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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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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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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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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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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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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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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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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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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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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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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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