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Moving To Thailand With Panic Attack Problems..


driedmango

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So, I will try to keep this brief.

My 1st ever panic attack in my life - I just got off the train in Chiang Mai and the people I was with took off to their fancy hotel and there I was with plastic sandals I just got in BKK and they rubbed a big wound on my toe, that got all dirty and swollen up on me. I thought I had tennious (spelling) after someone asked me if I got the shot, so I starting freaking out and read all the symptoms of this and thought for sure I was dying (don't laugh)

anyways, so there i am all alone in Thailand, on a tuk tuk to the hospital where the doctor there checked me for all these things I thought maybe I had because I couldn't sit still, felt like my feet were twitching, short breath, and panic feeling... The doctor kind of laughed and told me I was having a panic attack, gave me some valuim and I went away feeling much better...

Anyways, so I have been back to SE asia 3 times, everytime I get regular panic attacks, at least now I have a script from my doctor in Canada for a valuim like drug that at least works for me.

The attacks I think come from lack of sleep, being alone, and feeling like I might have sort of tropical illness ...

So, I get these a little even in Canada, when I am boating without a radio, hiking with someone who pretends they know where we are... stuff like that, yes it sucks, but it happens alot less here than when I travel over there.

But, I don't want to let this stop me from moving to Chiang Mai. I do think it's a stress problem, coming from expectations and things like this, boredom.. also maybe runs in my family.

So - I am thinking I will be alright once I get to chiang mai, find a steady place to live and some friends, and get busy. I am also thinking that soon after my arrival I will look for a doctor and try to get some sort of help ( i can't really afford it in Canada and I live in a rural area) maybe learn some meditation from the Monks, and some other general Thai ways of relaxing and going with the flow.....

Anybody have any advice ? Part of me says not to go as I always freak out and want to go home, but i have done it before, and at least now I know what to expect from these attacks, i have pills that knock me out, and I am hoping that it is a good idea to try to push threw this and maybe come to control it threw getting out there and living my life..

Anyone know good Doctor that might work with people like me ?

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actually sounds like a specific panic attacks that can be gotten rid of with behavior modification since the trigger seems to be speicific things... like someone who had a car accident so every time they drive they have a panic attack so they are afraid of having an attack while driving so the fear of the attack causes one... a vicious circle (that woudl be me btw, after dehydrating on a road trip with former husband going out west in the states, i was severely dehydrated, causing muscle spasm and breathing difficulties, causing me to not be able to shift the gears or hit the clutch in the car i was drivng -- we maanged to pull over, got medical help, but it took me about six years to get back in to real driving again, because i avoided driving, or would find other ways to get places etc. i finally got back in to drivng when i actually had to drive, so every day would drive a small ways, stop before i had a panic attack (numb hands, sweating, not being able to move leg to clutch, etc)... and worked my way back to driving. and trust me, driving in this country is not for the faint hearted. so it can be done, the help comes from a cognitive psychologist or coacher, not from a doctor. the doc just gives meds to alleiviate the anxiety.

but to actually treat the anxiety, you need to learn what exactly are the triggers, and work on changing behavior patterns. i catually didnt use any outside help , i used the same methods i would use for an animal that has 'issues' like a horse that refuses to walk through puddles, or a dog afraid of a vacuum.

that is, unless you have an underlying syndrome that comes with panic attacks, OCD, etc.

so before you move, you have to develop some methods for dealing with the panic before it gets out of hand: prepare yourself ahead of time for the various situations, train yourself to react in certain ways before the on set of panic: if you are afraid of diseases, bring alcohol gel, cream antibiotic or other med , even if it has just placebo effects, bandages, etc... so you know u have the stuff. if something does happen,you know you have that particular situation under control.

if you are afraid of getting lost or whatever , then book a regualr (westernized)hotel for the first night of arrival when u are still jet lagged, make sure you drink enough water, eat energy bars, stay away from coffee and alcohol, plan your route, make a plan B just in case, do everything step by step... and sometimes, if u feel an attack about to start, divert your attention to something that is calming and known to you, like singing some stupid song to yourself that u memorized, or run through a shopping list or recipe in your head. these are great calming methods (like a child sucking a thumb only here its mental actions). familiarity breeds calmness. stay away from the giant malls/shopping areas of large cities unless you feel most comfortable in them ( i hated them with a passion, too much noise, too crowded, too much light, sound whatever- i would rather be in a jungle surrounded by wild animals, but each person has his/her own level of 'regular').

try to make a list of contacts even from here, thai visa 'just in case' for yourself, that should also give u a feeling of security;

only suggestions sorry cant recommend docs...

bina

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Sorry, don't know of any doctors to recommend, but I'd like to share a little about myself.

I'm from the US and I moved to Thailand almost 5 yrs ago. I had a very stressful life in the US and changing environments saved me. I have a very relaxing job here as an English/Math teacher. Stress and anxiety symptoms take time to heal and go away. Medications, for the most part, are a temporary fix. Time is the greatest natural medication. Change in lifestyle is probably the most important thing. Thailand is a good place to experience a change in pace. I plan on living here forever.

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Not being doctor, but from your post it looks like your attacs come more frequently when in an unknown environment...

So best recommendation is: try to make contacts as fast as possible with people you can trust and (most important in my eyes) start to learn Thai as fast and as good as you can... because that will enable you to talk with everybody around you and the feeling of being alone on yourself without knowing anybody and not being able to tell your story and your problems will go away fast...

Just my 5 cents, as I know how inseure I feel when I need to go to Russia / Ukraine on business and never know whether i find somebody talking a language I know also... I also feel pretty lost when i have nobody around me who I can talk to...

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Good advice from Bina.

I wouldn't let this stop you from moving to Thailand if you anticipate you won't have too many stressors in your life here. For example, coming to retire is one thing, coming to work, start a family, go to school -- those could be panic-inducing.

Consider moving here during the cool season (mid-Nov-mid-Feb), so you can handle all the little things you have to do to get settled when the weather is nice. Rent a condo or stay in a serviced apartment near the center of town, so you don't have to drive or sort out getting a house. Get up early and walk around the neighborhood then (before 7:30 am) to learn where stores and restaurants are located before the heavy-traffic times of the day. Take on new tasks slowly -- don't try to get everything set up in your life during the first week. Stay hydrated and well-rested, avoid coffee, alcohol and high-fat foods. Exercise daily. In short -- keep yourself healthy.

I've heard there's a very good psychiastrist at CM Ram hospital. Can't remember his name. Hubby and I saw him a couple years ago when we had to get certification we were of sound mind when we did our Thai Wills. He seemed like a very calm, knowledgeable person and I've heard he's helped people with problems much more difficult than ours.

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I don';t thin "we all panic" is appropriate to this person, what is described qualifies as a specific disorder and not at all the same thing as the stress and anxiety everyone has.

I am also less sanguine about advising that someone with this to go ahead and move to a new country and culture, especially without first having gotten efefctive treatment back home.

The best treatment for panic disorders is a combination of therapy (usually CBT - cognitive/behaviorial, a short-term goal oriented approach) either by itself or in combination with medication; drugs alone are not a good idea and there is high risk of addiction.

Best to start with a good therapist and then let them refer you to a psychiatrist for a prescription if necessary. This is much easier to do in the West than in Thailand, especially the therapist part. in Thailand you will readily find psychiatrists but therapists are fewer and not in all locations. I don't off hand know of any in Chiang Mai; there is a pinned notice on mental health in this forum that lists a couple in Bangkok.

I really urge you get some therapy back home first and then make the move when you have made some progress and feel more confident of being able to handle panic attacks when they come...as they surely will, at least initially, after moving to a new environment.

In terms of medications, you need to be wary of the benzos (Valium and the like). The incidence of addiction among people taking them for anxiety or panic disorders is quite high and they are terrible to detox off of. There are other medications of use which are not addictive, including beta blockers, Lyrica etc.

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Thanks everyone. I agree the benso is a dangerous drug, but if used only at the start of a full on panic attack, works, they are not a daily thing so you can't get addicted if you take them only for emerg.

The stress a regular person might feel is not the same as panic disorder. Panic disorder comes from the fear of panic, at least for me it does.

I find letting people know around you, that you are having a panic attack helps, warning anyone from a border or airplane attendant helps, because the last thing you want to be doing is trying to hide one.

They do pass with time, sleep, rest... activity..

Lucy, I never seem to have them in stressful situations, at least not yet, so when i am in a very stressful situation (so far) it seems the real stress prevents you from dwelling on stuff.

I always find that I get them after no sleep the night before I fly, no sleep on flight, I get to BKK and am fine, but you know jet lag, might not sleep much, jump on a night train, if there is no rowdy party animals I sleep well, if there is I don't, then when I get to Chiang Mai, they start to kick in... I think the lack of sleep starts to make one negative and that snowballs.. I think sleeping is the best cure.

I haven't so far had that bad of a time with the panic, I found riding a bike around chiang Mai cured me sometimes... but when you have this the risk of addiction from the benzos seems pale compared with having no backup plan, you take a benzos because they work when you have no other option.

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