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Why am I having panic attacks at night? Any ideas?

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Hi. I have been having nightly panic attacks usually around 4 AM and cant get back to sleep. I find a glass of wine makes my low level anxiety improve in the evening but I do not take anything else. During the day I constantly feel on edge. Any suggestions? I am otherwise a healthy 44 year old male with no medical problems. A family health issue is the root of my anxiety
Mon, 17 Dec 2012 in Mental Health
Answered by Dr. Jonas Sundarakumar 8 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I will certainly advise you regarding your problem. In order to understand your problem better, please provide the following clarifications...

How long have you been having these symptoms?

How did they start? (suddenly or gradually?)

Can you describe a typical panic attack which you experience at night?

Are you woken up from sleep with a panic attack?

Are you anxious before going to sleep "anticipating" a panic attack?

Do you have these panic attacks during daytime also?

How much of dysfunction is this problem causing you and in what way?

Do you have any other symptoms like feeling low, decreased energy, lack of interest, negative thoughts, poor concentration or decrease in appetite or weight?

Please get back to me with these clarifications, so that I can guide you in a better way.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
Follow-up: Why am I having panic attacks at night? Any ideas? 10 hours later
Hi. Thanks for replying. My symptoms began about a month ago right after my wife was diagnosed with MS - although a very mild form. Her symptoms have been mild and her prognosis is favorable. However, I am always thinking the worst about the future and this has affected me. She is very optimistic. Right after the diagnosis I began feeling very tense all the time. I fall asleep fairly quickly (because I am always tired), I wake up at about 2 to go to the bathroom, the same at aroind 4, and it is at this time that I wake up with my heart racing, with a very anxious feeling that keeps me up the rest of the night. During the day, especially in the morning, my heart is racing and I often just feel like crying. I am functional during the day as I am busy with work, but there is always an inner sadness that makes it difficult to relax. My appetite varies. I have lost some weight - but I have been eating healthier lately so that may be a part of it (I went from 200 to about 188. I am 5'11) I do have negative thoughts as well - just about the future with my wife, and I am worried about my health from all of this. I am normally very sensitive about anything concerning my wife, so this is just overwhelming. One neurologist made my feel better at the time after he examined her, but that has sort of "worn off". We will me seeing an MS specialist at Mt Sinai here in NY as well as someone in XXXXXXX Fl in 3 weeks. I feel that maybe I just need more information to make me feel better about her future, but I am fearful that I will always have this anxiety about her and I will never be able to completely be normal.
Answered by Dr. Jonas Sundarakumar 16 hours later
Hello again and thanks for your clarifications.

I understand that you are going through a very stressful time due to your wife's health problem. Constant stress can indeed lead to a variety of psychological problems, including anxiety disorders. Form the description of your symptoms, it appears that you are suffering from an anixiety disorder with panic attacks.

Now, since these anxiety and panic symptoms are causing you significant amount of distress and dysfunction, it is essential that you need treatment. Though your anxiety is mostly in direct response to the difficult situation you are in, still your level of suffering suggests that you need help. Moreover, only if you are able to stay calm and stable, you will be able to handle your wife's problem effectively.

There are effective treatment options available to treat anxiety / panic disorders. Treatment will be in the form of medication or psychological therapies. Medication such as SSRIs (Selective Serotonin Re-uptake Inhibitors) - Citalopram, Escitalopram, Fluoxetine, etc. are commonly used and quite effective in controlling the symptoms of panic disorder. Usually these medication take about 2 weeks to bring about their actions and may take upto a few weeks to reach their full level of effectiveness. In the meantime, you may also require small doses of fast-acting anti-anxiety medication like benzodiazepines (on a temporary basis) to provide quick relief of your symptoms.

In addition, there are certain specific and targetted psychological therapies like Cognitive Behaviour Therapy (CBT) which have been found effective in managing panic disorder. You can be taught stress management techniques and coping skills, which will enable to handle this stressful situation in a better manner. Also, relaxation techniques like XXXXXXX breathing, progressive muscle relaxation, applied relaxation, etc. can help relieve your anxiety symptoms.

I would advise you to consult a psychiatrist in your place, for a detailed psychological assessment and further treatment. With appropriate and regular treatment, I'm sure that you will be able to overcome your problem soon.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
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