New to Anxiety and to Beta-Blockers

[Ziggy78]

Hi all:

I suffered my first panic attack in public three months ago. A nasty situation at work I believe was the 'trigger' but so was ongoing and work related stress. My bouts of anxiety have been coming and going in intense waves since then - unfortunately, the worst of them happen when I'm giving public presentations and not doing these is not an option for me. So: I have to face my most fearful space time and again and deal with the physical effects.

My Doctor recently prescribed Beta-Blockers for me (the lowest dosage ) - I took one but I honestly did not feel its effects when I talked. The Dr said that should 'play around' with the dosage but I'm frightened to do that... Does anyone have any advice? I am practicing my deep breathing, seeing a psychologist also - I'm trying to resist going on prolonged medication and trialling everything else first.

[JessF]

Hello Ziggy78,

Panic attacks are terrifying aren't they? And sometimes the anticipation of having one can be just as bad.

I am not too familiar with how beta blockers work, I have never been prescribed them. I can see why you would be anxious about 'playing around' with the dosage, the instructions you have been given do sound a little vague.

How have things been going with the psychologist? Have you been talking about what goes through your mind when you're presenting?

The thing about anxiety is that it is all about fear of an (imagined) future. Our bodies and brains are reacting to an imagined threat and preparing us to either run, fight, or freeze up. Much of the therapy techniques to combat this, like the deep breathing, are working on trying to bring you back into the present moment and putting the panicky thoughts to one side, not trying to stop them, but just acknowledging they are there, putting them to one side and keeping your focus on what is happening right now.

It might help to develop a routine for when you get up to do a presentation. I imagine at the moment, because of what's been happening, you have thoughts running through your mind that you are going to have a panic attack. You can try starting by trying to distance yourself from those thoughts, and not taking them on board as facts. They are just thoughts, and the phrase "I'm going to have a panic attack" popping into your head is no different to "I must get some milk on the way home". Focus on your words, your slides, your pacing. Perhaps even rehearse the presentation by yourself, and when you're doing it for real, you can imagine it's the rehearsal to keep you focused. What do you think?

[Ziggy78]

Hello JessF:
Thank you so much for responding to me. You have captured the experience for me very well - fear of an (imagined) future/fear of failure/of not being able to get through etc. The hardest thing for me has been the physicality of the experience - the onset of my anxiety/panic has come late in life and I've been a very good public speaker all of my life. It is a terrible feeling to feel like you cannot do something that you have been doing for 20+ years... it has hit me like a freight-train.

From what I understand, Beta-Blockers will only treat the physical manifestation (not the underlying causes) so having a routine - perhaps documenting what works and what doesn't may be useful. Practicing over and over again may be key, I think - if my body can remember panic, perhaps it can also remember that I know this material? I will try.

[OverAnxi0us]

Hi Ziggy78,

Let me say i have been on several beta blockers and they can help, however, my advice is find another doctor. Being told to "play around with the dosage" is not only terrible medical advice but could also have other implications.

A good doctor who is well versed in anxiety disorders will assist you with a mental health plan that may or may not include medication. But they will tell you the dosage and the times and should monitor you for any side affects.

Hope this helps.

[BoyImAnxious]

Hey Zig!

Beta-blockers work by stopping the effects of adrenaline on the body, so instead of helping with the emotional side of your anxiety, they will stop the effects caused by your fight or flight response allowing you to deal with your triggers a bit easier. However, your doctor doesn't sound too sure about the use of them or the dosage. I would recommend you see a different doctor and if this is long term anxiety it wouldn't be a good idea to just rely on these. For your social anxiety, I would recommend taking a beta-blocker up to 2 hours before so you are in the peak of the effects during your presentation. But please do go see a different GP for your correct dose and the times you should take it for your symptoms.

I hope everything goes well for you, anxiety is pretty horrible especially when it's stopping you from doing something you have done for years with no problem.