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By Amy M. Collins, associate editor

A recent post on our blog describing how many psychiatrists have abandoned psychotherapy in favor of short consultations and pharmacotherapy struck a chord with me.

Eleven years ago I moved abroad to live and work in a new country. I looked forward to great adventures, but I didn’t expect the sudden, crippling anxiety that spiraled into daily panic attacks lasting for hours. After several months I flew home to seek treatment.

I spent over half an hour in the waiting room wanting to crawl out of my too-tight skin. When he finally called me into his office, the psychiatrist smelled strongly of lunch and was still cramming a sandwich into his mouth—thus, I supposed, the long wait. I was still describing my symptoms when he shoved a checklist into my hands. I skimmed the symptoms—palpitations, trouble breathing, chest tightness, a need to escape—and realized I had them all. Bingo! His five-minute diagnosis: panic disorder.

I was overwhelmed with emotions: a mixture of relief to learn there was a reason for the mayhem, and something like a feeling of failure. When I started to explain the possible culprits (the move, the new language, the new culture), the doctor cut me off and handed me a prescription for Zoloft, explaining that antidepressants were also being used to treat anxiety, and that I’d probably feel worse before feeling better.

“I’m not sure I want to take medication. Can’t I just explain why I think this might be happening?” I asked.

The doctor wrinkled his brow. “You mean you want to talk?” he scoffed. “You won’t get better by talking. You need to be medicated.” When I started to cry, his look softened. “Listen, take these pills for a month and when you come back we can talk a little more.”

He stood up to let me out. I’d been in his office for less than 10 minutes.

But there’s one thing I can thank him for. He unintentionally laid a challenge at my feet when he told me I’d only get better with drug therapy. I wasn’t antimedication, but I was against using it as a first resort. For me, it felt wrong. As I looked at the prescription he’d written (Zoloft plus long-acting Xanax plus rescue Valium), I thought to myself, “Sure, I won’t have panic with these meds. Or a pulse!”

Instead, I sought treatment from a therapist who wasn’t opposed to talking, learned coping mechanisms, employed relaxation techniques, cut out caffeine, and read everything I could on panic to understand the mechanisms behind the disorder. It was a long hard fight, but 11 years later I see the attacks for what they are: a textbook pattern that culminates in an attack only when fear is present. Instead of stopping everything I’m doing at the onset of an attack, I tell myself I’m not scared, that I’ve handled hundreds and this one will be no different. Using this approach, nowadays panic fizzles out like a wet firecracker, never really taking off or exploding.

With over 2 million U.S. adults living with panic disorder, and twice as many women as men suffering from it, health care providers should ensure they give patients all available options for treatment. Medication may work for some, but there are alternatives. I know because, despite what my psychiatrist said, I did get better.

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