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adderall, anxiety, and chest pains
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adderall, anxiety, and chest pains

I am a 25 year old female, I run 3 miles every day and eat healthy, take vitamins. I recently lost 30 pounds after I changed my diet and started running 6 months ago. I take adderall (adderrall) 30 mg in the morning and 5-15 mgs in the afternoon. I am in a masters degree program and am working on my thesis which is due by the end of this month, i plan on reducing my dose and sleep more often and stop smoking after I have finished my thesis, but I have literally a month left to have it finished. I sleep very minimum hours (4-6 hours a day at very odd hours). Sometimes I take an extra 30 mg if I wake up at 5 am and plan on working on my thesis the rest of the night (I know I shouldn't but I kind of have to in order to get my work done in time).  Sometimes I feel like I am on my medication 24 hours a day because I take an extra one and then when that wears off in the morning (12-15 hours later) I have to take another. I sleep every other night for the most part but I try to be aware of my medication and how frequently i am taking it because I don't want a buildup of amphetamine in my system. A few days out of the month I usually take off and don't take my medication at all for a few days and get 8-15 hours of sleep to let my body rest.  I have bad anxiety and am extremely stressed out right now. For the past 5 months, I have been getting extremely bad panic attacks where I need to call someone to talk me down or wake someone up that lives with me (which can be at 3 or 4 am sometimes). The panic attacks went away last month but then my mostly infrequent chest pains started changing to weird mild pain feelings in my breast, tightness in my ribcage and I sometimes get weird pains in the center of my chest, tightness in my chest, pain that comes and goes in my right breast near my sternum, and on my left side that come and go, sometimes my shoulders feel heavy but I am not sure if that is because I am constantly writing or typing or if it has something to do with my heart. Two months ago I had a painful pulsating sensation in my neck that scared the crap out of me and triggered a panic attack. This has been happening for over 6 months now and it is driving me crazy. I have been to the ER twice to check out my heart and they tell me that the ECG is fine and gave me a shot of ativan and a week prescription for the anxiety. I am also a smoker and smoke maybe a half pack a day (I am quitting after I finish my degree) and I am sedentary (12-15 hours a day) most of the day because I am working on my thesis. This is only a temporary thing for the next 2 weeks- month, but I feel like I have to manage to not kill myself in the process.  I have medication that I take maybe once or twice a month that helps me if I cannot get to sleep but usually I am usually too tired to need it.  When I get the pains it usually comes with shortness of breath and I start noticing other pain. I start taking deep breaths and try meditating but I start panicking because I feel like I stop breathing and feel like my heart is going to give out on me.  I am constantly taking my blood pressure and checking my heart rate.  Normally my bp is 112/73 but it fluctuates, and when I get anxious it can get up to 143/95 ish. My heart rate on my medication is usually consistently 75 to 85 and when I am not on my medication my blood pressure drops down to 102/68 and my hr drops to 60-70. However, last week I decided to take 3 days off of my medication before I got back to working on my thesis and when I took only the 30 mg in the morning, my heart rate was 100-115 through the entire day.. my heart rate has never gone this high before after taking a medication break. It was 95-105 the next day. Blood pressure was normal, and I felt fine but I didn't know why my heart rate was so high because I was sitting the entire day and even went to the doctors and I looked at my blood pressure/heart rate and my HR was 103 and my blood pressure was 123/93 I do not know if what I am experiencing is just the result of wearing my body down and being tired and taking stimulant medication around the clock or if this is something heart related that I should check into further. I am aware that medication like I am taking can trigger panic attacks and anxiety and I have underlying anxiety, but I am scared that there is something serious going on that I am brushing off as anxiety.Also, it may be worth mentioning that my back has been constantly bothering me because I am sitting all day and on christmas I let my sisters boyfriend crack my back (which I think he did wrong because it was extremely painful!!) and a few days after I started getting a mild throbbing pain in my right breast that comes and goes and a feeling of pressure or heaviness in my upper arms. I also felt like I couldn't breath last night and was having on and off chest and arm pains for a few hours that only went away after I slept it off. When I lean over I sometimes get mild chest discomfort as well. If anyone has had a similar experience any help or comments would be helpful. (PS I am aware of the effects of medication, caffeine, not sleeping, and anxiety on my health.. I am a graduate student in a Clinical psychology program and have attempted to reduce my anxiety, change medications (i.e. non stimulant, antidepressants) and have changed my diet and started running in the last year and I have a plan to help me quit smoking and will be reducing my adderall (adderrall) dosage after my thesis is completed next month) But I need some help to get me through this next week if anyone has any advice that is not criticism I would greatly appreciate it.
9 Comments Post a Comment
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Avatar_f_tn
The first part of your post read like classic anxiety chest symptoms then you said you have had a few ER checks and the chest is fine which is good. I don't know anything about adderal but it says not to take it if you have severe anxiety so you may be stuck with anxiety induced pains until the thesis is over. I imagine you already know that but wrote just in case.

You know the heart is fine because you passed the ECG tests so I would make that the focus of your thinking, rather than exploring if a new type of heart issue has suddenly cropped up right after 2 ECGs.
I imagine that it is impossible to tell if the back crack was done improperly at this stage but maybe you should talk to a doc for a definitive answer. I know someone who suffered a stroke and the docs say they can't prove the crack done previously loosened up an artery, but they suspect the stroke was a result. This is totally unrelated to your pain other than to point out that it might be a waste of time, so don't get worried about it.
I wallclimb every 2 days, and am used to pains in the back where a rib gets puled out of place and takes weeks to settle down while I continue with my climbing modified to baby the sore area, so I am telling you that every pain does not always mean something or if it does, it is not always dire.
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Avatar_m_tn
You know, you admit to taking speed beyond your prescription or any medical need, and wonder why you might be anxious.  Generations of students have managed to get through school without taking drugs, and generations of students have taken drugs to get through, so who knows?  I have two graduate degrees, and never needed speed to get through it.  I assume you have a medical reason to take Adderall (adderrall), but again, you admit you're taking excess amounts, and Adderall (adderrall) is speed.  I always believed in getting my sleep when I was doing my graduate work so when I worked the work was the top of my form.  Of course, I didn't have my anxiety disorder then, but I can't imagine what my anxiety would be like if I took stimulating drugs now.
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Oh, and I also exercised quite a bit.  I admit I had no social life, because beyond sleep and exercise it was just school, but anyway just some food for thought.
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I'm sorry..I didn't specify my dosage above!!!. I am prescribed 60 mg a day.. I said I have been taking an extra as in I take a second one.. instead of taking it he second one in the afternoon I have been waiting until the first one wears off so that I am on a lower dose spread through out the day . I don't do take my meds like this very often but the past semester has been extremely hectic and I have had very long hours at school and work.I know that there was a study that found that participants taking their second dose later in the day can have increased side effects. I have talked to my doctor about my concerns and symptoms and she told me to monitor my heart rate and that it is just anxiety from deadlines that are coming up next month. We agreed to adjust the dosage next month or try anxiety medication (which I do not want to take). I meditate every morning and every day  I run 3 miles . I take frequent breaks. I left my job to have more time to do my thesis... I had more of a crazy routine last semester working part time, going to an internship, working on my thesis, and taking classes.. But I have never had this problem before. this was more directed towards ppl who have been prescribed a higher dose of adderral.. instead of telling me I'm taking speed and telling me something I already know. Maybe you have a bias towards adderall (adderrall) because you are not very informed on this medication because adderrall actually isn't anything like speed. My teachers had me tested for ADHD when I was younger they had been trying to put me on medication since I was in middle school. As an adult I have attempted to get off the medication and try other things to avoid taking a stimulant. I have had panic attacks since I was 13 years old ..4 years prior to taking adderall (adderrall). Clearly you are trying to give advice.. This is about chest pains and panic/anxiety not about me taking speed. I was stating that I take medication and that I am well aware of the effects that taking them has on your heart rate and blood pressure.. And wanted advice on the effects of anxiety and cardiovascular effects to determine whether this was similar to anyone else's experience with adderral and anxiety
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6579347_tn?1388505968
I'm sorry you're going through this!

Just my two cents, but here's what I'm reading:
- VERY stressful time in your life
- taking adderral (stimulant)
- smoking (constricts blood vessels/raises BP)
- sporadic sleep schedule
- you say you run 3 miles, and also say you have a sedentary lifestyle

I'm not a medical prof., so I can't diagnose anything.  But all of those together can absolutely contribute to anxiety!  Your body is being asked to handle a huge load right now.  It would be completely understandable for someone to struggle with anxiety with all this.  The symptoms you describe can all be attributed to anxiety.

I've never taken Adderrall, but would be happy to offer tips that have worked for me managing my anxiety.  It's great news that your EKGs are coming back normal - that can take a load off your mind that nothing is wrong with your heart.  It's good to focus on those positive things, especially when our anxiety makes us very aware of physical symptoms we experience.

I would really encourage you to try and get on a more regular sleep schedule.  Exhaustion and fatigue definitely make us more vulnerable to anxiety.  Drink plenty of water and avoid caffeine.  It's great that you plan to quit smoking - my humble opinion is that trying to go through withdrawal in the midst of this stressful time might make things harder for you.  But avoiding caffeine and upping your water intake may help.  

Make sure you're getting good nutrition.  Protein/carb combos are great to fuel you up and give you some staying power.  Cram in some type of fruit/veggie, even if it's just applesauce or something.  

I'm still a bit confused on your exercise - if you're doing the 3 miles frequently in a week, that's great!  When you're working on a monster paper, that does mean a lot of sitting.  Set yourself a timer - every 30-45 minutes, get up and do some good stretching, or take a walk around the block.  Not only will this get some good bloodflow going, you'll also be giving that tired brain of yours a break!

Some people's anxiety passes when the big stressful event is over.  So, when your monster thesis is done, take a well-deserved break!  It sounds like you've got a plan to take good care of yourself in January.  If your anxiety-related symptoms don't resolve soon after, I'd encourage you to pursue some counseling and/or other professional.  There are lots of good resources available to help us manage our anxiety.

You sound like you're very aware and attentive to what's going on - that's good!  In my humble opinion, I just think your body is overloaded.  Be kind to yourself, hang in there, and good  luck with your thesis!


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Avatar_f_tn
Maybe just looking at some other threads on the anxiety forum where the poster has passed an ECG exam as you have but thinks they have "unusual" chest pains that scare them into thinking something is wrong with their heart will help you realize it is just typical anxiety affecting you and them.
Some think parts of their head are twitching too much, others their chests or lungs but it all comes from anxiety if they have passed the medical tests.

Since you claim to have had anxiety attacks for 12 years it may be that you are going to have heart fears for the next month partially due to the adderall (adderrall). I have to wonder if a switch to an anti-anxiety med would be a better choice since it might help with the sleeping too, but it is up to your doc to figure that one out. Why are you so anti-anxiety med but pro-adderall instead?
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On second thought I can see why you are adverse to anti-anx meds since you are able to calm down from attacks without them. However I don't get the adderall (adderrall) consumption routine because it increases anxiety and the higher your anx level goes the greater the chance you will end up with a serious problem. Good luck over the next month.
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Avatar_m_tn
I wasn't trying to tell you what your medical situation requires, so I'm sorry if I gave that impression.  But Adderall (adderrall) is speed -- we all really do need to know what our medications are.  Adderall (adderrall) is amphetamines, which is pure speed.  Hopefully, your ADHD diagnosis is a correct one, because this is a notoriously overdiagnosed and medicated condition, but the fact remains, speed and anxiety do not go together well.  Neither do your best work and no sleep.  Having done the graduate school thing for more years than anyone should, I was just trying to suggest that fewer hours of work with good sleep and a calm mind are worth more than more hours of agitated anxious work.  The quality is better, and you can produce more in a shorter period of time.  I was just trying to be helpful based on my own experience and what your post suggested, so I hope you'll take it in that regard.  I have no bias against Adderall (adderrall), only a bias against patients who aren't well informed by their doctors what they're taking and against diagnoses that might not be correct or continuing, so that we as patients can monitor our doctors as they monitor us.  I wish you only the best of success.
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480448_tn?1403547723
I agree with Paxiled completely.

I think the combination of your stressful lifestyle and the Adderall (adderrall) is causing your anxiety.

There are a couple of statements you yourself made that stand out to me, and should be of a concern to you...

"Sometimes I take an extra 30 mg if I wake up at 5 am and plan on working on my thesis the rest of the night (I know I shouldn't but I kind of have to in order to get my work done in time).  Sometimes I feel like I am on my medication 24 hours a day because I take an extra one and then when that wears off in the morning (12-15 hours later) I have to take another. "

" However, last week I decided to take 3 days off of my medication before I got back to working on my thesis and when I took only the 30 mg in the morning, my heart rate was 100-115 through the entire day.. my heart rate has never gone this high before after taking a medication break"

I have to be honest, you're on a bit of a slippery slope right now.  You're abusing your medication, even if YOU have found ways to rationalize taking an extra dose, abuse is abuse, you are taking it other than how it was prescribed, and you are noticing that at certain times, you feel you need to take another dose.  Also, when you have taken a medication break, you felt horrible, which could have been a result of some w/d symptoms.

I noticed in your post that you keep repeating that you're aware of all the things you're doing "wrong" and the possible consequences, this is another sign of kind of rationalizing what you're doing to function.  It's like you're saying, "Hey, don't tell me that this is bad for me, because I already know".

The TRUTH of the matter is, you're not only causing a perfect storm for anxiety (not to mention depression), but you're also teetering on ending up with an addiction problem.  Most people don't set OUT to become addicts, it happens just like you have described.  You've said, "I know I shouldn't but I kind of have to in order to get my work done in time".  Of course you don't "have to", you've just gotten stuck in this cycle.

I think you absolutely DO know the answers to your questions already.  I think you're probably very knowledgeable.  You just need to decide when you've had enough of this madness, and make some changes.  

Like Paxiled said, graduate school can definitely be grueling and tough, but plenty of people survive it without abusing stimulants.  There ARE ways you can manage your lifestyle that wouldn't include self medicating with your Adderall (adderrall).  You will benefit from making changes in many different ways...your anxiety will improve, your sleep, and your overall sense of well being, and actually you may find that you're BETTER able to function.

I would have an honest chat with your doc about this, and I most definitely wouldn't recommend adding any other habit forming meds (like an benzodiazepine) to the mix.  

I wish you the very best, and please understand that my advice is just honest and straight forward.  There is no judgement here.  I see that you got a little upset with Paxiled's post to you.  That sort of defensiveness often happens when we hear things we don't particularly want to hear.

Just understand that we're here to help you and support you, we're not judging, or lecturing.  Take care.


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