panicface
23-08-22, 17:55
I've had GAD for 35 years. Omnipresent.
Currently take Lexapro (15mg) which allows me to function (travel, mostly avoid panic attacks). When I do start to have an attack - I pop a .5mg Xanax and it usually cuts the anxiety and I fall fast asleep. (so, not a solution).
Since wearing my Apple Watch (5yr) I've started to notice a trend. I can actually see my panic attacks coming, usually the same day, sometimes the day before.
It goes like this:
My sleeping HR is around 57 - 65
I'll notice my sleeping HR (or resting) will first stay in the 70's and never get to 60's.
Then it will do the same to the 70's and stay in 80's.. This is where I normally begin to 'feel it'..
At this point it will rapidly (over an hour or two) ascend into the 90's as a baseline and it's time to take a Xanax. after an hour it's back in the 70's then next day 60's.
Keeping an eye on your pulse is a very useful biofeedback tool (for me) for alerting me that something is 'building up' and try to cut off it's head before that monster-face confronts me.
If you don't do this already, check it out - watching the trends might be useful to some of you.
But - that's not the purpose of my post.
HRV - Heart Rate Variability.
If you don't know it - it's basically the length of time between each heart beat, and your bodies ability to adjust / recover to stressors. It involves your nervous system etc. Here's a good primer:
https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4 (http://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4)
Normal HRV should be 100 or above, bad HRV is 50 - 100, showing something is wrong with you, below 50 is just plain crap.
It's been used (in healthy individuals) to upcoming serious disease and early / sudden death etc.
My average is 29! lol - and throughout the day it will vary from a low of 14 up to 34 or so..
I've noticed over the last year of tracking it on my Apple Watch - that the closer to 14 I get - the less energy and 'life-force' I have.. The higher it is, the more normal I feel.
Doing housework, or anything physical will lower it quickly.
Two quick quotes from the article:
"Individuals suffering from an anxiety disorder are characterized by chronically low heart rate variability (HRV) compared to healthy individuals during resting state conditions."
"However, according to GUTS, chronically anxious individuals have difficulty detecting safety and therefore, the chronic stress response is not inhibited but rather stays chronically active [5 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR5)]. The GUTS differentiate between the stress response during a stressor and the prolonged stress response, namely the recovery after the stressor has ended [8 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR8)]. According to GUTS, the prolonged stress response from experimental stressors is associated with adverse effects of anxiety and stress; e.g., by an increased risk of cardiovascular disease [9 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR9)]. Stated differently, an anxious individual does not seem to recover from the stress response but still chronically stressed (e.g., [10 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR10)])."
As someone with GAD, I know we all try to sort out what is causing this hell on earth we suffer from, and there seems to be a million reasons - low vitamin D, magnesium, blah blah..
I'm more geared toward cold hard facts... (as I think I've tried everything else).. (sigh)
Over the last few months, when my HRV is in low 20's I'll take a Xanax and see what happens, sure enough - over it's 4hr lifespan my HRV rises to high 80's and as the drug peaks it begins to fall back down. (this has happened 8 out of 8 times I tested) 100%.
This shows me that my constant low-level state of anxiety is keeping my HRV very low, and when I remove that - through Xanax - my HRV returns to something close to normal.
(see screenshot below)
Now my question -
It's my theory that the Lexapro is masking a large percentage of my perceived anxiety, however allowing the internal mechanism of anxiousness in my body to continue unabated. This is negative for long term health.
Xanax on the other hand is working under some other mechanism that actually changes the underlying anxiety and allows me to reach normal number (albeit briefly). Taking a Xanax every 4 hr is not an option.
Is anyone familiar with this? Or have any suggestions? I'd like to find an online psychiatrist that is familiar with this correlation - and then look for another drug other than Lexapro - that will indeed cut the anxiety and allow my HRV to go higher, for longer.
Any ideas?
Thanks..
5632
Currently take Lexapro (15mg) which allows me to function (travel, mostly avoid panic attacks). When I do start to have an attack - I pop a .5mg Xanax and it usually cuts the anxiety and I fall fast asleep. (so, not a solution).
Since wearing my Apple Watch (5yr) I've started to notice a trend. I can actually see my panic attacks coming, usually the same day, sometimes the day before.
It goes like this:
My sleeping HR is around 57 - 65
I'll notice my sleeping HR (or resting) will first stay in the 70's and never get to 60's.
Then it will do the same to the 70's and stay in 80's.. This is where I normally begin to 'feel it'..
At this point it will rapidly (over an hour or two) ascend into the 90's as a baseline and it's time to take a Xanax. after an hour it's back in the 70's then next day 60's.
Keeping an eye on your pulse is a very useful biofeedback tool (for me) for alerting me that something is 'building up' and try to cut off it's head before that monster-face confronts me.
If you don't do this already, check it out - watching the trends might be useful to some of you.
But - that's not the purpose of my post.
HRV - Heart Rate Variability.
If you don't know it - it's basically the length of time between each heart beat, and your bodies ability to adjust / recover to stressors. It involves your nervous system etc. Here's a good primer:
https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4 (http://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4)
Normal HRV should be 100 or above, bad HRV is 50 - 100, showing something is wrong with you, below 50 is just plain crap.
It's been used (in healthy individuals) to upcoming serious disease and early / sudden death etc.
My average is 29! lol - and throughout the day it will vary from a low of 14 up to 34 or so..
I've noticed over the last year of tracking it on my Apple Watch - that the closer to 14 I get - the less energy and 'life-force' I have.. The higher it is, the more normal I feel.
Doing housework, or anything physical will lower it quickly.
Two quick quotes from the article:
"Individuals suffering from an anxiety disorder are characterized by chronically low heart rate variability (HRV) compared to healthy individuals during resting state conditions."
"However, according to GUTS, chronically anxious individuals have difficulty detecting safety and therefore, the chronic stress response is not inhibited but rather stays chronically active [5 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR5)]. The GUTS differentiate between the stress response during a stressor and the prolonged stress response, namely the recovery after the stressor has ended [8 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR8)]. According to GUTS, the prolonged stress response from experimental stressors is associated with adverse effects of anxiety and stress; e.g., by an increased risk of cardiovascular disease [9 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR9)]. Stated differently, an anxious individual does not seem to recover from the stress response but still chronically stressed (e.g., [10 (https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00551-4#ref-CR10)])."
As someone with GAD, I know we all try to sort out what is causing this hell on earth we suffer from, and there seems to be a million reasons - low vitamin D, magnesium, blah blah..
I'm more geared toward cold hard facts... (as I think I've tried everything else).. (sigh)
Over the last few months, when my HRV is in low 20's I'll take a Xanax and see what happens, sure enough - over it's 4hr lifespan my HRV rises to high 80's and as the drug peaks it begins to fall back down. (this has happened 8 out of 8 times I tested) 100%.
This shows me that my constant low-level state of anxiety is keeping my HRV very low, and when I remove that - through Xanax - my HRV returns to something close to normal.
(see screenshot below)
Now my question -
It's my theory that the Lexapro is masking a large percentage of my perceived anxiety, however allowing the internal mechanism of anxiousness in my body to continue unabated. This is negative for long term health.
Xanax on the other hand is working under some other mechanism that actually changes the underlying anxiety and allows me to reach normal number (albeit briefly). Taking a Xanax every 4 hr is not an option.
Is anyone familiar with this? Or have any suggestions? I'd like to find an online psychiatrist that is familiar with this correlation - and then look for another drug other than Lexapro - that will indeed cut the anxiety and allow my HRV to go higher, for longer.
Any ideas?
Thanks..
5632