Is This Normal Anxiety or Something Else?

Reader’s Question

I need to know if I’m experiencing normal anxiety, an anxiety attack or an anxiety disorder.

I’ve been experiencing the following symptoms for the past 2 weeks:

• Woke up from a dream (once) and I was feeling nervous and my heart was racing.
• Shortness of breath sometimes. I went to the hospital the first time it happened and they said all my vital signs were ok, even my oxygen; the doctor could not recommend anything but rest and enough sleep. Another doctor said that it may be caused by my acid reflux so she recommended me to take my meds for it but I only started taking them today.
• Dizziness occasionally.
• Chest pains.
• Nervous and cold — when I’m alone at work because I am still new and I still don’t know a lot.
• Difficulty concentrating when I’m at work (because I am nervous I guess).
• Constant acid reflux.
• Dreams about work often.

I experience the symptoms sometimes together (2 or 3 symptoms) or separately. As for the chest pains, I read online that acid reflux may also be a cause. So I really don’t know what is going on.

Psychologist’s Reply

Much of what you describe may be symptoms of panic and/or a panic attack. Panic disorders are very common, impacting 3 to 6 million Americans and occurring more often in women than men. They can begin to occur at any age and can affect both children and the elderly. Often though, they begin during young adulthood. Some who do experience a panic attack go on to experience more. Left untreated, panic disorder can be rather debilitating.

Let me first tell you about the physical symptoms, as most people tend to identify and experience these first. A panic attack is a very discrete period of intense discomfort accompanied by fear and anxiety in which the following can occur quite abruptly: racing heart, perhaps even with chest pain, sweating, feeling like you’re going to choke, nausea, dizziness, numbness (often called paresthesias), and shortness of breath. However, those I’ve worked with who have panic attacks often tell me that the psychological symptoms are just as distressing. People with panic disorder tend to have very intense feelings of fear and terror. In addition, they can encounter problems with concentration and feelings of derealization which they often describe as feelings of unreality or depersonalization, which bring on feelings of being detached from oneself. Also, it’s common to feel out of control. These experiences tend to be intense enough that the person begins to fear another occurrence and may begin to avoid situations that they believe are likely to trigger another attack.

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It’s still debatable if anxiety and panic can cause acid reflux as you’re experiencing. However, what researchers are finding is that although anxiety does not increase the production of stomach acid, you can become more sensitive to smaller amounts of acid in the esophagus.

Now, here’s the good news. Panic and anxiety are highly treatable. Often the best results are seen when you can combine medication interventions with therapy. However, here are some thoughts which can help immediately for anyone experiencing panic and anxiety:

• Although the fear and panic usually occur suddenly and without warning, know this: It. Will. Pass. Your body while in a panic attack is sent into its “fight or flight mode,” which it cannot maintain for long periods of time. We just aren’t built for it.
• The fear you are experiencing is likely out of proportion to the situation you are in. It may feel like the walls are collapsing in, but you will live through this. It will not kill you although it will try to convince you otherwise.
• Recognize you are having a panic attack. Get educated on the symptoms and get better at recognizing when they are happening to you. Sometimes it’s helpful to just say “This is a panic attack, not the world ending.” Try not to resist the attack as it only tends to make it worse. Just accept it for what it is and understand that you are going to be fine. Uncomfortable, but fine.
• Make yourself comfortable. Breath, relax, and stop what you are doing. Then try just to passively observe your panic attack. This can help you learn about how panic affects you but more importantly help you get through it. Just observe and note. Taking this role can help you regain control quicker. Meditation and relaxation techniques can also be quite effective here.

Finally, you may need to make some lifestyle changes should they continue. Diet and exercise can have positive impact on anxiety and panic. Exercise daily and watch your caffeine intake. Talk to a therapist too. Sometimes just being able to unload your worries with someone helps almost immediately. Don’t let it go untreated if it continues.