Autonomic Nervous System Disorders: Anxiety and Panic Explained

Q: Autonomic Nervous System Disorders: Anxiety and Panic Explained

Hello： It appears that the level of anxiety is quite high, and the presence of physical symptoms indeed indicates a problem related to autonomic nervous system dysregulation. <br>Therefore, it is advisable to continue seeking treatment from a mental health (psychiatry) clinic, as

Autonomic nervous system dysfunction, anxiety, and panic?

Hello Dr.
Chiu, I am 22 years old and have Tourette syndrome, but I have almost no symptoms now.
I used to take antidepressants (Venlafaxine) and medication for Tourette syndrome for nearly two years, but I have been off medication for almost a year and have not experienced any discomfort.
Recently, I started smoking (a pack a day) and drinking alcohol, almost three times a week, with completely irregular sleep patterns.
Then, I suddenly felt unwell one day, experiencing dizziness, a spinning sensation, numbness in my hands and feet, and even felt faint, so I went to the emergency room.
The blood tests showed no issues.
Later, I consulted an ENT specialist who diagnosed me with inner ear imbalance.
After taking the medication prescribed by the doctor, my dizziness gradually improved.
After some rest, I returned to work and resumed smoking and drinking, leading to a recurrence of dizziness (with a strong heartbeat and body swaying), irregular heartbeat (alternating fast and slow), palpitations, anxiety, inexplicable crying, unstable blood pressure (which sometimes spikes even though I do not have hypertension), occasional difficulty breathing, shoulder and neck pain, extreme dryness in my mouth, fatigue, weakness, numbness in my hands and feet, and a vibrating sensation in my muscles.
The symptoms fluctuate, causing me significant discomfort.
Sometimes the dizziness feels like a floating sensation, which feels very unreal.
I have also been struggling with insomnia, so I worry that my body might break down due to lack of rest.
I visited a clinic, and the doctor prescribed Xanax.
I took it for about a week, but my condition remains unstable.
I had a brain MRI and blood tests (liver function, cholesterol, fasting blood sugar, and others) two days ago, and the doctor said everything was normal, suggesting it might be an endocrine imbalance.
These symptoms have persisted for almost a month now, and I feel very uncomfortable, often feeling off, dizzy, anxious, and panicked.
Sometimes I feel weak and dizzy, just wanting to lie in bed and not move.
Could this be autonomic nervous system dysfunction? I am slowly adjusting my routine, but the symptoms are still unstable.
I have undergone all the necessary tests at the hospital, and they found no issues.
Please help me, Dr.
Chiu.

Mr. Wang, 20~29 year old female. Ask Date: 2016/09/09

Dr. Qiu Junda reply Psychiatry

Hello: It appears that the level of anxiety is quite high, and the presence of physical symptoms indeed indicates a problem related to autonomic nervous system dysregulation.
Therefore, it is advisable to continue seeking treatment from a mental health (psychiatry) clinic, as medication may sometimes need adjustment.
Additionally, psychological therapy may be necessary, so it is important to have patience and confidence, believing that the condition will improve soon.

Reply Date: 2016/09/09

More Info

Hello! Thank you for sharing your experiences and concerns regarding your health. Based on the symptoms you've described, it seems you may be experiencing a combination of autonomic nervous system (ANS) dysregulation, anxiety, and possibly panic symptoms. Let's break this down further.

The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, blood pressure, respiration, and digestion. It consists of two main branches: the sympathetic nervous system (which prepares the body for 'fight or flight' responses) and the parasympathetic nervous system (which promotes 'rest and digest' activities). When there is a dysregulation in this system, it can lead to a variety of symptoms, including those you mentioned: dizziness, heart palpitations, anxiety, and feelings of unreality.

Your history of anxiety and the recent lifestyle changes, including smoking, alcohol consumption, and irregular sleep patterns, can significantly impact your autonomic nervous system. Substance use, particularly alcohol and nicotine, can exacerbate anxiety symptoms and lead to fluctuations in heart rate and blood pressure. Additionally, poor sleep can further contribute to feelings of anxiety and physical symptoms like dizziness and fatigue.

The symptoms you describe—such as dizziness, heart palpitations, anxiety, and feelings of unreality—are often associated with panic attacks or anxiety disorders. Panic attacks can occur suddenly and may include physical symptoms like shortness of breath, chest pain, and a feeling of impending doom. It's important to note that while these symptoms can be distressing, they are often not indicative of a serious medical condition, especially since your recent medical evaluations have returned normal results.

Given that you have already undergone various tests, including MRI and blood tests, and have been cleared of significant medical issues, it may be beneficial to focus on managing your anxiety and lifestyle factors. Here are some recommendations:
1. Lifestyle Modifications: Gradually reduce alcohol and nicotine intake, as both can contribute to anxiety and autonomic dysregulation. Establish a regular sleep schedule to improve your overall sleep quality.

2. Stress Management Techniques: Consider incorporating relaxation techniques such as deep breathing exercises, mindfulness meditation, or yoga into your daily routine. These practices can help calm the nervous system and reduce anxiety.

3. Physical Activity: Regular exercise can be a powerful tool for managing anxiety. Aim for at least 30 minutes of moderate exercise most days of the week, as it can help regulate mood and improve overall well-being.

4. Professional Support: Since you have a history of anxiety and are currently experiencing distressing symptoms, it may be beneficial to consult with a mental health professional. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders and can help you develop coping strategies.

5. Medication Review: If you find that your symptoms persist despite lifestyle changes, discussing your medication options with a psychiatrist may be helpful. Medications such as SSRIs (selective serotonin reuptake inhibitors) or other anxiolytics may be appropriate, depending on your specific symptoms and history.

6. Monitoring Symptoms: Keep a journal of your symptoms, noting when they occur and any potential triggers. This can help you and your healthcare provider identify patterns and develop a targeted treatment plan.

In conclusion, while your symptoms may be related to autonomic nervous system dysregulation and anxiety, they are manageable with the right approach. It's essential to prioritize your mental health and seek support as needed. Remember, recovery is a process, and with time and the right strategies, you can regain a sense of balance and well-being. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention. Take care!

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