Fear of ALS\ Perceived (or real?) speech issues

[TinkrTonkr]

So let me introduce myself. I am 20 years old, my name is Fábio, and I'm from Portugal. I had stomach cancer 1 year ago, had surgery and thankfully everything is fine, I'm cured. But since then I developed other problems, I am currently being treated for anxiety and depression. Currently taking Mirtazapine, Olanzapine and Diazepam (quitting this slowly)
So my symptoms are: Weird Jaw feeling, it is like a dull pain and feels like sometimes it shakes a little and I can't find a comfortable position for it to sit, feels awkward and I'm constantly thinking about it. Then one day I looked at my tongue and saw twitching\\fasciculations and a online search eventually led me to ALS.... 2 and a half weeks ago I saw a Neuro, he said I don't have ALS but didn't do much testing only tested reflexes and said there were no tongue fasciculations. But for a 2 months (more or less) I've been having trouble speaking, saying some words and sometimes I kinda stop before saying the next word like my tongue was not fast enough, get it? Another symptom I have since Christmas is sometimes I feel like I can't initiate a swallow, again Neuro wasn't worried at all, but it still happens to this day although it seems to be getting better. So all of this trouble speaking, swallowing and jaw has me thinking I must have ALS, bulbar onset. I know the statistics are in my favor, it's INCREDIBLY rare to have bulbar ALS at 20 but what else can this be? Anyone had similar symptoms and turned out to be benign? Thanks for any help!

[Fishmanpa]

Please read THIS! (http://www.nomorepanic.co.uk/showthread.php?t=196071)

Positive thoughts

[TinkrTonkr]

I read that Fishmanpa, in fact I posted in ALSFORUMS and got banned, twice, because I was so persistent with my questions. I know I shouldn't have, people there are mostly suffering with this terrible disease, I was insensitive.
My question is: Anyone here with anxiety had the following symptoms: Jaw feeling awkward like there is no comfortable position and feeling like it's shaking or feeling the pulse in the jaw, also tongue feeling odd. Then speech feels a lot more difficult but I'm not slurring (Noone commented on it and I recorded myself, I sound fine) I just seem to have a weird difficulty pronouncing some words and also some trouble initiating some swallows. I just wanna know if these are possible anxiety symptoms... The Neuro dismissed me and said "Forget ALS" but he didn't even test my tongue strength so I don't know if I can trust him.

[Fishmanpa]

Ahhh... I see that. That's truly sad and incredibly disrespectful! So I "respectfully" ask your to please read that post over and over until it sinks in. Especially the part about Bulbar.

Positive thoughts

[TinkrTonkr]

I know I was disrespectful, and I know I feel terrible about it :(
I read the part about Bulbar but I still have these odd symptoms and all I wanna know is if someone that suffered with anxiety has ever had these symptoms, I mean the jaw thing is weird, I have no jaw weakness but it feels weird and it's like I can feel the pulse and it feels like there's no comfortable position for it to rest. Also the speech issues I don't understand I have always been a fantastic speaker and now all of a sudden I cannot speak clearly a few words...

[Fishmanpa]

I echo the sentiments of the posters with ALS that were so kind to offer their reassurances. "Yeah buts" won't get you anywhere. Please get help with your anxiety.

Good luck and as always...

Positive thoughts

[TinkrTonkr]

I'm scared, today my speech is worse I have trouble saying words with the letters "tr" and "d" and I think I'm slurring a little...
Can anxiety really cause this?

[Fishmanpa]

Can anxiety really cause this?

Absolutely... from an article about anxiety and speech issues....



Anxiety can cause slurred speech, as well as issues that resemble slurred speech. All of the following are potential links between stress/anxiety and slurring of words:

Overactive Thoughts
One of the key reasons that some people slur their words is because anxiety makes it so hard to focus their brain. Stress can affect recall and mental accuracy, and extreme anxiety can cause you to be so far "in your head" that it is extremely difficult to get words out. In a way, anxiety makes your brain work too hard, and when it does some of the other things your brain needs to do don't work as well - like speaking.

Muscle Tension
Anxiety also causes significant muscle tension. Muscle tension can make it harder to move mouth muscles, which of course is the main cause of slurred speech in most other conditions.

Over-Awareness/hyper-focusing
An interesting problem with anxiety is the way it makes you over-aware of what would otherwise be subconscious/automatic behaviors. It's seen in other areas of life as well - for example, anxiety can make it harder for some people to walk because they're more aware of the movements in their legs. It can affect the mouth and speech as well. Speech is an automatic movement, and during intense anxiety your mouth movements may be controlled by you rather than your subconscious mind, making them much harder to do.

Anxiety Medications
Slurred speech is the side effect of many different anxiety medications. Most often it's because these medications act as muscle relaxants and make it harder and harder to move the muscles in your mouth and face.

Tiredness, Caffeine, and More
Several fairly normal issues can also affect speech. For example, those that are very tired may be more prone to slurred speech because their brain is not functioning as well as normal. Tiredness (as well as a lack of caffeine for those with caffeine addiction and other issues that may affect alertness) slows the brain down to the point where both muscles and function work less effectively.These are just some of the reasons that anxiety may be responsible for slurred speech. It should also be noted that some slurred speech once in a while is normal even in those without anxiety. But when you have anxiety, it's easy to feel as though your problems speaking mean "something more" than what someone without anxiety would think. Slurred Speech From Anxiety Isn't Dangerous. While it's important to talk with your doctor about the cause of your slurred speech, slurred speech caused by anxiety is not dangerous. It's not a sign that you have something else coming, or that your brain will somehow be inefficient for handling life tasks in the future.There isn't a specific treatment for slurred speech because slurred speech is simply a response to anxiety. One thing you should do, however, is avoid forcing the words out. If your speech is slurring, forcing yourself to speak is going to add more stress. The more you try to force out words that aren't coming out naturally, the more you'll find that the words become more troubling as your brain becomes more stressed as a result.

Positive thoughts

[TinkrTonkr]

Interesting.... I guess the constant yawning today can be a result of anxiety too, and the fact that I sleep poorly last night?
I yawned at least 10 times in the last hour or so...

[Fishmanpa]

Interesting.... I guess the constant yawning today can be a result of anxiety too, and the fact that I sleep poorly last night?
I yawned at least 10 times in the last hour or so...

That should be a statement, not a question.

What are you currently doing to treat your anxiety?

Positive thoughts

[mjh82]

Hello,

20 years old to be diagnosed with ALS is unheard of in a extremely rare disease.

I can sympathize with the PERCEIVED speech and swallowing issues as that was some of the earliest issues I freaked out about during this horrible fear ridden journey.

Your hyper aware of your automatic functions right now due to anxiety and fear of an illness that you don't have.

The best thing you can do is evaluate your anxiety/depression medication with your doctor and maybe seek some therapy as I've done recently. It's helped calm me down to a degree.

Your 20 years old man and way too young to be worrying about death. This is the prime years of your life right now don't let those waste away due to fear.

[TinkrTonkr]

That should be a statement, not a question.

What are you currently doing to treat your anxiety?

Positive thoughts

I had depression last year after my stomach cancer which I guess is very normal, so I began treatment with Mirtazapine+ Olanzapine plus Diazepam (Valium)

I'm quitting Valium right now, so I guess some of these symptoms could be Valium Withdrawal? I used to take 15mg daily I'm now taking 1,25mg only.
But I really want to quit this drug, it gives me anhedonia (I have no pleasure in things I used to enjoy, like videogames, movies or going out with friends)

---------- Post added at 16:15 ---------- Previous post was at 16:13 ----------


Hello,

20 years old to be diagnosed with ALS is unheard of in a extremely rare disease.

I can sympathize with the PERCEIVED speech and swallowing issues as that was some of the earliest issues I freaked out about during this horrible fear ridden journey.

Your hyper aware of your automatic functions right now due to anxiety and fear of an illness that you don't have.

The best thing you can do is evaluate your anxiety/depression medication with your doctor and maybe seek some therapy as I've done recently. It's helped calm me down to a degree.

Your 20 years old man and way too young to be worrying about death. This is the prime years of your life right now don't let those waste away due to fear.

It's not unheard of, there have been a few cases, but "Bulbar onset" according to what I learned in ALSFORUMS (should never have been there) is almost impossible.
That should help calm me down, but you know, I had stomach cancer at 19, the doctors said that was almost unheard of so...

[Fishmanpa]

I had depression last year after my stomach cancer which I guess is very normal, so I began treatment with Mirtazapine+ Olanzapine plus Diazepam (Valium)

I'm quitting Valium right now, so I guess some of these symptoms could be Valium Withdrawal? I used to take 15mg daily I'm now taking 1,25mg only.
But I really want to quit this drug, it gives me anhedonia (I have no pleasure in things I used to enjoy, like videogames, movies or going out with friends)

Ahhh a fellow warrior/survivor. If you beat the beast, you most certainly can beat the dragon. I'm a two time heart attack, triple bypass, stents and Stage IVa Head and Neck cancer survivor (I'm also old enough to be your Dad!). I suffered from some depression and "scanxiety" after my illnesses. With therapy (talk and CBT) and a chill pill as needed, I've gotten past all that. Yeah, benzo withdraw can be tricky.

Look into CBT. While all areas didn't apply, I found some very good techniques that helped me rationalize some of the fears and thoughts and in fact, it's been useful in every day life situations (work, relationships etc.). It would make sense based on your experience that you would fear something as rare as ALS but there comes a time when you have to allow rationality and reality to take control. Right now you're allowing a fantasy to rule your life. Think about this. We've both had conditions that could have put us six feet under. By hanging onto this irrational fear, you're essentially doing that to yourself above ground.

Positive thoughts

[TinkrTonkr]

Ahhh a fellow warrior/survivor. If you beat the beast, you most certainly can beat the dragon. I'm a two time heart attack, triple bypass, stents and Stage IVa Head and Neck cancer survivor (I'm also old enough to be your Dad!). I suffered from some depression and "scanxiety" after my illnesses. With therapy (talk and CBT) and a chill pill as needed, I've gotten past all that. Yeah, benzo withdraw can be tricky.

Look into CBT. While all areas didn't apply, I found some very good techniques that helped me rationalize some of the fears and thoughts and in fact, it's been useful in every day life situations (work, relationships etc.). It would make sense based on your experience that you would fear something as rare as ALS but there comes a time when you have to allow rationality and reality to take control. Right now you're allowing a fantasy to rule your life. Think about this. We've both had conditions that could have put us six feet under. By hanging onto this irrational fear, you're essentially doing that to yourself above ground.

Positive thoughts

I certainly can beat this, I know I can!
Benzo withdrawal is hard, but I'm going through with it. And the ALS fear should disappear with time, I mean I won't have progression (hopefully!) and by then I will know it's not ALS and I'll be good (hopefully).
I know right now I should believe the neuro who told me NO ALS and also believe all the people at alsforums who said "no als" and I should take in account the odd being something like 1 in 165 million for my age, but right now I can't and the fear took control. But I know with time this will get better and hopefully I'll have a happy life!
Just knowing anxiety can cause speech issues seems to have made these issues less noticeable!

[Catherine S]

Another thought is that you also take quite a few meds at the moment, so some of the symptoms you describe can be side effects from those, as well as withdrawal symptoms if you are reducing diazepam, which is a tranquiliser and coming off tranquilsers can produce strange sensations as your body learns to cope without them.

ISB ☺

[TinkrTonkr]

Another thought is that you also take quite a few meds at the moment, so some of the symptoms you describe can be side effects from those, as well as withdrawal symptoms if you are reducing diazepam, which is a tranquiliser and coming off tranquilsers can produce strange sensations as your body learns to cope without them.

ISB ☺

I read online that one of the possible side effects (1 to 10%) of olanzapine is Dysarthria, which is difficulty speaking. It's probably reasonable to think that if up to 10% experience dysarthria with this medication, probably a lot more experience minor speech issues, which is what I have right now. So I'm holding onto that. It's all related to Olanzapine+Mirtazapine. And also the withdrawal from Diazepam.
Life has been a pain, but I know it will get better.
Thanks all for the support and kind words.

[TinkrTonkr]

So yesterday while trying to fall asleep I had a strange symptom that freaked me out!!!
I felt my throat was closing up and it started twitching for a few seconds. Today I'm better but I have a tight feeling in throat and it's twitching ocasionally.
Tried to eat\drink and I can do it fine though.
Again is this a symptom of anxiety?

[TinkrTonkr]

I am again scared about Bulbar Onset ALS because today I choked on water, but then tried again and went down fine.
Other problem is that I think my voice is sounding weird, very weak and scratchy and also cracking... I fear this may be due to vocal cord paralysis... :(
Anxiety is hell

[Catherine S]

This is quite a common symptom of fear. I've kinda given up using the word anxiety lately, because let's be honest, most people who join the forum are terrified not just a 'bit anxious'! When we are experiencing fear our muscles contract, and that's every muscle in the body including the throat, because in the old days of battle, tightened muscles meant less damage if you were hit.

Unfortunately we still have those 'fight or flight' responses in a modern world, and our reflexes react the same way they did when we lived in caves. In those days we wouldn't notice all of this going on as we prepared for battle...well you'd be preparing for it, i'd be at home looking after bam-bam and Dino, but the lives we live today, unless we run marathons every day to use up the surplus stress hormones, we are much more tuned into the symptoms of stress.

Your fear and the stress it's producing is doing all of this to your muscles. Nothing else. Not ALS. Climb out of the hole.

ISB ☺ x

[TinkrTonkr]

Yeah I called my doctor because I was afraid I would stop breathing but he said this is just anxiety, the muscles in my throat have tightened and he said with a clean neuro exam and considering my age it's 0% chance I have ALS.
I feel better now, had to take a Diazepam 5mg, I really want to quit this med but from time to time I still need one.
Thanks all for the reassuring words.

[Catherine S]

It can be a double edged sword with the diazepam too. The withdrawal symptoms can include this muscle tightening too, because relaxing muscles is what diazepam does, so again it could be because you're trying to reduce them. Not easy I know. I took them many years ago when doctors were not so careful prescribing them. Be well.

ISB ☺ x

[TinkrTonkr]

New symptom since last night: Excessive Yawning. Since last night I've been yawning a lot, like 2 times a minute sometimes. Is this common in anxiety?
I know this is common on Bulbar-Onset ALS so I got scared again, but I guess it might very well be anxiety right?

[TinkrTonkr]

Terrible hard time today, I feel my head is gonna explode, and I've been having for the last 2 weeks but today it is much worse a very weird feeling like tongue doesn't fit in mouth and my face I feel like it's very tense\\numb or whatever and I feel jaws slightly shaking and even feel the pulse there. Is this really all anxiety?