Managing Anxiety and Autonomic Nervous System Disorders: Treatment Insights

Q: Managing Anxiety and Autonomic Nervous System Disorders: Treatment Insights

Hello, Hao： It seems that your symptoms have improved significantly after taking Liyou and Anlifufu, which is a good thing. <br>The lack of significant improvement with Lefutai indicates that this medication may not be suitable for you, which is quite common in clinical practice.

Anxiety, autonomic nervous system dysregulation?

Hello, I was diagnosed with anxiety and autonomic nervous system disorder two months ago.
I have been taking Lexapro at Tzu Chi Hospital in Taipei for two months without significant improvement.
I have now switched to Mackay Memorial Hospital's psychiatric department and am taking Liyou and Anliflu, which have improved my condition considerably.
However, I still experience panic feelings in the morning and afternoon, although they are not as severe as before and do not reach the level of panic attacks where I feel faint.

I would like to know if the main medications I took at Tzu Chi Hospital were ineffective.
Although the panic feelings are not intense, they do cause disruptions in my daily life, making it difficult for me to go out and affecting my work.
The doctor at Mackay mentioned that I need to take medication for six months.
My anxiety has diminished significantly, leaving only mild panic feelings.

Is there a connection between the panic feelings and the autonomic nervous system disorder? Are any of the medications I am currently taking targeting the treatment of the autonomic nervous system? Will the autonomic nervous system disorder and anxiety-related panic eventually resolve? I would prefer not to be on medication for life.
Thank you!

Hao, 30~39 year old female. Ask Date: 2021/08/10

Dr. Lin Mianzhang reply Psychiatry

Hello, Hao: It seems that your symptoms have improved significantly after taking Liyou and Anlifufu, which is a good thing.
The lack of significant improvement with Lefutai indicates that this medication may not be suitable for you, which is quite common in clinical practice.
Since everyone has different constitutions, it often takes trying a medication to determine its suitability.
The medications you are currently taking are commonly used to treat anxiety and depression, and they all have the function of regulating the autonomic nervous system.
Generally speaking, anxiety disorders and autonomic nervous system dysregulation are related to both innate constitution and environmental factors, as well as how one copes with stress.
Medication can alleviate symptoms and reduce sensitivity to stress related to innate constitution; however, if there is no change in the environment or in your coping strategies when facing stress, symptoms may recur.
In that case, continuous medication may be necessary to prevent relapse.
Therefore, if you want to avoid taking medication for life, I recommend asking your doctor for a referral to psychotherapy, where you can learn to understand yourself and adjust your coping strategies for stress.
Additionally, maintaining a regular daily routine, having a balanced diet, and engaging in regular exercise can all help improve your constitution and reduce dependence on medication.
Wishing you a speedy recovery!

Reply Date: 2021/08/10

More Info

Managing anxiety and autonomic nervous system disorders can be a complex process, as these conditions often intertwine and can significantly impact daily life. Your experience with anxiety and autonomic nervous system dysfunction, as well as the medications you have been prescribed, is a common scenario in the field of mental health.

Firstly, it’s important to understand that autonomic nervous system disorders can manifest as a variety of symptoms, including anxiety, panic attacks, and physical sensations like heart palpitations or tremors. The autonomic nervous system (ANS) regulates involuntary bodily functions, such as heart rate, digestion, and respiratory rate. When it becomes dysregulated, it can lead to symptoms that mimic or exacerbate anxiety disorders.

You mentioned that you initially took a medication called "樂復得" (likely referring to a type of antidepressant or anxiolytic) without significant improvement, and then switched to "離憂" and "安立復" (which are likely other classes of antidepressants or anxiolytics). It’s not uncommon for patients to experience varying degrees of effectiveness with different medications. The response to psychiatric medications can be highly individual, and it often takes time to find the right medication or combination of medications that work for you. The fact that you have seen some improvement with the new medications is a positive sign, even if the panic symptoms persist.

Regarding your question about whether the time spent on the initial medication counts, it’s essential to recognize that each medication typically requires a trial period of at least four to six weeks to assess its effectiveness. If you did not experience any improvement during that time, it is reasonable to conclude that it may not have been the right fit for you.
The lingering feelings of panic you experience, especially in the mornings and afternoons, can indeed be related to autonomic nervous system dysregulation. The ANS has two main components: the sympathetic nervous system (which prepares the body for 'fight or flight' responses) and the parasympathetic nervous system (which promotes 'rest and digest' functions). An imbalance between these systems can lead to heightened anxiety and panic symptoms.

The medications you are currently taking may help regulate your ANS and alleviate anxiety symptoms. For instance, many antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like sertraline, can help stabilize mood and reduce anxiety over time. However, it’s crucial to have ongoing discussions with your healthcare provider about your symptoms and any side effects you may experience. They can help adjust your treatment plan as needed.

As for the concern about whether you will need to take medication for life, it’s important to note that many individuals with anxiety disorders can achieve significant improvement and even remission with the right treatment, which may include medication, therapy, lifestyle changes, and coping strategies. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety and panic disorders, as it helps individuals develop skills to manage their anxiety and change negative thought patterns.

In conclusion, while your current medications may not completely eliminate your symptoms, they are likely contributing to your overall improvement. It’s essential to continue working closely with your healthcare provider to monitor your progress and make any necessary adjustments. Additionally, consider incorporating therapeutic approaches and lifestyle modifications to support your mental health. Remember, recovery is a journey, and with the right support and strategies, it is possible to manage anxiety and autonomic nervous system disorders effectively.

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