Seeking Help: Managing Anxiety and Physical Symptoms in Daily Life

Hello, Director Chen?

Dear Director Chen,
Thank you for your prompt response to my email.
I have consulted various specialties, including neurology at Renai Hospital, where I was diagnosed with myositis, and rehabilitation medicine at the Postal Hospital for muscle inflammation.
I also had a urine test in the nephrology department, which showed no abnormalities.
Additionally, I visited the endocrinology department at National Taiwan University Hospital for blood tests, but I did not follow up on the results.
I have high expectations for myself and always hope to be very successful and well-rounded.
During my studies, I was relatively healthy, but after serving in the military, I began experiencing dizziness while walking, especially after being assigned to a unit (during school service).
As I approached my discharge, the symptoms became more pronounced; I would panic upon seeing a group of people, feel dizzy, and fear fainting, needing to lean against a wall to walk.
However, these symptoms would subside after a while, indicating that they were not constant, but after an episode, I would feel extremely fatigued.
After graduation, I worked at a futures company, which was very stressful.
There were times when I felt short of breath while monitoring the market and had to step away to take a break.
I often found it difficult to relax.
On one occasion, while I was the speaker at a presentation, I suddenly felt breathless midway through.
I had to make an excuse to step out for something, and I hastily concluded the presentation.
It felt like I was suffocating, but I felt better on the way home, only to feel completely exhausted.
I later transitioned to a job at a bank, which is my current position.
The pace is somewhat slower, and I experience less dizziness than before, but I still occasionally feel very uncomfortable, with symptoms such as shoulder and back pain, restlessness, nausea, severe eye strain, a sense of helplessness, and extreme fatigue.
I feel as if my body is swaying, and I often feel sad, frustrated, and on the verge of tears.
However, these symptoms are not constant; they come and go, which is very distressing for me.
I am unsure if there are ways to improve my condition.
Could you please advise me, Director Chen?

Mr. Yang, 20~29 year old female. Ask Date: 2004/06/18

Dr. Chen Wenke reply Psychiatry

Hello Mr.
Yang, based on your clearer self-description, it can be preliminarily assessed that you may be experiencing anxiety disorders, commonly referred to as autonomic nervous system dysregulation or neurasthenia.
These types of conditions are generally closely related to stress.
More specifically, it seems to resemble panic disorder, which often manifests unexpectedly with symptoms such as shortness of breath and inexplicable fear.
Currently, pharmacological treatment has shown promising results for this type of condition.
If your symptoms occur too frequently, it is advisable to consider medication to alleviate your symptoms and prevent them from becoming chronic, which would make treatment more challenging.
Additionally, managing daily stress is also an important aspect; avoid accumulating stress, ensure adequate sleep, and engage in regular exercise.
These seemingly simple steps can be significant therapeutic measures.
You might want to give them a try.
Wishing you well.

Reply Date: 2004/06/18

More Info

Hello, thank you for reaching out and sharing your experiences. It sounds like you are dealing with a complex interplay of anxiety, physical symptoms, and the pressures of high expectations. Your symptoms, including dizziness, fatigue, and feelings of panic in social situations, suggest that you may be experiencing anxiety disorders, which can manifest physically as well as emotionally.

First, it's important to recognize that anxiety can significantly impact both mental and physical health. The symptoms you describe, such as dizziness, fatigue, and physical discomfort, can often be linked to anxiety. When we experience anxiety, our bodies can react in various ways, leading to physical symptoms that can be distressing and confusing. This can create a cycle where anxiety leads to physical symptoms, which in turn increases anxiety, making it difficult to break free from this cycle.

Given your history of seeking help from various medical specialties, it seems you have been proactive about your health, which is commendable. However, it may be beneficial to focus on a more integrated approach that addresses both your mental and physical health. Here are some strategies that may help you manage your anxiety and physical symptoms more effectively:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective form of therapy for anxiety disorders. CBT helps you identify and challenge negative thought patterns and beliefs that contribute to your anxiety. A trained therapist can guide you through this process, helping you develop coping strategies and skills to manage your anxiety more effectively.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety and improve your overall sense of well-being. These techniques can help ground you in the present moment and reduce the physiological symptoms of anxiety.

3. Regular Physical Activity: Engaging in regular exercise can significantly reduce anxiety levels. Physical activity releases endorphins, which are natural mood lifters. It can also help improve your sleep quality and reduce feelings of fatigue.

4. Healthy Lifestyle Choices: Maintaining a balanced diet, getting adequate sleep, and avoiding excessive caffeine and alcohol can help stabilize your mood and energy levels. Nutrition plays a crucial role in mental health, and ensuring you are fueling your body with the right nutrients can have a positive impact.

5. Medication: If your anxiety symptoms are severe and significantly impacting your daily life, you might consider discussing medication options with a psychiatrist. Medications such as SSRIs or benzodiazepines can be effective in managing anxiety symptoms. It’s important to have a thorough discussion with your healthcare provider about the potential benefits and side effects.

6. Support Groups: Connecting with others who are experiencing similar challenges can provide a sense of community and understanding. Support groups can offer a safe space to share experiences and coping strategies.

7. Gradual Exposure: If certain situations trigger your anxiety, gradual exposure to these situations can help desensitize you over time. This involves slowly and systematically facing your fears in a controlled manner, which can reduce the power they hold over you.

8. Professional Help: Since you have already seen various specialists, consider seeking a mental health professional who specializes in anxiety disorders. They can provide tailored strategies and support to help you navigate your symptoms.

In conclusion, managing anxiety and its physical manifestations is a multifaceted process that often requires a combination of therapeutic approaches. It's essential to be patient with yourself as you explore different strategies and find what works best for you. Remember, seeking help is a sign of strength, and with the right support and tools, you can work towards feeling better and regaining control over your life. Please consider reaching out to a mental health professional who can provide you with the guidance and support you need.

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