Psychiatrist Questions Psychiatrist

Need help with panic episodes?

When I was 12 y/o I tried spice crap and had to go to the ER due to psychosis/derealization/extreme panic attacks. I tripped badly. In my adult life, I still have very mini and quick episodes that are quickly resolved.

However, I have been having extremely severe (like extremely) episodes of panic attacks w/ derealization. Then when not severe, it’s kinda an all-day ongoing mini-episode.
Some recent stressors — moving, nonprofit can’t pay us last few months, broke up with my bf a few months ago. I told the doc about two weeks ago that panic attacks were occurring, increased RLS, and slight derealization episodes. She said to try Xanax and Lamictal.

Xanax made me feel like crap and more anxious. So we switched to clonazepam. After taking Lamictal for a week and increasing to the next dose, the episodes got worse.
I stopped taking Lamictal. I had many large and mini-episodes daily and saw an online psychiatrist. She said let’s do Effexor and go back to Lamictal. Then had a major episode last night. 3 clonazepam did not take me out of the episode really and couldn’t sleep. Multiple episodes basically all day today and have taken to clonazepam with literally no response.

I don’t know what the hell is going on. I’m scared. I feel like crap. I’m panicking nonstop and going through nonstop derealization episodes. I don’t want to go to the ER with COVID or want to clog up the ER. Personal off the record insight on what could be going on/possible action plan you would take?

Male | 25 years old
Medications: Gabapentin; Xanax; Effexor; Lamactel
Conditions: Asthma; anxiety; pituitary cyst

3 Answers

Unfortunately, it sounds like the professionals you have consulted are of the belief that you have a brain disease. You need a therapist who has enough experience to help you understand the real factors in your life that are leading you to have such severe anxiety. In my experience trying to cover it up with medications will not work. You might look at the website
Mad in America to find resources that would be more helpful. The book by that name by Robert Whitaker could also give you a better understanding of the issues you are facing.
Hello Sir, 

So sorry to hear that you are suffering so much from a mistake made in your teen age years regarding using street drugs without consulting with your pediatrician, or your parents. You are on several medicines. I am a psychologist and medicines are not my specialty. In fact, I am not allowed, by licensing laws, to make any comments in that area. Regarding an action plan I am not able to advise as I have not evaluated you. So, I would like to suggest that find a licensed psychologist in your area who specializes in DBT (Dialectical Behavioral Therapy) and ask them for a referral to a psychiatrist that they are closely working with. Do not postpone this. You need to find a professional in your area ASAP (as soon as possible) and remain in therapy until you resolve the issues. In the meantime, start with a healthy life style, free of drugs, full of healthy eating, exercising, meditating and taking care of your well being (physical, emotional, social and spiritual).  
Take care and remain safe. 

Dr. Lata Sonpal
Check this link out...
https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms
A good self-help resource is Anxiety and Phobia Workbook by Bourne 7th edition.