Question:
My point in all my ranting is that I think my condition is
physical/biological rather than mental/emotional in origin. My doctor
would think otherwise. He prescribed Xanax for me, and wants to send
me to a psychiatrist.
But I think I still have my sanity and rationality, and I wonder about
underlying medical conditions that can cause PD coupled with
hypertension, like pheochromocytoma, thyroid dysfunctions,
aldosteronism, Cushing's syndrome, and other maladies in endocrinology
and nephrology. I've spent some time poring over web sites and adding
words to my vocabulary that should not be there!
But the point is my BP is still high (constantly 140/90), even on 2
doses of Altace, and sometimes spikes to 180/110 during a panic
attack.
I'm seriously ready to refer myself to an endocrinologist, and I
wonder how many other panic sufferers out there have done so. My GP
seems to want to label this as simply panic. What should I do?
Answer:
I am a 32 y/o male, and had my first panic attack in April 2004. I
had just recently been diagnosed with hypertension and, perhaps
coincidentally, started taking 5mg Altace on that day.
Since then, I lost 35 lbs (now down to a normal body weight for my
height), exercised regularly, and my BP did not change one bit. That
was kind of discouraging.
My next attack was November 1 last year and I drove myself to the ER,
narrowly avoiding a traffic violation. They quickly labeled me a
panic sufferer and sent me home in a couple of hours after my BP
stabilized.
Lately, my attacks have started coming on more frequently, and at
apparently random times. For example, I was sitting quietly watching
TV last night and had an attack. I know it is said that physical or
emotional stressors can trigger attacks, but for me it is not the
case. And what of all those other stressful periods in my previous 32
years of life that gave me no panic symptoms? Why now?
My point in all my ranting is that I think my condition is
physical/biological rather than mental/emotional in origin. My doctor
would think otherwise. He prescribed Xanax for me, and wants to send
me to a psychiatrist.
But I think I still have my sanity and rationality, and I wonder about
underlying medical conditions that can cause PD coupled with
hypertension, like pheochromocytoma, thyroid dysfunctions,
aldosteronism, Cushing's syndrome, and other maladies in endocrinology
and nephrology. I've spent some time poring over web sites and adding
words to my vocabulary that should not be there!
But the point is my BP is still high (constantly 140/90), even on 2
doses of Altace, and sometimes spikes to 180/110 during a panic
attack.
I'm seriously ready to refer myself to an endocrinologist, and I
wonder how many other panic sufferers out there have done so. My GP
seems to want to label this as simply panic. What should I do?
I always believe that someone initially labeled with panic disorder should
see doctors to rule out any physical causes for the symptoms. I think your
idea of seeing an endocrinologist is a good one, as thyroid can sometimes
play a role, as well as other hormones. In the end, it will make you feel
better to know that you have been checked out physically.
I'd go to a doc who will rule out all the organic causes of anxiety and
panic. If he finds nothing, then see a psychiatrist.
There are indeed many other conditions with symptoms that mimic panic
attacks. It's always to be recommended to have a thorough physical
check-up before chalking it all up to anxiety.
ACE inhibitors are good meds for high BP but maybe you need another med
to go with it, a betablocker or calcium channel blocker (I had high BP,
was on a betablocker first, that didn't work so well so a calcium
channel blocker was added and together they have been doing the trick
for 11 years or so).
Having a Panic Disorder doesn't mean you lost your sanity or rationality
(although you may have noticed that we are not the epitome of rational
thinking while having a panic attack).
Most panic disroders have both a biological (often hereditary) and a
psychological aspect. Xanax is *the* med of choice to kill PA's in the
bud and a very good maintenance med as well (especially the XR version).
A psychiatrist is a *doctor* so (s)he will mostly be involved with the
physical aspect and prescribe medications. Should you get a clean bill
of health and be diagnosed with panic disorder seeing a psychiatrist
would be the thing to do as well as seeing a clinical psychologist for
*Cognitive Behavioural Therapy* (CBT): often triggers will be found with
the help of the therapist that you weren't aware of before.
