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Dad died in 2010 and mum's confidence took a dive. She had an isolated panic attack about 3 years ago, but since December 2014 (following a fall and hospitalization) they have become more frequent - several in the past few days. She is on low dose Citalopram which has helped with her general anxiety but done nothing for the PAs. I'm trying to be encouraging, but just don't know what to do when an attack strikes and am a bit concerned I'm making things worse. I was hoping someone else might have handled this.

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Citalopram (Celexa) is an antidepressant, not an anxiety medication. It can trigger manic episodes. If the primary problem is anxiety, an anxiolytic like Xanax, Ativan, Klonopin would be more appropriate. Ask the MD about an SNRI instead of an SSRI medication.
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Lizzie--
As a life long sufferer of panic attacks, large and small, I can tell you that they are as real and terrifying as anything a Dr, can physically see or test for.

Sounds like she may have some true medical reasons for having PA's. Nevertheless, they're real in the here and now. I myself take Klonipin, and it ALWAYS works for me, even tho I have taken it for years. I can calm down, think out a situation and decide if my anxiety is "legitimate" or "passing through". Sometimes we are anxious for truly serious reasons. Sounds like your mom legitimately feels scared, perhaps just that fear of falling, which is very real. Please don't tell an anxiety ridden person to "calm down" or " "you're being dramatic", b/c to us, it's as real as a heart attack. There are MANY meds she can use to calm her down. Maybe she will find chamomile tea to be calming, and that would be great.
I did try a LOT of holistic/natural remedies, but ended up just acknowledging that I am a panicky, anxious person by nature and gave in to the drug that I KNOW will help me. I'm not proud of it, but I am also no ashamed. I imagine I will be on Klonipin the rest of my life--and that's OK. Let your mom have peace of mind. (If she has trouble swallowing, I do know that Valium comes in a compounded ointment that can be massaged into the forearms. We gave that to daddy when he could no longer swallow and he was so anxiety ridden and miserable. Just wash the stuff off your hands afterwards (or don't, if you also want to calm down. I had more than one VERY peaceful afternoon with daddy as I'd apply the Valium compound to his arms and then rub the rest into my hands, as you do with excess lotion....no one told me to wash it off my hands...I can attest that it works great!
All the best--and yes, don't "cluck" at mom, that just makes anxiety worse. My DH will fuss at me and be so angry for MY anxiety it just makes me feel worse.
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Please have her evaluated by a geriatric psychiatrist, someone who knows her/his pharmacology, like Pam does. Write down the details of mom's Panic attacks and give them to the receptionist before mom's appointment.
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Exercise is good for a panic attack, but I realize that not all elderly and get up and dash about the house.

Panic attacks aren't easy to make disappear, I know because I have attacks while driving. Use to get similar attacks while waiting in line at a bank or grocery store but those eventually went away :)

Try to notice what happens just prior to a panic attack... what is the trigger and then work from there trying to ease the trigger. Distraction is great, but it has to be a strong enough distraction to make the mind shake loose that panic. For me, thunder storms while driving helps.
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Check into a natural remedy for this. Chamomile Tea and other teas offer a calming sensation without the side effects of drugs. Add coconut oil and organic olive oil to her diet. Olive oil has antioxidants and vitamins A and E. Coconut oil if taken orally either by itself or mixed in food helps with memory loss, anxiety and a hole host of other problems including digestive. Too many people want to opt for the drugs that only take care of the symptoms and not the actual cause.
Consult a holistic doctor and one who specializes in geriatrics.
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You might not have known about it before but it is possible she's been having episodes most of her life. Citalopram will cause anxiety. It stimulates rather than calming down. Anxiety like this is caused by a chemical imbalance in the brain as are other mental disorders. Triggers can be environmental such as loud crowded locations, grief, perceived loss of sanity.
My own generalized anxiety disorder does not give any warning. Learn deep breathing exercises. Help her by coaching her through the timing of the inhales and exhales. Run cold water over the inside of her wrists(I don't know why it works but a psychologist taught me that). It helps me to go to a dimly lit,totally quiet place, and put my bare feet on a cool floor. Lying down in the cool grass in the shade. Perhaps feet on a cold compress, or bag ice wrapped in a pillow case. In my opinion, herbal teas take too long to affect change and they are not
effective because of the level of anxiety being experienced.
Anxiety you described is not what unaffected people think of as " nervousness" . it is far greater and a person really thinks they are literally dying. What I do is talk myself through it knowing I will come out the other end of it without dying just like the other times.
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Thanks for all the advice. We went back to the GP for blood tests today. She has had an overactive thyroid in the past and was taken off her medication for that approx. 4 months ago. GP thinks that may have something to do with it. Will speak to GP about meds when the results come back. She has appalling balance due to an acoustic neuroma plus no feeling down her left side following a bleed on the brain 3+ years ago. She says she's frightened of "not making it' to where she's trying to get and falling. I can't tell her that this is an unrealistic fear, because it's not :-( We had a 're-enablement' worker in this morning, she was very calm but firm and mum seemed to respond to that. Perhaps it's an approach I have to learn, at the moment I'm like a fussing mother hen.
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My mother used to have terrible panic attacks, mostly in the middle of the night or early morning. They were so bad she would sometimes throw up and often defecate in the bed. She would call my sister two or three times a week and off they would go to the ER, only to discharge her a few hours later. The doctor prescribed clonzapam before bed and that seemed to help. Also told her to take one if she started to feel one coming on. They started because her husband was a domineering mysogynist who used to tell her she was having a heart attack and force nitro down her throat - when he was the one causing it. When he died, they escalated. This went on for several years until we moved her to AL. She had two attacks over a period of a year, both times they put her in an ambulance and she went alone to the hospital, and then had to take a taxi home. Amazingly, she never had another one. I think the key is to get control of the attacks with some meds, and then help her to learn to cope with one before it starts - there are signs they can recognize and then be able to control - even with some psychiatric counseling.
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Some chemical food additives can cause panic attacks in some people. MSG is a common culprit.
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Pam has said it all nothing to add, just stay close and hold her.
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