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Mental Health  (Expert Forum)
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lil advise?...
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

lil advise?...

by helloandgooday, Dec 20, 2006 12:00AM
This question may sound a bit strange, but im sure you've probably heard worse from other people in the past.



I began having panic & anxiety at the beginning of this year and eventually was able to overcome the panic attacks at least. The first panic attack that i had back in feb of 06' forced me to drive myself to the emergency room and once they had told me it was anxiety, they gave me some xanax and sent me home. This wasnt enough for me and i was very worried that it could be some sort of heart problem because my heart was always racing. I decided to visit a cardiologist and that was a clean bill of health as well. Basically over the past few months i have become extremely paranoid about my health and it seems that no matter how many clean bills of health that i get,my mind races and races to find something to obsess over. My panic attacks are now over, however my obsession is another story. It seems as though my panic/anxiety has somehow manifested itself into "what if" thinking and obsessing all the time.



Just recently, i started thinking back to my trip to the cardiologist and suddenly realized that prior to my heart exams that they had performed on me, i took a xanax pill just so i wouldnt be as anxious before going to see him. Then i started to think "what if" you're not suppose to be on anti-anxiety medication(xanax) while having these heart tests performed, and "what if" the only reason that my tests came back normal was because i was on xanax?? For some reason i was too nervous to call the cardiologist and ask him, and ironically my dad bumped into another cardiologist a few weeks later and he got his card and gave it to me. I decided to email him and ask him if xanax would effect the results of my heart tests. He replied a few days later and he said that xanax would NOT have any effect on the results of my heart tests. This eased my mind a great deal but then i noticed in the email that i sent him, i spelled the word "received" incorrectly and accidently typed "recieved" instead. I put the "I" before the "E"....Now i know this may sound funny to most, but for some reason this really bothered me and i started thinking "what if" xanax really DOES have an effect on these heart tests and this doctor that i am emailing is lying to me because i spelled the word "received" incorrectly....



I know that this may sound rather silly, but believe it or not, it is giving me intense anxiety and i cant stop obsessing about that email i sent him. I wish that i could obsess over something positive and productive, but i need to know if this "what if" thought that i am obsessing over (THE EMAIL THAT I SENT TO THE CARDIOLOGIST) is rational or not....also, what are your thoughts about this obsessive thought? is it rational? does it make any sense? etc etc....



i apologize for the length of this email, but i felt i had to tell you in as much detail as possible....thank you for your time!
Doctor's Answer

by Roger Gould, M.D., Dec 23, 2006 12:00AM
Anxiety can easily morph into obsession, because obsessions take the focus off the anxiety, and it becomes a vicious circle. No, your thoughts re cardiologist lying to you are not rational at all. The best thing you can do for yourself is to see a therapist so you can talk this through before your obsessions cause you more misery.
Member Comments (16)

by marlowgs, Dec 21, 2006 12:00AM
I'm sure there are many reasons for anxiety and panic attacks. I can tell you what I did to eliminate mine - maybe it can help you. First, when I had a panic attack and my heart was racing, I said to myself this is just another panic attack and I did some slow deep breathing - within a couple of minutes my heart started to slow. Second, I started light therapy. I use a GE Full Spectrum (F15T8-SR) fluorescent lamp which I set up to shine in my face in front of my computer about 12" from my face. For about 3 hours in the morning. Then for another 3 hours in the evening I set the lamp on my chest to shine in my face while I'm watching TV in a reclined position. Third, I discovered that I wasn't getting enough salt in my diet. So I take an extra half-teaspoon each day.

by sparkeler, Dec 21, 2006 12:00AM
Your are classical for OCD.  Or OCT as I call it.  (Obsessive compulsive thinking.)  I do the same things.  Are you on an SSRI, like lexapro or paxil?  If not, you should ask your doctor to try you on some meds.  Take that along with the xanax (xanax when needed.)  Also try meditating and exercising.  This should take some of the pressure off your thougths.  It won't eliminate it.  Trust me.  I still battle everyday.  But you have to just tell yourself it's your mind.  It's apart of who you are. How do you cope?  Well you can let the thoughts control you or you can control your thoughts.  It's being able to decipher what's really worth worrying about and what's ridiculous.  You know deep down that spelling the word receive wrong wouldn't affect the doctors opinion about the xanax and your heart tests.  It's the little devil in your mind that's not letting you let the thought go.  You have to tell him to shut up once in awhile, (for your own sanity.) We all have our crosses to bear.  Having the necessary skills to cope is the challenging part.  That is where a little therapy may come in to play.  Life isn't easy, trust me, but it can be beautiful!  Happy Holidays!

by helloandgooday, Dec 21, 2006 12:00AM
i am a bit of a perfectionist when it comes to letters, and i actually have a full bottle of Zoloft sitting in my room  staring right at me as we speak. I guess u can say im a little worried about taking it because then i will start "what-if-ing" about side effects and all the other crapola that goes along with it. Deep down inside i still would like to have the strength within my own brain to try and overcome this without drugs. ALso, i am a light social drinker and part of my job sometimes consists of wining and dining, and im also aware of the fact that its dangerous to drink and be on this medication. SO i am still a little hesitant about that.



i even noticed that the title of my first posting was "lil advise" and that even started to bother me because i know that it's an incorrect spelling. It should be "a little advice?"...sorry, just had to let you all know that.... especially you Dr. Gould...Merry Christmas to all!! ooops im sorry "happy holidays"...dont wanna offend anybody!!! =)

by nervous_nikki, Dec 21, 2006 12:00AM
To: helloandgooday
From a medical/scientific perspective there is ABSOLUTELY 100% NO WAY THAT XANAX EFFECTS A HEART TEST. The test that was done is called an EKG, electrocardiogram. It measures electricl impulses in the heart to see if everything is functioning properly.  Xanax cannot make your heart work improperly.  Medication does not effect this test and its results.  The only thing it might effect is your heart rate meaning making it slower than it might be w/o xanax.  Keep in mind, the heart is the most powerful muslce in the body and it will keep working hard for you unless you put your body in danger: lots of fat/cholesterol, drugs, excessive alcohol and cigarettes.

by nervous_nikki, Dec 21, 2006 12:00AM
To: helloand gooday
i would advise against taking the Zoloft unless it was recently prescribed by a physician...if you're worried about your health dont start popping random pills.  A prescription is a prescription.  Either take it everyday like the label reads or toss em. Seriously.  That is worse than xanax.

by helloandgooday, Dec 21, 2006 12:00AM
thanks for the advice on the zoloft....i dont think i need them, however they are there if i DO decide to take them, but i wont take them without knowing full well that i am going to stick with them....

as far as the heart tests that i had, i didnt have a regular ekg......i had what they call an "echocardiogram" which is basically an ultra sound of the entire heart muscle and the other test i had was called a "stress test" which to my knowledge is basically a test to see how your heart functions under stress and exercise......u have any info about the echocardiogram & stress test?

by helloandgooday, Dec 21, 2006 12:00AM
oh p.s....

the zoloft was in fact given to me by my doctor ...he gave me 50 mg tablets...

by headshrinker, Dec 21, 2006 12:00AM
It sounds like you have OCD.  OCD is when you have either Obsessive thoughts and/or compulsive behaviors that interfere with normal functionality in your life.  Some people have Obsessive Compulsive traits but have learned to use them to their advantage as in organizing and being very efficient and detail oriented.  When they become a hinderance is when they rise to the level of disorder.



First of all, how old are you?  Are these symptioms new?  Did you have other symtoms previously in your life?  Washing hands, paranoia, counting things, checking and rechecking the locks, the on/off controls, other odd behaviors?



Sometimes we have these behaviors as youngsters but they get worse as we age and when they begin to interfere we begin to fear them, then worry more about it = thinking more about it = worrying about thinking more about it = fearing thinking & worrying about it = more anxiety = panic === and it becomes a vicious cycle.



SSRI's like Zoloft are the first line treatment for anxiety disorders and panic as well as OCD.  No doctor would give you bad info because you misspelled something.  As smart doctors we deal with people less adept than we are at spelling, speaking, thinking, taking tests, whatever EVERYDAY.  If we tried to give them all bad info or bad medicine we soon wouldn't have any patients left to treat.  Besides, maybe you KNOW how to spell it but it was a typo - why on earth would someone be a jackass to you because you type fast and don't bother to proofread?  It's absurd.  WORRYING ABOUT IT IS A SYMPTOM OF YOUR OCD!!!



Drinking one or two drinks occasionally won't hurt you.  Drinking is NEVER recommended with any medication