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Question
Posted by: Concerned | 2011/12/08

Is this anxiety or depression?

Dear Doctor

I hope you can help.

2 nights ago my boyfriend went to a work dinner. When he came home he went to sleep but woke up shortly thereafter feeling like he was going to swallow his tongue and had a tightness behind both ears which lasted an hour or 2. He was anxious about this and barely slept that night for fear of it happening again.

Yesterday he went to the GP who prescribed an anti histamine, an anti inflammatory and an anxiety / depression tablet (S5 - I can''t remember the name except that it sounded similar to Xanax but wasnt Xanax).

Last night he slept a bit better but woke up around 1am gasping for no apparent reason. After a while he was able to sleep again.
Tonight we went for dinner to a friends house and while standing chatting to his friends he suddenly felt light headed and had the tightening feeling again but this time in front of both his ears right down his jawline. He called his GP again who said that he hadn''t wanted to mention it initially but the symptoms he showed 2 days prior were as a result of either an allergic reaction or a panic /anxiety attack as a result from stress.

We are concerned about this diagnosis. While my boyfriend certainly has a large share of stress, he doesn''t feel that he is more stressed than usual. He is worried that there may be something physically wrong with him resulting in these episodes.

My boyfriend is in his mid thirties and is very healthy and a very fit mountain bike rider.

Judging by the symptoms I''ve described, would you think these episodes could be anxiety or panic attacks, or should he be seeing a different doctor for a physical exam?

Thank you very much!

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Our expert says:
Expert ImageCyberShrink

The problem with many troubles related to anxiety is that one easily becomes understandably anxious about them - which makes them feel worse.
What you describe isn't exactly typical, but does sound like panic disorder, as panic attacks can show themselves in such ways. It would be wisest to arrange to see a good local psychiatrist for assessment and a discussion of treatment options. While some sedative / tranquillizers of the valium family can provide some fairly rapid relief ( and some can be placed under the tongue and absorbed from there ) these meds can provide relief but don't help to clear up the condition. Other meds also used to treat depression, can be more effective at helping to clear up the condition.
An allergy doesn't sound as likely, as it seems unlikely that he would be exposed to one particular substance, to which he was notably allergic, in so many different situations, and which he must never have met before, as he hasn't had such symptoms before.
Its actually typical of Panic Disorder that one experiences both psychological and physical symptoms of anxiety, accompanied by a strong sense of fear that one is seriously ill, or may go mad or drop dead. Fortunately this doesn't actually happen, but it feels at the time as though it might.

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Our users say:
Posted by: cybershrink | 2011/12/09

The problem with many troubles related to anxiety is that one easily becomes understandably anxious about them - which makes them feel worse.
What you describe isn't exactly typical, but does sound like panic disorder, as panic attacks can show themselves in such ways. It would be wisest to arrange to see a good local psychiatrist for assessment and a discussion of treatment options. While some sedative / tranquillizers of the valium family can provide some fairly rapid relief ( and some can be placed under the tongue and absorbed from there ) these meds can provide relief but don't help to clear up the condition. Other meds also used to treat depression, can be more effective at helping to clear up the condition.
An allergy doesn't sound as likely, as it seems unlikely that he would be exposed to one particular substance, to which he was notably allergic, in so many different situations, and which he must never have met before, as he hasn't had such symptoms before.
Its actually typical of Panic Disorder that one experiences both psychological and physical symptoms of anxiety, accompanied by a strong sense of fear that one is seriously ill, or may go mad or drop dead. Fortunately this doesn't actually happen, but it feels at the time as though it might.

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