Autonomic Nervous System Disorders: Symptoms and Treatment Options

Q: Autonomic Nervous System Disorders: Symptoms and Treatment Options

Hello, Xiao Chen： It is recommended to adjust your bedtime to around 11 PM, and definitely no later than midnight. <br>This typically improves sleep quality and makes it easier to regulate autonomic nervous system symptoms. <br>For individuals who have previously experienced auto

Autonomic nervous system dysfunction

Hello Doctor, I am currently a freshman in college.
About two years ago during the summer vacation, I experienced sudden palpitations, increased anxiety, and gastrointestinal discomfort.
I first visited a gastroenterologist and a family medicine clinic, but the doctors found no physical issues.
I then consulted a psychiatrist, who diagnosed me with autonomic nervous system dysregulation.
I was prescribed medication (Clonazepam) for about two years, which improved my symptoms.
Although I still experienced occasional episodes, they were not as severe as before, so I stopped returning for follow-ups and medication around mid-last year.
However, this summer, I noticed that my symptoms have worsened again, with frequent sudden palpitations, anxiety, and gastrointestinal discomfort.
Recently, I have also experienced occasional acid reflux, despite eating regular meals.
I often have a reduced appetite and feel bloated after eating a small amount, which can lead to acid reflux, abdominal bloating, and nausea.
These symptoms tend to increase my anxiety, triggering the aforementioned autonomic nervous system dysregulation symptoms (palpitations, dizziness, and overall tension).
I have been keeping irregular hours during the summer, often staying up late, but I am trying to adjust my schedule now, aiming for about 6-8 hours of sleep, going to bed around 2-3 AM and waking up before noon.
However, I occasionally feel mild dizziness and a sense of pressure in my head upon waking.
I am unsure if these recent gastrointestinal and psychological symptoms are due to my irregular summer schedule, as I rarely felt unwell during the school term.
I would like to ask if you recommend returning to the psychiatrist or visiting a gastroenterologist for an evaluation of gastroesophageal reflux disease.
Thank you, Doctor!

Xiao Chen, 10~19 year old female. Ask Date: 2021/07/18

Dr. Liang Sunyuan reply Psychiatry

Hello, Xiao Chen: It is recommended to adjust your bedtime to around 11 PM, and definitely no later than midnight.
This typically improves sleep quality and makes it easier to regulate autonomic nervous system symptoms.
For individuals who have previously experienced autonomic dysfunction, maintaining a regular routine is an important protective factor.
If there is no improvement after a period of adjusting your schedule, and considering that you have previously benefited from medication, it is advisable to return for a follow-up evaluation and treatment.

Reply Date: 2021/07/18

More Info

Understanding autonomic nervous system (ANS) disorders is crucial, especially for individuals experiencing symptoms like palpitations, anxiety, and gastrointestinal discomfort. Your situation, as described, reflects a common interplay between psychological stress and physical symptoms, often seen in conditions like anxiety disorders and autonomic dysregulation.

The autonomic nervous system is divided into 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. When these systems are out of balance, it can lead to a variety of symptoms, including those you've mentioned: heart palpitations, gastrointestinal issues, and anxiety.

Your history of experiencing sudden heart palpitations, gastrointestinal discomfort, and anxiety suggests that you may be dealing with a form of autonomic nervous system dysregulation. This can often be exacerbated by lifestyle factors, such as irregular sleep patterns, which you noted have become more pronounced during your summer break. Sleep is essential for regulating the body's stress response and maintaining overall health. Disrupted sleep can lead to increased anxiety and exacerbate gastrointestinal issues, such as acid reflux and bloating, which you are currently experiencing.

Given that you have previously benefited from medication (like Clonazepam) and have seen improvements, it might be wise to consider returning to your psychiatrist or a healthcare provider specializing in mental health. They can reassess your symptoms and determine if a medication adjustment or a different therapeutic approach is necessary. Cognitive-behavioral therapy (CBT) is also an effective treatment for anxiety and can help you develop coping strategies for managing your symptoms.

Additionally, it would be prudent to consult a gastroenterologist regarding your recent gastrointestinal symptoms, particularly the acid reflux and decreased appetite. Gastroesophageal reflux disease (GERD) can be influenced by stress and anxiety, and a specialist can provide guidance on dietary modifications, lifestyle changes, and possibly medications to alleviate these symptoms.

In the meantime, consider implementing some lifestyle changes that can help manage your symptoms. Regular exercise, mindfulness practices such as yoga or meditation, and maintaining a consistent sleep schedule can significantly improve your overall well-being. Reducing caffeine and alcohol intake may also help decrease anxiety and gastrointestinal discomfort.

In summary, your symptoms are likely interconnected, and addressing both the psychological and physical aspects is essential for your recovery. A collaborative approach involving both mental health and gastrointestinal specialists will provide a comprehensive strategy to manage your symptoms effectively. Don't hesitate to seek help; your health and well-being are paramount.

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