and Managing Anxiety Disorders: A Personal Journey - Psychiatry

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Anxiety Disorder


Since high school, I have experienced anxiety when traveling alone on trains, feeling the urge to get off at every stop.
At that time, it only occurred when I was physically unwell while riding the train.
Now, as a senior in college, I faced significant anxiety on the day I was set to travel abroad with friends during the summer.
At the airport, I felt anxious to the point of constantly needing to use the restroom.
I previously thought my anxiety was due to physical discomfort or nervousness about traveling abroad.
However, over a week ago, after attending an event, I began to feel intense anxiety while chatting with friends.
I had an overwhelming urge to use the restroom, but even after going, the anxiety persisted, and I started shaking.
The next day, I found it difficult to walk far from my dorm, experiencing shortness of breath and anxiety, along with the urge to use the restroom.
Even after using the restroom, I did not feel any better.
That evening, I went to see a doctor and remained anxious until I reached the hospital, where I finally calmed down.
While describing my symptoms to the doctor, I ended up crying.
The doctor diagnosed me with anxiety disorder but also checked my thyroid.
They prescribed me an ER medication.
During a follow-up visit this week, the doctor confirmed that my thyroid is indeed enlarged, but my endocrine function is normal.
They continued my medication without providing much explanation.

Yesterday, after a full day of classes and dinner with friends, my anxiety returned.
Although the medication has made the episodes less severe than before, I still feel palpitations and a strong urge to use the restroom.
Now, when I go out, I often feel uneasy and experience inexplicable anxiety, which makes me hesitant to leave home.
Am I exacerbating my condition by being overly concerned about my health? Regarding the thyroid enlargement, although the doctor said it should be benign, should I seek a specialist in endocrinology? My anxiety disorder is significantly impacting my life.
What triggers anxiety attacks in patients with this condition? How can I improve my situation? It seems that the ER medication merely suppresses my symptoms; will my condition ever improve? Could I become dependent on it? A friend suggested that I might consider seeing a different doctor, and I am thinking about consulting in Taoyuan.
Could you recommend a doctor suitable for my condition? Thank you.
I have just come to terms with this issue, and my feelings are complex, filled with questions.
I hope to better understand and overcome this to return to my normal life.
Thank you.

Jiao Lü Zou Kai, 20~29 year old female. Ask Date: 2007/12/13

Dr. Xie Dicheng reply Psychiatry


Hello, I apologize for the late response.
Indeed, your "anxiety symptoms" are quite pronounced and have a significant impact.
At this stage, pharmacotherapy would be a more rapid and effective approach—besides anxiolytics like ERA, it is also important to consider other treatments such as antidepressants.
To put it simply, anxiolytics suppress symptoms, while antidepressants replenish neurotransmitters in the brain, helping to adjust the brain's response to psychosomatic symptoms.
Once there is initial effectiveness from medication, non-pharmacological treatments should also be considered, such as diaphragmatic breathing relaxation training and cognitive-behavioral therapy, which can enhance your coping strategies.
That said, to confirm your condition, a medical examination is necessary (hence the mention of "anxiety symptoms" rather than "anxiety disorder").
Regarding thyroid issues, if you have concerns, you can ask your physician for a lab report and then consult with an internist for confirmation.
In terms of consultations at the clinic, any physician should be available during the scheduled hours (except for initial consultations on Friday afternoons), and I hope you find the experience satisfactory.

Reply Date: 2007/12/13

More Info


Your journey through anxiety is a deeply personal and often challenging experience, and it's commendable that you are seeking to understand and manage it better. From what you've described, it seems that your anxiety has been a persistent issue, manifesting in various situations, particularly in social settings and during travel. This is not uncommon for individuals with anxiety disorders, and it's important to recognize that you are not alone in this struggle.

Anxiety disorders can take many forms, including Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, and Panic Disorder, among others. The symptoms you describe—such as feeling an overwhelming need to use the restroom, shaking, and difficulty breathing—are often associated with anxiety and panic attacks. These symptoms can be triggered by specific situations, such as being in crowded places or feeling pressured to socialize, which seems to resonate with your experiences.

It's crucial to understand that anxiety is a natural response to stress, but when it becomes excessive and interferes with daily life, it may require professional intervention. You mentioned that a doctor diagnosed you with anxiety and prescribed medication, which is a common approach to managing these disorders. Medications like SSRIs (Selective Serotonin Reuptake Inhibitors) or other anxiolytics can help regulate mood and reduce anxiety symptoms. However, it's also essential to combine medication with therapy, such as Cognitive Behavioral Therapy (CBT), which can provide you with tools to manage anxiety more effectively.

Regarding your concerns about your thyroid condition, it’s wise to follow up with an endocrinologist if you feel that your thyroid issues might be contributing to your anxiety. Thyroid dysfunction can sometimes exacerbate anxiety symptoms, so ensuring that your thyroid levels are stable is an important step in your overall treatment plan.

You also raised a valid point about whether your focus on your anxiety might be exacerbating your symptoms. This is a common phenomenon known as "anxiety sensitivity," where the fear of anxiety symptoms themselves can lead to increased anxiety. It can be helpful to practice mindfulness and grounding techniques to help you stay present and reduce the cycle of anxious thoughts.

As for your question about whether your medication could lead to dependency, it’s important to have an open dialogue with your healthcare provider about your concerns. Many medications for anxiety are not addictive, but they can have withdrawal symptoms if stopped abruptly. Your doctor can guide you on how to taper off medication safely if that becomes necessary in the future.

In terms of finding a new doctor, it’s essential to seek a mental health professional who specializes in anxiety disorders. You might consider looking for a psychiatrist or psychologist who has experience with anxiety management and can provide a comprehensive treatment plan tailored to your needs. Online platforms or local mental health organizations can often provide recommendations for qualified professionals in your area.

Lastly, remember that recovery from anxiety is a process that takes time. It’s okay to have setbacks, and it’s important to be patient with yourself. Engaging in regular physical activity, maintaining a healthy diet, practicing relaxation techniques, and building a support network of friends and family can all contribute to your overall well-being.

In conclusion, your journey towards understanding and managing anxiety is a significant step towards reclaiming your life. By continuing to seek help, educating yourself about your condition, and practicing self-care, you can work towards a more balanced and fulfilling life. Remember, it’s okay to ask for help and to take things one day at a time.

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