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Forum Name: Chest symptoms

Question: Pressure On Chest, slight tingling


 OHmuscle - Wed Nov 05, 2008 2:28 pm

Hello, I am a 21 year old male, non-smoker, and I recently (two months ago) started working out religiously again. I have anxiety disorder, but my symptom is usually (99.9999%) nausea. I have Klonopin and Promethazine that I take as needed. About three weeks ago, I started having what feels like slight pressure on my chest and a very slight tingle every now and then around the center/off center of my chest. I can breathe, but it is hard for me to yawn and hard for me to get a full breath (possible, but can't get one all the time). I am under stress, but this has been going on for three weeks now. Please help, as now my anxiety does nothing but exacerbate the situation.
 John Kenyon, CNA - Mon Nov 24, 2008 10:56 pm

User avatar Hi there -

This is a real problem, because anxiety could explain your new symptoms (they tend to change as soon as you think you've got it all figured out, which can be infuriating), and yet it's also true that anxious people get sick and have regular problems, just like everyone else, so it's tricky and one has to be careful to not blame everything on a known anxiety problem.

That being said, what you describe does sound like a classic, if "new to you" anxiety symptom. The sensation of slight (and poorly localized or else highly localized) chest discomfort, accompanied by a sense of the inability to draw a full, satisfying breath, is commonly a sign of anxiety-related faulty breathing and/or breathing awareness, either of which can cause this sensation. Stress, of course, not only exacerbates existing anxiety, but will help set off new symptoms.

This is not to say it's impossible you could have developed a breathing problem (such as asthma, most likely, although still unlikely). There are simple ways of telling: for instance, your doctor could test your ability to exhale (a simple pulomonary function test, PFT, using a simple asthma guage into which you blow, moving the needle). If you have developed asthma, it should be managed with oral medication and an inhaler. If you don't have it then you'll have to come to terms with the probability that your anxiety is now affecting your awareness of your breathing, which can be very difficult to control, but can be done by the patient. Knowing is the first step. If you don't have a pulmonary problem, then you'll have to learn to disregard the awareness of your breathing. Since most anxious people tend to be very somatically aware, it's hard, and just telling you to "ignore" it would be ridiculous, as trying to ignore something is almost impossible once you've taken it on as a task. Instead, what needs to be done is to find things to distract you from your body's behavior. This is important, because trust me, when it really wants your attention you won't be able to ignore it anyway. If you can be distracted from paying attention to your breathing that's a huge plus, but it usually requires some work on the part of the patient, in terms of talking to somone about the anxiety problem and, eventually, other things. When one "forgets" one has a "problem" it mysteriously disappears.

A provocative test you can do for yourself would be to see how you tolerate exercise given this apparent difficulty breathing. If you tolerate exercise well, you almost certainly don't have a true respiratory problem. It most likely occurs only when you're sitting and thinking. If you are, instead, active and doing, you're likely to not notice anything wrong unless it is very concrete. Then you can identify it more specifically and bring it to the attention of a healthcare provider.

I'd do both: rule out asthma, then see if you can find ways to move your attention from your body's behavior to more interesting and absorbing things.

I hope this is helpful. Best of luck to you. Please keep us updated.
 OHmuscle - Fri Nov 28, 2008 6:02 pm

Mr. Kenyon,

Thank you for your response. I went to the doctor, my EKG is fine, P02 was 100% and I have been working out. I breath fine......except when I stop to think about it or just sit there. Once it is in my mind it "mysteriously" gets worse. I just wasn't aware that anxiety could shift symptoms, as I still have nausea when I do get anxiety. And you hit the nail on the head when you said it is hard to pinpoint where the pressure comes from...I can't. It feels like it is sporadic, but not terribly bad if that makes sense. Even typing here it is getting worse. I have Klonopin and Promethazine...but my doc wanted to put me a an MAOI...I tried one before and the side effects are terrible. Thank you again for your response.
 John Kenyon, CNA - Fri Nov 28, 2008 8:46 pm

User avatar You're very welcome.

It sounds like you're already developing some good and useful insights about how anxiety affects you. This can only be helpful. It is a sometimes weird crittur, and it can be difficult to recognize many of its inconsistencies from the "inside", from a subjective point of view. I'm glad you wrote us here. I think you'll do very well.

My only reservation, which you seem to share, is the suggestion of an MOAI. Not only can they have essentially unpleasant side effects, but they can interact with so many things, including many foods and other medications. I'd try and avoid that class of drug if at all possible. Best of luck to you. Keep in touch with us.

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