My Symptoms: Seeking Answers for Anxiety and Health Issues

Q: My Symptoms: Seeking Answers for Anxiety and Health Issues

Hello Ms. <br>Lin： From your description, it seems clear that you are experiencing significant discomfort. <br>You appear to have a good understanding of your body and some medical knowledge. <br>Your main symptoms include sudden cold sweats, difficulty breathing, shortness of br

What illness do I have?

Since noon on July 28, I experienced gastrointestinal discomfort and vomiting.
By evening, I still felt unwell, so I skipped dinner and took a shower.
After showering, I didn't have time to dry off before I started sweating profusely, had difficulty breathing, and almost fainted.
I quickly threw myself onto the bed and was unable to get up for medical attention, remaining breathless and incapacitated for over an hour before recovering somewhat.
Since then, my condition has fluctuated; I have a history of anemia with hemoglobin levels between 7.8 and 8.8.
On the third day, I began to experience facial flushing, palpitations, and severe shortness of breath.
I consulted gynecology, cardiology, and pulmonology, all of which returned normal results, but I continued to feel unwell and lacked appetite.
After more than a week of feeling weak, I was hospitalized at Chang Gung Memorial Hospital, where I received a transfusion of 500cc of fresh blood and iron supplements, which improved my condition somewhat.
After discharge, I went to the obstetrics and gynecology department for blood tests, and the doctor indicated that I am not yet in menopause.
However, my symptoms have not improved, and I am unable to manage daily activities.

I would like to ask the doctor about the relationship between menopause, anemia, and autonomic nervous system dysregulation, as I am experiencing palpitations, shortness of breath, anxiety, dizziness, and a racing heart.
What could be wrong with me? Currently, I have been taking iron supplements (Hausmann Ferrum) and Xanax 0.5mg daily for a month.
My menstrual cycle is normal.
Although I feel somewhat better with Xanax, I am concerned about the long-term effects of this sedative, and no underlying cause has been identified.
Which specialty should I consult?

Lin, 40~49 year old female. Ask Date: 2002/09/15

Dr. Chen Wenke reply Psychiatry

Hello Ms.
Lin: From your description, it seems clear that you are experiencing significant discomfort.
You appear to have a good understanding of your body and some medical knowledge.
Your main symptoms include sudden cold sweats, difficulty breathing, shortness of breath, palpitations, facial flushing, anxiety, dizziness, and even gastrointestinal discomfort.
Given the variety of symptoms, it is likely that you are in a state of noticeable anxiety.
Additionally, considering your age, which is during menopause, and your issue with anemia, these factors may exacerbate your discomfort.

Your visits to the cardiology and pulmonology departments did not reveal any significant issues, allowing us to preliminarily rule out cardiovascular diseases or respiratory problems as causes of your palpitations and shortness of breath.
Autonomic nervous system dysregulation is quite common in modern life, influenced by stress from work, family, in-law relationships, and interpersonal interactions, all of which can easily lead to anxiety.
Some individuals experience these symptoms less frequently, while others may have them more often.

For you, it seems that your body's resilience is gradually diminishing due to the decline in female hormones, which affects your ability to regulate these symptoms.
It appears that your symptoms improve with the use of Xanax, further indicating that anxiety is contributing to the instability of your physiological responses.
You need not worry excessively about the potential adverse effects of taking a sedative; it may be beneficial for you to consult a psychiatrist for further discussion.
This should help you feel more at ease.
Wishing you a speedy recovery.

Reply Date: 2002/09/15

More Info

It sounds like you are experiencing a complex interplay of physical and psychological symptoms that can be quite distressing. Your symptoms, including gastrointestinal discomfort, cold sweats, difficulty breathing, palpitations, and feelings of anxiety, can be associated with various medical and psychological conditions. Given your history of anemia and the recent episodes of severe discomfort, it is essential to approach this situation holistically.

Firstly, the symptoms you describe could be indicative of several underlying issues. Anemia, particularly when severe, can lead to fatigue, weakness, and even exacerbate feelings of anxiety. The low hemoglobin levels you mentioned (7.8-8.8 g/dL) are concerning and can significantly impact your overall health. Anemia can cause palpitations and shortness of breath, especially during physical exertion or stress. It is crucial to manage your anemia effectively, which may involve dietary changes, iron supplementation, and regular monitoring of your hemoglobin levels.

The episodes of cold sweats, difficulty breathing, and feelings of impending doom you experienced could also be related to anxiety or panic attacks. Anxiety can manifest physically, leading to symptoms such as rapid heartbeat, shortness of breath, and gastrointestinal disturbances. The fact that you mentioned feeling better with Xanax (a benzodiazepine) suggests that your anxiety may be a significant component of your current health issues. However, long-term use of benzodiazepines can lead to dependence and may not address the underlying causes of your anxiety.

Given your symptoms and the complexity of your situation, it would be advisable to consult with a healthcare provider who specializes in both physical and mental health. A psychiatrist or a primary care physician with experience in managing anxiety disorders and chronic health conditions would be beneficial. They can help assess whether your symptoms are primarily due to anxiety, a physical condition, or a combination of both.

In addition to medication, consider exploring therapeutic options such as cognitive-behavioral therapy (CBT), which has been shown to be effective for anxiety disorders. CBT can help you develop coping strategies, challenge negative thought patterns, and reduce the physical symptoms of anxiety.

It's also essential to monitor your lifestyle factors, including diet, exercise, and sleep. A balanced diet rich in iron and other nutrients can help improve your anemia and overall well-being. Regular physical activity, even light exercise, can also help alleviate anxiety symptoms and improve your mood.

Lastly, keep an open line of communication with your healthcare providers. If you feel that your current treatment plan is not addressing your symptoms effectively, do not hesitate to discuss this with them. It may take time to find the right combination of treatments that work for you, but with persistence and support, you can find relief from your symptoms.

In summary, your symptoms may stem from a combination of anemia and anxiety. It is crucial to address both aspects with the help of healthcare professionals. By managing your physical health and seeking appropriate psychological support, you can work towards improving your overall well-being.

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