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Question
Posted by: David | 2020/06/06

Anxiety attack or something more synister?

For the passed week or so I have had a tight feeling/a feeling of pressure/a dull ache in my chest around my lower left pec which gets worse when i take a deep breath. The passed two days i have had intermittent nausea and a dull ache in my upper left arm. I have also been feeling generally anxious. I did also have a event the other night where i suddenly started bleeding quite heavily from a small red lump on my left cheek, this bled quite a bit for over an hour, but i doubt this is related to my question but thought id mention it just in case. These symptoms are eased greatly for 4-5 hours when i take 5mg diazepam which makes me think this is a prolonged anxiety attack rather than a heart issue? But i would really appreciate if someone could put my mind at rest? So i am 23 years old, male, generally fit (Gym 4+times/week pre-coronavirus). I do suffer from quite severe anxiety which comes and goes. I take 30mg Mirtazapine nightly and Diazepam as needed.

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Our expert says:
Expert ImageCyberShrink
- 2020/06/10

Hello David,   Mirtazepine is an antidepressant used to treat Depression, but also used effectively to treat anxiety disorder.  It does indeed sound as though you may well have an anxiety disorder.  Antidepressants like Mirtazepine can be very effective in treating anxiety, and take a couple of weeks to show their full potential.  Valium is very different : more specific to anxiety symptoms, its a bit like a drink of alcohol : it shows its effects quickly, which is helpful when one wants a quick response. It and is relatives tend to reduce concentration and coordination, and even the next day, so one needs to be cautious about driving, maybe handling gym  equipment, and so on. The big problem with them is that if they're used every day for a couple of weeks, there's a real risk of developing dependence on them, and this can be difficult to shake off. 
Anxiety can also be effectively treated by specific type of psychotherapy called CBT (Cognitive-Behaviour Therapy, so you can see why we call it CBT! ) which doesn't take ages, and helps you to learn to understand and avoid or control whatever triggers your episodes of anxiety, and how to calm yourself psychologically, and to relax deliberately when you need to do so.
The symptoms you describe are really typical of an anxiety disorder,  including concern about bodily symptoms, amplification of any minor source of pain, discomfort breathing, maybe a rapid pulse ( though regular exercise tends to help reduce pulse rate ), sweating, etc. One easily gets caught in a vicious circle where such a symptoms makes you worried, which increases the symptom, and so on.
And anxiety is sneaky, and people who become very anxious worry that their symptoms must be due to some awful disease, or even, in a full-blown panic attack, feel sure they're going to go mad, or drop dead. Fortunately this does not happen, but the concerns are very convincing.
The lesion on your cheek is probably not directly relevant, but if it bleeds fairly easily ( rather than only when it gets nicked shaving, or scraped in the gym ) it's worth having your doctor have a look at it.  These things are usually nothing serious, but its always worth checking to be sure.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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