[26F] Experiencing chest tightness and psychological distress

Patient Description

A 26-year-old female presents with a tight chest described as a compressive sensation, racing thoughts involving embarrassing memories and insecurities, and difficulty concentrating, particularly with reading. These symptoms have persisted for a couple of days to a month. The chest tightness is not exacerbated by physical exertion but is relieved upon pressing on the chest. The patient also reports changes in sleep patterns, with difficulty falling asleep until early morning and waking up with panic. There is a noted loss of appetite with eating once a day and an irritable, angry mood that has been present since around December or January. The patient has a history of depression, generalized anxiety disorder, PTSD, and a potential diagnosis of borderline personality disorder. Current medications include Sertraline 200mg daily and Buspirone 30mg twice daily. The patient also uses psilocybin once or twice a month. There are no known allergies or recent changes in medication, and no other over-the-counter medications, supplements, or herbal remedies reported.

Arora's Assessment

What might be happening

Based on the information you've provided, it's possible that you're experiencing an exacerbation of your diagnosed Generalized Anxiety Disorder (GAD) and/or depression. The symptoms you've described, such as chest tightness, racing thoughts, trouble concentrating, changes in sleep and appetite, and heightened irritability, are common in these conditions.

Generalized Anxiety Disorder: This is a chronic condition characterized by excessive, long-lasting anxiety and worry about nonspecific life events, objects, and situations. GAD is the most common cause of feelings of anxiety.
- Treatment typically involves a combination of medication and cognitive-behavioral therapy.
Depression: This is a mood disorder that causes a persistent feeling of sadness and loss of interest. It affects how you feel, think, and behave and can lead to a variety of emotional and physical problems.
- Treatment usually involves a combination of medication, psychotherapy, and lifestyle changes.

Please note that it's also possible that other conditions could be contributing to your symptoms. For example, your chest tightness could be due to a respiratory issue, such as asthma, especially given your stuffy nose. However, the fact that the tightness is relieved by pressing on your chest suggests that it might be more related to anxiety.

What you can do

Continue taking your prescribed medications (Sertraline and Buspirone) as directed by your healthcare provider.
Try to maintain a regular sleep schedule. Go to bed and wake up at the same time every day, even on weekends.
Engage in regular physical activity, which can help reduce anxiety and improve mood.
Try relaxation techniques, such as deep breathing, meditation, or yoga.
Maintain a healthy diet. Try to eat regular meals and stay hydrated.
Limit caffeine and alcohol, as they can increase anxiety and trigger panic attacks.
Try to spend time each day doing something you enjoy. This can help distract you from your symptoms and improve your mood.

What you should look out for

Please seek immediate medical attention if you experience:

Severe chest pain or discomfort
Trouble breathing
Fainting or loss of consciousness
Thoughts of harming yourself or others

Remember, it's important to reach out to your healthcare provider to discuss your symptoms. They can provide a formal diagnosis and appropriate treatment. This is especially important given your history of mental health conditions and the potential for your symptoms to be related to these conditions.

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11 mo ago

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