Managing Anxiety and Autonomic Nervous System Disorders: A Personal Journey

Q: Managing Anxiety and Autonomic Nervous System Disorders: A Personal Journey

Hello, Xiao Lan： The medications for anxiety require patience. <br>If the current treatment is effective, it is advisable to maintain stability for a period before discussing the possibility of gradually tapering off the medication with your physician. <br>Getting enough sleep, e

Anxiety and autonomic nervous system dysregulation?

Hello, doctor.
I previously experienced anxiety during the summer vacation, but it improved later.
However, it relapsed during this winter vacation, and I feel very frustrated.
The reason for the relapse was due to gastritis, which caused excessive worry and led to the recurrence of my anxiety.
I find it difficult to control, and it has now developed into chronic gastritis.
Currently, I am taking traditional Chinese medicine to manage the chronic gastritis, but often stress leads to excessive gastric acid secretion, resulting in fluctuating symptoms.
The Chinese medicine practitioner mentioned that I do not have any particularly serious illnesses, but I am just too tense.
I understand this, but I cannot control my thoughts.
I am also seeing a psychiatrist, who prescribed me Alpraline (Alprazolam) as an anti-anxiety medication, which I take half a 0.25 mg tablet when needed.
I have noticed that I tend to feel more anxious from morning until noon.
Although I want to avoid medication, I find it difficult and fear that this medication may be addictive and that I won't be able to stop taking it.
While this medication does alleviate my symptoms, such as anxiety, gastrointestinal discomfort, and palpitations, I am afraid that without it, I won't be able to control my thoughts, leading to a reliance on medication.
I also feel that I have hypochondriacal symptoms, often worrying that normal bodily reactions indicate serious illnesses.
For example, if I burp, I might think of gastroesophageal reflux, or if my stomach feels uncomfortable, I worry it might be something more serious.
I know these bodily reactions are normal, but I still find myself worrying uncontrollably, feeling as though my brain is not under my control.
I often try to forget these thoughts, but I cannot control them and end up feeling anxious or resorting to medication.
I have noticed that I feel most relaxed when I return home; both my body and mind are more at ease, and I worry less.
My brain tends to have fewer negative thoughts and emotions during that time.
Additionally, if negative thoughts arise while I am at home, I will immediately go out for a walk or exercise to change my mood.
I find that this helps reduce negative thoughts.
At school, aside from using medication for control, I can only take limited time to go outside, making it difficult to express my feelings, and my physical condition and anxiety often worsen.
I do not experience insomnia at night, but I usually wake up after 5 or 6 hours of sleep and then go back to sleep intermittently.
I feel this affects my daily energy levels, and I wonder if this is caused by autonomic nervous system dysregulation.
Thank you, doctor, for listening to all my concerns and for your responses.

Xiao Lan, 10~19 year old female. Ask Date: 2018/04/18

Dr. Liang Sunyuan reply Psychiatry

Hello, Xiao Lan: The medications for anxiety require patience.
If the current treatment is effective, it is advisable to maintain stability for a period before discussing the possibility of gradually tapering off the medication with your physician.
Getting enough sleep, exercising, and diverting your attention are indeed helpful for anxiety treatment, so it is recommended to maintain these habits.
A continuous six hours of sleep should provide a good restorative effect, and when you focus on certain tasks, your mental state usually improves.
Wishing you all the best.

Reply Date: 2018/04/18

More Info

Managing anxiety and autonomic nervous system disorders can be a complex and challenging journey, especially when it involves the interplay of physical symptoms and mental health. Your experience highlights several important aspects of anxiety disorders, the autonomic nervous system, and the impact of stress on both physical and mental well-being.

Firstly, it’s essential to understand that anxiety disorders can manifest in various ways, including physical symptoms such as gastrointestinal issues, heart palpitations, and sleep disturbances. Your experience with chronic gastritis and the subsequent anxiety is not uncommon. The mind-body connection is powerful; stress and anxiety can exacerbate physical conditions, leading to a cycle where physical discomfort increases anxiety, which in turn worsens physical symptoms. This cycle can be particularly frustrating, as you noted that your anxiety often flares up in response to physical sensations, leading to a heightened state of worry about your health.

The autonomic nervous system (ANS) plays a crucial role in regulating bodily functions, including digestion, heart rate, and respiratory rate. 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' functions). Anxiety can lead to an overactive sympathetic response, resulting in symptoms such as increased heart rate, sweating, and gastrointestinal distress. This dysregulation can contribute to feelings of panic and discomfort, as you have experienced.

Your concerns about the medication, Alpraline (alprazolam), are valid. While benzodiazepines can be effective for short-term relief of anxiety symptoms, they do carry a risk of dependence, especially with prolonged use. It’s crucial to have open discussions with your prescribing physician about your fears regarding dependency and to explore alternative treatment options. Cognitive-behavioral therapy (CBT) is one such option that has been shown to be effective in treating anxiety disorders. CBT focuses on identifying and challenging negative thought patterns and developing coping strategies to manage anxiety without relying solely on medication.

You mentioned that you feel most relaxed at home and that engaging in physical activities like walking or exercising helps alleviate negative thoughts. These are excellent coping strategies. Regular physical activity is known to reduce anxiety levels and improve overall mood by releasing endorphins, which are natural mood lifters. Additionally, practicing mindfulness or relaxation techniques, such as deep breathing exercises, meditation, or yoga, can help activate the parasympathetic nervous system, promoting a state of calm and reducing anxiety.

Sleep disturbances are another common issue associated with anxiety and autonomic nervous system dysregulation. While you may not experience full-blown insomnia, fragmented sleep can still impact your daily functioning and overall mental health. Establishing a consistent sleep routine, creating a calming bedtime environment, and limiting screen time before bed can help improve sleep quality. If sleep issues persist, discussing this with your healthcare provider may lead to further evaluation and tailored interventions.

Lastly, it’s commendable that you are seeking help and trying to understand your condition better. Mental health is just as important as physical health, and addressing both aspects is crucial for overall well-being. If you feel that your symptoms are significantly impacting your daily life, it may be beneficial to seek a comprehensive evaluation from a mental health professional. They can provide a more in-depth assessment and help develop a personalized treatment plan that may include therapy, medication, lifestyle changes, and stress management techniques.

In conclusion, managing anxiety and autonomic nervous system disorders is a multifaceted process that requires patience, self-compassion, and support. By actively engaging in your treatment and exploring various coping strategies, you can work towards achieving a better balance in your mental and physical health. Remember, you are not alone in this journey, and seeking help is a strong and positive step forward.

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