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Mental Health  (Expert Forum)
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Can this all REALLY be just anxiety?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
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MedHelp Member's Question

Can this all REALLY be just anxiety?

by tlg0123, Mar 20, 2006 12:00AM
Hi, I'm in desperate need of advice. About 8mos ago, i started having really weird symptoms happen to me. When i would get tired I would have like electric little jolts going through my body it felt like lots of adrenaline rushes. As time went on i began to have difficulty sleeping. I awake at night with a racing heart of up to180-190 bpm, i awake feeling jittery then like i have too much energy and then "I shiver" and my heart begins to race. Weird i know! I've had a sleep study and the tech told me i had episodes of hypopnia ,and i had an episode of the tachycardia as well it went from 84bpm to 176bpm in seconds the tech said i was in REM stage. When the report came back the pulmonologist that read it said it was normal, but possible i had a nightmare and recommended Xanax. I was NOT having a nightmare, this happens every night!!! I've also had a 30 day event monitor (Normal with sinus tach of up to 180bpm)a stress echo bloodwork galore .(all normal) My other symtoms are weight gain of 15 lbs,hypoglycemia episodes about 2hours after eating BS goes to 60's, severe dizziness most of the time,very jittery in am , debilatating headaches,(i've never had headaches this bad in my life),low blood pressure,weakness,and anxious most of the time. I've had panic disorder in the past and this feels totally different. I keep saying it feels like i have way too much adrenaline flowing through my body. The doctors have given up on me. I think they believe that i'm just a hypochondriac or a really nervous person. Something is happening to my body and i just can't explain what. Could this be hormonal as in perimenapausal? I'm 36yo. I'm taking Ativan .5mg bid and Lexapro 10mg 1/2 pill daily.(I've only been taking this for a week though)I've also wondered if i have an autonomic disorder of some sort. My family doctor said,"Endocrinologists are hard to see, and they will just give you a pill". So what now. Is this all anxiety? I really don't think i have panic disorder because when the tachycardia happens it scares me but i'm not panicking. If you cannot help, is there a doctor that you could recommend? Please, any advice would be appreciated. Thank you for your response
Doctor's Answer

by Roger Gould, M.D., Mar 23, 2006 12:00AM
Ask your doctor to consider the diagnosis of pheochromocytoma, a tumor of the adrenal gland.
Member Comments (8)

by Jenny Wren, Mar 20, 2006 12:00AM
To: tlgulley
I ask myself the same thing.  Is this some kind of hormonal thing.  I'll be 35 in May.  My grandmother went through menopause when she was 39.  My mother though much later.  I started getting headaches when I was around 30, never had a headache before.  I wake at night gasping for air, and the pounding heartbeat also.  I do have a mitral valve prolapse, known about this since I was 15, but never had a problem before.  I started having anxiety attacks about 6 years ago.  Now my chief complaint is facial tingling, and headaches.  I know they all shrug it off as anxiety.  I've been on Prozac, the only thing that helped was gave me lots of energy, didn't help the headaches, I take a half a Xanax now when I feel bad.  Hope you get some answers, I've had this for about 6 years.  It seems to be worse around that time of the month.  Take care.

by rosetoes, Mar 21, 2006 12:00AM
TLGULLEY:



You may be having a adverse reaction to the Ativan or Lexapro.  That does happen with those meds.  I started xanax due to panic attacks after experiencing rapid heart rates of 240bpm.  I was rushed to the hospital and given beta blockers and other meds to slow my heart down.  I was admitted and given several test, ekg, stress test and echo and all was normal.  I was diagnosed with super ventrical tach.  The episode was so so frightening that I started to have panic attacks which lead to me taking xanax for a few months.  I am currently off of them totally, but I do take Toprol xl for the SVT (to prevent it) and it has worked for me.  



From your symptoms, one would think that you are in withdrawl but I know that you are not.  But many times, you must find what medicine works best for you.  Personally, benzos mask the panic and it comes back once you stop taking the meds.  And I can honestly tell you that getting off of the meds are worse than the panic/anxiety attacks.  I've been there and it is a nightmare for weeks...the doctors don't tell you that.  If only I knew the addictiveness of xanax, I would have taken them only when the panic was unbearable and not 3 times a day as prescribed.  When a medication can supress the chemicals in your brain that causes panic and anxiety, you know that it is strong and it is not without side effects.  Best wishes.

by deps, Mar 22, 2006 12:00AM
I'm 54 and have panic disorder my entire lifetime.  Watch the meds you are taking, they can also mimic panic attacks.  But also, every sign you said also sounds like full panic disorder.  Panic attacks can tend to change over time.  What and how you use to remember is not always how they come on again.  Also, many people with panic disorder have mitral valve prolapse.  Interesting eh?  If this is just starting to happen since taking Lexapro, then Lexapro is not for you.  Plain and simple.  what works for one may not work for another.  People with headaches and all you've described can be panic or adverse effects from your med.  I hope the doctor didn't start you on both meds at the same time.   hate when they do that, then it's hard to tell what med might be causing the problem.

wishing you the best.

Sorry anout my caps, my key doesn't always work

by LynnSB, Mar 26, 2006 12:00AM
sometimes it is very hard to tell sinus tach from atrial tach on a holter or even monitor. Please look up the symptoms of a heart condition very often confused with panic attacks -- paroxsymal supraventricular tachycardia or PSVT.  It took me almost 20 years and countless event recorders before mine was documented and I was finally BELIEVED. I had been discounted as having panic attacks for decades. My heart would race up to 200 and no one believed me...  I had an EP study and an ablation finally.Anyway, if i were you, I'd just look up the info and see if that sounds like your symptoms.

Here are a couple of links: http://www.psych.org/pnews/97-04-04/cardiac.html



and

http://www.geocities.com/Wellesley/Garden/8988/heartrhythmindex.html

by terramuggus, Mar 30, 2006 12:00AM
Hello,



I don't know how long you've been taking Ativan, but I suspect you're now suffering interdose withdrawal, also known as tolerance withdrawal/rebound. Professor Heather Ashton of the University of Newcastle in England ran the first iatrogenic benzodiazepine addiction clinic in the world. She's written the definitive handbook on doctor-induced (iatrogenic) benzo addiction, describing exactly what you've written about here. You might want to visit www.benzo.org.uk before going back to your doctor. Specifically, read the symptoms lists, then click on the Ashton Manual, on the left menu of the home page. You will see yourself rightaway in Dr. Ashton's description of benzodiazepine (Ativan is just one) victims.



You can successfully withdraw from Ativan, though it will require a cross over to valium (the most reliable, less painful method) and about 12 to 18 months of a patient withdrawal schedule. Since you've just started Lexapro, you might consider tapering off of that first. This should take about 6 weeks. You will suffer moderate to severe withdrawal symptoms from a Lexapro taper. For additional information and support you might consider visiting www.paxilprogress.org



Good luck and God bless,



Terramuggus

by TwentySomething412, Apr 05, 2006 12:00AM
You said you were having a drop in blood sugar a few hours after eating. Have you changed your diet at all? Low blood sugar problems left untreated can sometimes create anxiety-like symptoms (at least in my experience with it) which often lead me to have even MORE anxiety and if it gets too low your body will have very adverse reactions that feel almost like a panic attack but worse- really shaky and jittery is how mine start. Low blood sugar problems are helped by eating a high protien, lower carb diet. If you eat something that has high sugar or carbs, your blood sugar will go up and you'll feel better for a time and then it will crash a little while after eating. Maybe you should ask your doctor about your blood sugar- just a thought.

by comets, Apr 21, 2006 12:00AM
To: tlgulley
Hi, did you have your thyroid checked? I have exactly the same symptoms as you have and I am 29 year old female. My PCP didn't diagnose me with anything. She also thinks I am crazy and refer me to psychiatrist. One day my heart was racing too fast and my parents took me to the ER. They diagnose me with hypothyrodism. Now, I am working with Endocrinologist. Your symptoms could be your thyroid or adrenal problem. Be persistant and ask your doctor to do a complete thyroid lab check, and then 24hour urine and saliva to check adrenaline and cortisol level. I am on 75mcg synthoid now. I have been fine since.