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Suggest Treatment For Severe Anxiety Attacks

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Posted on Tue, 17 Nov 2015
Question: For the past three days, I think I am battling anxiety attacks or heart problem symptoms. It started at night when I would have trouble falling asleep and would wake up with heart palpitations. One night it took me three times/three hours to fall asleep. I took my blood pressure after one of those times and it was 136 over 88, heart rate 80. A half hour later, the BP was 109 over 77, heart rate 74

Throughout the day, I feel tense and like my heart is racing but when I take my pulse, it is actually okay. When I get the night attacks, I get this intense pain in my left arm that radiates up into my neck and jaw, plus middle of the back pain. That also comes and goes.

Today I just have a nervous feeling again, no racing heart (yet) yet a burning pain in my left breast.

How do I properly address this with my doctor without them blowing me off or thinking I am a hypochondraic? I've gone to the ER in the past for these attacks and they always find nothing wrong. But I would hate to be wrong one of these times and misread symptoms. Thank you.
doctor
Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
it is called panic disorder

Detailed Answer:
Hello XXXX,

Thanks for writing to us. I can understand your concern.

You have very well narrated your problem.
Your history suggests you are suffering from some type of anxiety disorder it is likely panic disorder. For confirmation of diagnosis detail history and mental status examination to be done by a psychiatrist.

In this case first we need to rule out physical problem by physical examination and doing EKG and chest x-ray. You probably have record of past normal check-up.

Yes pain is felt there in chest but it is not related to heart it is due to neurotransmitters changes in brain which causes sympathetic hyperactivity.

In panic disorder panic attacks occur which mimic like heart attack and after attack person become apprehensive about future attack.

Your age is also 37 which favors diagnosis of anxiety problem not of heart problem.

So next time it is better to consult psychiatrist directly with all your past reports or ask ER doctor to refer you.

Specific treatment of panic disorder includes both medicines and cognitive behavior therapy (CBT) - a type of psychotherapy.

In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.

In medicines SSRI group of drugs (fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs(clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.

This specific condition is treated by psychiatrist. Medicines I mentioned are prescription medicines. You need to consult doctor for the same. I request you to consult psychiatrist personally to get rid of your problem.


Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest Treatment For Severe Anxiety Attacks

Brief Answer: it is called panic disorder Detailed Answer: Hello XXXX, Thanks for writing to us. I can understand your concern. You have very well narrated your problem. Your history suggests you are suffering from some type of anxiety disorder it is likely panic disorder. For confirmation of diagnosis detail history and mental status examination to be done by a psychiatrist. In this case first we need to rule out physical problem by physical examination and doing EKG and chest x-ray. You probably have record of past normal check-up. Yes pain is felt there in chest but it is not related to heart it is due to neurotransmitters changes in brain which causes sympathetic hyperactivity. In panic disorder panic attacks occur which mimic like heart attack and after attack person become apprehensive about future attack. Your age is also 37 which favors diagnosis of anxiety problem not of heart problem. So next time it is better to consult psychiatrist directly with all your past reports or ask ER doctor to refer you. Specific treatment of panic disorder includes both medicines and cognitive behavior therapy (CBT) - a type of psychotherapy. In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually. If medicines alone are used chances of relapse are more after stopping the medicines. In medicines SSRI group of drugs (fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs(clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief. This specific condition is treated by psychiatrist. Medicines I mentioned are prescription medicines. You need to consult doctor for the same. I request you to consult psychiatrist personally to get rid of your problem. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.