Overcoming Anxiety and Panic Disorder: A Patient's Journey to Recovery

Anxiety and panic disorder suddenly exhibit opposite symptoms?

Hello Dr.
Wu,
I am a panic disorder patient diagnosed over ten years ago.
After understanding the causes of my condition, I have managed to get through this difficult period with minimal panic attacks, which only occasionally required emergency injections (though I’m unsure what the injection was).
I relied on medications like Clonazepam (later switched to Lyrica) and Rifampicin, and I have been relatively stable.
However, on April 16, 2020, I experienced an unexplained bacterial or viral attack, resulting in mild daily low-grade fevers.
I also took antiviral medication for influenza but saw no improvement.
I then consulted a different ENT specialist who performed a rapid flu test, which came back negative for both Influenza A and B.
The doctor prescribed Erythromycin, and I underwent three outpatient treatments, taking the medication for a total of nine consecutive days.

Now that I have recovered, I have been informed by my gastroenterologist that excessive use of Erythromycin has led to acute gastritis.
An endoscopy was arranged, revealing mild esophagitis and gastritis, with slightly elevated gastric acid levels.
The duodenum and small intestine appeared clean, with no abnormalities found.
Basic blood and urine tests showed everything normal except for slightly abnormal lipid levels.

As my various health issues gradually improve, my anxiety has intensified (even more severe than my panic).
I am finding it extremely difficult to fall asleep, often lying down at midnight and not sleeping until dawn.
My wife has been giving me her sleeping pills, but the more I take, the more awake I feel.
I have tried medications like Lunesta and Ambien (except for Lunesta 0.25 mg, I am hesitant to take the others).
I have an appointment in four days with the doctor who initially diagnosed me at Yadong Hospital, and I am feeling anxious every day.

I would like to ask for your preliminary assessment: Am I experiencing severe anxiety? How should I utilize the medications I have on hand, such as Lyrica, Rifampicin, and Ambien? I was prescribed Ambien 0.5 mg during the 51-day holiday, and I take it twice a day, half a pill (0.25 mg) each time.
Most importantly, my greatest source of anxiety is my inability to sleep; I feel like I am missing that crucial element (previously, Lyrica and Rifampicin helped me sleep).
I have gone two days without sleep, and despite working out to tire myself, I still find myself unable to sleep until 5:00 AM.

This situation has escalated to the point where I cannot arrive at work on time, causing misunderstandings with my family.
I have been searching online for related information daily.
My stomach issues are still recovering, and I am facing the unknown anxiety of not being able to sleep every day.
I have lost 10 kilograms in the past 30 days.

I sincerely ask for your guidance, Dr.
Wu, to help me navigate through this mental health crisis.
So far, I have been cautious about taking sleeping medications, which adds to my anxiety and distress.
I fear being alone and fear not being able to sleep.
Thank you for your understanding.
(I apologize for the lengthy message.)

Lin Xiansheng, 40~49 year old female. Ask Date: 2020/05/11

Dr. Wu Enliang reply Psychiatry

It is indeed a severe anxiety disorder.
It is recommended to schedule an earlier follow-up appointment to adjust medication or to incorporate psychotherapy or other relaxation training.
If necessary, inpatient treatment may even be required.
Wu Enliang

Reply Date: 2020/05/11

More Info

Overcoming anxiety and panic disorder can be a challenging journey, especially when compounded by physical health issues. Your experience highlights the complex interplay between mental and physical health, and it’s important to approach this situation with a comprehensive understanding of both aspects.

Firstly, it’s crucial to recognize that anxiety disorders, including panic disorder, are not uncommon and can significantly impact daily life. Symptoms such as difficulty sleeping, heightened anxiety, and physical manifestations like gastrointestinal issues are often intertwined. The stress of dealing with multiple health concerns can exacerbate feelings of anxiety, leading to a vicious cycle where anxiety about health leads to more physical symptoms, which in turn increases anxiety.

From your description, it seems you have been managing your panic disorder with medication, including Clonazepam (克憂果) and other anxiolytics. While these medications can be effective in the short term, they may also lead to dependency or tolerance, making it difficult to manage anxiety without them. It’s commendable that you are cautious about using sleep medications, as they can sometimes mask underlying issues rather than address them.

Given your recent health challenges, including the gastrointestinal issues and the anxiety that has arisen from them, it’s essential to adopt a multifaceted approach to your recovery. Here are some strategies that may help you navigate this difficult time:
1. Consult with Your Healthcare Provider: Since you have an upcoming appointment with your psychiatrist, it’s vital to discuss your current symptoms, medication regimen, and any concerns you have about your anxiety and sleep issues. They can provide a thorough assessment and may suggest adjustments to your medication or additional therapies.

2. Cognitive Behavioral Therapy (CBT): This form of therapy is highly effective for anxiety disorders. It focuses on identifying and changing negative thought patterns and behaviors that contribute to anxiety. A therapist can help you develop coping strategies and tools to manage anxiety more effectively.

3. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety levels. These techniques can be particularly useful when you feel anxious about sleep or other triggers.

4. Establish a Sleep Routine: Creating a calming bedtime routine can signal to your body that it’s time to wind down. This might include activities such as reading, gentle stretching, or listening to calming music. Avoiding screens and stimulating activities before bed can also improve sleep quality.

5. Physical Activity: Regular exercise can significantly reduce anxiety symptoms and improve sleep quality. Even light activities like walking can be beneficial. Aim for at least 30 minutes of moderate exercise most days of the week.

6. Nutrition and Hydration: Maintaining a balanced diet and staying hydrated can positively impact your mood and energy levels. Avoid excessive caffeine and sugar, which can exacerbate anxiety symptoms.

7. Support System: Lean on your family and friends for support. Open communication about your struggles can help them understand what you’re going through and provide the emotional support you need.

8. Limit Information Overload: While researching your symptoms online can be helpful, it can also lead to increased anxiety. Try to limit the time spent searching for information and focus on what you can control.

9. Gradual Exposure: If certain situations trigger your anxiety, consider gradual exposure to those situations in a controlled manner. This can help desensitize you to the triggers over time.

In summary, overcoming anxiety and panic disorder is a process that requires patience and a willingness to explore various treatment options. It’s essential to work closely with your healthcare provider to tailor a treatment plan that addresses both your mental and physical health needs. Remember, recovery is not linear, and it’s okay to seek help and support along the way. You are not alone in this journey, and with the right strategies and support, it is possible to regain a sense of control and well-being.

Similar Q&A

Overcoming Anxiety: A Journey Through Mental Health Challenges

During middle school, I was aware that nothing serious would happen, yet I was very afraid to go to school. At 19, I worked part-time at a convenience store, but I had to quit because I couldn't control myself when faced with the morning rush of customers; everything in fron...

Dr. Qiu Junda reply Psychiatry
Hello. Since you have been seeing a psychiatrist for many years, you can ask your doctor during your appointment about what the specific issues are. The doctor should be able to clarify your concerns. Based on the text, it seems to fall under the category of anxiety symptoms. The...

Overcoming Panic Disorder: Helping a Loved One Conquer Fear of Leaving Home

Hello, doctor. My mother has heart disease and has undergone two surgeries. After the second surgery, she was diagnosed with panic disorder and anxiety disorder. For the past few years, she managed to control her symptoms with medication and even stopped taking it, but in the las...

Dr. Wu Enliang reply Psychiatry
It's good for netizens to encourage her, but it's important to remember that mental health issues still require appropriate treatment. If she feels very anxious and is afraid to go out for medical care, she might consider taking some anti-anxiety medication before headi...

Understanding Anxiety Disorders: Overcoming Social Phobia and Panic Attacks

Hello, doctor. I believe I have social anxiety disorder, phobias, panic disorder, and obsessive-compulsive disorder. The following issues are my symptoms, which have led to me having no friends and being unemployed for over a year. I would appreciate your help in addressing these...

Dr. Liang Sunyuan reply Psychiatry
Hello: Based on your description, you are experiencing a lot of anxiety and worry, which is indeed affecting your daily life. Medication, psychotherapy, and lifestyle changes can all help alleviate these symptoms. It is recommended to incorporate more activities that you enjoy or...

Can Panic Disorder Improve Through Personal Courage and Change?

Hello, Dr. Huang. After learning about the term "panic disorder," I realized that I am indeed a patient with this condition. Throughout my life, I often experience symptoms such as palpitations, nervousness, anxiety, and high levels of stress in various situations. I ha...

Dr. Huang Weiqin reply Psychiatry
Dear Inquirer, Panic disorder is a condition related to dysregulation of the autonomic nervous system. With appropriate medication and relaxation training, symptoms can often improve or resolve. However, panic disorder typically does not subside simply by deciding to be brave; r...