Anxiety, panic attacks and phobias have much in common
DEAR DR. DONOHUE: What is the difference between anxiety and panic attack? I am claustrophobic, and I need to fly from the West Coast to the East Coast and back. I can’t do so because of my problem. I have tried therapy several times, but it did not help. I do not want to go that route again. Can you give me some suggestions on how to be able to fly with this problem? Is there a medicine I could take before I get on the plane? — Anon.
ANSWER: Anxiety is excessive worry. In some cases, worry is appropriate. But with pathological anxiety, the worry is about things that don’t merit worry or about imagined things that truly merit no concern. Under “anxiety disorders” are many different conditions, each with a slightly different set of symptoms. They all share some things in common.
Panic attacks are the sudden onset of terror in places where such terror is inappropriate. The attack builds to a high point in a matter of 10 minutes or less. The attack can take place in a perfectly neutral situation, like shopping in the grocery store. During an attack, the heart beats fast, people become short of breath, and they often sweat and fear they are at death’s door.
Phobias are unreasonable fears of people, places and things that don’t engender fear in others. Claustrophobia is the fear of being in an enclosed space, like an airplane. Phobias can bring on a panic attack. Maybe your phobia is not so much a fear of enclosed space but a fear of flying.
I’m not certain these distinctions are of importance to you. The important thing for you is to uproot whatever it is that paralyzes you when you must board an airplane or to blunt it so you can function. Mental health professionals can get you over anxiety, panic attacks and phobias. I’m not positive what you mean by “going that route” again. Do you mean a detailed probing into your childhood and such matters? That isn’t usually necessary. The doctor might prescribe a medicine that calms you and that you take only when needed. You won’t become dependent on that medicine every day of your life. You use it only for the situation that throws you into such high anxiety.
DEAR DR. DONOHUE: I am 42 and am ready to go vegetarian for health reasons and for issues of animal cruelty. I will continue with milk, cheese and dairy products, but might discontinue them later. What is your advice on this? — Anon.
ANSWER: A vegetarian diet is a very healthy diet. In countries where vegetarianism is the custom, the incidence of heart attacks is quite low. I don’t believe I have ever met an overweight vegetarian.
Animal products are the only source of vitamin B-12. But you can find many plant products, like cereals and soy milk, that are fortified with B-12, or you can take B-12 tablets. Since dairy products are the main source of calcium and since you are going to continue to use them, you’ll get enough calcium. If you do forgo dairy, you have to make an effort to find alternate calcium sources, and that’s not too hard to do.
If you can consult a dietitian, it would be worth your time. A dietitian can show you how to best accomplish a healthy vegetarian diet. Such a diet keeps most of the world’s population alive.
DEAR DR. DONOHUE: Years ago, on one of the morning news shows, I heard people talking about taking a vitamin or mineral to keep mosquitoes from biting. Do you know what that is? Mosquitoes prefer my blood. I do not want to use some type of poison, like a repellent. — P.J.
ANSWER: Vitamin B-1, thiamine, has been touted as a way to discourage mosquitoes from biting. No proof of this exists, and I have serious doubts about this advice.
Exhaled carbon dioxide attracts mosquitoes, as do other body chemicals and body heat. You don’t have to fear repellents. They aren’t poison. They don’t kill mosquitoes. They drive them away — repel them. Ones with DEET work well. Or if you want a natural product, try Repel. It contains oil of lemon eucalyptus.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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