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Monday, August 10, 2009 JackO asks

Q: what are some of the best drugs or combination of drugs for adhd and ocd and severe anxiety w/ panic

attacks? I used to be diagnosed w/ ocd, panic attacks and major depression. i have been on too many medicines to list. However, the adderall seems to severely increase the ocd. Is this common? Also, when the adderall wears off i become extremley agitated and have to take my xanax and buspar right away. i am also having new symptoms of seasonal affective d/o. I am a 36 yr. old female and I have been medicated since the age of 11. I am not any better.

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8/11/09 2:01am

At the first sign of one, employ an ANTI PANIC ATTACK breathing technique. Advice from a published psychiatrist on controlled breathing: (1.) Get a clock, or watch with a second timer. (2.) Practise for 5 minutes, 4 times daily, until proficient. (3.) Take a small breath in, and hold it, for 6 seconds. (4.) Think to yourself: "RELAX", just before breathing out. (5.) Try to feel a sense of releasing tension, as you breathe out. (6.) Breathe in for 3 seconds, then out, for 3 seconds. Try to make your breathing very smooth, and light, as you breathe in through your nose, and out through your mouth, or nose. (7.) For the next minute, continue to breathe in, and out, every 3 seconds. (8.) Go back to step 3, at the end of the minute, and proceed through to step 7, doing this for 5 minutes. Use this at the very first sign of a panic attack starting, or any time you feel anxious, or tense. Similar, but simpler advice, from a clinical psychologist is to breathe in to the count of 3: (one thousand one; one thousand two; one thousand three) each takes around a second to say to yourself, in your mind, and out to the count of 3. Also see http://deeplyrelax.com & www.deepsloweasy.com/html/intro.htm 

Note: the controlled breathing only helps with the symptoms (as do medications/herbal remedies): you need to address the underlying cause, which requires some form of therapy, and Cognitive Behavio(u)ral Therapy has been shown to be effective. Imagine that the cause of your panic; your anxieties, fears, your self doubts, self recriminations, all the agonizing "I'm-so-Stupids"; every painful "I-can't-do-it" are huge raging, hurtful bulls snorting and charging at you. You see them coming at you and you hold out your red matador's cape at arms length and simply let them charge right by. Every time they come at you, hold out your arm with the red cape and let them rage and snort and go right on past. Some people recommend nettle tea, with a little honey. Others use Lavender tea, Lemon Balm, Chamomile, but use no milk or cream with herbal teas, or Valerian (caution: its use may become habitual). Know how these affect you before driving, or doing anything dangerous, and it is far better to use the treatments, rather than relying on herbal remedies. There is a free online PANIC COURSE at www.panic-attacks.co.uk and it is also available by email. Well worth a look, too, is the section on panic attacks at www.mind.org.uk which they also have in booklet form.
 
Unlike some other websites, they also recommend letting a panic attack run its course, without doing anything to treat it, so you KNOW you will survive it. The usual maximum is 30 minutes, until symptoms begin to subside. Also see www.anxietypanic.com/signs.html and http://www.onestepatatime.com (chatroom, and one free email is allowed to their resident expert on joining [free] - more if a paid up member) and www.medicinenet.com/panic_disorder/artic... and www.squidoo.com/controlpanicattack/modul... and www.nimh.nih.gov/healthinformation/index... and www.healthyplace.com/communities and http://panic-attack-over.com and http://www.anxietynetwork.com Most people are suggestible, to some degree, so you could either seek professional hypnotherapy, or, quicker, cheaper, and more conveniently: http://www.hypnosisdownloads.com Perfect Partners: Stop Panic Attacks + Breathing Exercise, or http://www.instant-hypnosis.com Stop Panic Attacks, & http://www.asktheinternettherapist.com/shop3/scripts/prodList.asp?idCategory=31 ADD products, and take 4 Omega 3 fish oil supplements, daily. Use a relaxation method daily, like http://www.drcoxconsulting.com/managing-stress.html or http://altmedicine.about.com/cs/mindbody/a/Meditation.htm or http://www.wikihow.com/Meditate Tai Chi, Qi Gong, or yoga.


OCD is an anxiety spectrum disorder, and the obsessions and compulsions are a way of avoiding, or coping with it, so; treat the underlying anxiety effectively, replacing your habit with the EFT, below, or (hopefully only temporarily) something more socially acceptable, like using worry beads, stress ball, electronic palm held game, or stringing beads, etc. It's important to regularly monitor, and deal with a negative internal monologue (self talk), or mental process, such as disturbing thoughts, images, impulses, or emotions, by the process of (a): recognising it, and (b): challenging it immediately. Technique For Re-Programming Negative Thoughts: When you notice something negative, such as: "I can't do this/ am never going to get over this!" or: "Why am I always so pathetic/useless/such a loser?" or even an image, emotion, or a memory; recognise that it is being generated from the negative part of your mind. Having identified and labelled it, visualise a large, red, flashing, "STOP!" sign, and/or possibly a stern faced person wagging an index finger at you in a negative manner, then say to yourself as forcefully as you can, even aloud in a big voice, if alone: "I know this tactic: GO AWAY FOR A WHILE !!!" You may want to use either: "ruse", "ploy", "game", or "trick". In the case of an image, visualise a large "STOP" sign, or your preferred version. Some people go so far as to keep a wide rubber band in their pocket, then put it around their wrist, when they catch themselves backsliding, stretch and release it, as a method of reprogramming their mind sooner, but I don't regard it as being strictly necessary.

Remember to remove it, afterwards, if you use this method. Practice a relaxation method, daily, and when needed, such as: (free) http://www.drcoxconsulting.com/managing-stress.html or http://altmedicine.about.com/cs/mindbody/a/Meditation.htm or http://www.wikihow.com/Meditate  Tai Chi, or yoga suits others better. Give the EFT a good tryout, to see if it helps you. It is free via the searchbar at http://www.mercola.com "EFT" & "EFT therapists" Professional is best. - There is a version for use in public places, (if anyone asks, you can claim to have a headache, as you massage/lightly tap your temples, but you would then be restricted to subvocalising: saying it to yourself in your mind: "Even though I sometimes suffer from obsessions/compulsions, I deeply and completely accept myself." Herbal remedies, such as St. John's wort, are often effective, but the idea is (as with anxiolytic medication) to use them like water wings, or training wheels on a bicycle, providing initial support, and giving time for other treatments, such as therapy, and relaxation techniques, to take effect. Imagine, as vividly as you possibly can, that your concerns, anxieties, worries, fears, your self-recriminations, all the agonizing "I'm-so-Stupids"; every painful "I-can't-do-it", etc., are huge raging, hurtful bulls snorting and charging at you. You see them coming at you and you hold out your red matador's cape at arms length and simply let them charge right by. Every time they come at you, hold out your arm with the red cape and let them rage and snort and go right on past. A free E course in CBT for anxiety is at: http://ecouch.anu.edu.au/welcome

Most people are suggestible, to some extent, so consider professional hypnotherapy, or: http://www.asktheinternettherapist.com Conquer Obsessive-Compulsive Disorder (ocd) Hypnosis CD or MP3, or: http://www.instant-hypnosis.com
Obsessive Compulsive Disorder (OCD), & Quiet the Voices Within, or: http://www.hypnosisdownloads.com Improve Impulse Control, & Overcome Fear and Anxiety, or: (free) at: http://www.freehypnosistreatment.com - anxiety. Books: Coping With OCD: Practical Strategies for Living Well With Obsessive-compulsive Disorder by Bruce M., Ph.D. Hyman and Troy Dufrene, and/or: Overcoming Obsessive-Compulsive Disorder: Client Manual: A Behavioral and Cognitive Protocol for the Treatment of OCD (Best Practices Series) by Gail Steketee Try your bookstore, or Amazon.com searchbar for them.  I suggest that you wean off the adderall first (check out www.drugs.com & www.rxlist.com) in accordance with http://theroadback.org/workbook.htm

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8/11/09 2:03am

Depression: Identifying the cause often leads to the best course of action. Was there a triggering event? If so, it is probably reactive (situational) depression: counselling, such as Cognitive Behavioural Therapy may be indicated, but most of life's adverse situations are resolved within 16 weeks, yet the medical criteria for depression, and the prescription of antidepressants is only 2 weeks!. Or, was it a more gradual thing, with no apparent cause? (a nutritional deficiency, hypothyroidism, environmental toxicity, or reactions to some medications, such as Advil (ref: Mercola.com) etc., becomes more likely as the cause). Antidepressants work quicker than the following; 2 - 6 weeks, but you may have to adjust dosage, or types. St. John's wort helps most people; tolerance doesn't develop, and the few side effects don't occur often, and even then are normally not severe (neither antidepressants, nor the wort, nor supplements should be relied on as a sole treatment). It doesn't cause sleeping problems, or weight change, but usually takes at least 2, and generally 4 - 6 weeks to become effective, but can sometimes work quicker than antidepressants. See http://www.ncbi.nlm.nih.gov/pubmed/10759336?dopt=Abstract A recent, independent German double blind study showed it to be as effective as a commonly prescribed antidepressant, in cases of major depression, with far fewer side effects, and those were generally better tolerated, with a lower rate of discontinuation.
 
Unlike antidepressants, where sexual dysfunction is a common side effect, it happens much more rarely with St. John's Wort (I didn't experience any). A multidimensional approach to treating depression without medication follows. All except for no. (7.) are safe to use with medication, but not SJW, because of interactions, and it's sensible to check out anything else first, like Ginkgo Biloba, Gotu Kola, or supplements, such as SAMe,  5HTP, or L-phenylalanine,  with your doctor. (1.) Take at least 4 Omega 3 fish oil supplements, daily: (certified free of mercury) it is best if consumed with an antioxidant, such as an orange, or its FRESHLY SQUEEZED juice. If vitamin E is added, it should be certified as being 100% from natural sources, or it may be synthetic: avoid it! In the winter months, if not getting sufficient daily exposure to strong light, see http://www.mercola.com SEARCHBAR: enter: "vitamin D3". Go to a doctor and ask for a 25(OH)D, also called 25-hydroxyvitamin D, blood test. When you get the results, don't follow the typical "normal" reference range, as these are too low. The OPTIMAL value that you're looking for is 45-52 ng/ml (115-128 nmol/l)". The company which tests your levels has to be one of those using the correct form of test, and this topic is addressed via the searchbar at Mercola.com - "vitamin D3; testing". Also take a vitamin B complex which is certified as being 100% of natural origin; the deficiency in vitamin B9 (folate, or folic acid) that most depressed people have, is known to cause depression. Around 30% - 40% of depressed people have low vitamin B12 levels.
 
(2.) Work up slowly to at least 20 minutes of daily exercise, or 30 - 60 mns, 5 times weekly in daytime, outside. Too much exercise can cause stress, which isn't wanted when dealing with depression. (3.) Occupational therapy (keeping busy allows little time for unproductive introspection, and keeps mental activity out of less desirable areas of the brain). (4.) Practice a relaxation method, daily, and when needed, such as: (free) http://www.drcoxconsulting.com/managing-stress.html or http://altmedicine.about.com/cs/mindbody/a/Meditation.htm or http://www.wikihow.com/Meditate or Tai Chi, Qi Gong, or yoga. Give the EFT a good tryout, to see if it helps you. It is free at www.emofree.com Professional is best. - There is a version for use in public places, (if you want to, you can claim to have a headache, as you use the acupressuremassage/tapping on your temples, but you would then be restricted to subvocalising (repeating it to yourself in your mind) "Even though I suffer from depression, I deeply and completely accept myself." (5.) Initially, at least, some form of psychotherapy or counselling; later, perhaps either Cognitive Behavio(u)ral Therapy, (a free E course in it, which may well reduce the time needed in therapy, as should *, & ** is at: http://ecouch.anu.edu.au/welcome ) or Rational Emotive Behavio(u)ral Therapy for, say, 6 months. (6.) Maintain a mood chart, and daily activities schedule**. (7.) As options, if desired, either a known, effective herbal remedy, such as St. John's wort, (get a German variety, if possible; local ones may vary in effectiveness. Jarsin, Perika, and Kira brands have been recommended as being effective.

Take with a meal), Ginkgo Biloba, Gotu Kola, or supplements, such as  SAMe, 5HTP, or L-phenylalanine: see: http://www.indepression.com/depression-natural-remedy.html (from vitamin and health food stores, some supermarkets have old/inferior types, or mail order: Google: " ... ; supplies"). 80% of people in the Western world have low magnesium levels; this is known to cause depression & anxiety. Try pharmacies & supermarkets for the magnesium supplement types shown in http://www.real-depression-help.com/magnesium-for-depression.html or magnesium chloride. Low levels of calcium, and potassium can also cause depression. Have your blood tested, and correct any deficiencies, preferably through improved nutrition. An improvement can be noticed in as little as a week, if a deficiency is the cause. Use sea salt, http://www.naturalnews.com/025883.html as many people are iodine deficient, adversely affecting thyroid function. Google: "depression quizzes" and if positive, print, and take to your doctor, to eliminate medical causes. Read: "Lift your mood now." by * John D Preston, Psy.D. 2001, New Harbinger Publications, Inc., 5674 Shattuck Avenue, Oakland. CA, & "Feeling Good - the new mood therapy" ** by David D. Burns, M.D., from your bookstore, or Amazon.com
IF TAKING ANTIDEPRESSANTS: I suggest that you check out www.drugs.com & www.rxlist.com and wean off, in accordance with http://www.theroadback.org/workbook.htm and begin the core treatments  below immediately, and the herbal remedies, or OTHER supplements, like SAM-e, 5HTP, or L-phenylalanine, when below 50% weaning dosage.

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By JackO— Last Modified: 12/24/10, First Published: 08/10/09