[44F] Experiencing anxiety and related symptoms

Patient Description

A 44-year-old female has been experiencing significant anxiety for the past 3 years, which has been worsening to the point of preventing her from entering vehicles or stores. The anxiety manifests suddenly with gut churning, racing heart, feelings of detachment, sweating, and overheating. Episodes occur weekly and last for approximately 40 minutes. The patient finds some relief with cold water, ice, or the comforting presence of another person. Accompanying symptoms include a fine internal tremor present for 4 months, a tight feeling in the head associated with panic, and difficulty concentrating during episodes of anxiety. Insomnia has been a recurring issue for 5 years, with the patient often staying awake due to worry, which also leads to sweaty hands and feet. The patient has a medical history of lupus, hypertension, fibromyalgia, GERD, and rheumatoid arthritis, and experienced a heart attack. Current medications include Atorvastatin, Metoprolol, Amlodipine, Plavix, Warfarin, multivitamins, Tylenol, and Benadryl. The patient has a known allergy to Plaquenil, which causes respiratory arrest.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • Panic Disorder: This is characterized by sudden and repeated attacks of fear that last for several minutes or longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or a fear of losing control even when there is no real danger. They may also have a strong physical reaction during a panic attack. It's also possible to have a panic attack without any trigger. Some people may experience these attacks regularly, while others may have them only occasionally.

    • Treatment typically involves psychotherapy, medication, or both. Cognitive behavioral therapy can help you understand what triggers your attacks and how to respond to them. Medications can help reduce symptoms and prevent panic attacks.
  • Generalized Anxiety Disorder (GAD): People with GAD display excessive anxiety or worry for months and face several anxiety-related symptoms. GAD symptoms include restlessness or feeling wound-up or on edge, being easily fatigued, difficulty concentrating or having their minds go blank, irritability, muscle tension, and sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep).

    • Treatment for GAD most often includes a combination of medication and cognitive-behavioral therapy.
  • Insomnia: Difficulty falling asleep or staying asleep, even when a person has the chance to do so. People with insomnia can feel dissatisfied with their sleep and usually experience one or more of the following symptoms: fatigue, low energy, difficulty concentrating, mood disturbances, and decreased performance in work or at school.

    • Treatment for insomnia can include lifestyle changes, behavioral therapies, or medications.

Please note that these are potential explanations for your symptoms based on the information provided, and not a definitive diagnosis. It's important to consult with a healthcare provider for a formal diagnosis and treatment options.

What you can do

  1. Seek professional help: If you're not already seeing a mental health professional, consider seeking help. A mental health professional can provide a safe space to express your feelings and can offer strategies to manage panic attacks and anxiety.

  2. Practice good sleep hygiene: This includes maintaining a regular sleep schedule, creating a restful environment, and promoting habits that aid in sleep.

  3. Mindfulness and relaxation techniques: These can help manage symptoms of panic attacks and anxiety. Techniques include deep breathing, progressive muscle relaxation, and mindfulness meditation.

  4. Regular physical activity and a healthy diet: Regular physical activity and a healthy diet can reduce anxiety by boosting your mood and acting as a natural stress reducer.

What you should look out for

If you experience any of the following, seek immediate medical attention:

  • Suicidal thoughts or behaviors: If you feel you're in crisis, reach out to a trusted individual immediately. You're not alone, and there are professionals who can provide help and support.

  • Increased frequency or severity of panic attacks: If your panic attacks are happening more often or are getting worse, seek medical attention.

  • Difficulty managing daily activities: If your symptoms are so severe that they're interfering with your ability to function, seek help.

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

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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 a racing heart, sweating, trembling, shortness of breath, feelings of impending doom, and a sense of detachment from reality. These symptoms can be intense and may last for several minutes.


How can anxiety disorders like Generalized Anxiety Disorder (GAD) be treated?

Anxiety disorders like GAD can be treated with a combination of psychotherapy, such as cognitive-behavioral therapy (CBT), and medications like antidepressants or anti-anxiety drugs. Lifestyle changes and stress management techniques can also be beneficial.


What lifestyle changes can help improve insomnia?

Improving insomnia can involve maintaining a regular sleep schedule, creating a comfortable sleep environment, avoiding caffeine and electronics before bed, and practicing relaxation techniques such as deep breathing or meditation.


What should I do if my panic attacks become more frequent or severe?

If your panic attacks become more frequent or severe, it's important to seek medical attention. A healthcare provider can help assess your condition and adjust your treatment plan to better manage your symptoms.


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