What a coincidence. I had a very similar experience, so I'm going to write it here so you can see how I handled it cause I had less trouble than you and maybe if you do what I do your next will be better. First off I used to have terror going to the Doctor. I'd have every thing I wanted to say planned out and the minute I was in his office I'd turn into a bumbling Idiot. I have a very good Doctor, he would tell me anecdotes about things as simple as the colour of my socks and I'd calm down. So here goes.  I had an appointment with my therapist so I made one with my GP also. I had a lot of negative thoughts but she kicked my ass for me and I left there feeling better. BUT. I had over an hour to wait for the other appointment and you know Doctors are always late so I had a long wait. Plenty of time for the negative thoughts to come back. And they tryed. I had to focus on the fact that although I was having a bad day (upset stomach, arthritic flare etc.) I was here and I was going to get the information I needed so it was a good thing. The news was not all good so now I had to have blood tests and wait for the results. I sat by a window and concentrated on the fact the tests would tell me what to do to fix the problem. Well the tests were half good half bad. I couldn't go home yet. Now I needed to have fluid drawn out of my knee with a big FR@#$%^EN needle. OK. I can do that cause as soon as that's done I can go home, besides I'm getting hungry. Well I managed that by staring at the wall and babbling to the Doc. Yeah. now I can go home I did it I survived. NOPE. I need to take home some bandages and the nurses are in a meeting, more waiting and I'm really hungry now. It has now been over two hours. There should be claw marks in the walls. but I'm treating this like exposure and thinking possitive. Besides I can always leave, right. But I want this and besides it's a good experience right, next time can't possibly be this bad. (positive thinking). I also managed some shopping and a trip to the library.  If you follow the program, learn the relaxation exercises, learn to focus possitive and learn also to focus elsewhere your next trip can be this easy. 

Was it all that easy? NO. That night after making phone calls and listening to other peoples problems and finally eating too late and the wrong foods, I'm about to have a panic attack. I'm starting to think about the day and put a negative twist on it. BUT I now have the skills to cope so it didn't happen All that happened is a headache and indigestion kept me awake. That alone used to be enough to make me panic.

Good luck and I hope this helped.

Davit

Good point. Never thought about it, but I move furnature around. The change makes me feel good. I do know routine leaves a person stagnant. I like change in music, food, driving to town for groceries and probably a lot of things if I thought about it. Interesting, very interesting.

Davit.

Davit

The way it was explained to me was that when you have a major depressive event it builds a pathway to the mind bipassing all the checks and stops that it would normally have to pass. If this is so then the next time it has a pretty much free run. The question I have is, is it possible to put all the controls back quickly? I know there is a lot of truth to the saying that time heals all and it does. The other question is does depression cause permanent chemical changes? I have to take 3 grams of Calcium every day or I get extreme agitation. This bring up the question, do I not absorb it or do I just need more for the neurotransmitters. I am not bipolar (according to my doc) but I have similar ups and downs though for shorter periods and not so strongly. I have been trying to find a chemical reason for this and haven't so far. Like today I want but don't want to go to town. I'm being pulled two ways and it's annoying. Is it true we are what we eat? Am I feeding my mind some chemical it doesn't like or worse yet since I eat little during a depressive state an I starving it of something it needs? It is very frustrating to have won the battle against panic only to find myself sitting in a chair all day because I'm too depressed to do any thing. I know exactly what set off this case of depression. (having the Doctor say I may have infection again) I want to know why I can't accept it and deal with it like I do with Panic. I don't seem to have any warning, it just shows up, which makes me think there is a chemical reason for it besides the fact that every thing the mind does is chemical. I can live with this, (work around it) but I would rather not. So any thoughts or ideas would greatly be appreciated. Besides I think depression and panic are too closely related. What do the rest of you people do to pull yourself out of this state? I really could use some help here. And no suggestion is too silly to consider. 

Davit

I'm so sorry. It makes me sad to think what you are going through. I made friends with a fellow in the hospital who had cronic back pain and suffered from depression and a tendancy toward suicide. His sister in law said I should phone him and talk to him since we were somewhat in the same boat. Unfortunatly he was already dead of an overdose so I couldn't. I'll never know if I could have helped. The older I get the more friends and aquaintenances I lose. We must have some sort of built in ability to cope but it still hurts. My first experience with anti depressants was when my Dad died. I felt so helpless, there was nothing I could do for him. I tryed to keep busy but it didn't help much. I eventually quit my job and moved to another provence. I had to see a psychiatrist because I couldn't cry. I couldn't let go. I still think there should have been more I could have done. I think my subcontious may be the cause of my ups and downs. Any way I tell myself this is a normal part of life and it will pass and if others can live with it so should I, but still.......!

Keep posting, it's good to know I'm not alone.

Davit

I went to the depression site and read a cross section of the posts. I don't think I'm depressed, I'm just mad. I'm mad at how I have to live. Mad because I have to hire people to do the things I used to so easilly do. Mad because I have people intruding in my house.(home support care) Mad because there is quite a bit of pain at certain times in each day, and theres nothing I can do. I'm at max dose of pain killers without taking opiats.I wont take them again they distort reallity, slow down my reaction time and eventually destroy internal organs. No thank you. I'll work on getting my anger down. If I can find a mental way to deal with the pain I'll be Ok. I'll go back to ejoying my hobbies, enjoying people. I suppose this is why SSRIs don't work for me. Celexa is the only one that doesn't make me violent. Any way this is my problem and I'll deal with it best as I can. Thank you for your concern.

Davit.

Davit

I think you will be happier when you are off the Mirtazapine. Been there done that. I am so glad so see you doing better. I too felt better and thought clearer off the meds but it wasn't clear sailling. I had to use a very small amount of valium on a few days to get over the hump. So if you back slide a bit please don't worry. Remember baby steps. A very possitive step. Congradulations.

Davit.

Davit.

My name is Davit and I would like to help you. First off I understand, because I have been there, I also do not have panic attacks any more. I still get anxiety but I know how to stop it from turning into panic. Night panic was the worst of my problems because it is subconcious. You can't do any thing about it till you wake. If you have been reading the posts here you will know two important things. First panic attacks are scary but they can't physically hurt you, and second, by following a few simple rules they can be stopped. And once you learn to stop them they will only come back if you let them. I would like to know what medication you are on. If I'm familliar with it I can explain some of the side effects. I will not tell you wether or not to take it, that is up to you and your doctor. This program will help you and if you work at it it will cure you. By the way I'm not trying to sell you any thing and I do not work for Panic Center. All I want to do is help you because I know how terrifiing panic is. For now the most important thing to do when you wake is concentrate on any thing but what is happening and the second is to let it happen and get it over with. It sounds stupid. but here is how it works. If you think about what is happening it will continue till you stop. Second if you don't let the attack happen it will continue till it thinks there is no more need to. Remember this is fight or flight gone out of wack!  If your body thinks there is still something to run from it will continue to pump adrenalin into your system. You will notice there is a calm between attacks. What you might not notice is that thinking your going to have one is the quickest way to have one. Right now you are thinking that there is no reason why they happen but there is always a reason why. You are not crazy or even on the verge of crazy. You may never ever learn what set them off and. I want you to know that knowing is not neccesary to stop them but it does help. For now do what ever you have to do to get sleep. Cut out all stimulants, drink herbal teas designed to help you sleep and take what ever medication you have to to get a full nights sleep. Read the protocal. learn how to slow down your heart rate learn how to relaxe your tense muscles and learn how to ignore what is happening to you. I know the not being able to breath is the scariest part. I find Ginger mint tea works good for this along with some form of heat on my chest. It may all be in my head but if it works do it. You want to be able to look this thing in the face and tell it to go away. and you will be able to. But not if you keep telling your self you can't. It thrives on fear. Let it happen. Concentrate on the fact that although it is uncomfortable, it can't hurt you. Remember the dizzy, the can't breath, the fast heart rate, are all things you are doing to your self and only you can stop them. The dizzy is all part of how you are breathing. read about box breathing.  Above all else don't dwell on whats happening, let it happen. Concentrate on making your heart slow down and it will, it needs you to tell it there is nothing to be afraid of even if you don't know that for sure. One thing that really helps is writing down how you feel at the time. Some where on here is post of me doing that and you can see me go from full panic to calm in less time than it took to write this. Ok I said I don't get panic attacks, well they still try but they can't any more. what I get is pretty mild and it gets less all the time. Talk it out with a friend or post it here. We are all here to listen and help.

Peace.

Davit.