Posted by: Tammy | 2009-07-10

Situational anxiety

I have a board meeting once a week. I' ve always been active in meetings since I know that I have a lot to offer, I' m an expert in my field and am a creative thinker - I don' t doubt my worth and recognise that I can add to the value of the organisation. Three years ago, I suddenly had vision problem during a meeting and became incredibly anxious. I started shaking uncontrollaby, struggled to say anything, started sweating and felt that everyones eyes were on me. This isn' t only that I imagined it - more than one colleague came up to me to ask what had happened, that they could see that I was besides myself. Anyway, to make a long story short: since then, I have been experience similar (but worse) panic attacks - only during the weekly meetings as well as any interaction with my boss outside of these meetings. I know all the relaxation techniques in the book, but they don' t help me at all. I also take Pur-Bloka an hour before the meeting, but that doesn' t help either. I' m also in therapy because of it, but that has also not made any difference. At one time, I started to fake sickness on those mornings in order to avoid these horrifying, dreaded moments but I realise that avoidance doesn' t help, so have been forcing myself to attend for the past two years - no luck. What, apart from relaxation exercices and Pul-Bloka would help? I have SO much to offer and this is really stopping me from showing what I' m worth. Any ideas?

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Our expert says:
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PSYCHIATRIST: The situation you describe is something I hear about fairly often. Public speaking is recognised as being stressful for almost all people and you probably felt a degree of anxiety,pressure and expectations of your performance and contribution to that board meeting when you had your first panic attack so it did occur under stress. What then happened is that you developed an anticipatory anxiety of having a recurrence of such a terrible experience which made you more anxious for your next presentation to the board. The so-called "fear of the fear". Your anxiety has now started generalising to other situations such as talking to the boss, someone in authority, so this is also a situation where you may feel you are being assessed,scrutinised or judged.

If you are already in therapy, you will know that avoiding the situation only worsens your anxiety. The avoidance acts as a short-term reward because you escape the board meeting that morning but as you say this makes the next meeting even more difficult to face up to.It sounds as though your fear of having panic attacks could even have a detrimental effect on your career advancement.

Are you having cognitive behavioural therapy(CBT) with your therapist bcause this is the type of therapy you need for panic disorder? If your therapist does not specialise in CBT, ask for a referral to one who does.

I also recomend that you ask your psychologist or GP to refer you to a psychiatrist who would start treatment with an appropriate SSRI anti-depressant.Remember, anti-depressants are also anti-panic/anti-anxiety medications. I think you need maintenance treatment, not just a pill before you go into a meeting, as your anxiety is spreading to other situations. You also don't want to reach a point where you become fearful that you can't face any performance situation without a pill on hand.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

Our users say:
Posted by: Elizabeth | 2009-07-11

Hello. I fainted recently whilst playing bridge. I felt absolutely terrible and felt as though I was dying. I had palpatations but no air hunger. I also didn' t experience the terror which is associated with panic attacks. Yet my Doctor recommended that I go for counselling. I have had similar attacks again but wonder whether these are genuine panic attacks.

Reply to Elizabeth
Posted by: Wilbur | 2009-07-11


I am in exactly the same situation as Tammy. How do you treat social phobia as you call it? What medication was prescribed and what form does the therapy take? Does it work?W

Reply to Wilbur
Posted by: Steve | 2009-07-11

Hi Tammy, in my opinion, the onset of the " vision problem" , possibly just " blurred vision"  was due to the onset of anxiety- and possibly a fully fledged panic attack. They hit were it hurts. You need to find a good doctor, not that you haven' t, but this Pur-Bloka stuff might not be what you need. From that day in the meeting you have been living in fear of fear. Does the thought of the upcoming meeting trigger the same reactions? Possibly.

The same thing happened to me about 3 years ago. I was diagnosed with social phobia 6 months later and started some medication and therapy. I do all this because I love what I do. Somehow since then I have been given a team leader position of 8 highly intelligent people, and I have to try and keep up despite my condition. I work at it every hour and every minute.

One thing, don' t be so serious, and don' t be so hard on yourself. You are probably the sharpest person in the room, but life dealt you this little handicap to slow you down.

When you are in the meeting the next time, FOCUS on something simple like your pet at home, nothing complex. Breath normally, interact a little - repeat as necessary. Have fun.

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