Does anyone have syncope followed by severe anxiety

[cracray72]

Hi. I'm a 46yr old female diagnosed with generalized anxiety disorder. My first panic attack happened in a restaurant 20 yrs ago. Two weeks prior to this panic attack I had ablation performed on my heart for SVT (heart arrhythmia). Since then, I have had several panic attacks and was put on Lexapro 20mg and Xanax .5mg as needed.  Most of my panic attacks happen in restaurants and I end up fainting. It is getting to the point where I don't want to eat out anymore because I am afraid of humiliating myself and whoever I happen to be having lunch or dinner with. It doesn't happen all the time, but when it does it hits me so fast I barely have time to warn my dinner date that I might faint.  I have had blood work, MRI, and I have an implantable loop recorder surgically placed in my chest to monitor my heart.  All tests come back normal.  It is so frustrating. I have heard of people coping with Anxiety/Panic disorders, but I never come across anyone who also faints. I have an appointment with my Cardiologist tomorrow, but I am assuming all he is going to say is that all looks fine. Thanks for reading.

[Paxiled]

Some people hyperventilate to the point of fainting when they have an anxiety attack.  My sister hyperventilated.  I don't, so we do differ.  It's possible the initial anxiety attack was related to fear because of the heart problem, but we can't know that really.  CBT might be very helpful to you given it's mostly this one experience that triggers them.  Might make it easier for that type of therapy to work.  If it's still happening then the meds you're on aren't working at the current dose, assuming you're been on them long enough for them to start working.  Because they seem to be tied to this one experience and aren't happening all the time everywhere, it would make it less likely for there to be a physiological cause.  If it was physiological, it would probably be happening randomly, even just while sitting at home relaxing.  I'm also not sure you're describing GAD -- that's when you're anxious all the time.  What you have sounds  like you've developed a phobia to eating at restaurants, unless there's a lot more to it.  I suffered from phobias, and they only bother you when you're in the situation or facing having to be in the situation.  GAD is all the time, I developed that from Paxil withdrawal.  Never had it before that despite the phobias.  The diagnosis can affect the type of therapy and relaxation techniques that might work best, but anxiety is anxiety.  

[cracray72]

Thank you for your response. My Cardiologist prescribed Fludeocortisone and he switched my beta blocker. I have been on an anxiety rollercoaster for many years now. I was given the diagnosis of GAD/depression about 5yrs ago when I went through a divorce. I was given Lexapro 20mg and I took it for a year. I was succssfully off the AD for a year and a half then I had a fainting episode during a dinner date. That triggered all my anxiety,  couldn't funcrion, so I got back on the Lezapro. I fainted again this past Wednesday  and my anxiety is back, even though I am on the Lexapro.

[Paxiled]

Did you faint without hyperventilating?  Also, corticosteroids can make anxiety a whole lot worse -- they can create anxiety in those who never had it.  There are several threads over the years just on this site about people who got anxiety problems from taking corticosteroids.  Again, if you're not anxious all the time for no reason at all, that's not GAD, and grief isn't depression, it's grief.  A great many people go through difficult things like the death of a close person or a divorce or hormonal fluctuations and are put on antidepressants when what they really need is to let time heal the grief -- nothing else does.  When grief lasts way too long, though, it can become depression in those who are prone to depression.   And while anxiety is triggered by certain things for us, those things don't cause chronic anxiety -- many people go through the same things and don't develop an anxiety disorder, so it's more likely some of us just have it in us.  My brother fainted while going to the bathroom a year ago, and it turned out to be a heart problem.  He needed a pacemaker.  Pretty scary, but he didn't develop an anxiety problem because of it and isn't afraid to go to the bathroom, if that helps explain what I mean.  I think therapy might be very helpful for you, but it does seem there's something physiological going on.  Hope you get better soon from all this.

[Paxiled]

Also, you're on a beta-blocker.  Do you also have a heart rhythm problem?  I only ask because some are put on these to treat anxiety, and it may be it slowed you down too much possibly causing the fainting.  

[cracray72]

Yes, I have a history of SVT (supra ventricular tachycardia). I have had 2 ablations to treat it.  My last surgery was in 2012 and my heart has been fine.  My cardiologist felt my heart was still beating too fast so he put me on Carvedilol and I've been on it since then - it helped me feel much better as far as my heart rate.  Now that I have been fainting, my Cardiologist decided to try switching my Carvedilol to Toprol XL and he wants me to try the Florinef.  My loop recorder didn't pick up anything abnormal when I fainted.  I was also recently diagnosed with kidney disease called IgA Nephropathy- The Nephrologist put me on low dose of Losartan as a preventive measure as HBP causes further kidney damage.  I think the combo of the Losartan and the Carvedilol is what made me faint.  My nephrologist told me to discontinue the Losartan for now.  My cardiologist doesn't think it was the Losartan, and thinks it's gotta be something else causing it since I have had other fainting spells in the past before being put on the Losartan. -AND almost all the fainting incidents happened at a restaurant!! All I know is that it's causing my anxiety to climb since they can't figure it out and I am always afraid of it happening again.  I am taking a daily dose of Xanax (.5mg) along with everything else, and that is helping me feel normal for now! I hate being dependent on meds.  Hate it!! --OH, and he also wants me to try compression stockings:/