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I'm a new caregiver.

My mom's been diagnosed with Panic Disorder + Major Depression recently and we're all suffering because of it.

She has symptoms such as heart palpitations, shortness of breath, dizziness, headaches, blurry vision, etc etc. We went to the ER tons of times but all the doctors said she was fine. Did ECG, CT scan, LOTS of blood tests, holter monitoring, MRI etc and the reports came back negative.

To date she's seen about 10 doctors, taken LOTS of different heart medications (none worked), BP medications (none worked), and is currently on Lexapro + Xanax and one BP medication (not working either). Nothing seems to be working and her complaints seem endless.

Right now we're beginning to suspect that it may be something else and not something psychosomatic that's causing this.

I'm sick of this! No doctor is giving us a proper answer to why this is happening! They're all "nothing is wrong. You may be discharged" and that's it! The only diagnosis we got right now is Panic Disorder but really! the SSRIs should work shouldn't they? But her heart is still pounding and she's still dizzy. WHY?! Is there a physical explanation to this? I'm extremely tired and stressed out just trying to find out what's wrong!!!

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This time your mother may well be right, ali. It does run in families. Your doc will likely test your TSH, Some docs won;t treat till it is way off. Hopefully if you are borderline your doc wil try meds.
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Timely conversation for me, as my mother sidled up to me Thanksgiving day and said softly "You're at the heaviest I've ever seen you." Hah! I knew what she meant. My weight really hasn't increased all that much in past couple of years, but I'm puffy - it's a different look for me. And my hair is... falling out, falling apart, in ways that never happened before. The texture is increasingly very dry and delicate.

I'll be making an appointment to see my GP and see if he will agree that trying a low dose of thyroid meds may help me, even though my thyroid doesn't test low enough to be considered officially "low," but I think after everything I've been though he may agree to let me try a low dose of thyroid meds. My mother takes medication for low thyroid. She thinks I'm showing some symptoms.
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ff - my daughter, my mother and I have had trouble getting proper diagnosis and treatment for hypothyroidism. It is fairly common in women and can show up around menopause - hair loss, weight gain, hearing problems, constipation, dry skin, depression, lethargy, under eye puffiness, water retention, and more all of which could be attributed to menopause and "aging".. When I taught biology, I often had a student in class who was having these problems and would urge them to talk to their doctor. When the tests are borderline it is recommended that the individual be started in a low dose of meds to see how it affects symptoms and how the person is feeling. I found I started feeling better quite quickly. Do let me know if your doc treats you and if it works.
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golden23, oh my gosh, thanks for the info on low thyroid. I checked the symptoms and I have quite a few of them... plus my doctor said I was borderline low. Wish she would have put two and two together because she has been treating me for panic attacks. Of course, maybe this has nothing to do with it, but to me it is worth investigating :)
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Cottoncandy - I had heart palpitations/panic attacks for years and it turned out to be due to borderline low thyroid. The thyroid tests were not off enough for doctors to diagnose and treat me for hypothyroidism, but, eventually, I looked up symptoms and had 19 out of a list of 20 and insisted that a doctor try me on a low dose of synthroid. He was very surprised that, as treatment progressed, I needed much more than a low dose of meds and the panic attacks and heart palps went away. Like your mother, all tests they did on me came back normal. I was 53 at the time too. I had very heavy monthly bleeding which was the symptom that pushed me to push my doctor for treatment. I know otherwise they would have referred me to a gyn for a hysterectomy which would not have solved anything, but would have stressed my body even more. Many doctors do not recognize the symptoms of and need for treatment for borderline thyroid disease. Not sure that the specialists are much better. Endocrinology is a relatively new area compared to, for example, cardiology.

My mother in her 80s was tired and getting weaker. Her doctor did not find anything wrong. Many would think it was "normal" at her age. She visited me and I noticed her symptoms and told her to mention thyroid to her doctor. Hypothyroidism runs in our family. She was put on thyroid meds and is 104 now.

I am not saying that this is always the answer for panic attacks and heart palps, but it should be checked out carefully. I agree with cm that likely she is grieving and counselling/treatment for that may help. And keep calm yourself! ((((((hugs))))) 53! I wish. She has many years yet and they can be very productive and enjoyable.
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Cotton candy, it's a "known thing" that anxiety/panic disorder can onset during menopause. I'm 41 and my docs have brought that up previously when I said "There's no reason for me to have sudden onset of this level of anxiety when I didn't have it previously," and they'll say "Not true, it's been known to happen during menopause changes." And then I scowl at them and think to myself that I'm far too young to be undergoing menopause... ;-)

While anxiety/panic disorder doesn't happen to MOST women undergoing menopausal changes, it is something known to happen. That would explain even further why your mom's docs went to this diagnosis after tests ruled out other things.

If the psychotropic meds aren't helping your mom after several weeks, ask docs to change to something else. It can take some time and trial-and-error to find the combination of meds that does help.
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53. Really!!??

You mom, whether she realizes it ot not, has many good, useful and hopefully healthy years in front of her. She needs to get to the psychiatrist and the gyn, yes, but she also needs a therapist or counselor who can help her get back to work, whether it's as a volunteer or as a professional.

Look at it this way. When grandma died, mom lost her job and her identity. Viewed that way, panic attacks seem like a reasonable response. She needs a new " job", doing something she enjoys. Get her to a mental health counselor so that she can figure this out with someone.
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Cottoncandy, oh my gosh your Mom could be going into menopause, glad you mentioned that. That in itself is enough to make one want to go running into the street screaming.

The mood swings.... those pesky annoying hot flashes.... wanting to cry.... all those sleepless nights.... thinning hair.... and that weight gain. It's enough to put anyone into a panic wondering why is my body mad at me.

Does your Mom have a GYN? I would schedule a visit and talk with the doctor. I have found GYN doctors who are female have a much better understanding of what is going on, especially if they are or have been going through menopause themselves.
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Bloody hell, CottonCandy - I'm 53! But it's still sweet of you to be looking after your "aging" mother..!

What your mother has been through... Oh boy.

The menopause makes you feel like crap, and the symptoms vary enormously both from person to person and from day to day.

What she's been through with your grandmother last year is also something I completely understand, because so did I, also up until last year.

I've discarded my siblings so at least your mother's doing better than me on that score.

Stop freaking out when she has symptoms. Your job is to introduce calm and control into the situation. Your mother needs to learn breathing techniques, she needs to allow herself not to be okay because she's not going to be over the caregiving trauma yet, she needs to talk to her peer group - tell her to join us here! - she may well need grief counselling and the anti-anxiety meds may help so persist with them. I would be surprised if she is not depressed.

Listen up. You, much as you love your mother, can't cure her. There is no way you can understand what it feels like to come through caregiving and be 53, on your own, menopausal and feeling existentially redundant. Your mother will need to find new motivations and new consolations herself, you can't do it for her. And you can't rush it.

Seriously, tell her to come and have a look at AC. She will be very welcome. Sharing her experience, getting it typed out and out of her system, might also be a great relief to her.
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Thanks for the reply, all. Was down at the ER again yesterday because my mom had those heart palps and shortness of breath; she was telling me where she kept her money as though she was dying and I didn't know what to do so I called the ambulance :'(

Anyway at the ER the doctor said it was clearly an Anxiety attack. He did another series of tests (all negative and clear) and told me to stop subjecting my mom to further testing because that'd just stress her out more - more radiation, more poking. He said my mom's perfectly healthy physically according to all the tests he's conducted and told me that we should stick with the Psychiatrist's treatment.

Now the appointment with the psychiatrist isn't until 10 more days and seriously I'm freaking out each and every time my mom goes in Panic mode. Not surprised if I get the Disorder myself in future.

My mom is 53. She is still getting periods and I don't know if she's menopausal? She told me this morning that she's in a VERY foul mood. I am an only child and I work and she's pretty much alone half the time. She has a TINY social circle that comprises mainly her siblings who hardly have time for her. She used to spend majority of her time being a caregiver to my late grandmother, who passed away last year. Now, my mom doesn't do anything at all.

My aunt has tried asking her to do some stitch work and craft but my mom's refused. She's pretty much lost interest in everything. I can't get her to go anywhere either - she'd be like "i'm afraid I might have those heart palps again".

She's now saying she feels like an invalid and is mad at herself. I have no idea what to do! She says she feels frustrated and hates everything.

I'm at a loss. I wish there was something I could do!
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Veronica. I think you hit on something important here. In so many cases there is an underlying cause for panic attacks. Genetics and personality has so much to do with it - at least it applied to my mother - all those things - worry wart, fears, being alone, poor self image, aging, being married to a very domineering husband, then losing him so she had to think for herself after ten years of being told what to do.
We would all do well, as we age to look at our parents for similarities to ourselves to see if we can prepare for what might happen to us also.
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Cotton candy, the drs are not giving you answers because right now because they don't have any.
Have there been any life changing events in Mom's life recently? I don't think you mentioned how old she is. if she is young enough could this be associated with menopause.
Does she still live indepenentantly and if so is she still managing the home the way she has always done? Has she always been a worry wort to a greater or lesser extent. Was she overprotective of you kids and sitting up half the night when you went out on a date till you got home. Is she fearful of how she will manage in later life or have money worries like low income or credit card debt. These kinds of things can have a culmative effect until they get so bad the person is paralyzed with fear. Psych consult sounds though it would be helpful unless that would make her feel more anxious ("Now they think I'm mad") Does she have a friend who has been diagnosed with something terrible and she fears the same fate. i am just throwing out ideas but sit down quietly and think through what she has been through in the past few years and see if any clues emerge. I am going to look up Conversion disorder now because if i stopped in the middle of a post I loose it.
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Cottoncandy,

Getting panicked and scared can make your heart pound. Also, sometimes people think their heart is doing something irregular, but tests show that it's not. Actual tests can rule things out. It sounds like this lady has done this already.

Your post stood out to me, because I have two family members who had very similar symptoms. Both have now been diagnosed AFTER extensive tests and multiple doctors and experts, including psychiatrists. Ruling out physical causes is crucial, but after you reach a certain point, I'd ask about psychological causes. They are just as real and painful as any other kind of condition. Don't underestimate them.

One of my family members suffered very scary symptoms that included dizziness, feeling of fainting, though he never actually fainted, loss of vision as if the room grew dark, and seizure like symptoms. He wore a monitor on his body for over 2 weeks that showed that he HAD NO HEART irregularities during these spells. And he had the test where you lay on the table and it tilts to measure blood pressure.....he had NO BLOOD pressure changes DURING these spells, as he had a spell while on the table. He had an MRI and all tests found nothing wrong neurologically. His meds were reviewed and he was cleared by cardiologists, neurologist and Primary. Later, a psychiatrist diagnosed him with CONVERSION DISORDER. Research it and you'll see how it presents in a patient. My loved one accepted the diagnosis, went on medication and has had no relapses in 2 years! So, this confirmed the diagnosis. I am so happy that he found treatment and relief.

I have another loved one who has similar symptoms, but hers are symptoms are more varied. She also has headaches, arm pain, nausea, etc. She has also had the same tests that rule out physical problems. There is nothing causing her these distressing symptoms. She eventually saw the psychiatrist . I was no in the consult, but believe that she was also diagnosed with a similar psychosomatic disorder. She's gone on meds and is improving. I have checked her meds and had to remind her they are important. She has a tendency to skimp on them. (She takes it in liquid form and is gradually increasing her dose.)

I would suggest that you DOUBLE CHECK THE MEDICATION that she CLAIMS she is taking. Sometimes, people lie about it and are NOT taking the meds. If she is, I'd discuss adjusting the meds. They should help. If they helped my loved ones, they can do wonders.

Good luck. I know how stressful this can be.
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My mother had panic attacks also. She would have them in the night (because she lived in a house alone but refused to move) She would wake and call my sister and say she was dying. She sweat, threw up, messed the bed, etc at least once a week - then a trip to ER and they would send her home in a few hours. This went on for years.
The doctor put her on Klonopin to take before she went to bed, or whenever she had a feeling of panic. It helped a lot, when she remembered to take them. Then we moved her to AL, she had two attacks the first few months, trips to ER - then they stopped completely.
Maybe the Lexapro and Xanax are too much for her. Maybe the doctor needs to change the meds, at least try to see if there is some other combination that would work.
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I commented and then re-read comments. ;-) My thoughts went to similar places - there should be BP monitoring at home, and those home BP devices aren't difficult to get. Doctors should provide due to situation if you ask about it, CottonCandy. You or mom (if she's able) can do BP checks 2x a day, log over several weeks, and that will give a clearer picture of what's happening with BP.

Klonopin could be an alternative if Xanax is causing dizziness, and consistency is important. Take at same time, on a schedule, regardless of absence of symptoms.
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Hrm. Your mom was feeling dizziness before and after she started a new regimen of Lexapro (SSRI) and Xanax (medium half life benzodiazepine)? Keep in mind that a few months of taking daily Xanax will make withdrawal difficult... so if mom's going to take those meds for more than 3 months, be prepared for her to take for years, and educate yourself on proper benzo withdrawal (Ashton Manual). Just... a side note from someone who's been there, and doc often doesn't tell you that class of meds is extremely habit forming.

The benzo can cause some dizziness, so can that particular SSRI while it builds up in the system. It can take a month for any effects of that SSRI to be noticeable -- other than the dizziness when you first start taking it, but that will lessen.

Is there any chance there is an environmental factor? Does your mother live in your home, and you're feeling normal and healthy? Did mom recently move into your home?

Mom's BP is a little too high? So she takes a medication to lower it but that's not having an effect, either?

Do you administer/watch your mom take her meds or do you trust her to take on her own? The dizziness could be explained by the new med regimen, the heart palpitations and shortness of breath by panic. Those symptoms should lessen as time goes on... but there's no way a BP med shouldn't be having some effect. :-/

I feel for you, Cotton. I've been to many doctors and a few ERs the past several years trying to get to the bottom of symptoms that were similar to your mom's -- no BP issues, though. Turns out there was an environmental toxin, a bad mold problem, that set things off, plus high stress (which your mom might feel due to recent changes -- you said you're a "new caregiver"). The SSRI and benzo should help the heart palpitations, shortness of breath, headaches -- if it's a chemical imbalance in mom's body due to panic.

I think the only thing you can do right now is to continue to monitor your mom. Any 2nd or 3rd opinion you take her in for will do the same tests, and without anything else flagging them in a different direction, they'll default to panic disorder because it fits your mom's symptoms.

Does your mom intake any stimulants, is she a coffee drinker? You might discontinue anything like that for time being.

Please come back and tell us if anything changes with mom's diagnosis. Take care.
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Cottoncandy, just curious if the heart palpitations feel like the heart is racing? I started to get that and it was such a scary feeling. Turned out I have a leaking heart valve, no big deal for the time being, and the cardiologist put me on a certain type of blood pressure pills and they worked.

Panic attacks are very real to a person. While helping my aging parents I was getting such attacks while driving. It took a lot of trial and error to find the right tranquilizer that didn't give me side effects. Everyone is different. What works for me might not work for your Mom.

And if your Mom is on a lot of other medicine the medicine might not be user friendly to each other. My doctor started me on the very lowest dosage and had me cut that low dosage in half. Then after a couple of weeks, tried the dosage without breaking it in half.

My own Mom had the dizzy feeling as she aged. She found over-the-counter antihistamines helped her [ask your Mom's primary doctor first]. Anti-vert is also very good, one can only get the generic of that now, but worth a try.
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One more thing. Are you monitoring her bp at home? When the doctor at IL started having mom do this, it sshowed that her bp was really all over the place and he came up with an algorithm for what dosage of bp meds to take based on what her bp was at various times diring the day.

Has mom ever been tested for orthostatic hypotension? Meaning thaat, upon getting up from a seated or lying down position, she experienced near passing out?
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Klonopin works better for my mom than Xanax did.

Is she taking Xanax on a schedule, or ' as needed'? For my mom, part of the solution was getting her to take antianxiety meds on a schedule, not just when panicky.
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Maybe the Xanax is not the right medication for her. Not all meds work for all people. Maybe her Dr. could try something else in the Xanax family.
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I've was nodding in agreement the whole time I read Churchmouse's answer.

There is something wrong with your mother. Her symptoms are very real. I've only had one panic attack, a side effect of a new drug. Because I was warned it might happen and because I have seen two of my brothers having panic attacks I knew what it was. But believe me, it was very clear that something was wrong. That is not how people are supposed to suddenly feel when there is no danger. That one experience was plenty for me, thank you, but it did help me understand what people who have this disorder go through.

I also know that people subject to panic attacks can learn to recognize them and manage them. Instead of simply diagnosing Panic Disorder, the doctors should refer her to a program or counselor where she can learn to deal with this.

Also as CM says, SSRI's can take up to 6 weeks to be effective. Don't give up (unless there are side effects) on one too soon. But not all antidepressants work the same for all people. If a drug isn't working after a reasonable try, work with the doctor to try something else.

All the people who interact with your mother regularly should learn about panic attacks. It is much less stressful for everyone if you know what is going on.

You've done the right thing to rule out other medical problems. Now Mom needs to get help with the problem she does have.
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I agree with all of CM's advice, but curious if she's been seen by geriatric psychiatrist. Panic disorder and depression are not " nothing wrong with her". They are physiological conditions that need to be treated by a specialist, like a geriatric psychiatrist.

Does your mom have any cognitive decline? Before you say "no", has she been tested, as in a full bettery of neurologival and neurocogtive testing? The reason I ask, my mom had developed increasing anxiety, crying and panic. Her " regular " doctor gave her an antidepressant and xanax for anxiety. They didn't help.

We ended up having to move my mother from her home to an Independent Living facility, because she could no longer be alone, she was so frightened all the time. At the facility, the internist there had the geriatric psychiatrist who visited other clients there see my mom. She changed her anxiety meds, and got mom on a schedle of taking them, not just when she was panicked. But more importantly, she insisted that mom be tested for cognitive issues. We thought this was silly, because mom was " sharp as a tack". Paper and pencil testing told another story, as did the MRI. Mom's reasoning and thinking abilities had declined to those of a 5 year old's. Somewhere along the line, she'd had a mild, undetected stroke.

So, think about some further visits in the psychiatric/neurologic areas.
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Her heart is still pounding... What is her heart rate?

If your mother hasn't got heart disease or hypertension then it's hardly surprising that the medications for these conditions do nothing for her.

SSRIs take some weeks to kick in. Again, these are only likely to be very effective if there actually is anything amiss with her serotonin levels. If not, then...

I know I sound unsympathetic, but honestly I'm not. Over the last few years, and still to a degree, I have been living in highly stressful situations and physically I felt like poo. All of these symptoms, like those your mother is experiencing, are *real.* But identifying and treating the cause is the hard bit.

If it were me, I'd stop medicating non-existent diseases and start working on techniques to relieve her symptoms. Breathing exercises, calming activities, walking, dancing, yoga or similar: there are all kinds of things that will help her focus her mind and soothe her body.

When your mother says her heart is pounding and she feels dizzy, ask her to sit in a comfortable upright chair. Take her hand and feel her pulse. See what it actually is. Ask her to breathe slowly and evenly - if she's panting with the panic, use the paper bag technique to stop her hyperventilating. This is just first aid, and others will know much more than I do about managing anxiety and panic disorders, but overall aim to calm your mother and get her to relax.

Don't tell her there's nothing wrong with her. She may not be having a heart attack but that doesn't mean nothing's wrong - she feels terrible. That's wrong just by itself!

Has she experienced anything recently that would trigger these extreme emotions? Are they a marked change in her personality, or has she always been highly-strung?
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