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"This essay summarizes current information about panic disorders and their treatment. It is based almost entirely on publicly available information gathered during the years 1998 through 2000 from sources (not specifically cited) that include published research papers (most available through MedScape or MedLine), published textbooks and trade books authored by qualified mental health professionals, articles in WebMD and the New York Times, the opinions of clinicians specialized or experienced in the treatment of panic disorders, and the experiences of some hundreds of individuals (patients, health care professionals, and peer counselors) who have shown up in various Internet-based support communities focused on panic disorders or other anxiety disorders. The intent is to introduce the reader to the wide body of knowledge that exists today and to integrate and disseminate a variety of emerging insights often omitted from the narrow classical view of these disorders."
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Are arrhythmias serious?
The vast majority of people with arrhythmias have nothing to fear. They do not need extensive exams or special treatments for their condition. In some people, arrhythmia are associated with heart disease. In these cases, heart disease, not the arrhythmia, poses the greatest risk to the patient. In a very small number of people with serious symptoms, arrhythmia themselves are dangerous. These arrhythmias require medical treatment to keep the heartbeat regular. For example, a few people have a very slow heartbeat (bradycardia), Causing them to feel lightheaded or faint. If left untreated, the heart may stop beating and these people could die.

How common are arrhythmias?
Arrhythmias occur commonly in middle-age adults. As people get older, they are more likely to experience an arrhythmia.

What are the symptoms of an arrhythmia?
Most people have felt their heart beat very fast, experienced a fluttering in their chest, or notice that their heart skipped a beat. Almost everyone has also felt dizzy, faint, or out of breath or had chest pains at one time of another. One of the most common arrhythmia is sinus arrhythmia, the change in heart rate that can occur normally when we take a breath. These experiences may cause anxiety, but for the majority of people, they are completely harmless. You should not panic if you experience a few flutters or your heart races occasionally. But if you have questions about your heart rhythm or symptoms, check with your doctor.
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Panic disorder, which affects an estimated 13 million Americans, manifests itself in unexpected attacks of extreme anxiety, with symptoms including rapid heartbeat, shortness of breath, trembling, sweating, nausea and dizziness. Some victims feel they are losing their minds or are about to die. Many become so obsessively worried about subsequent attacks that they make major changes in their behaviours, shunning whatever situation may have prompted the panic. In a journal, Darwin (1809 - 1882) described his malady as a "sensation of fear . . . accompanied by troubled beating of the heart, sweat, trembling of muscles."

The onset of panic disorder usually occurs between late adolescence and the mid-thirties. Darwin was 27 when his illness first became severe. He had been a gregarious collegian, intrepid traveler and vigorous outdoorsman. But by 1837 - only a year after his return to England after a five-year voyage to South America and the Pacific aboard "HMS Beagle" - he began to complain of an "uncomfortable palpitation of the heart," according to the 1991 biography by Adrian Desmond and James Moore. The symptoms arose shortly after he started a secret notebook that, 22 years later, would become his book-length elaboration of the theory of evolution.

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It's completely normal to worry about your hectic, complicated life, but if the worries become overwhelming, you may feel that they're running your life. If you spend an excessive amount of time feeling anxious or you have difficulty sleeping because of your anxiety, pay attention to your thoughts and feelings. They may be symptoms of an anxiety problem or disorder.
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Several print materials, including a journal advertisement, misuse data to say more patients suffered fewer symptoms of depression with Effexor than with selective serotonin reuptake inhibitors, or SSRIs, the FDA said.
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CCHR says psychiatrists and the FDA knew about the violent and suicidal inducing effects of the drugs, but didn’t want to bite the hand that feeds them—the pharmaceutical industry. In 2002, international sales of antidepressant drugs reaching $12 billion. CCHR charges that psychiatrists created the market for drugging children by fabricating mental disorders for inclusion in its billing bible, The Diagnostic & Statistical Manual for Mental Disorders (DSM) and then convincing people that these are medical diseases, which is fraud. There are no tests to scientifically substantiate any DSM psychiatric disorder as a “disease” or “illness.”

CCHR warns that despite yesterday’s FDA warning, parents can still be forced through schools to administer the same suicidal-inducing drugs to their children. Until the FDA universally prohibits these drugs from use in children, federal protections against forced psychiatric drugging in public schools is necessary. The group is urging Congress to pass the Child Medication Safety Act, which the U.S. House of Representatives passed last June in a landslide vote of 425 – 1. While introduced into the Senate, the bill, which would stop school personnel coercing parents into drugging a child as a requisite for educational services, has not moved since July. The FDA warning must serve to alert the public and Congress that federal protections must be enacted against coerced psychiatric drugging in schools. Children’s lives are at risk.

For more information on this issue go to http://www.cchr.org or contact CCHR at 800-869-2247. The Citizens Commission on Human Rights was established by the Church of Scientology in 1969 to investigate and expose psychiatric violations of human rights.

Epidemiological estimates have shifted over time because of changes in the definitions and diagnosis of mental health and mental illness. In the early 1950s, the rates of mental illness estimated by epidemiologists were far higher than those of today. One study, for example, found 81.5 percent of the population of Manhattan, New York, to have had signs and symptoms of mental distress (Srole, 1962). This led the authors of the study to conclude that mental illness was widespread. However, other studies began to find lower rates when they used more restrictive definitions that reflected more contemporary views about mental illness. Instead of classifying anyone with signs and symptoms as being mentally ill, this more recent line of epidemiological research only identified people as mentally ill if they had a cluster of signs and symptoms that, when taken together, impaired people’s ability to function (Pasamanick, 1959; Weissman et al., 1978). By 1978, the President’s Commission on Mental Health (1978) concluded conservatively that the annual prevalence of specific mental disorders in the United States was about 15 percent. This figure comports with recent estimates of the extent of mental illness in the population. Even as this figure has become more sharply delineated, the older and larger estimates underscore the magnitude of mental distress in the population, which this report refers to as “mental health problems.”
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Each year, panic attacks strike about 2.4 million American adults “out of the blue,” with feelings of intense fear and physical symptoms sometimes confused with a heart attack. Unchecked, the disorder often sets in motion a debilitating psychological sequel syndrome of agoraphobia, avoiding public places. Panic disorder runs in families and researchers have long suspected that it has a genetic component. The new finding, combined with evidence from recent animal studies, suggests that genes might increase risk for the disorder by coding for decreased expression of the receptors, say the researchers.
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It’s just that, busy as they are, I don’t think they understand why I can’t always follow medical advice.

For instance – “Take one pill every 8 hours until gone.”

Okay – first, this involves major timing – something I’m not good at, or my daughter would have been born in mid-July like she was supposed to, not mid-August. Say you get to the doctor at 1:30, you are seen at 2:00 (look, this is a hypothetical thing, quit laughing), and you leave around 3:00 with a prescription that is supposed to help you feel better.

One pill every eight hours SOUNDS easy, but if you take that first pill at 4:00 when the script is filled, that means you have to set your alarm for 2:00 in the morning, wake up, crawl over whatever spouse, child, or critter has taken up the other half of your bed, find the pills AND a glass of water and take your medicine. THEN you have to reset your alarm for 6:00 so you can make it to work on time, and try to remember to take your next dose at 10:00 when you are in the middle of taking notes at a staff meeting. Knowing THAT won’t work, you try to figure out another plan.

Okay – let’s NOT take the first pill right away. Let’s take it at 9:00 tonight – no, that won’t work – dinner with the Smith’s. Well, then, make it 10:00. Right before bed. Then your next dose is due at 6:00 in the morning when you wake up anyway. Just leave a note beside the shower to remind yourself to take it. The next dose is then due at 2:00 p.m. – during mid-afternoon snack break at work, so you are good to go. Unless you can’t take it with food, and then you are going to feel bad one of two ways – either because you won’t give up the snack so you aren’t feeling better yet, or because you DID give up the snack and the sugar fix you need is making you half crazy.

So, there you have it – first pill at bedtime, next in the morning, and next at break. Sounds good, huh?

Well – that’s IF you don’t have some major phobia about new medications and whether or not you might be allergic to them. What if you DO take the first pill at 10:00? What if you ARE allergic to it? What if your husband sleeps through your gasping for air and turning blue? What if your children aren’t as bright as the ones featured on 48 Hours and can’t remember the phone number for 911? Then, just because you wimped out and decided you needed medicine to treat something as trivial as a little difficulty breathing or minor chest pain, you’ve left orphaned children.

No, better to take the first pill at 6:00 in the morning so that you will be aware of the fact that you are suddenly not breathing and can get help. Unless it happens during rush hour – then you could cause a major pile-up as you are looking for an off-ramp and trying to self-induce CPR in the process. (Hit the signal, hit your chest, hit a pylon, hit your chest, count to five – look! Were those pedestrians? Hit your chest) Not a good thing.

Think again – okay – I know! Wait til you get to work to take the first pill! Casually mention to one or two co-workers that you are under a doctor’s care and have been given a shiny new yellow pill to take. Research its side effects on the Internet for a while, being careful to print out any severe adverse reactions ever noted in clinical trials of the new medicine you’ve been prescribed. Leave the list out in a place where it will be easily found should you be suddenly incapacitated and can’t tell your co-workers why your face is swelling and your heart is pounding. Before you actually TAKE the medicine, stroll casually to the water cooler, make a big fuss about popping the shiny yellow pill in your mouth, pray quick, and swallow.

If all goes well, you can readjust your schedule when you get home – even if you have to set your alarm for 3 a.m. to take the last dose. If it doesn’t go well, with any luck, there are first responders on hand in your place of business who will keep your heart beating until EMS shows up and transports you where you need to be. It may be slightly embarrassing, but sparing pedestrians is worth it.

It’s also possible that you will be prescribed a new medication right before something VERY important such as a daughter’s wedding, or right in the middle of a crucial time at work – like the week before Swiss Days. If you have researched the side effects and found that somnolence (medicalese for “sleepy as all get out”) is reported in 89.5% of those who report side effects (remind yourself that the other 11.5% just didn’t get sleepy – NOT that they didn’t make it), you will want to wait til a better time to begin the medication.

Your DOCTOR does not want you to do this – he wants you to take the medicine right away. But he isn’t the one in charge of decorating the wedding cake, the chapel, and arranging your daughter’s hair, and he isn’t the one who will be laying out umpteen jillion pages for the special Swiss Days edition of anything.

Waiting til after the wedding or Swiss Days makes sense and will earn you lots and lots of respect from your friends and co-workers who will admire your ability to trudge through one more week of feeling near death just so you don’t actually die when they need you most. Either that or they will think you are nuts, tell you to get over it and just take your stinking medicine. They may not even talk to you until you quit weirding out over the little yellow pills. It’s a risk, but you do what you must to get a job done, right?

Finally, the day will come, some 2-3 weeks after the prescription was made and about two days before your follow-up appointment in Decatur. You will finally take the medicine, realize you have lived through it… and feel totally sheepish as you explain to your specialist exactly WHY the medicine hasn’t helped yet.

YIPES!

Just say ??? to drugs

Although some people can quit Paxil and suffer no withdrawal repercussions, countless numbers of folks have quit or tapered and have suffered nausea, dizziness, electric shock sensations known as "the zaps", headache, flu-like symptoms, balance problems, anxiety, sleep problems, gastro-intestinal problems, sweats, vivid dreaming, sensitivity to light and/or sound, etc. The list goes on and on…..Withdrawal from Paxil is happening in much greater numbers than the manufacturer has reported to the FDA.
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http://www.quitpaxil.info

The amygdala "represents an important target for the development of pharmacologic therapeutics" because of its strategic location between inputs from the senses and memory and "physiologic and behavioral outputs," explains NIMH Director and conference co-chair Steven E. Hyman, M.D., in an editorial.
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Just recently, I read in one of my magazines that RLS can be alleviated by tonic water which contains quinine.

Last night the symptoms started up again, and I broke out my bottle of tonic water and had a small glass....voila...within a few minutes the twitching and crawling stopped.

I think this is something worth checking out for people who can't or won't take meds for the condition... Just remember to get tonic water containing quinine...

Check out Domino Cat panics.

Public Citizen's lawsuit, filed in U.S. District Court for the District of Columbia, claims the FDA's delay is illegal and asks the court to require the agency to act.

The group said Serzone, which was first sold in the United States in 1994, has already been removed from the Canadian and European markets and will be taken off the market in Australia and New Zealand beginning in May.
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Researchers funded by the National Institutes of Health have found a mutation in the human serotonin transporter gene, hSERT, in unrelated families with OCD. A second variant in the same gene of some patients with this mutation suggests a genetic “double hit,” resulting in greater biochemical effects and more severe symptoms. Among the 10 leading causes of disability worldwide, OCD is a mental illness characterized by repetitive unwanted thoughts and behaviors that impair daily life.

“In all of molecular medicine, there are few known instances where two variants within one gene have been found to alter the expression and regulation of the gene in a way that appears associated with symptoms of a disorder,” said co-author Dennis Murphy, M.D., National Institute of Mental Health (NIMH) Laboratory of Clinical Science. “This step forward gives us a glimpse of the complications ahead in studying the genetic complexity of neuropsychiatric disorders.”
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"Many Americans use dietary supplements like St. John's wort for depression without consulting a physician," says principal investigator Jonathan R.T. Davidson, M.D., professor of psychiatry and director of the Anxiety and Traumatic Stress Program at Duke University Medical Center. "We felt there was a need to conduct a trial that could help us determine where St. John's wort fits in the overall management of depression."
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