all, if you are going to continue on in this relationship, it will be best to feel good about your reasons for staying. Consider talking out your feelings with a counselor or supportive friend, and possibly also researching panic and anxiety disorders so that you have a better idea of how they work and what treatments are available. It’s often the case that people in a caregiving role feel guilty if they acknowledge anger or frustration, but these are often some of the feelings that caregivers really have. It’s okay and healthy to acknowledge them if they are there.

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