What are the effective strategies for managing anxiety?

Question

Hi doctor,

I am a 34 year old female. I have been having terrible anxiety for the past month. I wake up feeling very uneasy and nervous. Almost shaky. I also feel like I literally cannot breathe. I have to take deep breaths constantly. I went to an urgent care and they tested for a blood clot in the lungs, but I was cleared. My doctor put me on Escitalopram two months ago and I stopped taking it. But then the anxiety got so bad that I started again on it two weeks ago. My fear is that there is something wrong with my heart. I have had this before and chest pain. So, I have been to two different cardiologists. We did stress tests and echoes. I am afraid these doctors are blowing me off because I am active.

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Stopping the anxiety medicines abruptly and not taking the drugs regularly is an adverse event that aggravates the situation. Anxiety symptoms get worse if we suddenly stop taking the medications, especially Escitalopram. Escitalopram takes time to kick in (once you start taking it). It works to create a balance of certain chemicals in your brain and if you have to stop it, you have to consult the treating physician who will tell you how to taper it off before coming to a complete stop. Now that you have started it back, it will hopefully take some time to kick back in and you just need to be consistent with it unless asked otherwise by your physician to stop taking it.

Thanks for uploading the supporting documents (attachment removed to protect patient identity). I reviewed them and want to add that this is all that we expect from a normal heart. Your Holter monitor gives perfectly fine readings. The stress echo and other aspects of your heart's evaluation are all perfectly fine. Your heart is working as normal as it should. In short, your heart is perfectly fine and working the way it is supposed to at this age.

You just need to keep an eye on your lifestyle and keep yourself busy achieving life goals. Keep a naturally balanced diet and exercise on a daily basis. Follow up with your physician and of course, you may consult me back anytime you need. I would be happy to assist.

Hope it helps.

Regards.