Thyroid/medical issues and anxiety.

[danie17075rm]

I have always been a semi-nervous person.  I get nervous when I speak in public or while flying or something of that nature.  I led a normal, productive life though. In the last 10 months I became hyperthyroid.  This caused me to not be able to breathe one day unexpectedly.  I went to the ER and they found I was very hyperthyroid.  My heart rate was over 147 at rest.  I thought I was dying.  My whole body filled with this adrenaline that only beta blockers have helped (xanax and ativan never really did anything).  That whole month was horrible.  I could not stand without my body going into panic, I didn't sleep.  I know this was medically induced as I am scheduled to have my thyroid out next month.  However, having such constant panic attacks has caused me to develop panic attacks even when it's not caused by my thyroid.  I get so nervous about anything now and every time my heart races (even though it might be from a normal reason like running up stairs) I go into a full blownn panic attack.  It's hard because I have medical issues causing the heart and breathing issues at times so it's kind of hard to decipher between the 2!  It's like I opened pandora's box once I had the panic attack.  My heart palpitates due to my thyroid, and then I panic, and then the whole thing gets worse!  It's a nightmare.  At times, I can't shop alone.  I freak out because my heart is unsteady and sometimes if I am walking in the back of the store my heart rate increases and palpitates and I worry about losing control there.  I have had this happen in public actually as I struggled with having them almost constantly while hyper.  I now go hyper and hypo back and forth so at times its better and I can shop without an issue, but at others I have constant panic.  I have began to alter my life.  I don't want to go on meds at this point due to all the medical issues I am having.

I not have developed a mouth condition that is being biopsied and my tongue swells up and its HORRIBLE pain.  This on top of my thyroid is creating tons of anxiety.  I went to a therapist earlier in the year and she told me she couldn't help me because my problems were medical.  I do agree, but I think the medical issues have led to conditioned response (classical conditioning) or panic any time I have any emotion. I was just wondering if anyone had any suggestions on how to deal with anxiety in this type of situation?  I appreciate any answers.

[danie17075rm]

Thank you Hessy.  Your stories always make me feel better.  You went through similar experiences to what I have!  It makes me feel like I am not the only person in the world having all of these problems.  Sometimes I just want to hide away and let my body just fall apart.  I get so sick of fighting with it only to realize I never get ahead!!  If it wasn't for my son, I honestly think I would just give up.  

I can relate to the Bp and pulse.  I won't take my BP because I have a panic attack every time it gets taken.  I know this is the most ridiculous thing in the whole world, but my BP was going high all the time while hyper (higher than it has ever been before in my life) so now I am freaked out about that too.  It then started to go low, and I had no problem in taking it.  NOW, I am feeling hyper and once again it is high and I am panicking every time it gets taken ugh.  Ironically, having a panic attack WHILE your BP is being taken tends to make it go up, which makes me panic more.  It's such a vicious cycle.  I try to calm myself before BP i being taken and the docs look at me like I'm crazy.  I honestly try to stop taking my pulse and just let it happen and then I'll feel weird, or my heart will jump and I start to panic if I feel I can't take it.  I know this is all irrational and ridiculous, but my body just does this.  It is reassuring to know that once your thyroid was level you didn't have that problem.  It's just so weird to live 31 years without any problems like this and now to have everything pop out on me at once.  Thanks for all of your support, it really does help a lot!

[HessyKat]

Just wanted to comment about how you would take your pulse and all. I had gotten so OCD when my levels were off so bad that I was checking my pulse and B/P constantly. My boys got to were they would hid the blood pressure cuff from me. I actually was having some pyschosis when I was extememly hypo. I thought I had cancer , it went from liver cancer to female cancer and then lung. I started accusing my family of knowing that i had these problems and just didnt want to tell me. I would beg them over and over to tell me the truth and they knew that it was just my over obscessing about everything. I could not drive or go anywhere alone and if I went out I had to know where every hospital was and fire station in case I thought I was having a heart attack. These mental problems are so real when you are experincing anxiety and panic that comes with thyroid issues. Once I started getting my levels more stable I have stopped doing all those things. I actually went on anti depressants for a while but they made me worse.

[danie17075rm]

nursegirl- thank you! I will ask the docs to try something else to see if it works better.  Thank you so much for your replies.  Sometimes it feels better just to talk about it, even though the situation is ridiculous lol!  

Erica-  I do the breathing technique as well.  I think I have tried every anxiety natural product and technique known to man lol.  It does help to slow down the breathing though.

[erica127]

Wow that is alot on your plate. And i thought i had issues! I used to have the adreniline feeling as well on the way to social functions... i used the breathing tech it works sometimes and telling myself it will pass that fearing the outcome is making it worse.

[nursegirl6572]

I think looking for another therapist is a good idea.  I also think talking with your doc about other options for anti-anxiety meds is important.  The one I would recommend trying is Klonopin.  Since it is long acting compared to Xanax and Ativan, it may keep you at a steadier state.  The Xanax and Ativan, being fast acting but quick to dissipate may have actually increased the severity of your symptoms.  Valium would be a less common choice in your scenario, but with its muscle relaxing properties, it may be of some help as well.  Those are the two I would ask your doc about.

I also totally agree with you about the fact that the reason for the panic symptoms becomes secondary in a lot of cases.  Just the panic attack itself conditions us for the next one.  Like you said, we become obsessive.  We worry so much that we end up predisposing ourselves to continued attacks.  Without a doubt, you may struggle with that aspect for a while and may need to employ coping mechanisms to help try to break that anxious cycle of thinking/worrying/panicking.  It's not always easy.  I DO think, however that the improvement of your symptoms after the surgery will help a lot, even if decreasing the anxiety to a more tolerable level so you can start tackling the thought processes involved.

I feel for you, I really do.  Panic attacks without a medical cause are bad enough, but you have more challenges in that your worry is based on real circumstances...tests, results, surgery.

I hope and pray things turn around for you soon and you can find some relief after you pow wow with your doctor.  We're always here.

[danie17075rm]

It's funny you would pray for a medical condition when I just pray every day to not have one.  When you are anxious anyway and add a medical condition to the equation, it is not a good thing.  Every little ache and pain I think is a new horrible thing that will kill me.  Sadly, lately it seems like every thing that happens IS something major.  Even when I get my thyroid out, I will still have issues for a while until the treatment is right.  I think I might have issues anyway because my body is conditioned to panic now.  I actually become obsessive over it.  I take my pulse a million times a day.  I started when I was hyper, but now I just constantly wonder if I am going hyper again.  I think I honestly have posttraumatic stress over that whole hyper spell.  I also look at the world differently now.  I have to always make sure there is an escape for every situation I am in.  

I am working on my Master's in Health Psychology, so I have always been interested in mental health.  What I think I have discovered is that there is no difference between panic disorder induced by a medical issue and regular panic disorder.  They both end with the same result.  Once we have panic attacks, we all end up with the same thoughts.  We wonder where the closest hospital is, where exits are, we hate being in the back of the store, or in the middle of the crowd, planes, long car trips, etc, etc.  Ultimately, my body might get better and I might not have the same cardiac response (HOPEFULLY).  I will still have to deal with the mental aspect of it.  I REALLY do think that once you go over that line and have panic the way I have, you cannot go back to a place of never having experienced it.  It might eventually take medication for me, but I'm gonna wait for the madness I am going through to settle down.

I hope you are right that the reduction of symptoms stops a lot of this anxiety.  Maybe if I can go a large stretch of time without heart racing, palps, or shortness of breath, I will feel more confident in placing myself in situations where I have little control.  I know it will be a long process though.  

They gave me xanax .25, and that literally never did a thing during my episodes.  I still have the same bottle of 20 from August, because I never take it.  They then tried ativan at the ER.  I believe they gave me 1mg.  That can make me tired and it MIGHT help some, but that isn't a ton of help either.  I think my body is in such a state of HYPER panic that it's not enough.  I sometimes take a small piece of my beta blocker, and that does seem to help.  If I know I am in a situation which causes mental stress (such as visiting with my surgeon), the ativan might help a bit.  Again I take this RARELY.  I've probably taken 5 or 6 in the last 10 months of this.  What are the other options with these meds?  Is there something that might work better?

I was curious of the therapists reaction too (my undergrad was in psychology, I completed half of my masters in counseling, and now I am working on my masters in health psychology).  It was kind of weird as she was a counselor too, and I seemed to know more than her in some cases lol.  She wanted me to be her therapist!  I know though that it is not about education.  She could have listened and worked me through it.  I might start looking for one again especially during this horrible time.

I have been having HORRIBLE panic since Thursday waiting for my biopsy results.  I'm not sure how I will physically be able to walk in the office and get them =(.

Thanks for the help.  The website has been a life saver for me.

[nursegirl6572]

Hi there!  Glad you came over for some support!

You have a LOT going on, a LOT on your plate.  For one, I cannot even imagine how scary those initial symptoms were for you!  Then, when you found out you had a medical condition and continued to be ill, your stress level went through the roof, understandably!  Most of us with anxiety that isn't related to a medical condition would PRAY that we had some clear cut answer, like a disease, disorder, hormone imblance, etc...that would put our attacks into perspective.  Reading your story is a good reminder that regardless of the CAUSE, it's still he** and for us to wish that is crazy!

You DO have a few things greatly in your favor here.  For one, once you have the thyroidectomy, your symptoms will improve which will help take some of the power away from the anxiety cycle.  It's completely typical for you to have some residual anxiety for a time after your surgery, only because of what you explained in your OP....

...  The simple presence of very scary panic symptoms have caused you to begin fearing the sensations, and you're spinning in panic circles.  Like you said, sometimes it's hard to distinguish what is a symptom of your thryoid disease and what is an out and out panic attack.  The cycle of anxiety in a panic situation is a rough one.  The symptoms are terrible, and make such an impact on us that we begin to worry incessantly to the point where we bring on more panic attacks.  I'd be willing to bet at least a good 20% of your panic attacks are probably unrelated to the hyperthryroid.  In the very least, the severity of them has probably become so much worse.

I truly think that just the reduction in symptoms post op will make a HUGE difference in your anxiety, b/c you'll see that improvement and won't be stuck in such a round and round with worry and panic.  The less you panic, the better you will feel.  Again, you may still likely have some residual anxiety for a brief time, but nothing like you're dealing with now.

In the meantime...keep talking to your doc(s) about meds you can take until your surgery (why a month away, btw?) that will help with the anxiety. If Ativan and Xanax didn't work, there are other options.  Talk to your doc.  You shouldn't be left to suffer so much.  Sure, it won't probably be a total fix, but it will help a LOT if you can manage the anxiety and panic better.  Also, I'm shocked that a therapist turned you down.  I understand the primary cause for your panic is medically induced, but that doesn't mean this is not horribly emotionally stressful for you.  Perhaps try a different therapist?  You could still benefit from coping mechanisms and the support one gets from therapy.  

Try to hang in there.  I can't imagine the he** you're going through, and I really feel for you.  We're here for you...please feel free to come talk with us...vent...ask questions...anything we can do.  I hope you get some relief soon!