Panic Attacks or Something Else?

[althouse]

I am a 32 year old male, 6'0 200lbs, and would not be described by anyone I know as being stressed at all, never mind overly stressed.

About 4 months ago I had what I thought at the time was a heart attack.  I was sitting in a meeting and experienced an accelerated heart rate, felt clammy and light-headed; and thought I was going to faint.  About 60-90 minutes later I felt completely fine.  The same thing happened 2 days later watching the news at home and I went to the ER.  I had an EEG and bloodwork done and was told I did not have a heart attack and my heart looked fine.  The ER doc suggested it could be a panic attack, but suggested go on a Holder Monitor for 24 hrs.  I did and this came back fine.  I also had a stress test that was normal and will be seeing a cardiologist next month.

About two or three weeks later I had another attack in the middle of the night and went to see my GP.  He ordered blood tests for pretty much everything and they all came back negative except for a high cholesterol and uric acid.  He also thought panic attacks and put me on 10mg of Paxil a day and I was put on a low cholesterol diet.

I told him of some heartburn problems I'd been having and he sent me for an ultra sound.  The results of that was some "sludge" in my gall bladder and a slightly enlarged liver I was told could be due to weight (I was 12lbs heavier at the time).  

I have had only 1 real severe attack since being on Paxil, but I still have the following symptoms:  tight feeling in the chest (feels like I've done too many push-ups)that moves around, sometimes on the left, right or both sides; tingly face that comes and goes, mostly when I'm cold (right cheek only); "spaced out" feeling at times; anxiety as to what "may" be wrong; lack of energy; difficulty staying on-task.

The frequency of these feelings are also more often (2-3 times a week) and last longer than the attacks do, sometimes for half of the day.  I must admit that they are more managable and go unnoticed by others.  I can go about my daily activities; but I still do not feel right.  They also seem to come in bunches.  I may go 10-14 without anything and then feel "off" for 2 of the next 3 days.

A family friend had panic attacks that was attributed to her gall bladder.  She had it removed and here panic attacks stopped.

I'm not sure if the next doctor I see be a cardiologist, a gastroenterologist, or a psychiatrist/psychologist for panic.

Like I said before, I really don't see myself as being stressed, so I find it hard to believe it is stress.

Am I doing the right things here?  Could my latest symptoms be the side effects of Paxil?  If I'm still having the symptoms listed above is 10mg of Paxil enough?

What would you suggest that my next steps be?

Thank you in advance for your help :)

[Roger Gould, M.D.]

Some of the spaced out feeling may be from the paxil so you don't want to increase the dose until that wears away.

You should see a psychiatrist for a number of reasons, only one of which is medication management. Once you become afraid of what is happening to your body, you become too conscious of it, and too worried.. When you talk to a psychiatrist you will be talking about other worries in your life that are bothering you more than you realize.  You may be the kind who deals well with a lot of stress so don't feel stressed, but the worries and unsolved problems still eat away at you from below, and erupt in panic attacks.  Get help early, don't wait for it to get worse

[shubunkin]

Very well could be anxiety. I had all the same symptoms and had every test imaginable which all came out fine. I started taking 20mg Paxil and am now fine, I still have my moments but nothing like before. I have since cut my dose back to 10mg and I am doing great on that. But I had to start at a higher dose. It is still a good decision to get everything checked out to be sure though. Good luck ! Danielle

[lucylucy]

Just wondering... do u overdose on vitamins??  why is ur uric acid so high?

[althouse]

Nope.  I don't take any vitamins, don't drink a lot.  Don't know why it's high.  Although I think uric acid is produced by the liver and gall bladder.

[Koala]

I relate to many of your feelings,
and want to direct you to a forum with lots of members who share your symptoms, http://pub125.ezboard.com/fdizzyloungefrm0
I have had "panic attacks" since my early 20's back in my early 20's I wouldn't have been considered a "nervous" person I'm 38 now and basally have no life, if you scroll down this message board to my original post you can read how messed up I am...I got back on Paxil a little while back, when I  went from 10 mg to 20 mg I felt all weird and unreal so I cut back to 10 mg and it's better however now I'm also on 0.5 mg Xanax twice a day or as needed for my anxiety that causes panic attacks,
I never knew the trigger of my panic attacks I just know they have come and gone over the years and now I do know the panic attacks are directly related to stress, but I have other "issues" you don't have....The mind is a weird thing and it's weird how it effects the body. I know in my case I need to drop about 20-30 lb., I'm 210 now at 6'2" and I "feel" better at about 170lbs, I don't know your build, but exercise when you feel up to it is always a good thing for the mind and body....
Best wishes, koala

[Styles.]

I have had similiar feelings. I was at home with my wife when I had my first attack. I have since left my home/wife 3 times because of anxiety attacks and confusion. I am now on Paroxetine 20mg. I was on half a tablet for 10 days and then went to the full tablet. Four weeks later I still am experiencing side effects (Tired all day, Insomnia at night, Mood swings) but since being on the medication I haven't had any attacks. I still get anxiety every now and then but nothing severe. I just hope the side effects go away after a few more weeks as I hate not feeling normal. (Feeling unmotivated and tired most of the time). Before Paroxetine i took Prozac which knocked me for 6 and made me feel heavily medicated. I stopped those after 2 weeks. I have been looking at other drugs but all have side effects so I guess it's just part of what you have to go through to get back on top. Im currently going to counselling sessions as well to talk about my underlying fears/problems.

[KEV78]

Hi EVERYONE...I'm new to the forum.  Ive got tons on my mind and many questions to ask.  Seems as if my probs started one day when i used cocaine.  Just that morning I suddenly freaked out and was afradi my heart was going to explode cause of how it was beating etc.  Had used the stuff for two months on weekedns with no probs.  EMT's told me everything seemed fine and that it was prolly a panic attack.  But deep inside i thought for sure i may have screwed up my heart or something.  Few weeks later i tried it again and a few times after that and each time i freaked out swore I was gonna die.  Anyhow i stayed clean and didnt mess with the stuff anymore. However then i starteed to get thesee weird episodes like I had trouble breathing like a smothering feeling and concentrated alot on my breathing cause thought if i didnt i would stop also a slight abnormal feeling or i guess sense of sight was weird or seomthing not sure how to explain it.  Suddenly one day i had a panic attack i guess again and that was the end of that afterwards i think i fell into depression.  Then started to get these weird heart skips..alot everyday for about a month and a half all day long really scarey.  Bad thing is i was afradi i messed up my heart and now it was doing all that weird stuff.  got my heart checked out and doc said everything came back normal maybe just stress.  Ive got alot of symptoms including sleep disturbances like i wake up suddenly in a panic i guess doesnt last too long and i go right back to bed easily but very scarey.  I still worry about my health alot..just wondering if something is being overlooked etc.  get tons of muscle twitches all over my body..in the mornings when i wake up i feel shaky inside and out..i also kinda feel off balance like i feel like i sway alot when standing straight up or light my head or body rocks back and forth when i am at rest kinda goes along with my heavy pulse rate.  I am taking paxil 37.5mg CR.  I am alot better than I was but still have tons of doubts.  Can somebody help me with my questions or have any responses..please email me at ***@****  THANKS SO MUCH!!!!!!!

P.S.  also a little more depth about my history..previous to this all the only thing I can think of that has some importance is i ised to take alot of Ephedra dieting pills also drank lots of coffe and smoke cigarettes...and did have a bit of a stressfull realtionship too...dont know i was thinking maybe all that had to do with it too...who knows?

[Chromed]

I get numbness in my hands and arms and into my face
and lips sometimes. I get very dizzy sweat alot and
everything becomes blurry for some reason. I have been
on paxil havent taken it for about 6 months. It just
recently happened few days ago during work and than I
got very weak after couldnt even get out of bed I was
so week and had a pounding headache

Anyone know what this could be?
Please email me ***@****

[KEV78]

Hi Althouse!

Hey you sound alot like me.  Im on paxil 37.5mg CR...stuff i think had worked mainly for my depression due to the anxiety but hasnt reallly solved the worrying.  i worry too alot wether it is actaully anxiety or a possible problem.  like i said you do sound alot like me..email me and we can go into this further.

***@****

P.S.  you might want to check out this chat room there is a room for panic and anxiety sufferers...you most like do have an anxiety problem actually from the sounds of it i think you do..check it out at ABOUT.com and look for the room.  really good people in there and will help you learn more about this and youll see for yourself there are many many others like us.  CYA

[kennyd]

Althouse, as I read your post it was almost as if I was writing it myself.  I am the same age, and get the same symptoms.  Started happening two months ago, after the initial "out of nowhere" attack.  The feelings that last half the day is something I totally relate to -- spaced out, inability to concentrate, lack of energy, etc.  All my tests (similar to yours) came back and said I am fine.  It is so frustrating, and I still haven't accepted that it is totally psychological.

Do you have trouble sleeping?  I have no trouble at all.  But lately I have been waking up early in the morning feeling completely out of it.

Anyway, your post is a month old but if you come back here, I would love to hear if you have made any progress.

Ken