Anxiety about health

[Forrest Owl]

hi I am a 27 year old female, 4 months ago I started having pain in the left side of my back, shoulder and then it would go to my chest so I freaked out and went to the ER because I thought I was having a heart attack, they did a ton of blood test, chest x ray, ekg and a heart monitor thing while I was there and everything came back normal. well I went awhile without this problem and now its back again, the past week maybe a little more. so now I think its my heart again or maybe angina. I've never had high cholesterol, I don't have high blood pressure, I've never smoked and I don't drink. I exercise at least 4-5 times a week with walking or getting on my exercise bike for 15-20 mins so I guess I am young and healthy but I cant get it through my head my pain is probably just from my back, a few months ago I followed up with my primary doctor about this and she said I have a lot of tension in my shoulder and neck that was contributing to all the pain in those areas, but yet I still think I have angina now and will have a heart attack and die soon, my husband and everyone else says Im fine and its my anxiety, please help I am scared and don't know what to do. I can't get myself to be rational. so much doom.

[alankay]

Forrest, well the holiday stress can add to your anxiety a bit. Indeed stress and anxiety often results in muscle tension. It very often involves the neck and shoulders and if you're anxious, you might notice tight/tense head muscles(yeah, lost of muscles around the scalp area) and jaw muscles. This all feeds the "flight or fight"(anxiety) response and vice versa. Work on deep breathing exercises and consciously relax your head, jaw, neck and shoulder muscles and it will help defuse anxiety. If this is getting to the point of really distressing(bothering you), why not talk to your doc about it? I've been through the heart worry too(it's the most common worry for anxious folks as it's easy to pick upon it's beat picking up, etc) so understand. If you've been checked out via an EKG and holter test, you're fine. The odds of a healthy, 27 years old with normal lipids/BP, who exercises and passes those tests having a heart condition is very, very remote. I'm sure you doc. is 100% correct(muscle spasms, etc). There are muscles in the rib cage/shoulder blade areas that can spasm(ice pack on the area for 10-15 mins might stop the spasm). I'd talk to her and come out and say you're anxious. It seems you know or think you're anxious. I just think so by the wording of your post, I'm not trying suggesting anything here. Just being honest. Have you been to a doc. about anxiety? Just wondering as it doesn't exactly sound new to you. In any case I've been there. I'm sure you believe the docs but anxiety is really got you going and it's no fun. It turned out I have no heart issues and I'm a runner who somehow managed to worry allot and get very anxious about it big time. Looking back it seems kind funny now. Hope you'll be feeling the same way soon. Message me any time.

[Forrest Owl]

ive had this issue with my anxiety and hypochondria for 6 years no therapist seem to help of know what they are doing. yeah I was checked out and said I was fine that its def not my heart but im still scared it is

[alankay]

Have you had a trial of an ssri to see if it benefits you or are you opposed to any meds? If psychotherapy/counseling didn't help, I'd look into that. I hate to hear that you're suffering this anxiety if there is a way to reduce it.

[Forrest Owl]

Ive been on meds and they just made me worse

[alankay]

How long of a trial did you give the meds? Sometimes they do increase anxiety before they work to lower it(sadly). Often patients just start at a lower dose(I did) of an ssri and after a few weeks move the dose up slowly into the therapeutic window(dosage range with benefits) but slowly to reduce/avoid much of that ssri implementation anxiety/side effects. Did you do that? If not I'd retry with you and your docs talking about a schedule slowly titrating(increasing dosage) upward over time. Say zoloft 12.5 mg for 2-4 weeks, 25mg for 2-4 weeks, 37.5mg for 2-4 weeks then hold at 50 mg and reevaluate. Just an idea as it would likely help your anxiety. Message me any time.

[Forrest Owl]

I don't know why I think its my heart probably because its on the left side and even though I was checked out I don't believe the doctors. my husband says I need to see a chiropractor since ive had mild scolosis since I was young. and Ive been on several meds, I was on celexa for 2 years and went off of it 4 months ago. all the meds did were make me feel worse

[alankay]

Oh the scoliosis might involve a nerve in the back then. Yeah then I would check in with a chiropractor. If you got relief from the pain do you think that would resolve the anxiety or do you feel it's(anxiety) a separate issue?

[alankay]

Just a thought but to help determine if it's anxiety(differential diagnoses of sorts), I wonder if your doc would agree to a very short course of a long acting benzodiazepine like clorazepate or diazepam just to see what effect it has. If you all of the sudden you get great relief from a say, 2 day course of clorazepate(say 7.5 mg-15mg AM and them 12 hours later) that might help confirm it's just anxiety. They can also use Lyrica(as an alternative off label). If either effects that pain then it''s the nerve or anxiety but NOT the heart. Those drugs can reduce muscle tension and Lyrica can reduce nerve pain but that would still help rule out a heart issue(it has NO effect on any angina which is a result of lack of oxygen supply to a part the heart muscle, or other pain from heart issues). Just trying to think out side of the box to be of help. Still if it were angina you should be getting pain during any exertion. It must be frustrating and I'm sorry.
Otherwise a trial of another ssri might be different. It might not have the negative effect celexa had on you. I used it and it only messed with my sleep but even that passed. Yep, they can try other classes too to get you some relief.