Sage, anyone: Please help.

[kel12347]

I had a very strange thing happen to me today. There was another vomiting incident in court, I did not see anything, I just heard that a girl had been sick in the holding room (which is right next to the table I sit at). My anxiety only went up to about 50 when hearing this news, which I thought was pretty good. I was able to keep the anxiety in check all day today, and then I went to see my new psychiatrist. I asked for just Lorazepam, and she refused and told me I needed an SSRI too. She asked me if I was bulimic, and told me if I wasn't bulimic I must be anorexic. She also told me several gross v'ing stories, which I think was highly inappropriate. She did not even know what the phobia was when I mentioned it.


Anyway, I was somewhat anxious in her office, due to the nasty stories. I got home, feeling only a little anxiety (SUDS at 10, maybe), was walking on the sidewalk, and heard the negative thought in my head, "You're going to v****." Then I felt sick to my stomach....except I think it was panic nausea, not real nausea. I immediately started panicking, took a bath and a Lorazpam.


My questions: was it real nausea? or was it just a delayed reaction to the stress of the last couple of days? If it was just an anxiety reaction, how come it started with the climax of my panic attack, rather than the usual buildup? If I have the panic attack buildup, I can usually deal with the resulting "nausea", because I know it was panic induced. But this is a whole different ball game.


Advise anyone? Oh, and one more thing. Does anyone have any tips on dealing with these types of negative thoughts, as opposed to the "what-ifs?" The one I had today, "You're going to v****", scares me so much more than the what-ifs because it seems to true and authoritative (I think that's the word I wanted). Would just challenging these work?

[crystalmom]

Wow....I wish I had some good advice for you. The best advice I can give is to get rid of that shrink. If they don't know what they are treating, how on earth can they possibly know the HOW to treat it?


I also had a very bad experience today, and I know how you feel. Unfortunetly for me I'm thinking panic attack in the 80's. Horrid.


Anyway, if you figure oout how to banish those thoughts, please let me know, b/c I have them also, and can't seem to be stronger than they are.


Crystal

[sage]

Hey Kel,


Don't worry, buddy - you're doing ok. And I'd say yes that was anxiety walking home due to the stress of being in the psychiatrist's office...which turned out to be completely unsafe. Safety is #1 with emetophobics in therapy, and this shrink violated that for sure. She's also an idiot, by the way...by every indication. Move on to someone else! (Consider it an "interview", which she flunked). When someone goes to "get help" and then is violated instead, it will up your anxiety. But remember, there is good help out there, you just need to search a little more to find it.


As for the negative thought "I think I'm going to vomit" - I would ABSOLUTELY challenge that, every single time. Try substituting "I'm scared, but I'm alright". It has a lot of lovely nuances to it.


I also think (and my only info comes from your internet posts, so I'm no expert) that you're getting better from all these exposure episodes. Just the way you post about them. People are vomiting all around you, and you're ok. You haven't died. You haven't even gotten sick yourself. Also, it's probably more obvious to you that a person can vomit and not die, or it not be a horrible disaster. You've been observing other people just not making a lot out of it. THIS IS GOOD!


So you're on an upswing....all but that silly psychiatrist.


Another thing I advise people: when you ask if the nausea was "real" or not...just revisit it a day later. If you didn't vomit, then it wasn't "real". So note down exactly how you felt. Every symptom. And then you'll know next time, that those symptoms don't lead to vomiting. Instead, a bath and a tranquilizer "cure" them!

[kel12347]

Thanks for the responses. Sage, thanks so much for the inspiration. After yesterday, I definitely needed some. All I wanted from the psychiatrist was a refill of Lorazepam, as my therapist and Idon't think I need to be on an SSRI at this time. My panic attacks have been happening pretty often for the last couple of months (although I'm now down to about 1 per week, and had zero a couple weeks ago), and I still only take about .25-.5 mg of Lorazepam per week, so I think that adding an SSRI would be overkill, and that it would only mask the symptoms I am trying to get rid of. I used to be on Paxil and then it quit working. The withdrawal symptoms were terrible when weaning off of it (I was dizzy and had no appetite), and I don't want to be on an SSRI again unless it is absolutely necessary.


I did try to challenge that thought today, and found that just challenging it made me a little anxious....so I guess I need to challenge it a lot more! I was also kind of worried about the "nausea" happening when I was on the sidewalk walking to my house. I refuse to let anticipatory anxiety scare me about entering or leaving my house.


I will not be seeing that psychiatrist again. She also mentioned ipecac, not specifically that I should try it, but it was brought up. I am incensed by her behavior. When I need my next Lorazepam refill, I'm definitely going somewhere else!!


One last question, Sage: with panic attacks, when you can feel your stomach contents "rising", is that just your digestive system slowing down? That's what I feel during my panic "nausea," and it's the only symptom during a panic attack that really freaks me out. The rest of the symptoms are crappy, but I can cope with them, it's just the stomach feelings (of course) that get me.

[sage]

Yes, it's just the anxiety playing tricks on you. Remember that you feel that feeling every time, yet you've never vomited. So therefore that feeling is uncomfortable, but it doesn't lead to vomiting. RIGHT?? RIGHT!! That's what you have to tell yourself: I feel uncomfortable, but at least I won't vomit. This is just anxiety. I'm alright. I'm not in any danger. I'm afraid, but I'm ok.


I'm glad you have a "real" therapist, and don't ever need to see that psychiatrist again. Can't your GP prescribe the Lorazepam? GAK.


Hang in there, k?