[18F] Experiencing anxiety, migraines, and other symptoms

Patient Description

An 18-year-old female has been experiencing anxiety for over six years, which worsens with medical and scary situations. This anxiety has led to panic attacks approximately three times a week, lasting 5-15 minutes, and affects daily life by causing sickness, skipping class, difficulty concentrating, and depression. The patient reports migraines for the past three weeks, which have been on and off for years, located behind the eyes and on the top of the head, described as both throbbing and sharp, with sensitivity to light and noise. The severity is rated as 4 out of 10. Triggers include stress, dehydration, poor diet, and lack of sleep. Additional symptoms include dizziness, sickness, loss of appetite, sleep issues ongoing for four years, bad acne, and brain fog. The patient has a history of vasovagal syncope diagnosed 16 years ago and a family history of migraines and anxiety disorders. Current medications include 75mg of sertraline, 100mg of lamotrigine, and daily B12 and iron supplements, though exact dosages for the supplements are unknown. No known allergies to medications.

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Arora's Assessment

What might be happening

Your symptoms suggest a combination of anxiety, migraines, and possibly side effects from medications or supplements. Here's a breakdown:

  • Anxiety and Panic Attacks: Your long-standing anxiety, panic attacks, and related symptoms like difficulty concentrating and depression are common in anxiety disorders. Sertraline is often prescribed for anxiety and depression, and it seems you're already on this medication.

  • Migraines: The migraines you describe, with sensitivity to light and noise, are typical. Stress, dehydration, poor diet, and lack of sleep are known triggers.

  • Vasovagal Syncope: This condition can cause dizziness and fainting, especially when triggered by stress or dehydration.

  • Acne and Brain Fog: These could be related to hormonal changes, stress, or even side effects of medications.

What you can do

Anxiety and Panic Attacks:

  • Continue taking your prescribed medications. If symptoms persist, consult your doctor about adjusting dosages.
  • Practice relaxation techniques like deep breathing, meditation, or yoga.
  • Use MDandMe to journal your symptoms and triggers, which can help in managing anxiety.

Migraines:

  • Stay hydrated and maintain a regular sleep schedule.
  • Avoid known triggers like stress and certain foods.
  • Consider over-the-counter pain relief for migraines, but consult your doctor for persistent issues.

Vasovagal Syncope:

  • Avoid standing for long periods and stay hydrated.
  • If you feel faint, lie down and elevate your legs.

Acne and Brain Fog:

  • Maintain a skincare routine and consider consulting a dermatologist.
  • Ensure a balanced diet and adequate sleep to help with brain fog.

What you should look out for

  • If your panic attacks increase in frequency or severity, seek medical advice.
  • Monitor your migraines, and if they worsen or change in pattern, consult a healthcare provider.
  • Watch for any new or worsening symptoms, especially related to dizziness or fainting.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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2 mo ago

People Also Ask

What are some effective ways to manage anxiety and panic attacks?

Effective ways to manage anxiety and panic attacks include continuing prescribed medications, practicing relaxation techniques such as deep breathing, meditation, or yoga, and journaling symptoms and triggers to better understand and manage them.

How can I identify and avoid migraine triggers?

To identify and avoid migraine triggers, keep a diary of your migraines to track potential triggers such as stress, dehydration, poor diet, and lack of sleep. Once identified, try to avoid these triggers and maintain a regular sleep schedule and stay hydrated.

What steps can I take to prevent vasovagal syncope episodes?

To prevent vasovagal syncope episodes, avoid standing for long periods, stay hydrated, and if you feel faint, lie down and elevate your legs to improve blood flow to the brain.

Could my medications be contributing to my symptoms like acne and brain fog?

Yes, medications can sometimes contribute to symptoms like acne and brain fog. It's important to discuss any concerns with your healthcare provider, who can assess whether your current medications might be contributing to these symptoms and adjust your treatment plan if necessary.

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