Debilitating Physical anxiety but not mentally anxious (except about the physical symptoms)

Mental health
1

Hi!

I'm a 23 year old male who is considered healthy i.e. not over or under weight, no vitamin/mineral deficiencies, no officially diagnosed medical conditions etc. 

This issue is that one day when I was a young teenager about 13/14 years old, I randomly had a panic attack while at home, for no apparent reason that I can remember. Ever since then I have on a few occasions had panic attacks but mostly what's affected me are just episodes of physical anxiety/panic symptoms such as a raised heartbeat, shortness of breath, lightheadedness etc. these episodes would last for maybe a couple of hours or at most till the end of the day and be gone overnight. For most of my life I've managed well with these symptoms, I have lived a very fulfilled and active young life so far (exercising regularly and travelling/going out with friends) with these episodes of physical difficulty only popping up here and there and never usually during the normal working day hours, in fact I would sometimes go weeks even months without feeling a thing and then they might come up again here and there, but would eventually subside into a 'dormant' state again. 

In other words it has never bothered me or gotten in the way of me living, even when at the time it would feel uncomfortable and very unpleasant, once it was over life would go back to normal.

Until now, around late December 2017 I was out with a friend and we took the train to an event and when we got off the train and began walking I felt strangely dizzy and out of breath, I then felt some discomfort around my left chest and my heart rate increased, causing a bit of pain in the upper left chest near the armpit. This of course distressed me as it felt quite strong as if something dangerous was going to happen and this impacted the entire day out, we stayed out but the entire time my symptoms did not relent and I felt physically very distressed the whole time. 

Despite the episode being quite difficult and traumatic, I felt better within about 2 days, putting the whole thing down to these 'physical symptoms' that I've had here and there for 10 years but just a stronger than normal episode.

Fast forward to about early March 2018 and I was going out to see my friend again, not for the first time since, however I kept having this worry in the back of my mind telling me "I hope those horrible feelings don't prop up again this time !" Surely enough they gradually did and on a bus ride back home I was an absolute wreck, insanely fast heart rate, difficulty breathing, pain in left chest, pins and needles, light head, sickness in stomach and so on. It felt terrible and the feelings went down a little when I was home but nowhere near entirely and the next day I tried to go out and do things like normal but I just couldn't, those uncomfortable physical sensations were still there overnight and I decided to go to A&E. I had a panic attack in the waiting room, which although I brought to the attention of the receptionist they did nothing about and was told to just wait and the doctor would come. They kept me in all day around 10 hours doing various tests like ECG and bloods. In the end they told me there was nothing wrong and just sent me home since by the end of the day I was "a bit better" but was definitely not feeling normal, I still had an uncomfortable sensation in my chest, pins and needles and light headedness with short breath. 

Since that day these distressing physical sensations were at the forefront of my mind, rather than in the back where they'd always been, and everyday I've had to go through feeling them, almost all day. I'll either feel short of breath(sometimes from my throat, sometimes from my diaphragm), light headed, have a fast heart beat, feel an uncomfortable heavy pulling and pinching sensation in my left chest/armpit region, chattering teeth, feelings of doom and sadness etc. at some point and this had prevented me from enjoying life as normal. Before I was a happy go lucky, active young man but now I feel worried/sad all the time and caged in by these constant physical difficulties that stop me from enjoying life and wanting to do the things I usually love like travelling and sports.

My GP says it's all 'Maybe anxiety related' which isn't a helpful diagnosis. I'm on no medication and currently in a 12 week waiting queue for over the phone CBT therapy. I've gone through alot of CBT self help resources and even a CBT video course offered by my workplace, but they have been very limited in helping me, although I do feel slightly better by understanding how the thought process of a person works when panicked or anxious, the physical affects still remain and still give me great difficulty.

As a person I have no real worries, I'm in a great job, have a very supportive and loving family and good friends too. I have hobbies that I enjoy and in general I've always just enjoyed life to the fullest till now, I feel like my life is at a standstill and has completely nose dived since feeling like this. When my symptoms are not as strong and I'm having a 'good day' where perhaps I find myself able to go out with friends/family or to work without much or any physical difficulty I feel like I'm close to myself again and almost instantly start feeling better, until they come up again and I fall right back into feeling upset/distressed and just not like myself. 

I apologize that this is so long but I really needed to get this off my chest and explain myself in detail to get the best response smile. Thank you all if you've made it this far, I just want to know what could be done about this? Is there a name for what I have? Is there a form of therapy and/or medication that can help me? Essentially I just want to feel back to normal and like myself again, free, happy and active, not trapped, distressed and physically uncomfortable.

Also if it helps, I do not smoke, drink alcohol or take drugs/illegal substances. I've had Echo tests done on my Heart too which all came back normal. I've also had chest x-rays which were normal too. My blood tests also showed no Thyroid issues or lacking vitamins/minerals.

Thank you

2

Your story sounds similar to mine. However I never had anxiety at all until a fully blown episode last year, and have been having them since. I also agree that it can lay in a dormant state and it only takes certain things to set it off.

So It really does sound like generalised anxiety disorder, check that with your doctor though.  I go through 2-3 week anxiety episodes which are very severe, but i will then make a full recovery, until im triggered again.

SNRI's worked for me, reduced my anxiety massively. I did however decide to taper early and left to dealing with anxiety again. So that's something to think about. From my experience they only 'block' the symptoms.

I tried to phone counselling, didn't do much for me to be honest. You should try and see someone face to face, go privately if you can afford it.

 

3

Well the "name" for what you have is a Panic Disorder. As unbelievable as it sounds, anxiety can cause all of your symptoms mentioned and MUCH more. I know personally bc I've dealt with anxiety for 8 years now and have had all your symptoms and more at one time or another.

I'm reading a book called Anxiety & Phobia Workbook (6th edition), and it is veryyy interesting/helpful. I HIGHLY suggest giving it a read. But anyway, it discusses people just like u (and me), who get random panic attacks for no reason (that's what a panic disorder is) and the symptoms just like u described that follow. It says in the book how usually once a panic attack sets u off, u may feel completely fine afterwards for months OR it can often leave u feeling lots of anxiety for hours, days or even weeks afterwards.

I used to be like u where I would have a random panic attack, I'd feel anxious maybe for a day or 2 and then I would be completely fine for months like it never happened. Nowadays I have more generalized anxiety and less actual panic attacks. I'm not sure which is better... one really horrible attack every few months, or a day-to-day low level anxiety lol pick your poison I guess -_-

I see a therapist which helps me a LOT. I recommend seeing one yourself if you haven't yet. You mentioned one over the phone? But in person would be better. I used the Psychology Today website to locate one near me that took my insurance, etc. Made it really easy. And look for one who specializes in anxiety, that'll be more beneficial for you. You also may have to try a couple diff therapists b4 finding one you really like.

4

Also, I have xanax that I take on the really bad days and I highly suggest getting yourself some from your doctor if possible. Just taking one and having my body calm down helps me so much. I've never needed to go on actual medication before, so far therapy and an occasional xanax has been enough.

5

MM

Your GP seems to be pulling all the main cords and has arranged different pathways for you to travel. Hopefully after the CBT Assessment over the phone, they will decide if you need some form of support or treatment.

If you feel the need you could discuss a medication to help, however given your age, I suppose your GP will prefer to keep you of these medications at this time. Your Anxiety seems to not be around all the time, just frequent outbreaks, They will possibly feel if you can work out why the attacks happen it may be they can sort it.

What I would suggest however is as you wait for your appointment, write down what is happening when you feel anxious or stressed, and anything you feel are reasons for this situation.

It is interesting, the reasons why you have attacks and they clear on their own. Whatever the cause you need to consider anything that is causing the problem.

Do you feel it happens more at certain given times or when taking part in various life decisions or activities

BOB

6

Hey thanks for your reply!

It always helps to know that others have also been through what I'm going through (not that I would wish this on anyone of course!). Similar to what you said as well is that when I feel somewhat better something triggers off the symptoms again and I go back into a very physically uncomfortable state (back to feeling very short of breath, dizzy and sometimes fast heart rate).

You say SNRI's worked for you, did they get rid of all of your physical difficulties while taking them? Did they make you feel a sense of normality again ? I don't want to go down medication path is possible but I do want to keep my mind open to the idea and go down that route if need be.

Thanks ! 

7

Hey thanks for your reply Philly89,

I've read alot about Panic Disorder and i feel you may be right, either that or Generalized Anxiety Disorder (or a mix of both?). I'll definitely give that workbook a read through, I've read through a similar workbook and the info and work they provide can be quite helpful.

What resonates with me alot is when you say "Nowadays I have more generalized anxiety and less actual panic attacks. I'm not sure which is better... one really horrible attack every few months, or a day-to-day low level anxiety" because that's exactly how I feel these days. 

I am in a waiting list for over the phone therapy but I think with my case I may need to go through private care and find an actual face to face therapist.

Also you say you take Xanax as and when needed, does this tend to make you feel back to normal and get rid of the physical anxiety? 

Thanks !

8

Hey borderriever,

An interesting point you made is that you feel the GP would want to keep me off medication because of my age, I'm curious to know what factor does age play in taking medication for anxiety? 

I have had an initial appointment with both GP and CBT providers, but so far nothing past that apart from being referred for the over the phone therapy which I'm in a 3 month waiting queue for. However I will try and write down in more detail when these physical symptoms occur and why they may happen and then revisit my doctor.

I feel that these symptoms come up randomly but if I were to recognize certain times I would say they come up most when I'm with friends, when I'm extremely tired and in the mornings when on the way to work, at work in the morning period and when coming home from work. 

Thanks for your advise.

9

MM

As we get older medication doses need to be reviewed. I understand as we get old we need less medication, the body can become more responsive and side effects can be more of a problem. It is like as we get older general illnesses do become more marked and we will need to see the GP more often.

I have been on my medications for a long time now and one of my drugs was changed, the saying if not broke do not fix it comes to mind. This can be the case however  and a reduce of dose  may be all that is needed.

I am in the midst of reducing pain medications, I only take what is needed now and there is little I can do to reduce further. New medications may be the answer although I suppose the use of Tens may help me make the recommended changes for my age

BOB

10

In that book I mentioned it discusses the difference between having Generalized Anxiety Disorder (GAD) and a Panic Disorder. Panic disorder is when ur normal and then u get a panic attack for no reason, n that leads u to worry about getting future attacks and therefore brings on anxiety. GAD is when u are overly worrying about things and u become so anxious that u give urself panic attacks. So going by what u said I'd assume u have more of a Panic Disorder, not GAD. That's same for me too. I never knew the difference between the two until I read that ^^.

And yes, the xanax helps me a ton! For a long time I didn't want to take it bc I was afraid or bc I felt like I was failing, but I act wish I took it earlier now lol. I originally asked my Dr for it bc of my fear of flying, and I still use that excuse now to get more refills if I run out haha (I find if I say it's for anxiety they just wanna put me on antidepressants, so I say it's for flying lol). I only take xanax maybe once every few months, so I don't take it often at all.

But it really helps on those bad days, it completely calms me down and when that happens I realize that there IS an escape from those horrible feelings, and I'm not stuck and I'll be okay. And then in return I start to just feel better and calmer afterwards, even when the xanax has worn off. Actually, I feel calmer in general just now knowing I have something that will help me if needed.

 

11

Thanks for the info! Judging by what you said, I'd agree that what I have sounds more like panic disorder than GAD.

I'm really glad to hear how the Xanax has been a great help for you, the way I'm feeling at the moment I feel I will have to take some sort of medication, even if just to give me a lift from my current position, because I've been feeling quite hopeless with this. I've tried alot of self help CBT methods which have at most taken off a slight edge to the attacks, due to being aware of what they actually are and the methods involved, but most of the time it never works as a cure, perhaps I just need a boost of confidence which perhaps short term medication can provide? I'm really not sure but what I do know is that I'll continue seeing my doctor, will keep you all posted .

Thank you

12

Thanks, I totally understand what you mean and that's one of the reasons I'm reluctant to go down the medication path, but the severity of how I feel and how it's impacting my life is making me seriously consider it.

One thing I'm considering is the possibility of going on medication for a time long enough for me to feel better and then slowly taper off them? I'm not sure if that's even possible but I really want to not be on them forever.

But like you say, you only take what is needed in your case, perhaps my case could be similar? I'm not sure but either way I'll keep you guys posted.

Thanks  

13

Yeah I always hear/read that medication can definitely be useful to just get your mind set straight and pull u out of that hole feeling lol. But it deff is only a temporary solution, that's why therapy is always a good idea.

I deff think you should try face to face, phone is better than nothing but in person I feel like would be best bc they can physically show you deep breathing methods and such which they can't show you over a phone call.

14

I started medications when I was eighteen, and they really knocked me back and I became addicted to Largactil and Vallium.

My GP in the first and second instance was very much inclined to give me medications, because of possible addiction.

The same applied to those around early twenties. Over the years I had dealings with medications and the young, when in a Day Centre, about eight years ago and the same problem seemed to be the case if the patient was young, they would prefer other methods of treatment.

In my case I have been on and off of ASs for a great deal of time and now I am a pensioner and will need to take ADs for the rest of my life. Now all the medications do is to keep my mood on a level and sometimes I still have problems with the script.

Over a long period of time it becomes more difficult to reduce dose and given my age I would love to reduce my reliance on these medications. I should have taken the Bull by the Horns long ago as I am now beginning to reduce my medications to a lower level because of age. AD medications can cause to many problems as I try and sort out a reduction of all my medications because of age.

Medications can cause complications over extended periods

BOB

15

Thank you so much for your info and insight, it's helped me to put things into perspective, I feel like I'm going to try my best to see how far I can go without medication, so by using therapy techniques etc. and see how I fare. If in the end I do feel that I want to begin medication then I will do so with caution and perhaps use it as a temporary boost to assist with other methods like therapy and not see it as a long term solution.