panic attacks/fainting/citalopram

Postby anxiousmum » Fri Jun 16, 2017 10:27 am

Hello wise people
I wonder if someone is able to give me some information or even a glimmer of light at the end of the tunnel? My 18 year old daughter (who has downs syndrome) had a nasty bout of shingles at the end of last summer during which she had a few fainting spells. She is over that know but it has left her with an absolute fear of fainting to the extent that she panics so much that she actually faints. This is happening up to 4 times a day and is very debilitating. Her other symptoms include dizziness, almost incessant shaking and occasional headaches. When she faints it's only for a matter of second but she is absolutely terrified. She then goes on to avoid things she associates with fainting. An example of this is that she fainted on the stairs and now will not go up steps, she fainted in the shower and is now reluctant to go in the shower, and it goes on. She walks extremely tentatively clinging on to me or whoever is near by. She is reluctant to go anywhere in case it happens again.
I have had her back and forth to the doctor. He initially thought of prescribing her something for immediate relief (valium I think), but her blood pressure was low so he wouldn't. He has now prescribed citalopram and she has been taking this for about 8 days (10mg). She has had some (relatively) good days, but we have also had some terrible days since she has been taking it and this morning her movements were really jerky (as opposed to just shaking) for a few moments when she first got up. Every time I think there may be an improvement there is a set back. So I wonder can anyone tell me if this is normal, is it likely to settle down? Is there any "over the counter" medication you can suggest to relax her out of this anxiety? Should we continue with the citalopram? She has also been referred to the psychological service and she has seen one of the nurses a couple of times for assessment, but no action yet. Any help gratefully received.
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Postby Richard@DecisionSkills » Fri Jun 16, 2017 12:35 pm

The low blood pressure sounds like an underlying medical issue that needs to be addressed separately from any mental issue.

For the fainting I would work on her practicing being self-aware and/or mindful of her physical body, the clues right before a fainting spell and have her practice what she can do to react and/or cope. This will help her self-regulate and build her confidence that she can manage and overcome any fainting as a result of the mental side of things.

In simple terms, many times fainting is caused by anxiety which causes a person to tighten instead of relax. This unknowingly constricts blood flow and the person suddenly gets dizzy and then faints. You can see this happen with healthy people all the time. Young soldiers standing in formation lock their legs and then down they go. A person getting a shot tenses up and passes out. Perfectly healthy people fainting because they don't understand the need to be mindful of their body and how to relax and respond.

With your daughter it sounds cyclical. She builds stress/anxiety which then becomes a self-fulfilling act of fainting. If it is happening 4 times a day, have your daughter go through the exercise of taking five minutes every hour to mentally relax her entire body. Have her also use this same method prior to taking on a task she fears.
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#2

Postby anxiousmum » Fri Jun 16, 2017 1:55 pm

Thanks Richard
I have been doing relaxation exercises with her so I guess I just need to carry on and use the techniques you suggest. It's more of a challenge for her because of her learning disability. In relation to the blood pressure the doctor said it was within normal limits, but on the low side of that so he didn't want to give her anything that would decrease it any further. I should also have mentioned that she has had an MRI scan/blood tests/ECG and nothing showed up.
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