the Link Between Panic Disorder and Autonomic Nervous System Dysfunction

What is the relationship between panic disorder and autonomic nervous system dysregulation?

Hello Doctor: I am a patient with panic disorder and have been taking the same medication for about a year and a half (prescribed by a municipal hospital).
1.
Efexor XR 75mg capsule (Venlafaxine) 2.
Alpraline 0.2mg tablet 3.
GenDERgin-SR (Guanfacine) 1mg 4.
Stlinox [CR] 6.25mg.
My condition has been quite stable.
However, for some reason, over the past two months, I have experienced increased menstrual bleeding (with clots), high blood pressure, elevated total cholesterol, significant hair loss, unexplained hand tremors, shortness of breath, involuntary tearfulness, mood swings, and weight gain.
I also have unexplained body aches and difficulty walking, with pain in my legs.
Could these symptoms indicate a dysfunction of the autonomic nervous system? If I want to switch to a different psychiatric hospital for treatment, is that possible? My family does not understand my discomfort.
What should I do?

Youyou, 30~39 year old female. Ask Date: 2010/09/29

Dr. Ding Shuyan reply Psychiatry

Hello, the symptoms of autonomic nervous system dysfunction are typically present in panic disorder, and this is something you should understand first! The autonomic nervous system governs the functioning of our vital organs; therefore, symptoms such as shortness of breath, elevated blood pressure, and trembling may indicate autonomic nervous system dysfunction.
However, these symptoms could also be manifestations of an underlying physical illness affecting those organs.
Your physician will help you differentiate between the two!
One of the greatest advantages of the healthcare system in Taiwan is that you can walk into almost any hospital or clinic and receive services almost immediately.
You certainly have the option to switch hospitals for treatment.
However, treating panic disorder is often much easier than diagnosing it.
If your physician correctly diagnoses you with panic disorder, they absolutely have the capability and medical expertise to treat it.
Unless you have completely lost confidence in your physician, I believe switching hospitals and doctors is merely a waste of your time, starting over as a test subject!
The symptoms of mental illness are often more abstract, and not only can patients sometimes be unclear about their conditions, but those around them may also fail to recognize it, leading to misunderstandings that we are merely complaining or making excuses.
The best approach is to have family members accompany you to see the physician, who can then explain the situation to them.
Generally, physicians are more persuasive when communicating with family than we are ourselves.
However, you must also understand that family members' attitudes and opinions about us often carry a lot of emotional weight, shaped by our long-term interactions and established patterns.
Family members know us best, yet they can also be the hardest to communicate with, and I believe everyone is aware of this! Wishing you a speedy recovery.

Sincerely,
Dr.
Ding Shuo-Yan

Reply Date: 2010/09/29

More Info

Panic disorder is a complex condition that can significantly impact an individual's quality of life. It is characterized by recurrent and unexpected panic attacks, which are sudden periods of intense fear or discomfort that peak within minutes. Symptoms can include palpitations, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, dizziness, chills, or hot flashes, as well as feelings of unreality or detachment from oneself. The relationship between panic disorder and autonomic nervous system (ANS) dysfunction is an area of ongoing research and clinical interest.

The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, blood pressure, respiration, digestion, and sexual arousal. It is divided into two main branches: the sympathetic nervous system (SNS), which prepares the body for "fight or flight" responses, and the parasympathetic nervous system (PNS), which promotes "rest and digest" activities. In individuals with panic disorder, there is often an overactivity of the sympathetic nervous system, leading to heightened arousal and anxiety symptoms.

Your symptoms, including high blood pressure, increased menstrual bleeding, elevated cholesterol levels, hair loss, tremors, shortness of breath, and mood fluctuations, could indeed suggest a dysfunction in the autonomic nervous system. These symptoms may be exacerbated by the chronic stress and anxiety associated with panic disorder. The body’s stress response can lead to physical manifestations, such as increased heart rate and blood pressure, which may contribute to feelings of panic and anxiety.

Moreover, the medications you are taking, such as Venlafaxine (Efexor XR), can have side effects that may include increased blood pressure, weight gain, and changes in mood. It is essential to discuss these side effects with your prescribing physician, as they may need to adjust your medication regimen or explore alternative treatments. The presence of severe symptoms like significant hair loss, persistent tremors, and emotional instability warrants a thorough evaluation to rule out other underlying medical conditions.

If you feel that your current treatment is not adequately addressing your symptoms or if you are experiencing side effects that are impacting your quality of life, it is entirely appropriate to seek a second opinion or switch to a different mental health professional. Finding a psychiatrist or psychologist who understands your concerns and can provide a supportive environment is crucial for effective treatment. It may also be beneficial to involve your family in discussions about your condition, as their understanding and support can play a vital role in your recovery.

In addition to medication, consider exploring therapy options such as cognitive-behavioral therapy (CBT), which has been shown to be effective for panic disorder. CBT can help you identify and challenge negative thought patterns and develop coping strategies for managing anxiety and panic attacks. Mindfulness and relaxation techniques, such as deep breathing exercises, yoga, or meditation, can also be beneficial in reducing anxiety and improving overall well-being.

In summary, your symptoms may indeed be linked to autonomic nervous system dysfunction, and it is essential to address both the psychological and physical aspects of your condition. Open communication with your healthcare providers, exploring different treatment options, and seeking support from family and friends can significantly enhance your journey toward recovery. Remember, you are not alone in this, and there are effective treatments available to help you manage your panic disorder and improve your quality of life.

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