really worried :(

[E99]

Hi i am so worried that something is going to happen to me, i am usually such a coper and have been having palpitations, headaches and other symptoms for ages but not really worried about them too much, but since wednesday i have been in a constant state, i had a bit of a panic attack and since then i have been constantly worrying about things, or not even things just worrying about how i am feeling, like i am going crazy or i am going to die or something.. i went to see my Gp today but ended up seeing a different doctor, he wasn't that helpful but did give me some propranalol to try... are these going to help with my thoughts and feelings though because these are the main thing i am worrying about :( i am so fed up i feel really panicy and tearful but am trying so hard to appear normal to my kids, they have no idea how bad i am feeling... any help or advice regarding these horrible feelings of depersonalisation or whatever i read it is, and am i going insane?? i feel really stupid writing this by the way and am so annoyed that i have tis out of control feeling.. please help.. :(

[E99]

any advice? :) pleeeeease

[nomorepanic]

Hi

Propanolol will not help with the thoughts and feelings I don't think - they will just slow your heart down a bit.

[E99]

oh really? :( not what i wanted to hear.. my heart rate is slow, normally around 60bpm, i have ectopic beats rather than fast palpitations, the doc said that these could be sorted with propanalol and perhaps in turn this may help with the anxiety.. i just want to feel back to normal to be honest, i am normally such a coper, i feel totally out of control :(

[nomorepanic]

It will help with them yes but will that in turn then change the thoughts and feelings - I am not so sure.

I guess it depends on whether you think you will feel ok if it sorts out the ectopics?

[E99]

i guess before i started to have feelings of panic and anxiety, just dorting out the palpitations would have helped me to feel better, but now i am not so sure.. What do u suggest i do about the thoughts and feelings?

[RLR]

Okay, I've read your postings. Propanolol is within the class of drugs known as beta-blockers and they act on the heart by reducing cardiac force. They are most often prescribed to patients for treatment of primary hypertension, or in other words high blood pressure. They are being prescribed to you in what is commonly termed an off-label use, most likely in the attempt to try and reduce your heart palpitation events.

Beta-blockers also produce a mild anxiolytic effect and in some instances, patients can realize an ancillary benefit as well. Understand that the palpitations you have been experiencing do not originate from within the heart at all, but rather arise from stimulation of the heart muscle by the vagus nerve. It is sort of the equivalent of a muscle twitch elsewhere in the body. Significant anxiety or stress can produce physiological changes oftentimes misconstrued as symptoms of disease.

Feelings of depersonalization are quite common in patients suffering from intense anxiety or even clinical depression. Many patients describe the sensation as being inside a bubble that blunts their normal sensations, in a dream-like existence while watching themselves act in daily life almost as an observer rather than a participant.

Panic threshold events typically arise from an unidentifiable and unpredictable fear stimulus which the patient feels is constantly looming over them. Their internal vigilence is keen to any subtle changes taking place, either with their body or cognitive status, such that they become increasingly fearful that something dreadful is taking place beyond their ability to prevent it. Rapid and shallow breathing, together with a flight of thoughts and confusion, elevated heart rate and sensory disturbances usually drive the circumstances to the ultimate extent of experiencing a panic threshold event.

In many cases, these patients feel in a constant state of vulnerability, with greatly diminished self-confidence and uncertainty. There is poor locus of control and such patients feel threatened by irrational fear, unable to approach or challenge these fears due to avoidance of panic.

Just to make you aware, you are not "going insane." People with true psychotic break from reality demonstrate a phenomenon known as anosognosia, which is the unawareness that a problem exists. In other words, if you're aware that something is wrong, then you're not going insane at all.

You do need to identify the true source of your significant irrational fear and draw it out into the open for examination. You'll find that the actual souce of the fear is far less overdrawn or threatening than what you have anticipated from an irrational standpoint.

You're going to be just fine, so take a deep breath and relax. There is nothing actually wrong with you at all, only your body responding physiologically to significant and irrational fear. It's important that you realize the ability for anxiety and other mood related circumstances to produce physical symptoms of a broad nature and intensity.

Again, you should consider speaking with a professional trained and experienced in treating persons with panic disorder.

Best regards,

Rutheford Rane, MD (ret.)