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Psychiatrist


#1

Has anyone tried seeing a psychiatrist? I feel like I could live with my dizziness (rocking) but it’s my anxiety that is causing me the most problems and making my life debilitating. I get panicky in rooms full of people and def know I am dealing with anxiety issues. Do you think a psychiatrist would be helpful in treating the anxiety part of this condition? (without taking anidepressant drugs)

Briana


#2

Psychiatrists tend to treat with drugs (at least in uk). Why not ask to be referred for CBT. Often this is referred via Psychology. This did wonders for my panic attacks (unrelated to the MAV) and had a good evidence base behind it.


#3

Thanks dizzyizzy


#4

Hi Briana,

You should also check into “mindfulness based stress reduction”. Google it for something near to you. It was developed at the University of Mass and is based on Buddhist principles (minus the philosophy). It’s evidence-based and shown to work, especially for chronic disease like migraine.

Scott


#5

Hi Scott,
Have you ever dealt with anxiety issues? I am not sure if my dizziness is from MAV or from anxiety. It could be from both. Have you benefited from “mindfulness based stress reduction”? - I will look into that.
Thank you!
Briana


#6

Hi Briana,

Is the Pope Catholic? :lol: I’ve had enough anxiety to feed an army and I’m dealing with it right now as I navigate my way through another viscious MAV attack (self-induced unfortunately). The whole dizziness, MAV, anxiety thing is a real mess. But from what I have experienced and what others say here, and what is in the science literature, migraine and anxiety are comporbid conditions. That is, if you have migraine you probably have issues with anxiety too – and probably prone to depression.

Have a look at this article:

http://mvertigo.cloudapp.net/t/migraine-anxiety-related-dizziness-mard/451

When I get a MAV attack like now, it ramps up anxiety in a big way. When people are new to this condition they fret over what’s happening on top of the physiological stuff. We’ve all had that and go through it.

Understanding your own personal anxieties and learning to not react to MAV is a very difficult yet critical lesson to learn in my opinion. Constant stressing over this disease simply feeds it and either makes it worse or perpetuates the symptoms. And so courses such as MBSR are really useful in teaching you about this. I have to be honest and say that I haven’t been doing the mediatation like I should be but I am today and am meeting up with the old group tonight by the looks of it. I really need it now considering I have been off an SSRI for only 3 weeks and have had a racing heart most of the day.

Let me know how you go with whatever you choose.

Scott :slight_smile:


#7

Hi Briana

Yes, I’d agree with everything Scott says - MAV and anxiety/depression are a real muddle! Personally, for me, MAV can trigger my anxiety but I haven’t found the reverse is true. Although there is a condition called ‘Migraine Anxiety Related Dizziness (MARD)’, my neuro-otologist doesn’t think I have it but that my MAV and Anxiety coexist (being rooted in the same area of the brain as each other). (The reference for this paper is 'Migraine-anxiety related dizziness - (MARD): a new disorder? J M Furman, C D Balaban, R G Jacob, D A MarcusJ Neurol Neurosurg Psychiatry 2005;76:1–8. doi: 10.1136/jnnp.2004.048926) - I can email it to you if you like or I think Scott may have uploaded it somewhere on this site…)

Coincidentally, I’m trying some mindful meditation stuff at the moment to deal with my latest MAV flare-up. It’s getting my kids to leave me for 20 mins to actually do it which is proving the problem - they think it’s hilarious!

Anyway, re. the CBT. I was diagnosed with Panic Disorder (a form of Anxiety Disorder) in 1996 and tried many meds, much to no avail. I also tried Counselling and more traditonal psychotherapy, also not much use. I was having about 1-2 attacks a month but mainly at night - they would wake me up, then I started getting them when about to go out, then when actually out (e.g. in shops), and they made me agoraphobic. The attcks stopped completely when I was pregnant and returned after I stopped breastfeeding - so probably a hormonal link. I first had CBT (referred by my GP) in about 2004, for about 6 months (once a month I think) - it helped a bit, and the panic attacks more or less stopped for a while. Then in 2006-7 they came back, and I was rereferred. This time I saw a different CBT therapist - she was amazing, absolutely brilliant - and more or less ‘cured me’, although she couldn’t help much with the MAV itself, which came and went. SHe recommended a few books if you’re interested, and I also did an online CBT top-up course.

I’m in the UK, and CBT is seen as a bit of a ‘cure-all’ here at the moment, and the government seem to be putting money into services here, so it’s been available on the NHS. However, I firmly believe it’s very much dependent on the therapist you get, and whether you ‘gel’ and how intelligent you perceive them to be etc. as to how successful it is.

It may not be for you - I think it’s worth a try. And good luck with the mindfulness stuff too!

Dizzy Izzyx


#8

Hi dizzy izzy,

Your post really interests me because I can see myself in what you wrote. I seem to be coming unstuck very rapidly at the moment again despite using all that I have in my arsenal to keep the lid on this. I spent the whole night with quite severe anxiety symptoms and feel quite ill this morning. I’m 3.5 weeks out from stopping Paxil and wondering if this anxiety disorder is just something I will never shake on my own. I first had it quite badly when I was hit with VN in 2003. I’m certain the migraine I deal with and the anxiety are rooted in the same area of the brain. As soon as I set off migraine over the weekend (by having very little sleep over 2 nights) the anxiety has gone completely wild and out of control. I’m not sure how even CBT could stop this considering I’m not really having anxious thoughts at all. The only thing worrying me is the intensity of this current attack and wondering what med to use if I have to do so – I cannot bare SSRIs any longer.

Where are you at now with anxiety? Is it under control? I really thought I had this sorted – very disappointing.

Scott :frowning:


#9

Hi!

Lord only knows what time it is down under - you seem to post v. early in the morning there! Hope it’s not the anxiety keeping u awake/waking you up!

Really sorry to hear you’re suffering so much with this damn anxiety on top of the MAV. The MAV makes me utterly depressed and anxious about specific things, eg. work/family/what the future holds with MAV, but I feel that for me my MAV anxiety is not the same as the anxiety I had with the panic disorder. For a start, dizziness was never once a symptom of one of my panic attacks. Don’t want to bore everyone with the details but my main panic attack symptoms were the following:
sense of doom/impending death
intense fear (probably due to above!)
sudden tachycardia (130+bpm)
trembling and shaking - legs would shake so badly it would wake my husband up
weird and really scary ‘numb’ feeling which spead throughout my body, rising from stomach area or could start in hands/feet
cramps in hands and feet
tunnel vision

the whole thing would build to a peak and last between 10 and 30 minutes. Then I was left feeling exhausted for a day or more, and sometimes I could have one attack after another when it was at its worst.

Basically, the gist of the CBT was to learn NOT to fight/ignore or avoid the panic symptoms but to ‘welcome’ them and say ‘ok then, do your worst, kill me then’ and have a sort of ‘so what?’ attitude to it (obviously it was more sophisticated and structured than this!). I don’t think my first CBT therapist was nearly as good as the second, as she didn’t have the convicton or understanding of the second.

However, from waht you say, your anxiety sounds a bit more generalised, or am I wrong, are you having discrete panic attacks on top of the background anxiety? My attacks went from being very specific and circumscribed to almsot joining up into one continuous attack - I think developed generalised anxiety disorder on top of the panic disorder!

One thng though, I never found any of the SSRI’s any good whatsoever for the panic attacks, and I tried a few, incl. sertraline and venlafaxine (I think they made it worse). The Dothiepin (tricyclic) may have helped a bit, but I think trying to come off it was what triggered the return of the panic attacks in 2006 (you see I thought I had it under control and it bit me in the butt!).

Actually, I downloaded a really good book called ‘Power over Panic’ by Bronwyn Fox - Google her to see some reviews. I forgot I had it and have just had a quick look at it and it has lots about mindfulness in it - which I’d completely forgotten. It’s in .pdf format and is 779KB so I’ll try and upload it as an attachment with this post. I just remember this book being one of the better ones (and I’ve read a few). She advocates a CBT combined with meditation approach.

You can get it via Amazon:

(NB from admin: this image links to a product this member has found helpful and at the same time helps fund the site: As an Amazon Associate I earn from qualifying purchases. More recommended products here. Thanks for your support!)

DizzyIzzy


#10

Dizzy,

The anxiety I feel with the MAV attack is generalised. I don’t have heavy acute panic attacks per se but I do get some of the generalised stuff in heavy waves. Sleeping is interrupted throughout the night and I feel pretty nuts. Since writing this morning I think I may be coming out of this slightly after 3 days of hell. There are some sun beams shooting through but I have a long way to go yet. I really think the majority of this is migraine-generated. How else can I explain that I felt great on Thursday night and then again on Friday? It wasn’t until the second night without enough sleep that the bomb went off in my head so to speak. I have to say valium is the best thing ever invented for this crappy disease.

Thanks for your info.

Scott :slight_smile:


#11

Scott - I can definitely see how MAV and anxiety is related. I am pretty sure the MAV is what has brought on my anxiety. What are your anxiety symptoms? Have you only tried medication for your anxiety? I’m sorry you are having a hard time with this right now I am not doing so good with it either.

Briana


#12

Briana,

Symptoms are:

Occasional hot flushes.
Heart racing here and there.
A great sense of unease. Waking in the morning fills me with doom for the first 10 minutes.
Sleeping is interrupted throughout the night.
Lying flat brings on a strong thumping heart beat. I cannot lie on my right or left side right now without aggravating the anxiety.
Derealisation.
Disorientation.
I can’t fix my eyes on a small target. The object moves around in my visual field.
Light-headed.
Confidence has dropped a lot.
Occasional adrenalin shot.
Tightness in my head but no major headache.

All lovely stuff to have going on while at work.
Scott


#13

Hi Scott, everyone

I am having some bad anxiety issues at night too. If I am going to have a bad night, it generally starts with not being able to drop off to sleep, jolt awake by some small noise which seems to start the adrenaline going. From then on, everytime I start to nod off, I jolt awake with my heartrate running one beat into another (quite expect to have a heart attack), this goes on all night, no sleep, sometimes wonder how the body can take it. Had a bad night of this after a full blown vertigo attack the other day.

I still get the anxiety in situations like “school reunion” and taking an exam recently (I was shaking, sweating, sinking feeling, dizzy, but after half an hour in the situation, it seems to wear off.

I have learnt to cope with the severe vertigo attack anxieties. My friend who gets them always ends up on the loo, I dont anymore (having coped with them being on my own when my husband was working nights, baby in cot in the next room and me being unable to move etc. I do that thing automatically (well what will be will be). I know they will pass eventually, problem is instead of the usual 4 to 6 hrs, the last few have gone on much longer, but they do go eventually.

Something I have found what helps these situations is 10 mg propranolol, an hour before I had an MRI scan, and I was laying there cool as a cucumber, expecting the heart rate to go up as usual and instead I was fine.

The sleep issue is the worse for me.

Christine


#14

Adding my two cents…
My initial symptom was dizziness, which my internist interpreted as anxiety. Mind you, I never experienced any sort of anxiet issue EVER in my life, so I thought I’ll try this med (lexapro) and see if it helps my dizziness, but was skeptical if was anxiety related. I guess I will backtrack and say I was coming into this dizzy thing 6 weeks after having bells palsy, so I thought that might have a role play. I never had dizziness either and this particular sort of dizzy was more like feeling “high” or lightheaded…and seemed to really correlate with my vision. The Lexapro helped a little but still had issues. I stopped taking Lex because I didnt’ think I needed an Antidepressant and didn’t like the side effects. That is when my anxiety stuff really started…between the withdrawal of Lex and the worry of everything docs thought could be wrong with me…I ended up being a mess. No sleep for days…waking up trembling every morning…lost 10% of my body weight, had daily headaches for first time in my life that went on for 3 months, felt like a shell of my former self.

I think the trigger for this stuff stems from low serotonin. I think that’s what caused the initial dizziness (stress and age being factors that deplete our serotonin) and I think personally I needed some meds to get out of the hole. I really think it’s chemical and no matter how much we talk about it or meditate about it,(which can lower our stress level and maybe increase GABA), but there is a true physical imbalance that needs to be addressed. This last weekend I was in two earthquakes and a very bumpy flight. I was cool as a cucumber during all of that, but I can wake up feeling like adrenaline shooting through my body, or be in he middle of dinner or a movie and suddenly feel tightness in my chest and my heart starts to race for NO DAMN REASON…it’s so very strange and doesn’t make sense at all.

I started taking BuSpar 3 days ago, which is specifically for anxiety, as an add on to my Cymbalta. I haven’t taken any Klonapin (benzo of choice) since starting it, so we’ll see if it helps. My plan is to get off these meds eventually, but I think
it will take some lifestyle changes I’ve implemented to support that drug free life…and some supplements that help the body manufacture and maximize the serotonin I naturally have. A work in progress…
Kelley