physical anxiety before mental

[Footloose83]

Does anyone else experience physical anxiety symptoms before the mental. My comes and goes quite often (even being on Prozac for a year). I would wake up extra tired, feel sluggish, unmotivated, disoriented. Then the following day still feel that way then the mental part kicks in. Last anywhere from a few days to a week and then one I’ll wake up and it almost magically goes away for a few weeks, then the viscous cycle returns. My psychiatrist thinks it could be the Prozac, my CBT therapist says it could be multiple thinks or another undiagnosed medical problem. Had bloodwork done multiple times from my physician and endocrinologist and everything checks out normal. Just curious if anyone else experiences this and what helps them. I’m sure it’s some form of anxiety as I dealt with this stuff all my life.

[ShyEeyore]

I'm not a doctor, but my experience is that I, too, have had physical symptoms even though mentally I'm feeling ok. I can give you an example. I was chatting with a friend and my husband while sitting on the couch. My four grandchildren were in our media room just watching a movie. There wasn't any particular triggering event or conversation, and I was actually in a pretty good mood. We were all just talking and sometimes laughing. Without warning, I started to feel somewhat lightheaded super hot, and my heart felt like it was pounding out of my chest. My husband noticed I was having problems and went to get the blood pressure cuff. As he left the room, I was in a semi-state of consciousness and slumped onto the floor. I was complaining my chest hurt, my skin felt clammy, my blood pressure was really high, things were foggy, and I was talking incoherently. I'm a woman who was 58 at the time, so my husband, who had some training in first aid, called 911. My physical symptoms were pointing to a heart attack. I thought for sure I was having a heart attack; the pain was excruciating. My memories after that are scattered at best.

I was told the EMTs got me onto the gurney I couldn't stand. They did some preliminary diagnostics and said given my age and symptoms, I should go to the hospital. This incident happened at the peak of Covid, so my husband couldn't go into the hospital with me. He gave them a quick rundown of my medical history and current meds because I couldn't do it, letting them know I had been diagnosed with and was being treated for hypertension, MDD, GAD, and ADHD. During the trip to the hospital, the EMT gave me nitro and one of my Xanax. By the time we got to the hospital, I was starting to feel better. At the hospital, I was put on an IV and given something for the pain and anxiety; a ton of diagnostic tests were done.

As I became more alert, I now felt the emotional anxiety. I was scared and alone because no one could be with me in the hospital. Every test came back negative. By the end of my three-hour visit, I was told, physically, I was fine; they could find nothing wrong with me, and they chalked it up to anxiety. The doc explained to me that anxiety can mimic a heart attack and can come on suddenly. They did want me to follow up with a cardiologist and my PCP, but just in case something was going on, they just didn't see. I followed up, and there were more diagnostic checks, mostly on my heart, and everything came back just fine. So, yes, emotionally, you can feel somewhat ok but have very real physical symptoms. Some days, I feel really low and lethargic, and others, I am a functioning human. This is a strange disease. I'm certainly not advocating that you should ignore physical symptoms because the possibility of it not being anxiety is just as high as it being anxiety. So you should always get checked out to be sure. All we can do is to take each day, sometimes each moment, as it comes and deal with it as best we can. Just remind yourself that this isn't something you can control, and use skills to cope through CBT, DBT, and psychotherapy. All we can do is to take each day, sometimes each moment, as it comes and deal with it as best we can.

[Footloose83 in reply to ShyEeyore]

Thank you for your response. I have my good and bad days with the physical symptoms without having anything mentally bothering me. That experience happened to me earlier this year. Never had it that bad since being diagnosed 22 years ago. I’m now 40 and really taking this seriously. Kinda thinking it has something to do with the Prozac I’m on. Only been on it for a year, but before that was on another ssri and never got this bad, just was really emotionally numbed to n the previous one. I cut back on my caffeine, exercise 5 days a week, eat pretty healthy, no alcohol for over 2 years. Just weird why within the past 8-9 months I started to really feel like this.

[ShyEeyore in reply to Footloose83]

Have you expressed this to your doctor?

[Footloose83 in reply to ShyEeyore]

Yes. Had to change psychiatrist because my old one almost didn’t seem to care. The new one I’m seeing (just saw last week) may want to switch medications. It’s been a rollercoaster with finding the right one. This Dr seems to take more interest and time into my concerns

[Attaloss01]

Hi,Yes I experience physical symptoms a day or 2 before the 'great dread' feeling takes over.

I'm a lifer too when it comes to anxiety, some panic attacks, complex PTSD, 'anxious depression' etc.

My therapist and doc are not too helpful but I actually think that the physical run up to bad anxiety episodes are possibly caused by the physical symptoms to an extent. I may not be sleeping as deeply as I think. Do you have fibromyalgia or similar? A 'flare' can cause a bout of fatigue, aching, cognitive sluggishness and eventually anxiety attacks. When the flare eases up sometimes the anxiety will linger with no apparent ' cause'.

Just a thought, but I do relate to what you said for sure. Take care!

[Footloose83 in reply to Attaloss01]

Not sure if I have fibromyalgia. Is there a test for that? I do meet with my psychiatrist in a little bit, I’ll ask him about it. Thank you for the input. I’ve been wrapping my head around this for years

[Attaloss01 in reply to Footloose83]

Yes there are several physical tests for it now. 18 bilateral trigger points on the body that when pressed are unusually tender. You may want to google search it. I could be wrong but a number of your other symptoms, when combined with at least 12 of the 18 trigger ( tender) points, if you have them, made me wonder. There is medication now, to help control the symptoms. Pregabalin 8s one of them, or Lyrica ( I THINK).