Anxiety or Something Else?

By Kristina Randle, Ph.D., LCSW

Take a deep breath… hope I don’t bore you.. here is my story..

Bloated feeling, pressure in chest, feeling like I can’t talk or swallow, shaking, feeling of blood rushing to head, dizzy, tingling pins and needles in extremities, heart racing, frequent bowel movements, wake up sometimes soak and wet sweaty, really aware of every heart beat, wheezing, very hot/warm feeling in the center of my chest moving to my arms then gone, very easily startled. I feel like I’m in a movie or something just waiting for something to happen. Sometimes it will be like a switch.. click.. I’m perfectly fine.

All these symptoms came to a climax one day, I was driving home from work and was feeling these symptoms then all of a sudden it was as if someone punched me in the chest five times fast. (I wish I was exaggerating) I only live twelve minutes from work. I instantly pulled over and called an ambulance. I thought I was having a heart attack, I have never felt anything like this before.
I was in the ER a total of three times over 2 months, they tested my bloods three times everything was fine according to the hospital. They even did a heart attack test where they tested my blood every couple hours (T test?) Whatever it was they stated it wasn’t a heart attack, although my heart was racing something fierce when all this happened. I was hooked up to the ekg each time and everthing was normal.

I went to two cardiologists. Both listened to my heart and they said I had the slightest of a murmur but everything sounds fine and my heart is definitely not the problem. I wore a 24 hour holter, the results were “Underline Rhythm is Sinus, 4 PAC’s in 24hrs, no SVT’s. 1 isolated PVC was seen.” (translation?) Doc said that the holter was pretty boring and it was nothing I needed treatment on. What are SVE beats.. I had 13? Normal?

I had a stress echo done.

Results..
Resting ECG : Regular Sinus Rythmn, non-specific ST-T wave abnormalities
Resting LV Wall Motion : no segmental wall motion abnormalities, normal LV function
Exercised for 10 minutes reaching max heart rate of 164, 88% of max 186. Throughout test patient experienced no chest pain of shortness of breath. At peak exercise ecg revealed no ischemic changes. Post echo showed no segmental wall motion abnormalities. No significant arrhythmias. Appropriate blood pressure response.

Impressions; negative stress test for ischemia, appropriate blood pressure response, no arrhythmias, good exercise tolerance, no stress induced wall motion abnormalities seen.

Is there something I should be checking for that the doctors missed? Am I ok?

I saw a psychologist and he stated it is anxiety, but every doctor says that like it is their catch-all phrase. He gave me xanax but even taking xanax freaks me out because it just numbs me and I really don’t want to go that route. Like I break a .5 tab in quarters and I get an instant drunk feeling in about 15 minutes. The doc said I’m the only known person who won’t let xanax work. Like I fight it.
Background..

I’m in excellent shape I run 30-60 minutes a day. Even after that, I try to hike before work. I take vitamins and I juice daily. I don’t eat any crap. From the holter my avg heart rate is 66bpm and 45 asleep. (They say it is fine because of my conditioning). I get plenty of sleep. My bp is usually 110/80 when I wake up to 135/80 throughout the day.

Any ideas? From my lifestyle it makes no sense to me why this would be happening..
It is a constant battle for me everyday, I’m familiar with agoraphobia from what the psychologist mentioned. I literally force myself to do things even though I’m symptomatic and freaking out, I purposefully exercise hard even though I’m freaked about my heart, I drive exactly the same way home and get gas at the gas station I had the “heart attack” episode at. I started to get a feeling like “I gotta get outta here and get home”.. so purposefully walk in the middle of the woods off the path with my trail gps.

I have no worries whatsoever, none of this makes sense to me. Help.

A. Medical tests were negative but it still may be a medical problem. I would encourage you to get a second opinion. You should fully and thoroughly explore a medical cause.

It’s also possible the problem is psychological. According to psychoanalysts Sigmund Freud and Carl Jung, it is possible not to be consciously aware of a psychological problem and for it to be exhibited in odd behaviors such as panic attacks. Therefore it’s possible to be completely unaware of the source of your anxiety. A mental health professional who believes in this perspective would want to explore your dreams as a way to uncover the source of your anxiety. They may also utilize hypnosis to explore your unconscious mind.

I want to commend you on the fact that you returned to the physical location of the attack even though it frightened you. You also said you purposefully do things that frighten you as a way to confront your fears. This is very difficult to do and it’s encouraging that you are willing to stand up to your fears.

As I mentioned before you should fully explore the potential medical cause of this problem. You may also want to consult a psychologist or another mental health professional willing to explore the root cause or source of your anxiety. There could be a number of causes for your anxiety-like attacks. Something is wrong and you cannot stop looking for the cause. I hope you’re able to find relief. Good luck.

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Last reviewed: By John M. Grohol, Psy.D. on 14 Aug 2009

APA Reference
Randle, K. (2009). Anxiety or Something Else?. Psych Central. Retrieved on November 23, 2014, from http://psychcentral.com/ask-the-therapist/2009/08/14/anxiety-or-something-else/