Anxiety, agoraphobia, heart ... should I take Zoloft, Xanax?

[ajf08]

Hi everyone,

I'm a 20yo male suffering from anxiety with mild agoraphobia. It's been ~7 months since it all started basically out of nowhere. Since then there have been many ups and downs - sometimes I was ok for couple weeks, able to go out, do things with little to medium anxiety depending where I was, even got a job, which I had to quit after a month because throughout 1 week it got worse .. to a state where I couldn't even get out of my house, just laid in bed, watching tv series.

I was prescribed Citalopram and Clonazepam, first 1/2tab made me feel lethargic, low HR, discomfort - didn't take it. Then I got better event without it, but after ?3 months (when I had the job) it got much worse. Then, about a month ago I was prescribed Sertraline (aka. Zoloft) and Xanax. Didn't start taking it (was afraid?). But here I am, feeling better again, able to do things again, just not feeling 100% when I am out, but overall fine. Since Nov 2014 I haven't been drinking, smoking or drinking caffeine, just started eating warm foods more and been taking magnesium supplements (tried couple of them) since then till now.

My anxiety symptoms range from very high HR to very low HR (<50) at rest, couple different kinds of "weird beats" (palpitations) when resting, sitting, anxious, after physical activity etc., several different kinds of chest pains, some of them radiating to left pec/shoulder/arm, chest tightness, in extreme cases cramps (tetany) etc etc.

As I said, currently I feel good, only get very anxious after a while driving or in doctors' waiting rooms etc. ... about 6 weeks ago I was stuck to bed though.

My question is, What should I do? Should I try taking Zoloft? Will it prevent me from getting worse again, not getting anxious whereever, to function properly for a longer period of time, to be able to continue college or to work again?
What else should I do?

Please help. Thanks.

[ajf08]

Well, after my first panic attacks (before I even heard  of "anxiety disorder") I was diagnosed with tetany syndrome (through electromyograph), which is basically just very high muscle-nerve tension. I was told it can be caused by a deficiency in the system (Mg, Ca ...) or just by stress. Basically it is the main cause that SOMETIMES during an anxiety attack my hands are crawling, chest, abdomen and facial muscles tensing although I'm not hyperventilating - but it makes it worse.

Basically it tells that my mental state might be ok, but the nervous system overreacts. I've always been getting nervous in waitng rooms before, but now it's become just unbearable.

Anyway, anxiety and tetany still could be just symptoms of something else :/

Currently waiting for my MRI appointment (June 15), Cardiology: stress test, /another/ echo, 24holter; CBC with thyroid hormones and lymphoma onocomarkers, throat ultrasound and maybe a chest x-ray.

I'll keep it posted here.

[Paxiled]

You know, if you don't feel anxious or scared, maybe it's not anxiety.  I mean, I definitely feel anxiety and the fear, not just physiological stuff.  A lot of things can cause physiological problems that can be hard to diagnose, so it's easy to write if off to anxiety.  You know better than I do if you believe it's anxiety, but to me, anxiety is feeling anxious.  The other stuff is secondary to that stress.  As for me, medication did help, but unfortunately quitting a drug destroyed me -- watch out for psychiatrists who don't know how to properly stop these meds.  But before that happened, yes, the meds did help.

[ajf08]

@GabrielCE: I have already visited 2 psychiatrists, I just didn't take the medications they prescribed. Regarding the heart thing - I had mine checked too - EKG and ECHO came out ok, they just told me I have sinus tachycardia (I was anxious). I am going to visit an another cardiologist tomorrow (like a hypochondriac :D) hoping they will give me a 24hr holter and maybe a stress test cause it's still bothering me, I need to be sure. I am considering trying the drugs, but I don't know yet. I can relate to some of your symptoms but never experienced fear of eating or exercising (either I wasn't able to do anything or sometimes my heart is just not beating as I think it should during and after exercise). How long it took the medication to start doing its thing in your case?

@Paxiled: Just came home from the third session, but basically you are right. But all he has taught me so far is the breathing technique and the links between thoughts, emotions, feelings and physical responses. Maybe I have some kind of weird thought processes but I think I never have negative thoughts that cause anxiety or during anxiety. I see my anxiety as something that I feel physically eg. only have physical symptoms and become more "sensitive", but my thoughts stay more or less intact. I don't feel fear of death, fear of anything, just feel the physical symptoms caused by an external, real stumuli that is most times odd, but not my thoughts about it. (?odd)
btw. Has the medication helped you ?

[Paxiled]

By the way, I speak from experience -- CBT didn't work for me at least with the therapist I tried it with because I had a terrible time buying in.  I wish I'd known then what I've learned since about attitude and before I got on the medication merry-go-round.

[Paxiled]

Give the CBT a chance, but it doesn't sound like you're seeing a true CBT therapist.  They generally don't really care about your childhood or whatnot, they believe that even if you discovered why you got the way you are you'd still be that way, so they generally just work on a pretty standard formula:  teach you about cognitive distortions, teach you relaxation techniques, then when you're ready send you out into anxious situations a little at a time so you realize you can survive it okay and stop thinking anxious thoughts.  It's hard to do, though, as it requires you to buy in to their theory and do things you've been avoiding.  If you don't have the right motivation and attitude, CBT won't work.  Good luck.

[GabrielCE]

had a similar  problem for a year 23 to 24 years old  , and  I still have some symptoms  occasionally  but I know now it is anxiety and stress related, my suggestion to you is to visit a Psychiatrist so you can start treating your anxiety.  I took every possible test to check my heart and every time they told me the same thing, that my heart was perfectly fine and It was all in my head.
So relax, it is most likely not your heart and very probably your head, as soon as you realize that you can have a panic attack and control yourself because even though it feels terrible , you can be sure you are not going to die. You need to take some medication probably, If you dont like the medication they give you , just ask for something else until you feel comfortable.

My symptoms were:
- Fainting feeling
- Impeding doom feeling
- Terrible chest pains ( Left side and center of the chest)
- Sweating
- Back pains ( left upper side with burning sensation)
- Neck pain and Neck burns
- Numbness in my left arm
- Pain in my left arm
- Shortness of Breath
- Dizziness
- Fear of eating
- Fear of exercising

This symptoms where not all at the same time but a lot of them were, I was on therapy for a year taking  PAXIL everyday  and I had Xanax in case of a crisis, I finished my treatment and everything went away.

Good luck

[ajf08]

Thanks for replying :)

I actually am going to CBT therapy (my psychiatrist reffered me to it), tomorrow's the third session. But so far I haven't learned anything groundbreaking.

In the first session my therapist was talking about breathing - inhale fast, exhale slooowly for 20 minutes every day and when anxious. Then made me fill couple questionaires while he went through my health records.

In the second session we discussed whot I do wrong when anxious and my childhood - parents' divorce, fathers gambling, alcoholism, hitting mom and what I remember, what not.

The thing is, sometimes I get so anxious (when waiting for sth) I could use the xanax but I just dislike the whole idea of taking drugs, messing with my brain and the side effects.

I also recently started to bike everywhere, lift some weights at home but couple days ago, 5 minutes after doing 40 pushups I got some kind of stabbing chest pains ... went away in less than an hour .. weird.

[Paxiled]

Have you ever tried therapy, especially CBT?  You seem a good candidate for a non-medication approach.  Meditation might help a lot with your symptoms, for example.