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Medical Forum / Diseases and Disorders / Epilepsy / June 2005

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triggers

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Phin - 25 May 2005 04:18 GMT
When I'm at the mental health clubhouse program where I go, I don't
want anyone to talk to me and I don't want to talk to anyone. I can
talk to people fine over the internet because they are either 'in the
circle' or I don't have to see their faces. The rule seems to be that
one of my big triggers are the facial expressions of those not 'in the
circle'. I'm afraid they will give me a judgemental, condemnatory or
rejecting look or say something that will send me into a reaction. The
reaction is the 'fear attack' in which I become very fearful,
dysphoric, 'internal alarm going off' an intense feeling of distress
that goes on and on. I am quite happy to spend all my time indoors
avoiding this except that I tend to go stir crazy if I don't get some
involvement. So the computer becomes the obvious mode of interaction
during my isolation my means of interacting with, connecting to the
world, and to manipulate my own nervous system to keep it under
control.

The internal alarm, which I seek to avoid, is a feeling that I'm about
to be attacked, I'm about to get in trouble, something bad is going to
happen, I'm in DANGER. It is a car alarm going off without any thief
nerarby. It is a physical reaction. It is a terrible terrible feeling
that goes on for hours or for days. I have literally stayed in bed for
two weeks in the dark to avoid this feeling/in response to tihs
feeling. It has stolen my life. Intellectually I realize there is
nothing to fear, but it is like greats amount of adrenaline are being
poured into my system without my being able to do anything about them.
Klonopin or other benzos usually don't touch these attacks. Sometimes
benadryl seems to help if only to put me to sleep. Upon awakening I
usually am okay.

The 'fear attack' can also be set off by thoughts, as can emotional
outburts such as crying or even acts of agression (though I have never
physically attacked anybody I can become very agressive and disturbing
in my behavior and speech) which I have no idea where they come from.
I imagine myself in fearful scenarios and at some point these
scenarios cause a 'flashpoint' where things will be set off.

For an example of how the fantasies affect me, one time I was in a
taxi cab and I saw someone on the street who looked like Danny Elfman
of the group Oingo Boingo. In my mind, after I saw him, I *imagined*
myself meeting him on the street, and becoming emotionally caught up
in thie fantasy and quickly overwhelmed by it. And so in the cab I
started crying, solely by the fantasy caused by seeing this man.
Another time, on the bus I imagined how I would feel when my cat died,
or when I died, or some such loved one died and it would set off a
crying fit and enormous outpouring of emotions. Just from THOUGHTS or
the thought of this person or thing being lost. I feel I am actively
or habitually engaging in these thoughts to cause the emotional
outbursts for some reason which I feel I must have to feel better. I
get sucked into the overwhelmingness of it implacably.

Similarly to the 'crying fantasies' there are the 'fear fantasies' in
which I imagine myself in a fearful situation like hitting someone or
being the victim of a mass murderer or someone attacking me verbally
or physically or giving me a look and I will react to this internally
like it's really happening. Eventually if I have enough of these
'fantasies' then it will reach a flashpoint and my internal system
will say "okay we are getting a lot of these 'alerts' and we don't
know if they are real or not so we are going to raise the alert level
to HIGH" and I will have 'the fear' for hours or days. I feel I
actively engage in the fantasies but I can't help them, I can't help
doing it. I feel there is a mechanism within me, beyond my control
ultimately that is causing these fantasies and reactions. It has
stolen my life.

Being 'out there' that is outside my apartment and away from my
computer which is a tool I use to control my own nervous system, and
avoid threatening triggers, when I am in an in-person social situation
I feel most of the time it is a breeding ground for the fantasies and
therefore reactions because they provide 'new information' as do
movies or radio that I'm not familiar with provide 'new information'.
"Life is like a box of chocolates" but several of them have razor
blades in them. Best not to eat them. The realm of 'new information'
is like playing russian roulette with the bullet being 'the episode'
and there are 3 or 4 bullets in the chambers instead of being at home
where I can control the input and there is only one bullet or no
bullets.

I do not have problems so much with 'old information' such as familiar
songs or movies that I already know or people that are in 'the
circle', but if I'm in a new situation or watching a new movie (which
I tend to avoid) it is a breeding ground for these fantasies and
triggers that will set off these frightening inner scenarios or
emotionally overwhelming scenarios and these will translate to an
emotional reaction, attack or at worst an 'acting out' which is a
terrible terrible thing that must be avoided at all costs but cannot
always be avoided. The best I can do is to use my computer, the dark,
and isolation to regulate these attacks. But I am a prisoner of them.

If I get 'the fear', then I will react to it by isolating myself for
days.

In other words, boredom often necessitates a need for stimulation,
stimulation, if it is not the kind that I can control (such as 'new
information') can result in a trigger and a trigger can lead to an
'attack' or 'episode' which must be avoided at all costs. At worst, an
attack can lead to acting out which can lead to further trouble.

I stay inside to avoid trouble.

This is how I live my life right now, in fear of the fear and the
subsequent depression and isolation it brings which in itself is a
means of 'putting out the fire' of these attacks. I deal with these
things by spending as much time as I can in bed isolating myself where
I am safe from triggers and new perceptions or unfamiliar perceptions
that will trigger these episodes.

In the past, cannabis has been welcome antidote to this in that it
relaxes me and breaks up the chain of thoughts, in that it provides
short term memory loss, a sense of 'what was i just thinking about?'
and so the chain of thoughts that build up to an attack don't have a
chance to bind me. The thoughts don't have a chance to accumulate. The
snowflakes don't have a chance to build up because the mountain is
'hot' and the snowflakes melt, not giving them a chance to accumulate
and eventually create the avelanche or 'attack' which buries me and
from which I must climb out of again and again.
Beck - 25 May 2005 05:10 GMT
Phin,

Do you see a Psychiatrist? If so, what does he/she say about this?
The reason I ask is that I have been through this exact same thing.
Are you on any medication regularly? I felt exactly like you do now and my
doctor put me on Seroquel (Quetiapine) and it was like a miracle had
happened. I was able to go outside without feeling scared. I only get this
fear feeling maybe once in a couple of months as opposed to having it every
day for hours on end. If you don't have a doctor, maybe you should get one
soon and possibly mention that you heard about someone going on Seroquel (An
Anti-Psychotic medication) and feeling a lot better. Also sometimes I have
this fear and it leads to Petit Mals, I have also been put on Tegretol.
Maybe you could see a Neurologist and a Psychiatrist to see if they can help
you out. I know that isolated feeling is nice right now, but I can tell you
that when the fear goes away it is a better feeling.
Hang in there Phin,
Beck.

> When I'm at the mental health clubhouse program where I go, I don't
> want anyone to talk to me and I don't want to talk to anyone. I can
[quoted text clipped - 111 lines]
> and eventually create the avelanche or 'attack' which buries me and
> from which I must climb out of again and again.
Phin - 25 May 2005 06:14 GMT
I do see a psychiatrist, he has referred me to a neurologist to see if
I have TLE (temporal lobe epilepsy) because I also have olfactory and
tactile hallucinations. I have been thinking about seroquel. I think I
might give it a shot. I have also been thinking about tegretol too. I
get 'the fear' I don't know a few times a month it seems. It has only
been recently where I can really articulate and put together the
pieces of what has been going on. I feel like I have some perspective
on it. I am on 30mg of abilify and .5 of klonopin and 5mg of lexapro.
I am diagnosed there at the mental health place as bipolar with
psychotic features.

>Phin,
>
[quoted text clipped - 129 lines]
>> and eventually create the avelanche or 'attack' which buries me and
>> from which I must climb out of again and again.
CyberCafe - 25 May 2005 09:46 GMT
> I do see a psychiatrist, he has referred me to a neurologist to see if
> I have TLE (temporal lobe epilepsy) because I also have olfactory and
> tactile hallucinations.

Yeah, I sure think a neurologic evaluation would be in order.  A person
can have a constant/chronic 'fear component' with temporal lobe
epilepsy. At least I did until medications got rid of that (thank
goodness because it sure is hard living like that). Like you have
described, you kind of do things to protect yourself.  I never told
anyone I knew what I was feeling; it was all hidden.  Eventually, I feel
it got to a point where I was a danger to myself and to others because I
had these urges to get away from or get rid of the danger or threat.

Hey, keep us informed on how you're doing and what the neurologist says.

Barb

I have been thinking about seroquel. I think I
> might give it a shot. I have also been thinking about tegretol too. I
> get 'the fear' I don't know a few times a month it seems. It has only
[quoted text clipped - 137 lines]
>>>and eventually create the avelanche or 'attack' which buries me and
>>>from which I must climb out of again and again.
Sofia - 12 Jun 2005 00:29 GMT
> Yeah, I sure think a neurologic evaluation would be in order.  A person
> can have a constant/chronic 'fear component' with temporal lobe
[quoted text clipped - 4 lines]
> it got to a point where I was a danger to myself and to others because I
> had these urges to get away from or get rid of the danger or threat

Hi, I just wanted to say how much I also sympathised, as, although my
friends and relatives call me a very eccentric character, I'm just always
been offered their children and babies to hold, which is really scary in
case I have an attack and drop one.

This was also one of the reasons I didn't have a child of my own - I was
so frightened that I'd drop it on the floor and injure or kill it perhaps.

It's a shame though, that now my fear of holding other peoples children
is going, I've become too old to have one of my own.

Sofie
Beck - 01 Jun 2005 02:34 GMT
Phin,
I am not a doctor or even a nurse, I am only going on my personal
experience. If you think Seroquel may help I still recommend discussing this
with your doctor in more detail. Also see what the Neurologist says first as
we may not be having the same thing. If you don't feel your medication is
helping with this fear, I do suggest a second opinion. I had to see 4
doctors before I found the one who was able to help me. They all had the
same diagnosis but just kept saying it was lack of positive thinking that
made me feel the way I did. Anyway, I hope you can get the help you need.
Beck.
>I do see a psychiatrist, he has referred me to a neurologist to see if
> I have TLE (temporal lobe epilepsy) because I also have olfactory and
[quoted text clipped - 144 lines]
>>> and eventually create the avelanche or 'attack' which buries me and
>>> from which I must climb out of again and again.
 
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