Over the course of the past 6-7 years, I have been on and off beta-blockers to try and stem anxiety attacks. The rationale for this was so that my heart rate was slower during times of panic, preventing a full-blown panic attack from occurring. I think they have worked relatively well for this; they don't alter your thoughts or your mood, and so don't necessarily prevent the attacks happening in the first place, but they do change the way your body reacts to panic and anxiety. Consequently, you may be less fearful of an attack and therefore become less likely to have one.
Obviously, one of the key things that occurs when you have a panic attack is an increase in heart rate. If the heart doesn't go quite as fast, then you don't panic quite as much... right? After all, by noticing your heart rate is racing away during an attack, you get even more anxious because you're worried that your heart is beating out of control.
OK, fine in theory. And yes, the Beta Blockers (Atenolol 50mg initially, now on 25mg) did help to an extent. When I had a panic attack, it was basically a bit less severe than before I started taking the meds.
The problem is I also have health anxiety, and I have an over-zealous preoccupation with the way my body is feeling at any given moment. Because of my panic disorder, one of the biggest preoccupations is with the heart. A combination of having numerous attacks in the past and a couple of people close to me who have died of a heart attack has caused this, I assume. It meant that, at first, when I felt particularly panicky, my heart was still relatively slow... prompting me to think that it was going to blow up or something. "Surely it has to be beating faster than this?" I kept musing. This caused more panic and therefore more of me over-analysing the heart. After a while the effect the BBs had overtook this ridiculous notion that my panic was actually going to explode out of somewhere, because it wasn't been accurately reflected in the heart rate.
Despite this, I still had an obsessive preoccupation with the heart rate. I always had in my head that 'if it beats fast it's bad news.' CBT has taught me to try and not listen to the heart (in a physical sense, not an emotional one of course), which has had mixed success. After all, I can't control the multitude of natural factors that cause natural changes to the heart rate in the first place. Once I had been taught this relatively effective and yet blindingly obvious technique, I came down from 50mg to 25mg. I'm still scared to come off them completely though, for fear that I become more vulnerable to panic attacks again.
BBs are used for people with a heart attack history, and yet I was given them for panic attacks. Is it not possible, therefore, that being prescribed BBs has actually exacerbated my preoccupation with the heart and therefore the health anxiety?
My advice would be, in hindsight, as follows:
1) Yes, BBs for panic attacks may help, but
2) You might want to discuss with a therapist whether they would advise taking them if you also have health anxiety. Purposely altering the way a relatively vital organ (relatively? wrote this then realised it was stupid, but thought I'd keep it in for a much needed laugh...) works is not advised for someone with HA I wouldn't have thought.
No doubt I will update on this blog in future how my progress with coming off the BBs will go... if indeed I ever get to that stage.
Best wishes
Al
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