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Thursday, July 24, 2014
Anxiety and Stress Disorders
A couple months ago I suffered my first panic attack while at college. Ever since then I have worried constantly about my medical condition. I tend to get a tightness or slight pain in my chest still. I have had blood work, an ekg, and a chest x-ray done, which all came out perfect according to my doctor. Is this some sort of heart problem or just anxiety?
In reading between the lines on your question, I'm inferring that you believe that "some sort of heart problem" would be important, but that "just anxiety" wouldn't be. I would like to set the record straight. Anxiety disorders are serious, important health problems. When severe, they can interfere with one's ability to work, to establish and maintain relationships with others, to enjoy life, to study and learn and to perform those activities required for daily living. They can lead to hospitalizations and disability. Severe anxiety disorders are every bit at important to one's health as heart disease. That is why I encourage you to give as much thought and concern to the diagnosis of anxiety as you do to heart disease.
Many diseases and illnesses are hard to sort out initially, and a doctor needs to take a thorough history from a patient, perform a physical exam and often do tests and X-rays. This is true whether a doctor is trying to determine, if chest pain from heart disease or anxiety or if stomach pain is from an ulcer or gallstones. All these conditions are important, but treatment will be different depending of what the diagnosis is.
It sounds like your doctor did some appropriate tests when you developed some chest pains. And from your question, it also sounds like panic attack -- a kind of anxiety disorder, was the ultimate diagnosis. Panic attacks can be treated quite successfully. Some people have minor panic attacks that resolve on their own. Most people need some treatment -- either counseling (learning cognitive-behavioral skills to treat the attacks), medications (usually SSRIs (selective serotonin reuptake inhibitors), but rarely anti-anxiety drugs for a short time while counseling and the SSRIs start to work) or both.
Please check out the weblinks for more information about panic attacks. It is normal for physical symptoms to accompany an attack, as well as emotional symptoms like fear, panic, distress and even sadness. If you haven't talked about these attacks with a mental health counselor, I encourage you to do so.
Nancy Elder, MD
College of Medicine
University of Cincinnati