[29F] Experiencing severe discomfort and distress

Patient Description

A 29-year-old female is reporting severe full-body discomfort, difficulty breathing, difficulty speaking, and a distressing urge to rip her skin off and bang her head against objects. The patient is also experiencing nausea, dizziness, disorientation, and crying. There is no indication of pregnancy. The most troubling symptom appears to be the urge to harm herself. Further evaluation is necessary to determine the underlying causes and to provide appropriate care and support.

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Arora's Assessment

What might be happening

Based on the information you've provided, it's possible that you're experiencing a severe anxiety or panic attack. These can cause symptoms like difficulty breathing, dizziness, disorientation, and a feeling of extreme discomfort or distress. It's also possible that you're experiencing symptoms of a severe depressive episode, which can include feelings of despair, crying, and thoughts of self-harm.

  • Anxiety or Panic Attack: These are characterized by sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. People experiencing a panic attack may believe they are having a heart attack or they are dying or going crazy.

    • Treatment typically involves cognitive-behavioral therapy and medication.
  • Severe Depressive Episode: This is characterized by a persistent feeling of sadness or a lack of interest in outside stimuli. The person may experience significant impairments in daily life.

    • Treatment typically involves a combination of psychotherapy (talk therapy), medications, and lifestyle changes.

Please note that this is not a definitive diagnosis, and it's important to consult with a healthcare professional for a formal assessment.

What you can do

Given the severity of your symptoms and the distress you're experiencing, it's important to reach out to a healthcare professional immediately. If you're in the U.S., you can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use the Crisis Text Line by texting HOME to 741741. This is a crisis and you don't have to go through it alone.

What you should look out for

If your feelings of wanting to harm yourself intensify, or if you start to make plans to harm yourself, it's crucial to seek help immediately. You can call 911 or go to the nearest emergency room.

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10 mo ago

People Also Ask


What are the common symptoms of a panic attack?

Common symptoms of a panic attack include sudden feelings of terror, difficulty breathing, dizziness, disorientation, heart palpitations, sweating, trembling, and a fear of losing control or dying.


How can severe anxiety or panic attacks be treated?

Severe anxiety or panic attacks can be treated with cognitive-behavioral therapy (CBT), medications such as antidepressants or anti-anxiety drugs, and lifestyle changes like regular exercise, relaxation techniques, and avoiding caffeine and alcohol.


What should I do if I have an urge to harm myself?

If you have an urge to harm yourself, it's important to seek help immediately. You can contact a crisis hotline, reach out to a trusted friend or family member, or go to the nearest emergency room for support.


What are the signs of a severe depressive episode?

Signs of a severe depressive episode include persistent sadness, loss of interest in activities, changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide.


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