Conquering
your Panic, Anxiety, and Phobias
online conference
transcript
Dr. Granoff is an expert in the
treatment of anxiety, panic and phobias. Author of the book
"Help,
I think I'm Dying. Panic Attacks, Anxiety and Phobias", and
the video "Panic Attacks and Phobias Conquered".
Dr.
Abbot Lee Granoff:
Guest speaker
David:
HealthyPlace.com
moderator.
The people in green
are audience members.
David: Good
Evening. I'm David Roberts. I'm the moderator for
tonight's conference. I want to welcome everyone to HealthyPlace.com.
The topic of tonight's conference is: "Conquering
Your Panic, Anxiety, and Phobias." We have a
wonderful guest: Abbot Lee Granoff, M.D.,
board certified psychiatrist and a nationally known expert in the
treatment of anxiety, panic, and phobias. During the
approximately 30 years he's been in practice, he has successfully
treated thousands who suffer from panic attacks and phobias.
Dr. Granoff has written a book entitled "Help,
I Think I'm Dying. Panic Attacks, Anxiety and Phobias."
He also has a video: "Panic Attacks and Phobias Conquered"
in which patients share their stories and how, through proper
treatment, they were able to overcome these debilitating disorders.
Good Evening, Dr. Granoff and welcome
to HealthyPlace.com.
Thank you for agreeing to be our guest. To make sure everyone
is on the same page tonight, can you please define "anxiety,
panic and phobia" for us? Then we'll get to the tougher
questions.
Dr Granoff: Anxiety
is a generalized feeling of discomfort. Panic
is an attack of sheer terror as in the 'flight or fight
reaction. Phobia is an
unrealistic fear.
David: Since
we've all experienced panic attacks in our lives at some time or
another, how do you know when it's time to seek professional
treatment?
Dr Granoff: :
Only people who have experienced
life threatening experiences or have Panic Disorder have experienced
panic attacks. There are many who have experienced neither.
David: I
think what many people tonight want to know is; is there a cure for
severe anxiety and panic disorder? And if so, what is it?
Dr Granoff: You
first have to understand what panic attacks are and why they occur,
then one can find a cure.
Panic attacks are a chemical
imbalance in the brain which has a genetic predisposition.
When stress gets too high, it kicks the part of the brain that
causes fight or flight into a panic attack.
David: What
are the most effective ways to deal with it?
Dr Granoff: my
book and video go into this in detail. Understanding it is the
first step. The next step is to get medication to rebalance
the brain chemistry.
David: And
we'll get into the medications in a minute. First, some
audience questions.
sunrize: Do
you feel it is possible to overcome these phobias without
medication? I have a fear of medication.
Dr Granoff: I
have treated many patients who have medication phobia. This make
them harder to treat because medications are most often needed to
get a decent result.
David: What
are the most effective medications on the market today? And how much
relief should one expect from taking a medication?
Dr Granoff: The
bezodiazepine tranquilizers such as Xanax, Klomopin or Atavin are
the most effective medications available. You get full relief
when taking these medications. And taken appropriately, there
should be no side effects. You should feel normal.
Arden:
Have you ever heard of the natural supplement SAM-e and if so is it
helpful for panic?
Dr Granoff: All
herbal remedies are not FDA regulated so anyone could make any claim
they want about them. There is no standard dosage and a list
of side effects is not necessary nor medication interaction.
Therefore, while some of these herbal remedies may seem to have some
positive effect, I remain skeptical.
David: Besides
medications, what other forms of treatment would be effective in
dealing with anxiety and panic disorders?
Dr Granoff: Panic
attacks characteristically come in and go so there are many supposed
claims of treatment that don't pan out in the long run.
Desensitization can be effective but usually requires medications
first so a person can feel comfortable in a phobic situation.
Some techniques that are used in place of medication include deep,
slow diaphragmatic breathing, snapping a rubber band on your wrist,
concentrating on relaxing. All of these techniques take your
mind off the acute panic.
trayc: Does
hypnosis help panic and anxiety disorders?
Dr
Granoff: :No.
Not in my experience.
DottieCom1: Is
it common for people with this disorder to be on medications for a
lifetime? It is the main thing that has helped me.
Dr Granoff: Yes.
Since this is a genetic disorder and we can't fix the gene, the
illness usually remains for a lifetime. One has to view panic
disorder in the same way as any other chronic illness, such as
diabetes, asthma, high blood pressure, etc.
David: So,
just to make sure I understand; panic disorder can never be cured,
only "managed". Is that correct?
Dr Granoff: That
is correct.
KRYS:
I have been treating mine with herbs and vitamins. Do
you believe in the use of homeopathic ways the same as you would a
prescription.
Dr Granoff: No.
There is no scientific validity to homeopathic techniques. But
if it works for you, do it.
David: We've
been discussing anxiety and panic. I want to touch on phobias
for a minute. How is a phobia different than panic disorder
and what are the treatments for that?
Dr Granoff: Phobias
usually result from having panic attacks. These begin to occur
in places where a patient has experienced a panic attack in the
past. They become sensitized to the panic provoking situation,
which increases anxiety and stress causing another panic attack to
occur. The person will then become phobic to that situation,
and experience anticipatory anxiety when approaching that situation
again. They then become phobic to that situation and will
ultimately avoid it.
David: Is
exposure therapy, repeated exposure to the situation that causes the
phobia, the best means of treatment?
Dr Granoff: Usually
not. Some people will respond to that, however, most people
will become panicky in the situation and this will make them more
phobic of it. The recent show on 48 hours showed exposure
therapy as a new and wonderful treatment for panic disorder.
They had spoken to me and had a copy of my book and video, and while
they knew my treatment was much more cost effective and clinically
effective they went with exposure therapy because my technique
doesn't make for "good" TV.
David: So
what is the best treatment then, for phobias?
Dr Granoff: One
has to get the panic attacks under control with medication then have
the person de-condition themselves through exposure therapy.
This is much more effective than exposure without medication.
David: Here
are some more audience questions, Dr
Granoff.
cherub30: How can a person
who experiences these attacks, not keep repeating the problems that
triggers them?
Dr Granoff: It's not about
repeating the problem, it's about repeating the situation without
experiencing a panic attack. The benzodiaepine tranquilizer
mimics a chemical the brain produces on its own. The genetic
disorder kicks in when there is more stress present exceeding the
amount of chemical the person can produce on their own.
Martha: Can proper breathing
( i.e. hyperventilation) actually stave off an attack or at least
minimize the attack while it is happening?
Dr Granoff: No. Slow
breathing is better. When you hyperventilate, you blow off
carbon-dioxide and cause tingling and numbness and your extremities,
face and head. That is a symptom of a panic attack.
kathy53: What can you use for
anxiety attacks if Paxil, Zoloft or Celexa have no effect.
Dr Granoff: They all have an
effect. But the antidepressant medications have a secondary
effect on anxiety, where as the benzodiazepines have a primary
effect. The main concern with the benzodiazepine is addiction,
memory loss, and sedation. However, 98% of people using the
benzodiazepine use them appropriately even for a life time and do
not become addicted. 2% abuse these medicines while
abusing alcohol and street drugs at the same time. Sedation
and memory loss are dose related if these side effects occur,
lowering the dose gets rid of them. The antidepressant
including Paxil, Zoloft, Celexa and Imipramine, etc., have side
effects which often cause insomnia, weight gain, and sexual
dysfunction. For me it's a no-brainer to chose the most
effective and least problematic medication, the benzodiazime
tranquilizers. These are safe and effective to use for a
lifetime, if necessary. Also, t he
drug companies are marketing the antidepressants with lots of
dollars because they make lots of dollars on them. The
benzodiazpime tranquilizer generic is much less costly.
David:
That's a good thing to know.
sassy: I have a lot of
trouble with racing thoughts, a lot of daydreaming and stuff, I
can't seem to stay focused on anything, always feel frustrated and
confused. Feels like I am losing grip here. Can you tell
me what that is all about?
Raven1: i
have had anxiety attacks for 15 years and nothing has helped me at
all. In fact, I tried taking Zoloft and it made me very
sick. I'm now taking St. Jonh's Wart. I have been
through mounds of therapy, been to many doctors and I feel like I'm
never going to pull through and be able to live on my own. I'm
almost 18 and need to be helped before it's too late. What can
I take that won't make me sick?
Dr Granoff: The
benzodizime tranquilizers prescribed by a knowledgeable
psychiatrist. Your general practitioner is not qualified to
treat this.
David: And
that's a good point, Dr. Granoff makes. It's important to go
to a specialist, one who knows how to treat anxiety, panic and
phobias. Not your general practitioner.
Dr Granoff: A
psychiatrists is the only MD who specializes in mental health and is
the only mental health practitioner who is a MD.
David: Dr.,
we are getting quite a few questions on exactly what is your
technique for effectively treat anxiety and panic? Could you
be somewhat detailed?
Dr Granoff: That's
impossible to do in this forum. My book and video explain this
in detail. They can be ordered from my website http://www.drgranoff.com
David: Here
is the link to purchase Dr. Granoff's book: Help,
I think I'm Dying. Panic Attacks, Anxiety and Phobias. I
also believe Dr. Granoff's book is available at the major
bookstores. Is that right Dr. Granoff?
Dr Granoff: Yes,
using the capital ISBN number 0-938423-04-5. The video can be
purchased on my website.
Smoochie: Is
Paxil a good antidepressant for anxiety and panic attacks?
Dr Granoff: In
30% of cases Paxil and medications like it make the panic and
anxiety worst. In 30 %, it makes no effect and in 30%, it
seems to help. The antidepressants like Paxil usually helps
when the person has both panic and depression and the depression is
the primary illness with panic as the secondary illness. And
Paxil often causes weight gain, insomnia and sexual dysfunction.
vick b:
Would therapy help at all? And when will the non addictive
drugs for anxiety come out?
Dr Granoff: The
marketing department of the Paxil drug company doesn't want you to
know this because they won't sell as many pills.
David:
For the audience: I'd be interested in very short
comments on how you effectively dealt with your panic, anxiety, or
phobia. Here
are some audience responses "on what's worked for you":
wintersky29:
changing the way you think, from negative to positive,
that's how I deal with it.
Raven1: I
have tried exposure therapy for my separation anxiety and it only
makes me want to kill myself and more depressed.
cookie4: Paxil
made mine worse, switched 5 different times before finding one that
works
kristi7: For
me, a sufferer for 20 years now, I never had medications other than
Ativan for a funeral. I used relaxation techniques and
Attacking Anxiety program CBT therapy
Dr Granoff: CBT
therapy means thinking therapy and understanding your condition and
your body's response to it. My book and video are worth 6
one-hour CBT sessions.
Martha: I've
read that exercise acts in the same way as uptake inhibitors, is
this true?
Dr Granoff: While
exercise can reduce some stress, it is not going to reduce enough to
make a difference.
Hemlock: This
is very interesting, I had anxiety that was unreal over surgery and
I'm on Paxil.
Eileen:
Paxil gave me a new lease on life after 24 years of total fear and
misery!!
trayc:
What about Buspar?
Dr Granoff: Buspar
is not effective for panic attacks.
blusky:
I only have problems driving alone but can go places with people
without panic. How can I overcome the fear of panicking while
I'm alone?
kristi7:
Is there a test to prove the chemical imbalance?
Dr Granoff: Not
for the general public, for research only.
David: A
lot of the things we are talking about tonight have been around for
awhile. Do you know of anything new coming online?
Dr Granoff: Nothing
that I know of. However, with the deciphering genetic code we
will one day find the gene or genes that produce panic. Once
found, cures will be found to fix the gene.
David: Just
to jump back for a second Dr. Granoff, is there a reliable test
available to check for brain chemical imbalance. I mean, can I
go to my psychiatrist and have this done today?
Dr Granoff: No.
The diagnosis is made by taking a thorough history. This is
outlined in my book.
diana1: I
have stopped taking Paxil-30mg cold turkey and had what was referred
to my therapist as "brain firings". It is a
sensation somewhat like hitting your funnybone, but in your head for
a split second, is this normal?
Dr Granoff: You
were experiencing withdrawal from the Paxil. This should stop
after 4 or 5 weeks. If it doesn't, it is a return of anxiety
symptoms, which can be better treated by using the benzodiazimes (Xanax,
Ativan, Klonopin, etc.)
jeansing: Is
there research being done at this time for finding genes for Panic?
Dr Granoff: Not
that I'm aware of. There are a lot of genes to find for a lot
of diseases. It will be placed on the list and hopefully found
soon.
panickymommy:
Why is it that driving is so hard for me? I cannot drive in
places where there is nowhere to pull over, for example: in
construction areas or down narrow roads. This is ruining my
life!
Dr Granoff: Most
phobias occur in situations where escape is difficult or would prove
embarrassing. For instance, driving on an expressway, in a
tunnel, over a bridge, in the left turn lane, sitting in a dental
chair, standing in a checkout line at the grocery store or sitting
in church, a restaurant or movie.
David: What
would be an effective way to get some relief from that?
Dr Granoff: Getting
appropriate treatment from a qualified psychiatrist.
figa: Can
agoraphobia ever be cured? And if I start exposing myself to
my fears, like eating, etc., will my anxiety start to drop, or will
I have to take medication? I have lost 14 pounds in two weeks
and cannot eat or sleep well.
Dr Granoff: Medications
are usually necessary and effective and safe.
David: Here's
a question about "social phobia", or what many call
"shyness":
z3bmw: Hi,
have you ever treated a person who talked freely at home but
wouldn't talk in public?
Dr Granoff: Yes.
I would have to know the cause of the attacks. Counselors,
social workers, psychologists, and your family doctor will tell you
to exercise, provide relaxation training and supportive
therapy. While that might help some--a qualified psychiatrist
will help most
David: Here's
the link to our journalers
in the anxiety-panic community who keep online diaries of their
experiences. You can read them and post your comments on their
bulletin boards. It's one of the most popular portions of the HealthyPlace.com
site. Here's another agoraphobia question:
Aussiegirl:
I started having Panic Attacks 3 months ago. Everything was
fine before that. The last time I had a panic attack, I ended
up screaming and lost control. Since then, I have developed
agoraphobia. How can I help myself if I can't leave the
house? I couldn't even get to a therapist.
Dr Granoff: First,
get my book
and video to
understand your condition and how it should be treated. Then,
find a qualified psychiatrist to treat it, perhaps by phone at
first.
David: Dr.
Granoff, I want to thank you for being our guest tonight.
You've been helpful and given us more insight into the causes and
treatments of anxiety, panic and phobias.
Dr Granoff: It's
been my pleasure.
David: I
also want to thank everyone in the audience for coming. We
have a large number of people who are chatting regularly in the anxiety
chatroom, so I hope everyone in the audience will feel free to
visit anytime. I think it's important to support each other
and pass along information on what does and doesn't work.
Again, here's the link to Dr.
Granoff's book, and this
one takes you to his site, where you can also get his book and
video. If you haven't already, click
on this link and register for the mail list so you can keep up
with what's happening in the anxiety community. I also want
everyone to know, my address is: info@healthyplace.com.
If you have a guest or conference topic idea, please pass it
along.
Good night everyone and thank you for
participating tonight.
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