Lost confidence in medical profession - thoughts appreciated?

Hi, how long ago were you on ssri anxiety meds and how long were you on them for? Did you stop them cold turkey or did you wean off them? You could be getting protacted withdrawal symptoms. These can last for months or even years depending on your dosage and duration of the drug.

You have had all the important diagnostic procedures which appears to have come out positive in your favour, if I am interpreting it correctly. This should give you much encouragement.

Anxiety sucks, I understand the horrible symptoms that it causes only too well. I don't know if you are currently on any medication for it but there are other methods of treatment such as CBD, mindfulness, relaxation, breathing techniques etc. etc.

I know several people with long covid and the tiredness they experience years later. This must be very debilitating for you.

Why not try and take a baby steps approach, by that I mean each day attempt to do a little more than the previous day, building your confidence up as you go along. Maybe keep a log of your progress. I used this approach when I had a bad bout of anxiety several years ago when I had to take 11 weeks off work. I even trialled going back to work by driving part of the way each day and each day driving a little further until I finally completed the 40 minute journey.

Try and stay positive and try and stay in touch with your true friends. I wish you well for the future.

Okay, I've read the entirety of your comment. I'm a retired medical professional and I'll try and bring you forward with a better understanding of your predicament. Firstly, let's briefly examine your description of the medical concerns.

All of your tests are negative for any heart or lung disease. Realize that spirometry tests are notoriously inaccurate with the exception of instances where lung capacity is damaged by disease already known through other tests and where spirometry merely measures it. There are a magnitude of factors that can influence spirometry values and your opinion that the results have determined your capacity to be "marginal" is highly suspect as inaccurate due to your age, fitness and sedentary lifestyle, not to mention your lab and other test results. While it is possible for you to have experienced symptoms of long COVID, the effects are limited in duration with the exception of worries regarding any continued presence and influence. At this point, I very seriously doubt that it constitutes a factor in your life. The issue regarding long QT and hospitalization was merely out of an abundance of caution by the medical community. Drug-induced long QT is of no consequence. It is the congenital form of Long QT syndrome that is of concern, so no worries in your instance.

Your breathlessness is most likely the consequence of sedentary lifestyle and weight gain. Conditioning will easily resolve the matter with regimen and attention to a more active lifestyle that includes exercise that, contrary to common beliefs, can be successfully achieved by brisk walking 2.5 to 3 mph for 23 to 30 minutes daily. Combined with dietary considerations, your conditioning and BMI will benefit greatly. We don't pay as much attention to BMI as we once did because the historical data is riddled with confounds, together with the fact that a person with minimal body fat and high muscle content can result in the same BMI as a person who has low muscle content and is obese. For these reasons and more, it simply isn't as reliable as once thought to be the case.

Your description of symptoms that accompany your mention of SSRI treatment is quite similar to patients who suffer from Panic Disorder. It's necessary for you to understand the clinical nature of this disorder and how invasive it is throughout all aspects of your life. Also realize that Panic Disorder most often includes both full blown Panic events as well as sub-clinical episodes that occur with far more frequency than patients with the disorder realize.

Panic Disorder can usually be traced back to childhood in most instances and while studies have shown a connection between Panic Disorder and significant separation anxiety, there is is less evidence in proving a causal relationship. From a purely biological standpoint, Panic Disorder is a term used to describe activation of the fight or flight instinct that is thought to become prominent in persons with diminished levels of the neurotransmitter GABA, or gamma-aminobutyric acid. While SSRIs are touted by their manufacturers to be successful in treating Panic Disorder, the actual outcomes are quite mixed and while some patients claim improvement, others find no effect while still others experience a worsening of their symptoms. In instances where anxious depression is present, there may well be signs of improvement but in all instances of SSRI treatment, the side-effect profiles can most definitely prove to be as troublesome as the disorder under treatment that can serve to exacerbate the overall circumstances.

I'll provide information about how the fight or flight instinct functions and how Panic Disorder can arise from its persistent activation. Doing so can help you realize just how the patterns involved can not only interfere with the life you once knew prior to the disorder's onset, but moreover how it can actually transform your life due to the irrational perceptions that arise in response to the influence of the disorder.

Fight or flight activation is present in all mammals and for obvious reasons was more competent in its expression in early man than for contemporary persons. In brief, if the brain perceives a threat to its safety and survival, the body undergoes a multitude of changes to prepare the body in achieving the greatest success in that regard by either fleeing in avoidance or taking a stand and fend off the threat. While this system functions in a very straightforward manner where the threat is real, it very readily results in a far more complex and cyclic malfunction where the threat is unidentified and subsequently merely perceived.

Since the former instance is quite self-explanatory, we'll focus on the latter instance because it constitutes the origin of Panic Disorder. It's important to realize that whether real or unreal, the fight or flight instinct reacts similarly because the brain responds identically. The changes to the body in instances where the threat is unidentifiable are universally associated with physical symptoms of an imminent event tantamount to a risk to one's safety or survival. This happens because the absence of a true threat creates an irrational premise for the brain. It is far easier to understand the rational premise because the threat is both detected and defined by the brain. There is a direct recognition that completes the cycle in rational terms. This happens to people all the time and is resolved and accepted as rational by the brain, therefore eliminating the need for the fight or flight instinct to remain engaged. The body returns to normal functional status.

In instances where the fight or flight instinct is engaged in the absence of an imminent threat, it is unidentifiable and yet the body's senses are heightened significantly, heart rate and respiration are increased, adrenalin is released into circulation, visual acuity is elevated, the brain becomes highly vigilant and the body is prepared to either flee or fend off a threat that in reality does not actually exist. So if the threat never actually presents itself, the fight or flight response begins to loiter in a state of activation that is variable from minimal to intense. The brain is subsequently unsatisfied that safety and survival are intact. One of the unique properties of the brain is that it is driven to make rational determinations regarding the surrounding environment. Anxiety is driven by the fact that a rational target cannot be identified and so the brain creates a moving target scenario wherein cues detected by the senses become salient and misinterpreted as threats. Because the changes to the body functions feel unusual, they become the erroneous target of the threat in contemporary humans because our complexity permits us to understand the risks to health that constitute our frailties. In fact, we are regularly exposed and somewhat trained to pay attention to our bodies and therefore the threats to our safety and survival are instinctually now internal as much as they are external. This advancement in knowledge significantly broadens the representations of threats perceived by the body's senses.

You might well imagine that if a person perceives changes to body function subsequent to activation of the fight or flight instinct, then the senses become focused upon those changes and attach significance to them. The result is an irrational fear regarding one's bodily functions and the fears of health problems capable of significant risk of harm or survival become the target. People who experience this misinterpreted and irrational fear more typically are influenced by the flight portion of the response and seek safety, most often their home or a healthcare emergency department. Remember that this is an instinctual process that involves the brain that is intent upon identifying a threat by definition of some type. Consequently, people feel a sense of impending doom regarding the performance of their heart or other critical aspect that poses a significant risk if it experiences trouble.

Realize that among other circumstances, for every occurrence of engagement of the fight or flight instinct, the brain internalizes information received by all of the senses so that future detection can arise earlier in order to attain the greatest advantage. So when people afflicted with panic disorder happen upon any similar instance where conditions are present like those that set the original instinct in motion, whether it be visual, auditory, olfactory, tactile or taste, it automatically sets the process in motion and the afflicted individual suddenly feels unwell, anxious and experiences racing thoughts along with other changes in bodily function. There is an instinctual need to seek safety. Again, the home is most often the retreat of choice and this is most often the reason for agoraphobia, along with feelings of inadequacy in public that they might become helpless or too weak to help themselves due to the changes in the body being experienced. This process also goes a great distance in eroding self-confidence. You might well suspect that together these collective processes literally alter the life of persons afflicted with Panic Disorder.

The way back from where all of this irrational response to life in general began is to understand and realize that what is taking place constitutes nothing more than an irrational perception and natural instinctual response by the body. In no way does it constitute any sort of impending harm or threat to survival. Most persons with Panic Disorder describe themselves as being separated from the world around them, as though some type of barrier exists between them and the world around them. Their senses feel blunted and this is because continual over-activation of the fight-or-flight instinct results in exhaustion. Afflicted persons most often feel unwell generally and this only serves to bring about complaints that something serious is wrong with them and has been overlooked by the medical community, escaping detection until it's too late. In other words, the erroneous beliefs regarding one's health status is seeking a place in a rational context by repeated efforts to make it all real such that the brain accepts identity of the threat. This cycle begins to erode one's existence to the degree that life for these persons and the world around them increasingly shrinks until it carries very little meaning, albeit a perception that is very misguided and mistaken in reality.

You'll find that the life you once knew is far closer to your reach than you believe and it begins by a thorough understanding of how the process of Panic Disorder works and how you can very easily navigate your way back to normality. It's important to create regimen in life, a written plan of daily life that actually excludes room for the irrational perspectives of Panic Disorder to exert their influence. The plan needs to be very simplistic and includes being active in the home if agoraphobic and gradually working up to being active near home, from there moving farther out to levels of comfort.

It involves reversing the focus from internal to external, viewing life around you rather than within you, with the knowledge that your body doesn't need constant vigilance to function correctly. The return of focus to external stimuli brings patterns of social behavior and interaction back to normal and away from the appearance of detachment. It involves exercise to burn away excess adrenalin during each day to the extent that the body slowly becomes used to functioning more normally. Health status improves and reinforces one's health status. Steer well clear of any caffeinated products or other stimulant products, for they will constitute difficulty during the pursuit to obtain normal physiology and absence of artificial stimulation.

You're going to be just fine. Contrary to your statement, I see absolutely nothing within the context of your life that even remotely defines a life not worth living. You merely fail to see the forest for the trees, so to speak, allowing the influences of Panic Disorder to erroneously transform your life from entirely within your control to one seemingly almost completely beyond your control. Realize that you, like so many others with Panic Disorder, have misinterpreted a multitude of erroneous cues in life that have resulted in actions in the wrong direction in the hopes of halting its progression. First we must clearly understand the problem and define its components before we can establish a plan of action that is successful.

There are multitudes of people who have suffered from the grip of Panic Disorder who have subsequently went on to lead the lives they once knew and enjoyed. It is not only possible, but probable that you can do the very same regarding your own life.

Best regards

Arther,

I agree with anxious....too bad you retired. This was a wonderful explanation as to how panic disorder works. Almost made me cry. I have generalized anxiety disorder and panic disorder. My mother also suffered. She could remember as far back as when she was four years old and getting panic attacks. I was very young as well and I had horrible separation anxiety when I was a kid I am trying to work through everything as best as I can by understanding more of the disorder and how I got this way in the first place. Thank you so much for your explanation. I'm going to keep it so I can re-read it often.

im sorry that was for Arther oops