Anxiety attack from a constant long-term level of anxiety?
May 15, 2007 2:40 PM   Subscribe

Can this be an anxiety attack even though my anxiety/stress has been constant and not sudden?

Sometimes I get pains in my chest that feel sharp and hurt more when I inhale. They only last a minute or so, and subside once I force myself to relax, close my eyes and breathe slowly.

I do have a history of serious anxiety & have discussed this with my doctor. During my last physical I mentioned these pains in my chest after my exam and she seemed to think it was very unlikely that it was anything other than my anxiety.

Granted, I've had a consistent level of stress lately between purchasing a home, being busy at work, and just always being kind of stressed - but I don't feel like anything is triggering these episodes and I don't have many other symptoms of a panic/anxiety attack. I get panicked when this happens, but ONLY because of the pain, not a generalized panic.

I have another physical in 2 weeks and I'm going to mention it again - it's a new GP so it will be a 2nd opinion. In the meantime, should I be more concerned than I already am?

Basic info about me is that I'm female, 26, healthy but overweight, and I take SSRI antidepressants for anxiety (and occasionally Lorazepam for anxiety attacks).

I'm just feeling particularly worried lately. I know you guys are either not doctors or not MY doctors, but I guess I just want to know if anyone has heard of panic attack symptoms that come on during periods of long-term but consistent stress.
posted by catfood to Health & Fitness (10 answers total) 1 user marked this as a favorite
Where's the pain? In one place, all over, back, front? I was having awful chest pains last year that were diagnosed as costochondritis (benign, treatable, no big deal)
posted by tristeza at 3:05 PM on May 15, 2007

From one panicker to another, yes, long-term consistent stress will make attacks more likely. I don't think it has anything to do with whether or not the stress is constant -- if one's baseline anxiety is high, attacks will generally be more likely (which is not to say they will necessarily occur).

I'm wondering, though, if the initial physical symptom is actually anxiety-related. I used to get something very similar to what you're describing. It was like something got "stuck" when I tried to inhale, creating a small, localized band of tightness and sharp pain right over or near my heart. Continuing to inhale made it worse. It was kind of like a small cramp in some muscle over the ribcage.

Based on some research I did at the time (and it was quite a long time ago, so I'm afraid I can't point you to any resources), it turned out that's probably what it was -- just a simple muscle cramp. Then it stopped happening, for the most part (this was some time in my late 20's), so I lost interested in researching it any further.

So I'm thinking that what could be happening is this: you have the cramp, worry that it's something more serious, which in turn makes the physical symptom worse (because your breathing has started to change, and you may be unconsciously tensing your muscles all over your body), which makes the anxiety start to spiral toward panic.

Or at least that's how I can imagine it happening with me. Regardless, though, of whatever psychological mechanisms are at work, I'm thinking that if you doctor isn't worried about it, chances are you're finding a another way to scare yourself.
posted by treepour at 3:45 PM on May 15, 2007

As someone who has had anxiety attacks in the past, I can say that having a constant, background level of anxiety is not a good thing, and definitely made ME more prone to having an axiety attack.

One of the several books I read as I was learning about anxiety attacks compared one's base level of anxiety to a pitcher of water. Anxiety attacks happen when your body has no more "room" to store excess worry and anxiousness, and instead these spill over into the awful, adrenaline-laced fight-or-flight reflex associated with anxiety attacks. So one of the goals for successfully living with anxiety disorders is to reduce your base level of anxiety, to keep your pitcher half full instead of almost ready to spill. Failure to reduce this base level means that your body is constantly stressed, and this higher base level of stress on its own may eventually trigger an attack.

So, yes, in my own personal experience, a constant long-term level of anxiety can trigger an anxiety attack. For this reason, exercise -- especially the kind that leaves you physically spent -- is an excellent means for reducing your base stress level. Something like a cardio kickboxing class is ideal. A vigorous swim, bike ride, or run will also do the trick, but it needs to be an exercise that literally leaves you dripping with sweat when it's over, almost like you are exorcising demons, lol. Anyway, that's what ultimately worked for me. Good luck :)
posted by mosk at 5:20 PM on May 15, 2007

I should add, I was also overweight when my attacks began, so it wasn't like I just fell into an exercise routine. It was work, and it took a lifestyle change on my part. Ultimately, I realized that I much preferred the "pain" from exercising to the "oh-God-make-it-stop" anxiety attacks I was having. It was also a means of gaining control over my body, and that, too, was tremendously reassuring, and helped reduce my base level of anxiety.
posted by mosk at 5:25 PM on May 15, 2007

When I was in my teens and 20's I used to get what treepour describes, and that's also what I thought of when I read your description. It has a name, and it's been posted about here before, I think. But I can't remember what it's called, sorry. But I was always able to cure an 'attack' by taking a few very slow and gentle, but deep breaths. This seemed to unstick whatever seemed stuck. I'm not a doctor, and of course you should discuss it with your doc.

I'm sure you're aware of all the good advice on ask.metafilter concerning anxiety. Hope you find something that works for you.
posted by DarkForest at 5:41 PM on May 15, 2007

Yes, it happens to me. My GP is also a cardiologist, so when I got for checkups I get extra heart-checking just because he cares about that stuff. I am fine, if overly anxious.
posted by dame at 6:06 PM on May 15, 2007

To settle your soul, all of these things happen to me also. If you just let them go (and it took me a long time), you can control them. After you see your doc, and he/she tells you you are healthy, just keep telling yourself you are ok and not going to die (which I used to think) and eventually you can talk yourself out of the attacks. I got myself to get into the attack and wonder what the feelings really meant. If you want more advice on the panic attack things, email me. I can give you lots of pointers. If worse comes to worse, get a prescription of klonopin or some other benzodiazapine, I have one and when I get a panic attack I hold the bottle in my hand and usually just thinking of how the drug will affect me will quiet the panic. That's just me. It's all in your head. And in mine. Oh yeah, what mosk said, exercise REALLY helps.
posted by WaterSprite at 6:41 PM on May 15, 2007

Chest pain can be caused by many things. I would try to get a full work-up. Personally I would not attribute chest pain to anxiety unless I was hyperventilating.

That said, it sounds to me like the very common Pericardial Catch Syndrome.
posted by loiseau at 6:45 PM on May 15, 2007

Pardon me, it's precordial catch syndrome. I always make that mistake.
posted by loiseau at 6:48 PM on May 15, 2007

I just want to know if anyone has heard of panic attack symptoms that come on during periods of long-term but consistent stress.

Sure. It's quite common.

Am I certain, however, that that's what's happening to you, just from the description? No, nor do I think anyone could be. If that's your question you need to get it answered by your doctor.
posted by ikkyu2 at 9:13 PM on May 15, 2007

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