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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for anxiety with upper chest tightness

Answered by
Dr.
Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2242 Questions

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Posted on Fri, 8 Jan 2016 in General Health
Question: Keeping you informed helps in my recovery, thanks for your attention.

I have been making great strides in my recovery and am starting to breathe much better. The focus on everything to be stress and anxiety caused has helped tremendously. I am wondering if you can reach a certain point where another obstacle has to be the cause also. Lately,, I have run into upper chest tightness and a level of breathing somewhere in between panting from exertion to shortness of breath. I wonder if my anxiety level of matters that I am working on ridding might be slowing or pushing it back up a bit.
doctor
Answered by Dr. Alexander H. Sheppe 1 hour later
Brief Answer:
Consultation

Detailed Answer:
Hello again XXXXXXX so glad to hear from you. It's always a pleasure. And I'm even more glad that the focus on managing your anxiety is serving you well.

You're asking if addressing anxiety issues directly can temporarily push the problem up again and make things worse temporarily.

The answer is yes, but in a good way. The best forms of treatment for anxiety are CBT and desensitization therapy. Both involve confronting your fears directly, and by surviving that confrontation, you prove to yourself that nothing terrible is going to happen. This trains your brain to be less anxious in the long run. Sometimes anxiety can flare up during these confrontations as you note, but it is better to think of this as flexing a muscle and lifting weights -- it hurts in the short term, but over time you get stronger and can lift a lot more.

Does this answer your question adequately?

Always feel free to contact me with any questions or an update on your situation. I'm so glad you're feeling better.

In order to ensure that you reach me directly, continue to use my private link as you are doing. Take care, XXXX!

XXXX

OR

https://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70684
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Alexander H. Sheppe 19 hours later
CBT cpg behave therapy?

I guess you captured most of what I was asking but I failed to include that the body will be sensitized for a while until I come down quite a bit? correct? And having some of the same issues still be a bother can slow the healing process? Any sensations of slight breathing can agitate and start some of the issues over and need to be addressed to cease

I still have a few issues somewhere that are keeping the upper chest tight.and bothering the esophagus.

doctor
Answered by Dr. Alexander H. Sheppe 2 hours later
Brief Answer:
Private Followup

Detailed Answer:
CBT = cognitive behavioral therapy.

Yes, your body will still experience somatic symptoms of anxiety like shortness of breath, chest tightness, and esophageal burning. But as your anxiety improves, these bodily symptoms will likewise improve. Indeed, the less you focus on these bodily symptoms, and the more you are able to distract yourself through cognitive therapy techniques, the faster you will learn that these sensations are not dangerous, and their salience in your mind will decrease.

I do offer private cognitive therapy via this direct link

XXXX

OR

https://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70684


Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Alexander H. Sheppe 56 minutes later
I will see you at the other link in the next few days when I get free time from the holidays.
doctor
Answered by Dr. Alexander H. Sheppe 0 minute later
Brief Answer:
Private Followup

Detailed Answer:
Glad to hear it! I think we could accomplish a lot and get you feeling better more quickly. Have a great holiday season.

Remember to rate and close this answer!

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Alexander H. Sheppe 10 hours later
In our prior conversations, do I recall that a simple event, in my case heavier breathing from doing something like climbing stairs to trigger my brain to cause the anxiety to increase and make the sensation of shortness of breath exist or return.

I thought it was a discussion topic and that it can be triggered easily until CBT or therapy can stop this.

doctor
Answered by Dr. Alexander H. Sheppe 8 hours later
Brief Answer:
Private Followup

Detailed Answer:
CBT is designed to train your brain to catch itself when you are slipping into a panicky episode, and to redirect your thoughts and attentions to the fact that you are not in danger. This cognitive reinforcement over time can stop and even begin to prevent panic attacks. It can be curative. That is the goal!

Again, I do offer private cognitive therapy via this direct link:

XXXX

OR

https://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70684
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Alexander H. Sheppe 42 minutes later
After I type out this follow up, I am going over to the other two spots to check out

Perceived versus Actual physical sensations. You and two pulmonologists, a respiratory therapist and a general internal physician have commented in one way or another that chest tightness can/will occur with great levels of stress and anxiety with panic.

Today, I went out for lunch, I had to walk up a slope and stairs to get to the door to the restaurant. By the time I reached the door, I felt out of breath to the point of not talking for a moment just to catch my breath. As I inhaled I found that only the lower area of my lungs were taking in air and only so much. The area that I was breathing from was belly area to bottom rib. As I inhaled, I was stopped by a limit point.

So, I am working out the panic quicker than I used to but still bothered by this. Using your medical training,
1. Does it take the entire lung to breathe. And does the tightness caused by stress actually tighten muscles limiting the chest expansion and mentally cause this.
2. The therapy to reduce is not overnight, this i know but it will or can take months correct?
doctor
Answered by Dr. Alexander H. Sheppe 3 hours later
Brief Answer:
Private Followup

Detailed Answer:
I think this is actually a good example of how anxiety is hijacking your cognitive processes. Your focus on things like the amount of air that is going into your lungs is an example of a somatic preoccupation brought on by anxiety. Most people do not pay any mind to things like this -- but your mind is very focused on the possibility that something may be wrong, when in fact nothing is seriously wrong.

To answer your question, it does not take the entire lung to breathe, and in any event we cannot detect how much our lungs are expanding because we have no nerve endings in them. The chest muscles may tighten, but this is not dangerous in any way, nor does it affect breathing.

CBT techniques can take months to perfect, but it is first important to learn them, and I will be happy to teach them to you.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Sonia Raina
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