Shortness of breath, panic and dizziness after alcohol but ongoing

[louise123_uk]

Around a month ago I will admit I drank a few too many glasses of wine. I drink socially at weekends but can tend to be a bit of a binger at times. I've had my share of hangovers, and this is what I had when I first woke up the day after: feeling sick, slightly headachy, tired and dizzy and spaced out. No biggie I thought, later in the day I was sick but again this didn't worry me, however, later that afternoon I started to feel like I wasn't taking full breaths and not exhaling properly - so I guess I would term this shortness of breath and I developed a feeling of dread and a tightness in upper abdomen under boobs and my stomach felt bloated and big. I also got some tingling in hands and face.

I put all this down to a very bad hangover and didn't drink for three weeks, however some of the symptoms kept on going. For around a week after drinking I had the shortness of breath, spaced out floaty off balance feeling of being on a boat and a tightness under boobs. I also kept getting the dread feeling. I'm thinking the tightness under boobs was due to perhaps over breathing as I have been fixating on breathing, plus I have put on weight in last year or so, so er I do have a couple of small rolls! I'm not sure if perhaps I just also don't sit up properly with great posture might also be contributing.

The shortness of breath is worst when I am out and start worrying about feeling off balance and I start worrying that I'm going to get the shortness of breath before it starts and the dread dentist waiting room feeling is worst when I'm out especially when out alone..... but I have never had panic attacks before, I worry about health but have never had generalised panic attacks when not worrying.....

I have been feeling better and its just been the off balance floaty on a boat feeling. I went to the docs and she looked in my eyes briefly, got me to follow her finger and from this seemed to rule out eyes/brain as the cause of dizziness. She then looked in my ears and asked me to pop them by holding my nose and swallowing which I couldn't do (can anyone????) so from this she said the eustachian tubes are blocked with fluid. I got told to inhale steam and use a nasal spray to clear sinuses etc which apparently should help with the inner ear fluid build up. This diagnoses is backed up by fact that I do tend to get dizziness after flights etc, as can't clear my ears by popping them and I did just fly at the beginning of May and had the on a boat feeling for a few days after but this then passed but I guess it could have just come back?? Was my May flight too long ago?

She didn't say anything about the shortness of breath etc, I think she thinks this is down to me panicing about being off balance but I'm not 100% sure as she didn't really focus on this..... It does worry and scare me feeling off balance but I'm not sure if this is what causes the shortness of breath, although as I've said it is worst when I'm out and about and tends to ease off if lie down and relax at home, so I guess this would be consistent with panic wouldn't it?

Was feeling better this weekend just gone, off balance feeling has been easing after using the nasal spray so I decided it would be safe to have a few wines at boyfriend's house, big mistake! I spent yesterday all day with the feeling of dread and felt like was having shortness of breath and the dizziness got bad again. I was freaking out so much when my boyfriend was driving me home yesterday from his house I got a really tight chest feeling under boobs, face went tingly and hot and when I got out the car to walk into my house my legs were complete shaky jelly.... The breathing was also worse after I just ate a small amount. I had diarrohea in the morning and my stomach felt bloated all day, not sure if I had some acid reflux perhaps....


I've always been able to drink socially fine my whole life, alcohol is actually a big part of mine and my friends weekends usually and never had a prob. I am cutting down a lot now, well none at all for now, but if this is all alcohol related it has come on overnight! I never had anxiety before from drinking.... I'm worried perhaps I might have liver failure, or maybe alcohol cardiomyopathy or perhaps that I have parkinsons and alcohol just exacerbates rather than is the cause..... I've even been reading about probs with the pancreas such as pancreatitus or pancreatic cancer....

Does the inner ear thing for the dizziness sound plausible and a coincidence that its flared up after drinking? Could the shortness of breath all be panic from symptoms of a bad hangover initially but now I'm worrying its going to happen and so am focusing on breathing too much until it does actually happen coupled with unease at the dizziness from inner ear....?

I'm fretting there is something serious wrong..... I have also booked a far flung beach hol towards ends of year with boyfriend's family and now terrified I won't be able to have even the odd cocktail or that I will be unable to breathe due to panic on the 13hr flight...


What do you make all of this? Is it worth going back to docs to stress the shortness of breath rather than the off balance feeling she has focused in on?

[Bearinmind]

I wouldn't say it's something to fret over.

There is a very strong correlation between anxiety and vestibular (inner ear) problems. Nobody knows for sure what is the nature of the correlation but it's definitely not life-threatening. Some theories say that all mammals have a instinctual fear of falling down, so when you get strong physiological balance problems, like a inner ear issue, your brain gets lots of wrong signals of body position and starts to believe you will fall any moment real soon. So what you do?

Well, you do what everyone does when confronted with an imminent fall: you tense up. You get agitated. That's the natural response to prevent injury from a fall. Even like when you trip over something, while you still are in mid-air, you involuntarily tense up all your muscles, because falling tensed up is way more safe than falling relaxed and limp.

Just think about: if you had to balance yourself over a tight rope so you wouldn't fall off a building, wouldn't you get tensed, get stressed, get anxious, start racing and hyperventilating?

To your brain, it feels something like that all the time now, because of your inner ear issue. Specially if you keep focusing your mind on the dizzy feeling. That will cause a panic attack, which will make you feel more dizzy.

I know about that because I have something similar. I have a very old perforation on my left tympanum, more than 10 years old, haven't bothered myself enough to go to the myringoplasty to close the hole yet. But the side effect of that hole is that I had many middle ear infections through my whole life, those infections damaged my labyrinth, the portion of the middle ear responsible for balance, so now I have a somewhat chronic dizziness. And health anxiety. Great combination!

This dizzy feeling will feed anxiety. One relevant story from my experience:

I know very well that I have anxiety issues. I know that mine is a health anxiety, it's all about deadly diseases, weak body, bad luck and all that. So there was this time that I walked to the supermarket to do some groceries. Felt fine on the trip, health wasn't even on my mind. As soon as I got the store, I started to feel anxious. Hell lot anxious, like, beginning stages of a panic attack (tight chest, breathlessness, tight body, weakness and all that). My reaction was "What the hell?! Why am I having a panic attack here? It's just a supermarket! I don't have fear of supermarkets, I don't have social phobias. Why am I panicking?" Even though I did know I shouldn't be panicking, I still panicked all the way through the groceries. When I got out of the supermarket, I started to feel fine again. Then it started happening all the time I went to that supermarket. Never got a clue to what was happening. Then, one time I went to the mall, and the same thing again, panic attack for no reason, I started to think that I had developed agoraphobia or some social phobia. But then, on the mall, I got inside a store that had carpeted floor and I started to feel fine again.

Then it downed on me: Both the supermarket and the mall have very sleek floors! Sleek, hard and very slippable flooring! From that on I started noticing that whenever I had to stand on a easy-to-slip surface I would get anxious and get panicky. Whenever I moved to sure ground, safe ground, I would feel fine.

This anxiety triggered by balance doesn't happen only on sleek flooring, anything that makes me more unstable makes me more anxious, like getting out a car that has been shaken too much, getting out a boat, standing up too damn fast, turning my head too fast and so on.

Alcohol as well (which is terrible, I love some good wine). Alcohol does a lot of funny things to you, one of which is increased blood perfusion (penetration of blood in your tissues), that's a good thing. But those of us that have some issue on the inner ear this increased blood perfusion on the ear might do weird things to our balance system, which will make us more dizzy.

To make matters worse, alcohols slows down the brain, both on drunk state and on the hangover. Such slowness will make harder for the brain to process balance signals, which will make you more dizzy till things get back to normal.

What can you do now? If it eases your mind you can try to get an appointment with an Otorhinolaryngologist, specialist for the ear, throat and sinuses. He can order some tests to identify if your dizzyness is truly a vestibular (ear) dizzyness. Probably a caloric test.

It's very likely not something serious, ear conditions are rarely serious, and when they are you have a lot more ear symptoms other than dizziness. But a good Oto can pinpoint the exact cause, it can be something as simple as calcium aggregation on the otolith.

Other than that, you should try to stop focusing on your dizziness. Your doctor did well to look your eyes, it rules out anything serious on the brain, so the worst is out. Dizziness is something that can be trained off (vestibular rehabilitation, if you need your balance that much) and it usually tends to get better on the long term as your brain starts to compensate the faulty signal.

The tight chest feeling and the shortness of breath are classic anxiety symptoms. The shortness of breath in particular. You really do feel "airless", you feel that if you hold your breath you will passout! But it's the exact opposite, we're not lacking air, we have too much of it. Hyperventilation. Worse yet, the ******* hits without warning, sometimes you're not even thinking about health, just minding your own business, and suddenly you start to hyperventilate without noticing.

I have an oxymeter at home, I use it to know when I'm having a panic attack. If I see oxygen saturation above 98%, I know I'm hyperventilating and about to have a panic attack. And many times I get myself on 100% when I'm just feeling slightly tensed up. If I let it run, then I get panic attacks.

But really, to me, it seems you have some minor ear issue that is triggering panic attacks, it's not life threatening.

[louise123_uk]

Thank you so much for this post it has made me feel better. xx

The off balance motion is just so scary at times when its at its worst. I'm still getting what feels like laboured breathing off too and on and the upper abdomen tightening - its hard to know if the breathing is causing the tightening or the tightening is causing the breathing!!

I do feel the breathing is just panic really but have never had panic this bad before where even sitting in my boyfriend's car as a passenger driving a route I know well I had such paniced breathing my hands and face were going numb.....

The story about what happened to you in the supermarket rings a bell exactly, my dizziness and breathing seem at their worst when I'm out, when ever since the first time I went dizzy and shaky and had trouble breathing when I was out, I have fretted will happen again when I am out and have a long way to travel to get home. Once I'm home the breathing seems to get better quite a bit though still have the dizziness.

I never realised before how scary a real panic attack was, I've had anxiety but never anything like these past 5 weeks - as I've never had them before I can only think that it must indeed be the dizziness causing panic, and the worrying that something is going to happen making everything worse when out, especially when alone.

Have a day out planned for Saturday, a play we have had tickets for a while, it will involve going for an hour on a train and I am really freaking out a bout it but prior to these last five weeks I've always been someone you can't keep in the house, I'm usually literally out and about all the time!! Really hoping agoraphobia isn't creeping up on me somehow..... I hate staying in and just want to feel normal again!

I think the breathing actually scares me a lot more than the dizziness and why the bad relationship with alcohol all of a sudden I've no idea, it makes me worry that the alcohol thing has happened out of the blue that I have damaged my body in some way with drinking in the past..... Its hard to trust that the off balance floaty and spaced out feeling is just an inner ear thing but it does sound plausible since I have had dizziness following flights/cruises in the past but I'm sure my May flight was too long ago.

I'm even fretting I won't make my holiday to Thailand/Hong Kong in Oct as not sure how I could do the long plane journeys feeling like this!! I need this dizziness to leave lol!

[Bearinmind]

Well, it's against the norm to recommend medical tools for people with anxiety, but I'm already guilty of that so to deny you that would be a hypocrisy: if the breathing thing bothers you so much, you can try buying an Oxymeter off amazon or something like that, it's really cheap (no more than 100 quid). It's just a machine that measures your heart rate and oxygen saturation from the tip of your fingers. I bought one for my cardio workouts at home (oxymeter's heart rate metering is way better than the crap I have built-in my bicycle) but they're pretty useful for anxiety because their Oxygen Saturation meter is a good indicator for that breathlessness feeling. All true causes of breathlessness, real diseases, be an allergy, lung disease or any kind of obstruction in your airways will force the Oxygen Saturation down, I would say below 94% but it can go even lower and still be considered healthy (while we're sleeping is normal to drop in the 80s range for example). While on panic, that breathlessness feelings makes you hyperventilate, which causes many of the symptoms of anxiety actually. The oxymeter can spot that hyperventilation easily (it's usually how they can tell that you're just having a panic attack when you go to the ER), it will show your oxygen saturation at 99% or 100% (the normal range would be 95%~98%), which in itself is not serious, it just causes a bunch of inconvenient symptoms while the oxygen maintains itself this high (high oxygen saturation alters the blood PH temporarily, which is what causes the feeling of weakness, agitation, cognitive issues, lighthead, the tingling and the extremities tension and etc). It's actually really weird to try the oxymeter for first time while having panic. You could swear by what you're feeling in your chest that you are suffering from a LACK of air, but the oxymeter is showing that you're having too much of it! And the oxymeter is always right, whenever I saw the saturation at 100% I knew I should calm down and try to drop it, using breathing exercises for anxiety, even if I wasn't feeling particularly anxious. The oxymeter was a great reassurance for anxiety.

For some people the medical tools can worsen than anxiety because then they start to either distrust the equipment reading or to interpret every fluctation (which is normal) as a sign of serious disease, but if you know how to use it, it can be a powerful tool. The oxymeter itself can do some crazy reading, if your finger is too small for it for example, the acurate reading can take some time to show up. They read much better at low light condition, so checking with the room lights turned off is ideal. It's also good to get one with a plethysmograph, as the graph can be a good indicator that the oxymeter is doing an acurate reading (graph with waves all with the same height and repeating themselves = acurate). Using it while on weird body positions can increase or decrease the oxygen saturation reading as well.

And as I said, it's a great tool if you plan to exercise, their heart rate is much more accurate than the crap that is usually sold for fitness.

About the dizziness: yes, the boaty feeling is actually a pretty good indicator that the dizziness is coming from the ear. "Anxiety dizziness" feels more like a lightheadedness to me (as I have both kind of dizziness I learned how to differentiate between the two so I know which kind I'm having). The impression that floor or the walls are "breathing" (their image seems to be expanding/contracting) it's also a good indicator for ear dizziness. Ear dizziness also get worse when moving head too fast or moving yourself too fast, specially vertically. Vertigo ("room is spinning" sensation) is also more common in ear dizzyness.

But really, the best thing for you to do now is go for an Oto appointment. He would be able to tell (by some tests, like the caloric test) if your dizzyness is vestibular or anxious and he'll be able to prescribe some anti-dizziness meds for you if you need your balance that much (like on your trips).

About that trip: you should try to get some "emergency anti-panic" meds, meds that you take only when you're having a too strong panic attack that you can't control on your own, so it helps you maintain the panic under control. It could be useful if you start to panic inside the airplaine or something like that. I would suggest a weak one.

Also, avoid alcohol for sometime. Not permanently, for some time only, till you learn to control your anxious nature. When I'm having my bouts of anxiety I have to cut my caffeine intake as both, alcohol and caffeine, can make anxiety worse.

Anxiety is not a life sentence, it can be cured, you just have to work for it.

[louise123_uk]

Thanks so much for your reply. I might just try an oxymeter, although I am starting to see that the shortness of breath is anxiety as if I sit quietly and force myself to breathe slowly it does get easier and it seems its after I've been doing all this breathing my chest gets tight, I guess from the extra extertion, but then a vicious cycle starts as I notice the tightness!

The dizziness is really an off balance feeling I guess of the room leaning. If I try and stand still to long I will physically sway - does this sound like inner ear dizziness? I was reading on here last night about someone fearing vCJD and I have read that starts with off balance and poor coordination and I guess this feeling is off balance more than anything else. I've also read that anxiety is a symptom of CJD and these panic attacks have literally come out of the blue, haven't had them before, even in the past when have been dizzy/off balance.

I don't have dizziness or an off balance feeling at all when lying down, and its only there very slightly when sitting, its mainly when standing and particularly walking..... Is this consistent with the inner ear?

[Bearinmind]

Mad cow disease has a very rapid progression, you would have more severe symptoms by now (and the the people who ate the meat with you would also be suffering)

If the dizziness pulls you more to one side of your body than the other then this is almost the complete confirmation that it's ear related. Not having preference is no proof that is not rear related, but having preference is almost always ear related. The swaying is common on all form of dizziness, but on neurological dizziness they tend to be pretty severe, like, the person can't walk without assistance otherwise they fall down.

One test you can do at home just to check if it might be ear related is a Rumberg Test. Just put your feet together, hands in front of you or to the sides. Then ask someone to check your swaying while you have your eyes open, then check your swaying while you have your eyes closed. If you sway more to one side than the other while you have your eyes closed, then it's most likely ear related. If you sway to both sides just as much then it could be anything, from ear, to anxiety, to neuro.
Basically, a positive result can give you the indication it's ear related, but a negative doesn't say that itt isn't.

That's why it's good to go to an ENT specialist to check on this. There are other simple tests you can do at home but they need more experienced reading to give a reliable result.

I don't have dizziness when lying down too, only when sitting, standing or moving around too much. More swaying and boat feeling than vertigo. It's more consistent with inner ear ear, yes.