Anxiety disorder--related to sensory-tactile defensiveness?

[SylvanB]

    
      Re: Anxiety disorder--related to sensory-tactile defensiveness?
    


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Posted by ccf neuro M.D.* on September 13, 1997 at 17:59:59:

In Reply to: Anxiety disorder--related to sensory-tactile defensiveness? posted by SylvanB on August 31, 1997 at 21:32:37:
       My husband, age 45, has a severe anxiety disorder with agoraphobia. It's been
       suggested by an OT person (a friend) that this may involve tactile defensiveness--he
       is super-sensitive to touch, but also craves physical contact (we hug a lot!), and
       he startles very easily and severely. The sensory integration connection is a new
       idea which we would like to explore, but everything I've found so far relates to
       retarded, autistic, or adhd children or adults. He is emphatically not retarded;
       there are some features of adhd and perhaps autism but far from diagnostic. Please
       save us more wheel-spinning by directing us to resources relating to non-retarded
       adults. E-mail is warmly welcome. Thank you!
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Exaggerated startle response is a well recognized symptom of anxiety disorders and is not to the best of my knowledge related to any abnormality of the sensory nerves. This symptom is a feature of post-traumatic stress disorder and is so prominent in that particular disorder that its absence makes one reconsider the diagnosis. Exagerrated startle response is also a feature of certain rare, often inherited disorders known as the HYPEREKPLEXIAS. These disorders have been found to be caused by abnormalities in receptors or amounts of an amino acid called glycine, especially in the spinal cord. I think in your husbands case the most important issue is control of the underlying anxiety disorder, be it panic attacks with agorophobia or whatever. If this is under control, the exaggerated startle should reduce in proportion. Other so called somatic or physical symptoms common to anxiety disorders include trouble sleeping, nausea or stomach discomfort, hyperventilation, numbness in the fingers, toes, and mouth/tongue, sharp stabbing pains occurring in the chest and/or abdomen, and feelings of deja vu. Medications used to treat panic disorder specifically include benzodiazepine type medications like Xanax or Ativan, and tricyclic antidepressants, which, helpfully, also work for anxiety!!! If there is a strong history of exagerrated startling or sensory response in your husband's family and his anxiety disorder is under excellent control, it may be worth considering as a separate issue, but otherwise I would not try too hard to give your husband a second disease when the symptom is explained by the disorder he already has. Psychiatrists are experts in the treatment of panic disorder with agorophobia, especially for treatment-resistant or bad cases. If you are near the Cleveland area and would be interested in your husband seeing one of our Cleveland Clinic staff psychiatrists for a second opinion, the number is 1-800-223-2273; ask for psychiatry appointments. Our psychiatrists are AMAZINGLY down to earth, "normal" people.