What Are The Worst Things I Could Do If I Had Panic Disorder?

0:00One of the worst things I could do if I had panic disorder as a double board certified

0:08psychiatrist.

0:09I'm going to tell you, I'm Dr. Rodriguez from Healing Sky, I'm also the medical director

0:14of the Delray Center for Healing and today we're going to talk about the worst things

0:19that I could do knowing what I know as a double board certified psychiatrist if I had panic

0:25disorder.

0:27First one is simple, caffeine.

0:31Caffeine will agitate panic disorder, seems obvious but most people actually don't get

0:36this one right.

0:37People just are used to drinking coffee every day and think it's okay, they don't mean anything

0:41bad by it but they don't realize they're keeping that extra stimulation that also agitates

0:48a panic disorder.

0:49When you have panic disorder, you have these extreme panic attacks and really it doesn't

0:55take much to set one up.

0:57So the last thing you want to do is consume any amount of caffeine in any form, whether

1:02it's coffee, Red Bull, you know, a soda, you know, a caffeine pill, even other forms that

1:10are similar such as green tea or, you know, matcha.

1:14All these things will agitate a panic disorder.

1:19Next thing along these lines are taking actual stimulants, stimulant medications which may

1:24be prescribed for ADD, you know, or sometimes even for weight management but a stimulant

1:31such as an Adderall or a Vivense, you know, as good as they are for their intended purpose,

1:37these can be really bad if you have a panic disorder.

1:40Again, it doesn't take much to set off a bad panic attack.

1:44So you'd rather not have one of these on board, it'll make your life more difficult.

1:50Next thing is skipping medications.

1:52If you are prescribed medications to treat your panic disorder, all the medications that

1:56are intended for this purpose are going to be important and they're all going to play

2:00a certain role.

2:01If you skip any of these, you're going to cause problems.

2:06Panic disorder is more sensitive than other conditions when you are inconsistent with

2:11the medications, whether it be a serotonin-based medication such as an SSRI or serotonin selective

2:19reuptake inhibitor or one of these sedatives or tranquilizers known as the benzodiazepines

2:26such as an Ativan, a Valium, or a Clonopin, really especially those.

2:33If you miss any of these, it's going to cause problems.

2:35You're going to get symptom recurrence, you're going to get amplified symptoms.

2:39In the case of a benzodiazepine, you can actually get rebound anxiety where your anxiety is

2:45even worse than when you started with.

2:47You don't want that.

2:48That's really not good.

2:49And we have panic disorder that can directly trigger panic attacks and really bad ones

2:56at that.

2:57Now, alcohol.

2:58People sometimes turn to alcohol to try to manage their panic attacks and in the moment,

3:04it may slow things down in the moment.

3:08But there is a big price to pay if you do that, a big price to pay because later on

3:14when that wears off, you're going to have rebound anxiety and that can provoke another

3:19panic attack or a series of panic attacks.

3:22So you may be thinking, well, I'll just drink some more.

3:24Okay, that's definitely not the answer because you're just going to perpetuate and repeat

3:29this vicious cycle where you're drinking to suppress the panic disorder, which then you're

3:35in the background, you're creating dependence on the alcohol.

3:39And when it wears off, you get rebound anxiety, which means you want to drink again.

3:43That is one of the ways somebody with a panic disorder can end up inadvertently developing

3:49an alcohol disorder.

3:51You don't want to do that.

3:52That's going from bad to worse.

3:54Alcohol is not part of the solution.

3:57If anything, you want to stay away from it as much as possible because if you have panic

4:01disorder, alcohol is going to be destabilizing overall, regardless of what it does in the

4:08beginning when you first drink it, alcohol is going to be a very destabilizing substance.

4:13So you want to stay away from that.

4:14It is definitely one of the worst things you can do.

4:18Even worse though than alcohol is going to be drugs.

4:21You know, drugs are not good for you no matter what.

4:23I'm talking street drugs, illicit drugs.

4:25These are not good for you regardless.

4:26But if you have panic disorder, one of the rules of panic disorder that people have to

4:33really be mindful of and attentive to always is that people with panic disorder are exquisitely

4:41sensitive to everything in terms of chemicals that could affect their brain.

4:46They're very very sensitive to this.

4:48They don't mean to be, but their bodies really really are, their brains really really are.

4:53So if you're taking street drugs, that is going to provoke a lot of problems, is going

5:00to lead to a lot of instability, whether it's uppers or downers, either way you're going

5:05to have problems.

5:07So if you're doing drugs with panic disorder, you are most likely going to either A, make

5:12your panic attacks worse, or B, develop a serious drug problem, both of which are bad.

5:19Usually what happens is you get both, you get a worse, worsening of the panic attacks

5:24and a really bad drug problem.

5:25So really you're going from bad to much much worse actually if you do that.

5:29So please don't do drugs, bad idea.

5:32Now, special attention I must say when talking about drugs is marijuana, contrary to popular

5:39belief.

5:41People think, oh marijuana will calm you down, I'll chill out using marijuana.

5:45It's medical marijuana, a doctor gave it to me, it should be fine.

5:50Not if you have panic disorder.

5:53Medical marijuana or regular marijuana or anybody's marijuana, if you mix it with panic

5:58disorder, it is a loose cannon.

6:02Anything can happen, however, what will most likely happen is that your panic disorder

6:07will get worse.

6:09You can actually start to have not just more panic attacks, but you can have chemically

6:15triggered, induced and accelerated panic attacks, which is another way for saying, it's like

6:23a panic attack on steroids, you don't want that.

6:26Panic attacks are bad enough on their own, they don't need help to feel horrible, they

6:30really don't.

6:32Add marijuana and you can get an accelerated and amplified panic attack that will terrify

6:37you to no end.

6:39So you really really don't want to do that, marijuana is not part of the solution for

6:44panic disorder.

6:45So please, if you're doing that, you got to let it go, because otherwise you're just not

6:49going to get better.

6:50Or it will take a really long time and a lot of medication and you're going to have a lot

6:54of side effects.

6:55And you don't want that, that's not the solution.

6:58Some of the things you don't want to do, that are some of the worst things to do with

7:01panic disorder are to stay home and hide from the world.

7:07You might find that with panic disorder, certain things outside can trigger the panic attacks,

7:13and the condition makes you more inclined to hide, to stay home, to isolate.

7:18That is really bad.

7:19That is definitely one of the worst things you can do because that is going to create

7:24a negative reinforcement cycle where you are now giving in to the panic disorder and

7:31you're doing behaviors, you're exhibiting behaviors that are going to shrink your world

7:36and actually, although you're intending to avoid the panic attacks, you're actually setting

7:41yourself up to have more panic attacks because you are negatively reinforcing yourself to

7:48hide and isolate, which is not compatible with life, so you cannot do that.

7:52So don't do what the panic disorder would have you do, which is hide, isolate, stay

7:57home, stay in your room, that is definitely one of the worst things you can do because

8:02that creates psychological damage and you can teach yourself and train yourself to be

8:08even more scared with this panic disorder, you definitely don't want to do that.

8:13Now even worse than that is going to be not seeking treatment.

8:20You'd be surprised how long it takes for people to seek treatment with panic disorder.

8:23It can take a while.

8:24It is really a bad idea, arguably the worst thing you can do if you have a panic disorder

8:30is to not seek treatment and why?

8:34There is a big reason why, it is because what we just mentioned, the concept of psychological

8:40damage, unlike other disorders, having an active panic disorder has psychological consequences.

8:49Yeah, it feels bad, it feels horrible, it's a horrible thing to have to go through a panic

8:53attack, you think you're dying.

8:55I would argue that it's probably easier and feels less bad to actually die than to have

9:00a panic attack.

9:01That is how bad panic attacks are, they're really bad.

9:04Now the psychological damage that comes from not seeking treatment is that people inadvertently

9:12sooner or later will start to succumb to the severe negative feelings, the tortuous feelings

9:20of their panic attacks and they will try to hide from them, they will do things to try

9:24to avoid them, that avoidant behavior which is driven by negative reinforcement, we referred

9:31to that earlier, negative reinforcement and this will shrink your world and it creates

9:36layers and layers of psychological damage which is hard to undo and will take a while

9:43in therapy to fix.

9:45So not seeking treatment, aside from that it feels bad to keep having panic attacks,

9:50you're actually allowing yourself to incur psychological damage which makes it worse.

9:57If you have panic disorder, it's a condition that gets worse over time by virtue of this

10:02psychological damage, you don't want to do that.

10:06Another extra bonus here I'll give you as far as some of the worst things to do if you

10:12have panic disorder is to not seek psychotherapy.

10:18Treatment does not only mean medications, although with panic disorder medications are

10:22really important, probably unavoidable in most cases, you know because you want to

10:29stop the panic attacks in their tracks and then you want to address the origins of that

10:35neurochemically and if you want to get the best result you want to use psychotherapy

10:42as a tool because they can teach you coping skills and tools that will decrease your reliance

10:47on the medications and you will get a better result faster.

10:52You will also be able to process the psychological challenges of going through a panic attack

10:58or worse anticipating a panic attack by using psychological skills and tools that you can

11:04learn in therapy.

11:06So yes, therapy can help a lot, I recommend it highly, not doing therapy if you have panic

11:12disorder is a mistake.

11:15If you had it for a while, the panic disorder that is, if you had that for a while and you

11:18already have psychological damage, you're already scared of going to the mall, out to

11:23events or out to dinner or out to a concert, you must undo this in therapy, it is not good

11:29to just leave it be.

11:30If you can't drive on the highway because of your panic attacks, it is not reasonable

11:34to just live that way, please seek treatment.

11:37You can help this, you can treat this, you can make it better, you can make that go away,

11:41that will require the use of therapy and the use of medications to get the best results.

11:47I hope you find this helpful, if you would like to seek some help from me as a psychiatrist,

11:52you can find me at thedelricksenter.com, also please look for my podcast The Smiling Brain

11:58here on Healing Sky, thank you.