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Dr. Anderson: Panic Attacks

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Dr. Anderson: Panic Attacks

Dr. Eric Anderson, a charter diplomat of the American Board of Family Practice and a former president of the New Hampshire Academy of Family Physicians, is a regular contributor to Travel Tips 'n' Tales. He is widely traveled and published, having written a travel health column for Travel 50 & Beyond and a weekly online column, Ask The Doctor, for The New York Times Syndicate.
Dr. Anderson invites you to send your questions regarding travel health issues to ericmd@lorrypatton.com
The general problem of panic attacks

Dr_Anderson_189x241.jpg Question . I am taking a trip to Hawaii very soon. I am prone to anxiety attacks when I am stuck in a place for a long time and I cannot get out. A flight to Hawaii is nine hours. I don't anticipate any problems, but I would like a medication recommendation I should take with me just in case I start to get anxious and feel a panic attack coming on during the flight! What do you suggest?
Answer . There may not be enough time for us to tackle the general problem of panic attacks and how to deal with them but we'll come to that in a moment.
The immediate comment is to say that although alcohol may work in some, and simple Valium can be useful, there are specific medications for panic attacks like, classically, Xanax and now some of the newer medications used for depression, such as Zoloft and Paxil. You would not take alcohol with any of those and you need to have your doctor explain both the benefits and the side effects. Those medicines are very effective. You can really be helped with this problem.
Quick answers to your question would also include trying to get an aisle seat rather than one where you're stuck by the window. If that would be helpful but you've been told it's too late to change your seat assignment, enquire at the desk nevertheless, and ask a flight attendant to appeal on your behalf to anyone sitting neaby to trade their aisle seat for whatever you have. I'd even suggest you ask for a seat exchange if you have a particularly heavy or big person squeezing into your space from the seat beside you. And to make all this easier, I'd ask my doctor if he or she would print in big letters on a prescription page something like: "Dear Flight Attendant: Please help my patient with panic attacks to get seated in your wonderful airline."
The Hawaiian flights tend to be full -- but with cheerful, happy people. Be informal, comfortable. Wear loose clothing. Don't be up late the night before the flight and get to the airport with plenty of time. Check as much baggage as you can so you board with the absolute minimum of carry-on stuff.
But bring aboard the usual comfort extras:, wet wipes, skin moisturizer, eye lubricants, a snack bar or two and a bottle of water, maybe something to cover your eyes to help sleep, a paperback that could distract you.
The big picture story is, er, bigger. It sounds as of you have not had a consultation about this very common problem which takes many forms. I've had patients who couldn't enter an elevator or go down a basement. Others who were scared they might get lost driving in unfamiliar places or trapped by an attack when they were in a supermarket with a cart full of groceries.
All these fears need to be talked out with a doctor. The medications are so effective, they readily give most patients confidence that they can deal with panic. Some patients will tell the doctor they "don't like being dependent on drugs" and they've heard "persons can become hooked on even Valium." Those patients who think this are not being fair to themselves or their families. Use of those medications in patients who suffer panic attacks is completely appropriate, legitimate -- and effective.
What about the future? If patients say, how can I understand my problem? Where can I go? My reply would be, of course, to my doctor but there are other resources. There are even classes for those who have a fear of flying something a bit related to your problem.
An Australian woman doctor who died in 1990, Claire Weekes www.claireweekes.com/, for example, wrote five excellent paperbacks on panic disorders about 20--30 years ago. The books are still relevant. She had both a doctorate in Science and an MD degree but that didn't prevent her own panic attacks. She once told me she didn't need sympathy or pity when she had an attack. "It's no big deal. I know some chemicals have just become jumbled up in my brain," she said. "So I wait till they rearrange themselves. You see I know that, on the other side of Panic, lies -- Peace."
I see that an affiliate of amazon.com, WellnessBooks.com, of which I know nothing, has many books listed on anxiety.
What this means is that those who become educated about their health problem and understand them are already halfway to a solution. And that's true of many situations in health.
Hey! You are going to have a GREAT time in Hawaii!
Eric Anderson
Lorry Patton's Travel Tips 'n' Tales would like to remind you to always consult with your personal physician before following any medical advice and to please read the Travel Tips 'n' Tales "Terms of Use" found on the bottom of each page of this website. Dr. Anderson's opinions are not necessarily the opinions of Lorry Patton or Travel Tips 'n' Tales.