Panic Disorder and Autonomic Dysregulation: A Patient's Journey

Q: Panic Disorder and Autonomic Dysregulation: A Patient's Journey

Hello, A-Wan： Panic disorder and hypochondriasis often accompany physical symptoms related to the autonomic nervous system, in addition to anxiety and tension. <br>These conditions can be improved through psychiatric treatment, which may include medication or psychological/behavi

Panic disorder, hypochondriasis, autonomic nervous system dysregulation?

Hello, Doctor Dai.
Three months ago, I often stayed up late and played video games, and during that time, I was unemployed, which affected my health.
One night, I thought about doing push-ups, and after finishing, I couldn't catch my breath.
I felt like I couldn't get air, and my heart was racing as if I was about to die.
I immediately picked up the phone to call an ambulance, but after a moment, my body returned to normal.
Later, my mood became very strange, and I couldn't control my racing thoughts.
I wondered if I had heart disease or was about to have a stroke.
I frequently searched online for information about similar experiences and concluded that I might have panic disorder.
I then visited a mental health clinic and was diagnosed with panic disorder, hypochondria, and autonomic nervous system dysregulation.
I've been on medication for almost three months, and my mood has stabilized significantly.
Half a month ago, the doctor said I could stop the medication.
However, I stopped taking it, and in the past few days, for some reason, I've been feeling easily tense, my palms get cold, and occasionally when I change positions or suddenly feel anxious, my head feels momentarily dizzy, but it doesn't seem like a full dizziness; it recovers instantly.
Could you please tell me what this issue might be? Is it related to autonomic nervous system dysregulation? I'm very afraid that I might have some brain disease.

A Wan, 20~29 year old female. Ask Date: 2017/03/11

Dr. Dai Wanxiang reply Psychiatry

Hello, A-Wan: Panic disorder and hypochondriasis often accompany physical symptoms related to the autonomic nervous system, in addition to anxiety and tension.
These conditions can be improved through psychiatric treatment, which may include medication or psychological/behavioral therapy.
It seems that your symptoms have alleviated significantly after treatment.
However, it's important to be cautious about potential withdrawal symptoms or relapse after suddenly discontinuing medication for these mental health disorders.
I recommend that you return to the outpatient clinic to consult with your physician for further evaluation and to discuss a follow-up treatment plan.
Wishing you well.

Reply Date: 2017/03/11

More Info

Panic disorder and autonomic dysregulation are interconnected issues that can significantly impact a patient's quality of life. Your experience, which began with physical symptoms like shortness of breath and rapid heartbeat, is a common presentation of panic attacks. These episodes can be frightening and often lead to a cycle of anxiety and fear about experiencing another attack, which can exacerbate the symptoms.

Panic disorder is characterized by recurrent and unexpected panic attacks, which are sudden periods of intense fear or discomfort that peak within minutes. Symptoms can include palpitations, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, dizziness, chills, or hot flashes, and a fear of losing control or dying. The physical sensations can be so intense that individuals may believe they are having a heart attack or a stroke, leading to further anxiety and avoidance behaviors.

Autonomic dysregulation refers to an imbalance in the autonomic nervous system (ANS), which controls involuntary bodily functions such as heart rate, blood pressure, and digestion. In your case, the symptoms of cold hands, sudden dizziness, and feelings of faintness can be attributed to this dysregulation. The ANS has two main branches: the sympathetic nervous system (responsible for the "fight or flight" response) and the parasympathetic nervous system (which promotes "rest and digest" functions). When someone experiences chronic stress or anxiety, the sympathetic system can become overactive, leading to symptoms like those you described.

Your journey through diagnosis and treatment is an important part of managing these conditions. It’s encouraging to hear that your emotional state has stabilized with medication over the past three months. However, it’s not uncommon for individuals to experience fluctuations in their symptoms, especially after stopping medication. The body can take time to adjust to changes in treatment, and residual symptoms may persist as you navigate through recovery.

The feelings of tension, cold hands, and transient dizziness you are experiencing could indeed be related to autonomic dysregulation. These symptoms can occur when the body is in a heightened state of arousal due to anxiety or stress. It’s essential to recognize that while these sensations can be uncomfortable and alarming, they are often benign and related to the body's response to anxiety rather than indicative of a serious neurological condition.

To manage these symptoms, consider the following strategies:
1. Cognitive Behavioral Therapy (CBT): This form of therapy is effective for panic disorder and can help you understand and change the thought patterns that contribute to your anxiety.

2. Mindfulness and Relaxation Techniques: Practices such as deep breathing, meditation, and progressive muscle relaxation can help calm the nervous system and reduce anxiety symptoms.

3. Regular Physical Activity: Engaging in regular exercise can help regulate the autonomic nervous system and improve overall mood and anxiety levels.

4. Healthy Sleep Hygiene: Since you mentioned issues with staying up late, establishing a regular sleep schedule can significantly impact your mental health and help reduce anxiety.

5. Consultation with a Specialist: If symptoms persist or worsen, it may be beneficial to consult with a mental health professional or a neurologist to rule out any underlying conditions and to discuss potential adjustments to your treatment plan.

6. Medication Management: If you find that your symptoms are returning after stopping medication, it may be worth discussing with your healthcare provider the possibility of resuming medication or exploring other options.

In conclusion, your symptoms are likely related to the interplay between panic disorder and autonomic dysregulation. With appropriate treatment and self-care strategies, many individuals find relief from their symptoms and can lead fulfilling lives. Always keep an open line of communication with your healthcare providers to ensure that you receive the support and guidance you need on your journey to recovery.

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