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Default to anxiety, when all other tests are negative?

For those of you that have been down this road.

Son is 22, here is the chronology:

June 2017 - Babesiosis (tick-borne infection) treated and improves well over first few months
Oct 2017 - May 1 2018 : still suffering mild but constant fatigue temp. sensitive, back to college part time
May 3 - wakes up with shortness of breath/palpitations 24x7, normal route, sees PCP thinks respiratory 5 days Prednisone no effect, other blood tests (CBC/TSH/etc) negative. Improves a bit a few days later but more fatigued, still short of breath, heart palpitations.
May 11 - Pulmonary all tests for lungs and allergies, negative
May 12 - Severe shortness of breath, take him to ER. EKG, Cat scan, blood work, Echocardiogram, negative
May 15 - PCP punts us saying anxiety just put him on prozac.
May 23 - Appt. with Endocrinologist, give her enough symptoms she decides to check norepinephrine/epinephrine/dopamine (waiting)
May 24 - Cardiologist  follow up, palpitations are still there really without increased heart rate, going to do 24-hour monitor when they call us,, I think this is just being extra careful.

With these piles of negative results and the duration my son is struggling to get an answer to what is going on.

His current state is really just dialing things back to zero.
I work from home, he goes to the doctor, and other than that sits on the couch all day noodling on his computer.  The rest of his time is spent with me "troubleshooting" and "lamenting" about his symptoms. He says I don't feel "comfortable" enough to do anything given his symptoms especially shortness of breath.

No big changes in his life this last episode came literally out of nowhere. He has always been an anxious kid but I just don't believe he'd be dialing it back this much unless this stuff is really hampering him. To be honest he kind of freaks out (understandable) once a week, but other than that I am surprised at how calm he is. But in my mind there are too many symptoms to rule out an anxiety disorder.

But with all these negative results, I don't really know how to help him.

For anyone that stuck with me this long, could a long term anxiety just be unconscious and causing these symptoms?  For really the last 4 years all that he has done is go to school and play video games, he sees old friends every few months, but has no other friends and never had a girlfriend.
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Avatar universal
Has anyone tested his thyroid the right way?  TsH doesn't do that.  The endocrinologist didn't do that, although checking what they're checking might indicate that indirectly by indicating the adrenals aren't working properly.  To do that you have to check free T3 and T4 and go even deeper.  I doubt that's the problem but he hasn't yet been tested properly for it.  Also the predisone probably made the problem worse -- it's basically adrenaline and can make even the calmest person sleepless and nervous.  But the behavior your describe sounds a lot like depression and anxiety.  I say depression because he's not doing anything about it.  If it were just anxiety at the level you're describing, I don't think he would have stopped everything the way you describe and depression often causes anxiety.  Shortness of breath and palps, or the feeling of them more accurately since most of the time the person isn't really having that, they just feel like they are, are definitely anxiety symptoms.  But the difficult thing here is the tick bite starting this.  We've all heard of lyme disease by now becoming chronic and changing some people lives forever.  Sometimes these diseases from tick bites are very hard to find and very hard to completely get rid of and can lurk until you go see a great specialist who finds it.  If you do decide it's anxiety, and even if you don't at this point, he can't live like this forever and survive, so I'd suggest seeing a psychologist to work on what's going on and if you do want to pursue meds, see a psychiatrist.  Your regular doc might be okay at this, but these meds are very hard to use and choose and to stop taking, so you do want to use someone who does it the most as with any medical procedure.  If it is a mental disorder caused by the illness from the tick or from some other traumatic event or from nothing and it was just his time to get it, the best you can do is be very supportive but also try not to be so supportive of his avoidance.  22 is an age in the range of when most people get chronic mental illness, so again, the events might have just pushed him where he was headed anyway.  Nobody really understands this stuff.  Medication can cause this as well, including antibiotics, in some people.  So you've got a lot of possible triggers here.  The main thing is to get him thinking in a different way, but if he doesn't want to do anything about it, nothing will change.  He has to want it.  He's very lucky to have you in his corner -- I would bet most of us here, our parents haven't wanted to be involved much.  Eventually you will reach him or he will reach out himself, as he's young and therefore very resilient.    
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Sorry, meant to say in all that mess above that although it might be mental, never give up on trying to find a physiological cause, and I hope I was clear in saying he's got a lot of possibilities out there for that.  Drugs for mental illness don't treat physiological ailments.
Thanks, all great things to consider, I plan running down every physiological avenue as well as getting a psychiatrist to assess him.
The thing that just puzzles me is why would this shortness of breath come on so suddenly with all these other endocrine-like issues (temp. regulation, SOB, palps, strange massive fatigue after eating).  It just seems very hard to connect the dots to anxiety in lieu of this as well as it is really comes in waves 24x7.
Anxiety comes from thinking anxious thoughts on a regular basis.  Irrational fears.  If he's not thinking anxious thoughts it's not likely to be anxiety.  But bouts of anxiety do usually seem to come from nowhere, though you can often trace their evolution back once you're aware of it.  The problem with anxiety is that nobody understands it.  The best you can do is try to get over it.  Just so you know, seeing a psychiatrist will result in medication.  Seeing a psychologist will result in a diagnosis and therapy and possibly a referral to a psychiatrist if the problem appears to be out of control.  Up to you and your son how you want to handle it.
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