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How are panic attacks and anxiety neurosis treated ?

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Internal Medicine Specialist
Practicing since : 1998
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Hi, I am a 40 year old female and about 150 lbs. and about 5'8. When I was 13, I had my first "attack" where I was rushed to the hospital, the docs did numerous tests and didn't find anything. I didnt get anymore until my adulthood. Recently, I just had and "attack" last night. I'd say this has happened about 4-5 times in my adulthood. Here's what the attack is like: I start getting a heavy feeling all over my body, I start to space out but I'm well aware of everything going on around me, All my limbs seem too heavy to lift and I slowly sink to the floor. I feel tingly all over. I have no pain, headache, heart racing, or any other symptoms except my eyes start emit tears which I contribute to maybe crying. The attacks can last anywhere from 20 minutes to an hour. Today, my body still feels heavy but I'm able to function, it just feels like lead. It also seems like my reaction time and speech are slowed down. Trying to talk during an attack is difficult and my speech is very slurred and drawn out. My husband thinks it's a form of anxiety attack because every time I've had one of these attacks, I've had alot on my schedule and have been under stress, I'm worried that it could be something more physical. My thyroid has tested out fine and I'm a very active person otherwise in good shape. The only medication I take is Amitriptyline (40mg/day) for my bruxism and severe TMJ. I don't think this is the cause since my first attack happened when I was 13 (I did't take the Amitriptyline then). I also take supplements: Glucosamine, 1 aspirin daily, biotin, and a One-a-Day Multi. Please help!!!
Thu, 26 Apr 2012 in Anxiety and Stress
Answered by Dr. Jasvinder Singh 50 minutes later

Thanks for posting your query. I can understand your concern for these symptoms and your concern is genuine for a physical cause. It looks like panic attacks and anxiety neurosis (from the symptoms and the occurrence during stressful times) but before labeling it as any of these, it is advisable to get an EEG (electroencephalography) and a MRI of brain. Both these tests will rule out any organic or medical neurological cause.

Second for ruling out the conditions of anxiety neurosis and panic attacks you need to consult a psychiatrist. Panic attack is a response of the sympathetic nervous system and is characterized by trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, feeling of warmth and sweating. Symptoms of anxiety neurosis include sweating, headaches, nausea, muscle tension, muscle aches, trembling and hot flashes.

Both of the above the best fit would be a referral to Neuropsychiatrist by your primary physician which require psychological counseling and anti anxiety medicines.

Third you are already taking the antidepressant Amitriptyline and long term side effects of these drugs may cause neurological symptoms like confusion, tingling, abnormal involuntary movements and anxiety. Hence please discuss about dose modification with your treating physician as sometimes dose modification helps in decreasing the symptoms.

In addition, here are some of the other treatment options which you can follow:

1)     When you have such symptoms, breathe slowly through the nose and talk to your family and friends.
2)     Do not take caffeine of alcohol at night just before going to bed.
3)     Include in yoga and mid relaxing exercises like meditation to calm your mind in your daily routine.
4)     You can also practice progressive muscle relaxation which is useful in anxiety by alternately tensing and relaxing the muscles.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wish you good health.

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