Anxiety Caregivers

Ken Strong: is our guest tonight, Ken has not only suffered from panic attacks, agoraphobia, depression, and OCD, but he's also been a caregiver to a good friend who suffered from panic attacks, and agoraphobia.

David Roberts: HealthyPlace.com moderator.

The people in blue are audience members.

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David: Good evening everyone. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Anxiety Caregivers." Our guest is Ken Strong. Ken has not only suffered from panic attacks, agoraphobia, depression, and OCD (Obsessive-Compulsive Disorder), but he's also been a caregiver to a good friend who suffered from panic attacks and agoraphobia. Ken has written a book on the subject directed towards support people, family and friends.

Good evening, Ken and welcome to HealthyPlace.com. We appreciate you being our guest tonight. You have been on both sides of the fence as sufferer and caregiver. What is the most difficult part of caring for someone who suffers from an anxiety disorder?

KenS: Watching the mental pain they are in is very difficult.

David: Can you elaborate on that for us?

KenS: Seeing them lose their self-confidence, knowing it is really all in their heads and feeling they have lost control of who is running the brain. Also seeing them suffer with panic attacks.

David: What is the responsibility of the caregiver?

KenS: For themselves, or for the person with the disorder?

David: First, to the person with the anxiety disorder?

KenS: Remember, they are probably the primary caregiver and the person with the anxiety disorder needs a solid post to lean on. Especially, one they can trust. Also, they should try and understand the disorder and show empathy where they can. During a particularly bad time, the caregiver may be the only person that the sick one may be able to turn to for support, love, understanding, and assurances that they are not insane and that they are not going to die.

David: For lack of a better term, what are the job duties? What are the things that the primary caregiver does, or can do, to help the anxiety sufferer?

KenS: The most important "duty" is to give needed emotional support, however, there are a number of other things as well. For instance, they should see that the person is getting out as much as possible and help them all they can.

David: Could you be more precise when you say "help them all they can?" A lot of people who come to our anxiety chats want to know exactly what can they do to help?

KenS: There are a number of things which a caregiver can do depending upon the circumstances. However, first, I want to say, that the caregiver must not let the anxiety disorder affect his or her life to the point that they lose their friends, become depressed themselves, etc. To be more specific, they should set ground rules with the person as to how much help they can give. Once that is established, they can help in a number of specific ways.

The caregiver also needs to plan ahead. An anxious person does not need surprises, or last minute changes. If the caregiver is going to the store with the person, then they should just go to the store and not make any side trips. The caregiver should always stick to the plan and remember that the person they are on an outing with, calls the shots. If they have to retreat, then retreat. The caregiver should not make a fuss. As the person learns to become calm again over time, then the caregiver can start making changes.

I could go on all night, but unless there is something specific, the audience can find a lot on my anxiety caregiver site. There, you will find suggestions for many different types of events, etc.

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David: Ken, I imagine it's pretty tough being a caregiver. After awhile, I am sure that the stress of dealing with someone who has a severe panic disorder, can get to you. What are your suggestions for dealing with that?

KenS: Here are some general tips:

1. The anxiety caregiver must remember to look after themselves, because having two people sick will not help.
2. The caregiver must make sure that they are aware that they can only help the person so much. They need to realize that the healing has to come from within.
3. Also, being a very close and available person, the caregiver may get yelled at a lot. They need to realize that this is a way for the person to get rid of stress and anger. However, they don't have to be a doormat or a servant. In other words, they just need to have a thick skin. If the person is overstepping their bounds, the caregiver needs to tell them so, firmly but nicely. It may even be necessary for them to leave the area for awhile.
4. The caregiver needs to make sure that they continue to carry on their life as best as they can. They should keep up the social side, such as finding new activities, or even going out by themselves. Not being able to go out, or staying at a party, meeting, etc., can put a dent into their social life in a hurry. For example, if the anxiety caregiver can invite and have people in, then they should. However, they should be sure to tell their guests that their wife may have to go bed etc., due to her disorder.
5. The caregiver should find other people to be temporary support people such as; friends, neighbors, church groups, etc. Any of these "support people" can help come in, or take the person to appointments. The caregiver should not feel they have to do everything, because they are the only person that the person in need feels comfortable with. The caregiver may even be blamed for being the cause and that could hurt. The caregiver must remember that unless they have a particularly tumultuous relationship with the person in need, they aren't the cause. The roots of anxiety can be genes, and/or go back many years. They might even say they feel worse coming home, so it must be the caregivers fault. This is probably not the case. It is because they have come to associate the home with anxiety because that is where they spent most of their time.
6. The caregiver should not feel there is something that they must do in order to be able to help them recover. There isn't in the short run, because recovery is 3 baby steps forward and 1 back, or 2 back, or 3 back.

People frequently ask, "What can I do for my wife during a panic attack." Basically, very little. Someone in a full blown attack:

• may wish to be left alone
• may not want to be held
• may want to be reminded that they are not going to die
• may use relaxation breathing techniques
• may find that a certain type of music calms them

David: Ken, for those of us who haven't experienced it before, can you please describe what it is like having a panic attack?

KenS: That may be difficult, but let's try this. The body comes complete with a mechanism to protect itself in times of danger. This is when adrenalin is released as the body prepares to fight, or run away. This causes a number of things to happen: breathing increases, blood flow changes, and eyesight becomes more acute, as do the other senses. If your body is busy running or fighting, you don't notice this. However, if you are just hit with a sudden flow of adrenalin, without any discernable cause, you are fully aware of all the changes. There is list of panic attack symptoms on my site and the changes that take place in the body and their effects.

To get an idea of what it feels like, imagine the feelings of a six year old child who has been chased into a narrow rock crevice by a vicious wild dog. The boy can squeeze back just far enough to get out of the way of the snapping jaws, however, the claws keep trying to reach him but never quite do. His anxiety level is ready for battle, which is a very high level characterized by much adrenalin flowing. He is trapped, but the brain is screaming danger. He can't move, he can't do anything. He is freaking out and is really at panic station. When he is finally rescued, he probably wants nothing more than to be in the arms of his mother (his safe person) and at a safe place (his home).

A person with a panic attack goes through all that, but since they can't even find a cause for it, they can't do much about it. To take it a step further, if every time that boy went outside he found that dog was waiting for him, he would not want to go outside. The same thing happens with a person with agoraphobia. They are afraid and can't do anything and they don't know why. What has happened during a panic attack and subsequent agoraphobia, is that a natural protective response the body is instilled with, is occurring on its own without any discernable cause. I hope that helps.

David: We have some audience questions, Ken:

ashen: I take care of my forty-five year old wife. Her agoraphobia has been going on for the last six years, and it's about all I can stand to even come home anymore. I love her, but I'm about ready to give up. She won't even go out so we can see a therapist. What else can I do?

KenS: Since she won't see a therapist, I don't think there is much you can do. You need to take care of yourself and she should get help too. Also, make sure you have someone you can talk to about it. Do not carry the load alone. Why won't she seek help?

ashen: The doctor says that she has to come to his office. He won't come to the home and she won't leave our house.

KenS: Well, that can be "catch twenty-two" situation. Does she go out at all?

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ashen: She won't leave the house.

KenS: As you may know I live in Canada, but most of the people I am in contact with are in the US. In the U.S., many have had success in phoning their county mental health agency for advice and help.

David: Here's a similar comment, Ken:

thaiphoon: I feel like a hostage in my own home. My husband never lets me go anywhere, and on the rare occasion he does, I have to take a cell phone with me so he can call me if he has a panic attack. I feel like a dog on a leash. I'm getting angry and resentful. He too, due to his horrible panic attacks, will not leave the house to seek help. What can I do?

KenS: That is a common problem. Your husband is not going to die from panic attacks. Try taking short trips, or have someone come in with him while you are out. My friend wanted me to get a cell phone or a pager. I refused and took control by saying I will phone you two or three times while I am out. While at work, she would phone many times but I had alerted the secretary about what the problem was. I usually got around to phoning later, and by then the severe anxiety had passed. Have you spoken to any counselors, clergy, etc, about this? You must find a way to talk to someone and let off some steam.

David: Here's a comment from an audience member:

Debbles: Do what they did to me. They picked me up and took me to the doctor! That was the best thing that ever happened to me.

KenS: Thanks, Debbles. Nice to see you. Good idea. That would bring it to head in a hurry.

Debbles: I don't recommend it for all situations, just for getting that first initial help, if you feel you can't get out at all. The reason is, if you stay home you will never get better. There are therapists out there who will come to your home and work with you to get to the office. I have had one like that and she was very helpful, but you too can also do it by taking baby steps by getting them to go out a little at a time. Also, anti-anxiety medications are a big help with this disorder, finding the right one to work for you is the hard part.

KenS: Thanks , Debbles. Would you include Ativan (Lorazepam) in there? That is very useful for that.

David: What do you think about that, Ken? And I know you're not a doctor or therapist. But is it right to forcefully take someone outside of their safety zone?

KenS: I really would not want to force a person outside their safety zone, unless it were an emergency. However, I do see what Debbles is saying. It worked with her panic attacks. What works for one may not work for all.

thaiphoon: I also feel like a servant and not a wife. Marital relations have stopped, and I can no longer work due to his constant calling at my job. I'd love to have someone stay with him, but he won't let anyone else into the house. It's the only place he feels safe and he doesn't want anyone in his space. Since my husband can't work, and he won't let me get another job, we have no money for counseling. I wish I could.

KenS: You were fired for it?

thaiphoon: Yes, fired for repeated personal calls.

KenS: Thaiphoon, I am sorry that happened. I have helped some people find help when they could not afford it by getting them to contact their local mental health unit or university psychology department.

David: Here's a question, Ken...keeping in mind that many people with anxiety disorders deal with dual diagnosis; they turn to drugs and alcohol to quiet their anxiety symptoms:

KenS: Yes, they do. Anxiety and alcohol go hand-in-hand. Men, particularly, turn to alcohol for "help." It is not unusual to find alcoholics in the families of those with anxiety.

Alohio: What about someone who has a mate that also drinks?

KenS: I have helped some family members by directing them to go to places like Alanon, etc. Well, one of you is going to have to take control and get help.

David: Anxiety, Panic Attacks, and Agorophobia: Information for Support People, Family and Friends is the name of Ken Strong's book. I encourage you to pick up a copy. There's a lot of useful information in it.

KenS: Thanks.

CHRIS26: I'm wondering how long I have to be a caregiver? Does panic ever come to an end?

KenS: Well, some get over it in a few months. Others go on for years, but people do get over it eventually. You have to work at getting yourself in a balance between what you can do and time. There is nothing wrong whatsoever in saying you need a break etc.

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yahooemt: What do you do if your mate can come up with any excuse in the world for why they can't seek help?

KenS: Are they afraid to get help?

yahooemt: I'm assuming so. I also think they are afraid of change.

KenS: Yes, I think you put your finger on it. I would make a list of all the possible help available. Then I would tell them to pick one, because you are not going to devote your life to someone who will not help back.

yahooemt: I've made a list of all the help available, and I still am unable to encourage my mate to seek help. What now? How can I help? When I get frustrated due to his lack of helping himself, he gets frustrated with me. I'm at a loss.

KenS: Then look after yourself. Speak to counselors, or anyone else who can help. You can go to your county mental health agency too. They might be able to give you ideas of how to approach it. You may have said for "better or for worse" but you did not include "even if it kills me." Yahooemt, in some situations you can't do anything, that is why I suggest for you to get help for yourself.

David: I'm letting Thaiphoon ask two questions because I think a lot of people are concerned about this topic, but may be afraid to bring it up.

thaiphoon: Is it normal for people suffering from panic attacks to lose all interest in making love? I realize the intimacy question may prove uncomfortable to answer, but I need to find out if this is a panic attack related problem, or another. It's hard enough being a caregiver 24/7 under the best of circumstances, but without that needed marital contact, it's really miserable.

KenS: That is a common question. Depression, as well as psychiatric medications, can cause a loss of sex drive. Furthermore, even coming close to an orgasm is something that some feel they are losing control of their body with. ( I taught Sex Education for years to grades eighth through twelfth, so ask what you like. I am not uncomfortable.)

David: Thank you, Ken, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. You'll find a lot of helpful information there. If you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others: http://www.healthyplace.com.

Thank you again, Ken.

KenS: Thank you for inviting me. Good night.

David: Good night everyone and I hope you have a pleasant weekend.

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Disclaimer:We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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