Managing Anxiety and Hyperventilation: Your Symptoms and Treatment Options

Hyperventilation combined with anxiety issues?

Hello, doctor.
I kindly ask for your help.
I would like to briefly consult you about my situation.
Last year, I participated in the national examination but narrowly failed.
Since then, I've been feeling quite down.
I am preparing to retake the judicial special examination this August, but I have encountered several issues along the way.
1.
Starting in December of last year, I have had difficulty falling asleep and tend to wake up easily.
My doctor prescribed relaxation medication, which improved my condition after a week.
However, since February of this year, I have experienced shortness of breath and had to go to the emergency room.
After follow-up with my doctor, it was determined that I was hyperventilating.
I was prescribed Bropan, taking one in the morning and one at night, along with Inderal, which I continued until the end of April.
There was significant improvement, but during this time, I have continued to experience persistent chest tightness, anxiety, a feeling of heat in my face, and numbness in my hands and feet, along with excessive sweating.
However, I no longer feel as if I can't breathe.
In crowded places, my chest feels tighter, but I can still function normally.
2.
Starting in May of this year, I have had trouble sleeping at night, and when I do fall asleep, I wake up startled multiple times throughout the night, severely affecting my sleep quality.
I still experience chest tightness, but I can breathe; it just feels uncomfortable.
Recently, this has worsened, and I find myself feeling inexplicably anxious and unable to sleep due to racing thoughts.
Today, my doctor prescribed Kinzolm, Bropan, Lexapro, and Mesyrel for me.
My main concerns are:
1.
I am extremely worried about developing a dependence on these medications.
I need to study, and I fear these medications will make me feel foggy.
2.
Is this a typical panic disorder?
3.
The literature suggests that psychological therapy should be combined with medication.
Could you recommend where I might find psychological therapy services or how I should proceed with treatment? I feel quite frustrated.
If you have any time to spare, could you provide me with some guidance or suggestions based on your knowledge? Thank you.

Mr. Huang, 20~29 year old female. Ask Date: 2012/05/10

Dr. Liang Sunyuan reply Psychiatry

Hello, based on the symptoms you described, it is indeed very likely that you are experiencing symptoms of panic disorder.
Medication treatment can reduce the frequency of panic attacks, and in combination with cognitive behavioral therapy, the results can be even better.
In Changhua County, resources for psychological therapy and counseling can be found on the Health Bureau's website: http://www.chshb.gov.tw/download/101ChanghuaCountyMentalHealthResourcesList1.doc.
However, many hospital psychologists are still required to conduct outpatient psychological assessments and evaluations in inpatient settings, so the waiting period for outpatient psychological therapy is often longer.
When facing symptoms of panic, it is essential to understand that palpitations and shortness of breath are actually symptoms of anxiety.
By focusing on controlling your breathing and allowing it to become slow and steady, and accepting this temporary discomfort, you will usually gradually return to normal.
Generally speaking, medication treatment can sometimes lead to a dull or foggy feeling in the mind over time, but it can be very helpful during more severe and frequent episodes.
The side effects of medication typically diminish over time, and not everyone needs to take medication long-term.
However, when considering tapering off medication, it is advisable to do so gradually after symptoms have been stabilized, as this approach is less likely to lead to a relapse.
Wishing you all the best.

Reply Date: 2012/05/10

More Info

Managing anxiety and hyperventilation can be a challenging journey, especially when symptoms interfere with daily life and academic pursuits. Based on your description, it seems you are experiencing a range of symptoms that are commonly associated with anxiety disorders, particularly panic disorder and generalized anxiety disorder. These symptoms include difficulty sleeping, feelings of chest tightness, hyperventilation, and physical sensations such as tingling in the extremities.

Understanding Your Symptoms
1. Anxiety Symptoms: Anxiety can manifest both psychologically and physiologically. Common psychological symptoms include excessive worry, restlessness, and irritability. Physiological symptoms can include rapid heartbeat, sweating, trembling, and hyperventilation, which you have experienced. Hyperventilation occurs when you breathe too quickly or deeply, leading to a decrease in carbon dioxide levels in the blood, which can cause symptoms like lightheadedness, tingling in the fingers and toes, and feelings of panic.

2. Panic Attacks: The symptoms you describe, such as feeling chest tightness and experiencing episodes of intense fear or discomfort, suggest that you may be experiencing panic attacks. These episodes can be triggered by stress or anxiety about upcoming events, such as your upcoming examination.
3. Sleep Disturbances: Difficulty falling asleep and frequent awakenings can be both a symptom of anxiety and a contributing factor to worsening anxiety. Poor sleep can exacerbate feelings of anxiety and lead to a cycle of insomnia and increased anxiety.

Treatment Options
1. Medication: The medications prescribed to you, including Bropan (a form of propranolol), Inderal (another name for propranolol), Lexapro (an SSRI), and Kinzolm (a benzodiazepine), are commonly used to manage anxiety and panic symptoms. While benzodiazepines can be effective for short-term relief, there is a risk of dependence if used long-term. SSRIs like Lexapro are generally considered safer for long-term use and can help manage anxiety symptoms without the same risk of dependence.

2. Psychotherapy: Alongside medication, psychotherapy, particularly cognitive-behavioral therapy (CBT), is highly effective for treating anxiety disorders. CBT helps individuals identify and challenge negative thought patterns and develop coping strategies. You can seek therapy through local mental health clinics, private practices, or university counseling centers. Many therapists also offer teletherapy options, which can be convenient.

3. Lifestyle Modifications: Incorporating lifestyle changes can also help manage anxiety. Regular physical activity, a balanced diet, adequate hydration, and mindfulness practices such as meditation or yoga can significantly reduce anxiety symptoms. Additionally, establishing a consistent sleep routine can improve sleep quality.

4. Support Systems: Engaging with support groups or talking to friends and family about your experiences can provide emotional support and reduce feelings of isolation.

Addressing Your Concerns
- Medication Dependence: It’s understandable to be concerned about medication dependence. Discuss your worries with your prescribing physician; they can provide guidance on the appropriate duration for medication use and help you taper off safely if needed.

- Identifying Panic Disorder: Based on your symptoms, it is possible that you are experiencing panic disorder. A mental health professional can provide a formal diagnosis and tailor a treatment plan that suits your needs.

- Finding Therapy: To find a therapist, consider searching online directories such as Psychology Today or contacting local mental health organizations. Many therapists offer initial consultations to discuss your needs and treatment goals.

Conclusion
It’s important to remember that you are not alone in this journey, and many people experience similar challenges. Seeking help from healthcare professionals, whether through medication, therapy, or lifestyle changes, can lead to significant improvements in your symptoms and overall quality of life. Be patient with yourself as you navigate this process, and don’t hesitate to reach out for support when needed.

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