PANIC ATTACKS AND ANXIETY

[mercadies25]

I am just wondering how many of us have suffered from these before getting dx.

I have suffered from "panic attacks" for as long as I can remember. My grandmother asked me if there was any correlation with MS and panic attacks.

I know that many of us suffer from depression. Have you had issues prior to your dx.

I know that sometimes an actual lesion causes depression but how about panic attacks and anxiety?

Can't wait to see everyones thoughts.

[Moosette]

I find myself sometimes wondering what came first, the MS or the anxiety...have I just always had very minor anxiety issues that are getting progressivly worse over time or is it because of (at the time the undiagnosed MS) is the reason for my anxiety.

Either way it has gotten worse and when I was on Betaseron I didnt realise just how badly that drug had effected my mental health until I went off of it. I was on citalopram for awhile to try and get my anxiety under control and it seemed to work ok but had to go off of it due to the horrific headaches I would get.

Right now I am trying to keep myself under control without meds and some days are better than others, I feel like noone really understands how debilitating anxiety can be and out of sheer embarrassment I keep my ridiculously impractical panic attack inducing fears to myself which truly makes me feel alone in fighting it.

I guess if this level of anxiety is another effect of MS I can only hope that future ms meds can possibly do something to help? I am on tecfidera now and its still way too soon to tell whether it is or will help manage things. Gotta just keep in good spirits and hope that all will get better and that a cure is not too far off, right?

** Moderator's note - Post broken into paragraphs for easier reading. Many people with MS have visual difficulties that prevent them from reading large blocks of print. **

[SNOOPY]

Hi mercadies25,

Stress/anxiety/panic attacks can be common in the general population. If anxiety/panic attacks were something a person dealt with before a diagnosis of MS, it stands to reason a diagnosis will increase anxiety/panic attacks.

MS can affect emotions but much of the information about anxiety/panic attacks being a direct cause of MS is hypothetical and unproven (information is mixed).

It is possible to have anxiety/panic attacks as well as depression and it not be due to the disease process.

Typically, anxiety/panic attacks are caused by the life changes, uncertainty and fears related to having a chronic debilitating disease.

Some information about anxiety/panic attacks and MS:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/

Anxiety/panic attacks can run in families. You can also develop anxiety/panic attacks without warning and without any known cause.

[Beema]

Do the interferons raise chance of anxiety? I know that it says depression but my anxiety levels now are terrible since I started Rebif but my neuro tells me that is has no effect on anxiety??? If it does I need to get off it or something as its gotten bad.

[marti]

I believe that anxiety is built in to autoimmune diseases.

HealthlineNews
Healthline → Healthline News → Does Stress Make You Anxious? Blame Your Immune System
Does Stress Make You Anxious? Blame Your Immune System
Written by Rachel Barclay | Published on September 17, 2013 TEXT SIZE: A A A
A new study shows how the immune system’s response to stress causes symptoms of anxiety.

Healthcare professionals, not to mention most people, know that stress goes hand-in-hand with anxiety. The cause seems obvious—if anxiety is fear of the future or the unknown, then the unpredictability of stressors should cause it. But how this connection forms on a cellular level has remained a mystery.

In a new study from Ohio State University, principal investigator Dr. John Sheridan joined colleagues Dr. Jonathan Godbout, Dr. Nicole Powell, and Ph.D candidate Eric Wohleb to unlock the secrets of stress and the brain.

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The key, they found, lies in the immune system. When lab mice were under stress, immune cells traveled to the brain and activated the regions associated with anxiety. The greater a mouse’s immune response, the more anxious behavior it displayed.

Stress: A General Response to a Specific Problem
Stress occurs when a person experiences conditions that are harder than or different from normal in ways that he or she can’t predict or control. Sleep deprivation, starvation, combat, disease, and bullying may not seem to have much in common, but they’re all causes of stress, and they all produce similar responses in the body.

The fight-or-flight system kicks in (in case of enemies), the body begins conserving every calorie it can get (in case of famine), and the immune system gets stronger (in case of injury or infection). In the short term, the person is ready for whatever the world offers up. But in the long run, it’s a different story.

“Chronic, unrelenting stress tends to have an adverse effect on health, in part through its modulation of an individual’s immune response,” explained Sheridan in an interview with Healthline.

The researchers found that there is one type of immune cell, called a monocyte, that bone marrow produces during times of stress. Monocytes cause inflammation as part of the stress response.

“Inflammation is not necessarily damaging,” said Godblut, an associate professor of neuroscience, in an interview with Healthline. “Often times it is beneficial. Think about fever induction—an example of brain inflammation that does not result in tissue damage. This stress-induced brain inflammation represents a form of communication between the immune system and the brain.”

In the rest of the body, the inflammatory monocytes primarily fight infection and heal injured tissue. In the brain, however, they appear to behave differently.

The monocytes flock to the brain regions that send out stress signals: the amygdala and hippocampus, which are involved in processing feelings of fear, and the prefrontal cortex, which is supposed to regulate the fear regions. Once there, monocytes change the way the genes of brain cells behave. When the fear regions of the brain become overactive, the result is anxiety.

“Neuroinflammatory responses due to psychological stress are relatively mild compared to other neurological disease or infectious conditions,” Wohleb told Healthline. “In the case of stress, we believe that neuroinflammation may elicit changes in neurobiology that present as anxiety-like behavior.”

Stressed Mouse, Stressed Human?
Although the minds of mice hardly approach the complexity of human brains, their stress systems are similar to ours. To make the mouse model as accurate as possible, the team tried to create a stressor that is something humans might experience: bullying.

Several young male mice coexisted peacefully in a single cage. Then, to stress them, the researchers introduced a larger, more aggressive male for two hours. The intruder mouse attacked and bullied the resident mice until their behavior became cowed and submissive. After three such sessions, the resident mice had gone into full-on stress mode.

The mice had two living areas: an open, brightly-lit area to explore and a dark, enclosed area to hide in. Happy and healthy mice will spend more time exploring, while mice that are stressed or scared will spend more time hiding. The more the mice were bullied, the more time they spent in the hiding area, and the more monocytes the researchers found in their brains.

To confirm their findings, the researchers genetically engineered a set of mice so that they didn’t have the genes the monocytes were using to target the brain. When they did this, the bullied mice had the same immune response, but didn’t act more anxious and were happy to explore.

This new finding suggests that either monocytes in the brain or the genes they activate could be targets for new drugs to treat anxiety. However, Sheridan cautions that we shouldn’t assume mice and humans process stress in the same way just yet.

“Extrapolation from the mouse to the human is generally not a good idea,” he said. “However, what we do know is that in an animal model of repeated social stress, there are cells of the immune system that may play a significant role in the development of prolonged anxiety.”

This research was funded by the National Institute of Mental Health (NIMH), the National Institute on Aging, and an NIMH Predoctoral Fellowship.

[MSer102]

Whoa! Hold the phone! That Healthline news article has nothing to do with autoimmune diseases!

The article explains a theory of how the immune system works in EVERYBODY who has a functioning immune system. It's an article about what stress does to the body. It is not about AUTOimmune diseases and it doesn't prove or even address that anxiety is "built into" AUTOimmune diseases.

Immunity is not autoimmunity. I see too often on MS message boards that someone sees the word "immune" and misunderstands it to be the same thing as autoimmunity and the next thing you know the person has everything about a normally functioning immune system being turned into an autoimmune disease and responsible for all kinds of regular body functions.

Somehow making this theory of how stress causes certain cells in the MOUSE immune system to trigger anxiety a function of AUTOimmune diseases is like saying that pus forms in an infected abscess (eww!) because the person has some kind of autoimmune disease. No! That's what a normally functioning immune system does. That's the difference between immunity and the malfunction of autoimmunity.

This article is not about autoimmune diseases and in no way links anxiety to autoimmunity. Hey, let's be careful out there!

Poster SNOOPY linked to a good article that IS about MS. If anxiety were "built into" autoimmune diseases, everybody with MS would have anxiety and we don't. (Maybe only people with anxiety think that everybody has it?) The article says that only about 36% of people with MS have anxiety in their lifetimes.

The article says that there isn't any proof that MS is the inherent cause of anxiety (that means that anxiety is not "built into" it) but that the stress of having MS causes already anxious people to respond with anxiety.

It says: "The assumption that anxiety emerges as a reactive phenomenon to a variety of situations is strengthened by the lack of association between anxiety and MRI abnormalities or clinical variables. A baseline screening for anxiety at diagnosis of MS could be used to predict the levels of anxiety and distress in the period of follow-up."

One of the most interesting lectures I ever heard was by a psychologist who explained how people actually teach themselves to become more anxious by focusing on their fear until by repetition the anxiety reaction becomes automatic an unstoppable. He said that the good news is that people can unlearn how to be anxious and learn how to short circuit the anxiety response if they're willing to put in the work.

The bulk of the medical and psychological literature doesn't seem to support that MS is the cause of anxiety or that anxiety "built into" autoimmune diseases. Is it maybe only people with anxiety who think that anxiety is normal or that they are helpless victims of it?

[marti]

Maybe I should have explained myself better.

I have several autoimmune diseases and each one lists anxiety as a symptom. It just makes sense to me that when our vital systems are out of whack we will be nervous, anxious and even panicky. I was never this way before I started getting sick. I'm sure this is not the same for all MS-ers or Graves patients or IBS sufferers. I just thought it was interesting that science is looking into this possibility.

Didn't mean to scare anyone.

[SNOOPY]

MSer102
One of the most interesting lectures I ever heard was by a psychologist who explained how people actually teach themselves to become more anxious by focusing on their fear until by repetition the anxiety reaction becomes automatic an unstoppable.

He said that the good news is that people can unlearn how to be anxious and learn how to short circuit the anxiety response if they're willing to put in the work.

How it was explained to me:

Thoughts = worry/fear = anxiety = panic attack.

With the right coping skills you can learn to stop this progression. It can take time and practice but as MSer102 you can unlearn your automatic reaction.

[marti]

How it was explained to me:

Thoughts = worry/fear = anxiety = panic attack.

With the right coping skills you can learn to stop this progression. It can take time and practice but as MSer102 you can unlearn your automatic reaction.

Can you tell us more about these coping skills and how to unlearn our anxiety? Is there something we can read about your lecturer online?

[SNOOPY]

Can you tell us more about these coping skills and how to unlearn our anxiety? Is there something we can read about your lecturer online?

Hi marti,

I'm not sure who your question is directed to.

MSer102 is the poster who was at lecture given by a Psychologist.

My information comes from both a Psychiatrist and a Psychotherapist. I spent quite a few years in Psychotherapy for Post-Traumatic Stress Disorder (PTSD). My Anxiety/panic attacks are a result of the PTSD.

It has been through my work with a very good Psychotherapist as well as my continuing need to learn about how to have better control over anxiety/panic attacks that has helped me.

There are many self-help books but I strongly suggest working with a Psychotherapist for the best results.

A book that I am currently reading is 'When Everything Changes, Change Everything' By Neale Donald Walsch.

I would not necessarily call this book "self-help" but for my current needs it has been quite insightful for me.

[krystine]

I can relate

I have been dxd for 14 years and never had anxiety until 2 years ago. Doctors put me on antidepressants and sleeping pills until they did an MRI and found 8 active lesions. After a round of steroids, the anxiety went away.

Now, whenever I get a cold or anything that causes a flare, I always get anxiety. It seems to be a new flare symptom for me. Lucky me!

The docs don't say whether it is caused from MS but I definitely see a correlation between them.

A few weeks ago, I had my "October cold" that I always get, and there the anxiety was. It is difficult to deal with and even though I tell myself it is just the cold, when you're anxious you cant tell yourself anything!

I am sure it is different for everyone, but that is how it works for me.