I think I'm developing panic disorder

I posted somewhere or other that I started feeling awful the evening of my second booster shot. I thought I was having some sort of reaction to the vaccine. I felt sudden faintness and dread, shortness of breath, sweating, and heart palpitations. I went to the cardiologist, who did all kinds of tests, but he found nada. The symptoms gradually faded away over the course of a month or two and I forgot about it. That was back in January 2022.

In the past week or two, it has been happening again. This time no booster shot was involved. The symptoms aren’t as bad, but I recognize them as the same thing that happened last January. Now that I’m not worried about my heart, I did some research, and the symptoms certainly seem to align with panic disorder.

I’m not having full-on horrible panic attacks. I had one of those about four years ago after a toke of too-strong modern cannabis. That was hideous! I thought I was dying. What I’m feeling now is about 1/10th as bad as that, if that much.

But it’s still extremely unpleasant. I’d go to the doc, but I know there’s not a whole lot he can do. I just have to go into an empty room, practice deep breathing, close my eyes and tell myself it will come to an end soon. That’s kind of hard to do when you’re at work. I also will probably give up caffeine, as I read that that can be a trigger. Good-bye, strong cup of Assam tea in the mornings.

I hesitate to recommend benzos, but Ativan is literally made for this, and IME addiction is not common (don’t gobble them like Pez–use as directed).

GO TO A DOCTOR!

As far as I can tell, no one here is a licensed to practice medicine, let alone over an internet forum. There is NOTHING that any of us here can say that will be helpful to you. For all we know, you could be on the verge of death from a preventable disease. We are not licensed professionals. Please, go and see a real doctor and discount any advice you get here in regards to medication.

It sounds like it could be anxiety, but is worth talking to a doctor about. Many years ago when I decided to get my “house in order” physical health wise, I quit drinking alcohol completely. My drinking was more than was healthy, but I never observed in myself the sort of dependency associated with addiction. I did not suffer any of the common withdrawal symptoms at all (which isn’t surprising, while I was drinking too much, I regularly went multiple days a week without any alcohol.) In the first month of living health and entirely alcohol free, for basically the first time in my life I started having daily sessions of existential dread and panic, for no identifiable reason. Nothing that ever matched the description of a full-blown panic attack, but a sort of stomach-gnawing, anxiety that would churn right below the surface. This happened regularly for a few weeks, and then I said okay, let me try to drink two glasses of red wine this evening. I do that, and the anxiety melts away. Repeat the next day, same thing.

That’s when I tell myself–okay, something about my previous alcohol use has likely primed my system for this. So, I stop drinking again, and got some counseling the counselor I spoke with went into a deep dive of my drinking and other behaviors, and he is the one who confirmed he didn’t think I was an alcoholic, but he thought that prolonged problem drinking and the rebound effect of ceasing it was causing anxiety.

Yours obviously isn’t drinking related, but all that is to say that changes in our bodies can kick something like this off. The counselor I was meeting with basically said he could refer me to a physician who could prescribe a mild anti-anxiety medication, or I could try some non-medication approaches first. I decided to try to do it without medication first, which basically was some typical deep breathing, meditation etc stuff. I went into them with a bit of skepticism, but after a few weeks my anxiety really did melt away. Mine never really came back. FWIW I did later resume casual drinking, I never intended on going teetotaler, I just wanted to cut alcohol out while I was dieting and getting myself healthy–I have avoided drifting back into problem drinking.

But I have a close friend who had similar symptoms, but a different origin, and he ended up going on buspirone which fixed it for him. Mostly just sharing to let you know there’s a lot of approaches and the medical profession can actually help a lot with this.

What’s this “We” stuff? :stuck_out_tongue_winking_eye:

As a licensed MD who’s done telemedicine, I’d concur with the above advice to see a doc yet again. Make sure due consideration for diagnoses like pheochromocytoma, thyroid disease, medication effects/side effects, hypoglycemia, hypoxia, temporal lobe epilepsy, vestibular dysfunction, pulmonary embolism, and more were given.

THEN: a good neuropsychiatrist can take you further into the myriad of mental/cerebral health disorders which can cause symptoms like those you describe.

and don’t jump on the benzodiazepine bandwagon just yet. Benzos tend to harm more people than they help. THough for some folks, benefits outweigh risks.

Once that’s ruled out, then other

Well, I did see my PCP first back in January. He was puzzled by my descriptions of how I felt, and gave me a choice of referral to the cardiologist or a psychiatrist. I went to the cardiologist, who, like I say, ran a buttload of tests.

If this goes on, I may go back to the PCP, but I don’t want to go to a psychiatrist. If I was a fretting, anxious, scaredy-cat kind of person with an abusive crummy childhood, I’d consider that. But these spells don’t necessarily come on when things are stressful. They can come on when I’m relaxing in bed and reading a book, or when I’m watching a movie, or when I’m doing word processing at work. I don’t need any psychoanalysis for that.

Psychiatrists do more than psychoanalysis. In fact, psychoanalysis is not indicated at all for panic disorder anymore which, to my psychiatrist ears, this might be a case of. The occurrence of attacks seemingly out of nowhere is actually quite common.
Agree with @Qadgop_the_Mercotan that a thorough work-up with his given differential diagnosis should be done, especially if you’ve developed these symptoms later in life .
First line of treatment, if this were to be a case of panic disorder, would be CBT, with an emphasis on the behavioural component. Works to resolve or at least ameliorate the symptoms in about 80% of cases. Medication would come after that or in serious cases concurrently and first recommendation would be an SSRI IMO. Benzos for short term perhaps but only for a limited amount of time. Dependence can occur rather quickly and tapering off can lead to rebound panic.
You don’t need an awful childhood to develop psychiatric symptoms, these things can occur to anyone, anytime. However especially late-onset development warrants a thorough physical to rule out a physical disease as a cause.
Hope this information helps and all the best!

Psychiatrists do a lot more than psychoanalysis, and in fact the proportion of psychiatrists for whom psychoanalysis is a major portion of their practice is declining precipitously because of how difficult it is to get medical insurance to pay their rates for therapy versus what they will pay for a ‘medical’ consult that results in prescription. If you do a consult with a neuropsychiatrist they will probably have you fill out a survey, ask you a few questions, and either write you a script or refer you to a neurologist or clinical psychologist.

However, as @Qadgop_the_Mercotan notes, benzodiazepine is overprescribed and often detrimental for long-term maintenance; selective serotonin reuptake inhibitors (SSRI) and serotonin and norepinephrine reuptake inhibitors (SNRI) have fewer side effects for managing panic and anxiety disorders in general (although not no side effects, and their efficacy is widely variable). Before you jump on the medication bandwagon it’s probably a good idea to get a referral to both a neurologist and an internist to explore whether there is some kind of physiological problem like a hormonal imbalance, neurological disorder, or (unlikely but possible) brain tumor or defect. The brain does not function in absence of the body and medical science is constantly revealing new insights in how physical stressors can drive apparently psychological issues, including nutritional deficiencies. Your standard MD or DO just doesn’t have enough experience in this area to diagnose or manage these conditions and needs to refer you to specialists who can.

Even though you say you don’t have a background with trauma or mental health issues, it is also worth considering if there is anything that could be a cause for Complex Post-Traumatic Stress Disorder (C-PTSD). Although the general conception of PTSD is that it is the result of a few highly traumatic episodes, the more recent understanding is that C-PTSD can be caused by a regular exposure to less dramatic stressors including occupational or medical issues. Panic attacks out of the blue with no apparent cause are pretty much a hallmark of PTSD and it is at least worthy of consideration, particularly given the events of the last few years.

Panic attacks are frightening and disconcerting for how rapidly they can come on with no apparent cause or notice, and managing them is a largely matter of having a good practice for self-management; the medication (if you use it) is just to take the edge off the attacks and make them easier to control, and won’t eliminate them by itself. Finding a physiological or psychological cause is key to treatment and minimizing the effects on your life.

Good luck to you.

ETA: Ninja’d by @Drsunflower1 who also had good guidance.

Stranger

A few years ago, good friend of mine told me he thought “something was wrong “. He couldn’t really describe what was going on, other than every so often he’d “zone out”.

I suggested he see a doctor, which he did. The doctor suggested he get more sleep. I suggested he get a second opinion, which he did, which led to a neurology referral, testing, a neurology second opinion, more tests, then even more tests. He was eventually diagnosed with mesial temporal sclerosis.

Medication didn’t help, nor did two surgeries on his temporal lobe. Recently he beat a friend/neighbor with a brick, nearly killing him. He’s sitting in jail now, unable to afford bail.

I guess my point is that medical stuff can be complicated and a second opinion may be warranted.

I have been using Xanex for 10 years now to treat post traumatic stress and it works wonders for me. I have never had to take more than two of the smallest dosage (0.25 mg?) at bedtime and I am fine, most nights only one and many nights none at all.

This dispite having had previous out of contol addiction issues. For some reason my addiction doesn’t relate to prescription meds, never was a pill popper and needles freak me out.

My doctor is impressed that I never upped my dose. So it is possible to use them for solely medical purposes as intended. I used to have issues with my mind racing whenever I tried to sleep, but no more. YMMV.

Everybody is kind of stressed these days. That stress can make symptoms of problems that would have seemed inconsequential previously to cause concern. Maybe life will get better for everyone or maybe we all get used to it eventually. There’s at least some possibility some kind of non-prescription de-stressing will alleviate the problem. You don’t have to avoid psychiatrists, they just dispense drugs these days. It’s psychotherapists you want to avoid, and in my limited experience you’d be better off seeing a witch doctor because it will cost less and won’t take as long. Hope you are feeling better soon.