High Functioning Anxiety Makes Success a Struggle

High functioning anxiety affects 18% of the 40-million adults who must deal with an anxiety disorder at any given time. The National Institute of Mental Health (NIMH) reports that this type of anxiety brings struggle and stress into their daily lives impacting overall satisfaction with a busy lifestyle.

High Functioning Anxiety Described

Most adults typically viewed as being successful, an overachiever, or even as having an “A” personality, are prone to having high functioning anxiety. While the general public perceives the positive outcomes from having this type of anxiety, it fails to see the struggle involved in getting there, staying there, dealing with constant worry, or with keeping up the effort of presenting a false persona to the rest of the world.

High Functioning Anxiety Diagnosis

In speaking about anxiety disorders, the type, high functioning, is not a real medical diagnosis, but rather a term being used more and more by mental health professionals to describe actions, symptoms, and emotions. This type of anxiety may exhibit many features of an anxiety disorder without the criteria for an actual diagnosis – they may have symptoms but are able to function through the struggle without life disruption.

Common Symptoms of High Functioning Anxiety

Some of the common signs that you may be struggling through life with high functioning anxiety include:

  • You are often told you are a Type A personality or a perfectionist.
  • You may have unrealistic expectations of yourself along with a fear of not meeting them.
  • You exhibit controlling patterns, habits, or strict routines
  • You find your life constantly busy and packed with plans and tasks to accomplish
  • You do not sleep well, tossing and turning throughout the night
  • You find yourself with frequent complaints of aches or pains, feel like there is a knot in your stomach, or find yourself biting nails, tapping your foot or cracking your knuckles as a sign of suppressed anxiety
  • You often keep your emotions bottled up, presenting a “false face” to others making it difficult for others to really know how you are feeling
  • You have a fear of disappointing or letting others down, often talking negatively about yourself
  • You cannot say “no” to the requests of others, often taking on more than you can realistically handle.

High Functioning Anxiety Psychiatrist

Even if the anxiety symptoms experienced are not interfering at work, home, or in social situations, they can still impact enjoyment and quality of life. Reducing the high functioning anxiety symptoms can end the struggle and lead to a more satisfying life all around. Call Dr. Hege for a confidential evaluation and determine the more effective treatment strategy for your needs.


Panic Disorder Can Develop or Worsen During Menopause

On any given day there are approximately 45 million American women that are going through menopause, with 5% of that number between the ages of 45 to 50 years old.

Research data from the CDC indicate that while the majority of women transition to menopause without developing any troubling psychiatric problems, panic disorder is the most common mental health issue reported.

Menopausal Panic Attacks Can Last For Years

Menopause often brings difficult emotional and physiological changes during this change of life phase. Studies show new-onset panic disorder has become a common new diagnosis for women going through menopause. In addition, women with pre-existing panic disorder may find their symptoms and mood changes worsen. Menopause brings changing hormone levels where women often report alternating periods of extreme rage, mood swings and depression that can last for a few months to a period that covers many years.

Reason For Menopausal Panic Attacks

While it may be unclear as to the exact cause of a woman’s panic attack or disorder, it has been found that women are twice as likely to suffer from panic disorder as men, most notably during PMS, pregnancy and menopause. Hormones have been identified as the one common underlying cause in all of these cases. In addition, women entering menopause who are already living a stressful lifestyle or who are going through a particularly emotional life event are left even more susceptible to developing a panic disorder.

Panic Attack Symptoms During Menopause

Panic disorder is an anxiety disorder described as unexpected and repeated episodes of intense fear which includes chest pain, shortness of breath, heart palpitations, dizziness, heavy sweating, or gastrointestinal distress. During menopause the development of a panic disorder is often extremely debilitating when fluctuating hormone levels play havoc with a woman’s psychological and physiological state of health. Initial panic episodes often lead a woman to seek emergency medical care thinking that she is having a heart attack.

Treatment for Menopausal Panic Attacks

There is hope and relief from the many symptoms of menopausal panic attacks. An experienced psychiatrist with a history of successful treatment for women who develop mental health issues during menopause, has a wide variety of treatment options to fit one’s individual needs.  Following a comprehensive evaluation, medication may be part of the answer during the time of menopause with its hormone fluctuations.

Medications prescribed may include Xanax, Klonopin, Ativan, Librium, Zoloft, Elavil, Tofranil, Lexapro, Sinequan and many others. Atlanta menopausal panic disorder psychiatrist Dr. Darvin Hege may prescribe medications and may also suggest cognitive behavioral therapy or other adjunct therapies if your anxiety and fears feel insurmountable to you.

Atlanta Menopausal Panic Attack Psychiatrist

If you are in the beginning, middle or end phases of menopause and are experiencing anxiety, panic attacks or mood swings, make the call to Dr. Darvin Hege, an Atlanta menopausal panic attack psychiatrist and get your life back in balance again.

Panic Attacks: Control the Fear with the Proper Treatment Regimen

Panic attacks are often viewed by society with a negative connotation attached to the diagnosis which leaves many to suffer without seeking medical help. The Mayo Clinic reports the medical community recognizes panic attacks as a medical condition that is successfully treated with proper medication or a specific combination of prescriptions.

The U.S. National Library of Medicine reports statistical data indicates 2-3% of the population have panic disorder. That’s almost 7 million adults who are affected by panic disorder. Unfortunately most people with panic disorder never seek treatment. For those properly evaluated by a psychiatrist who specializes in the treatment of panic and anxiety disorders, 90% find relief from their fear and severe physical reactions.

What is a Panic Attack?

A panic attack is a type of anxiety disorder where you have a sudden overwhelming fear that consumes the person without warning or any obvious reason, peaking in about 10 minutes. In addition, an attack also triggers severe physiological reactions which take the fear and anxiety to new levels of extreme. Recurrent panic attacks, and living in fear of another attack may indicate you have a panic disorder, which can be successfully treated by a specialized psychiatrist.

What Causes Panic Attacks and Anxiety Disorder?

While the cause of panic attacks is unknown, there is a connection between major life transitions and degree of stress involved. The National Institute of Mental Health report one episode may not indicate an underlying anxiety disorder; however living in fear of having a recurring episode has a negative impact on your home and social life as well as gainful employment. A full comprehensive evaluation by a psychiatrist is crucial to provide the proper diagnosis that can then be successfully treated.

What are the Symptoms of Panic Attack or Panic Disorder?

There are a variety of symptoms that accompany a panic attack. People generally present with at least four of the following symptoms during a panic attack:

  • Chest pain or heavy discomfort
  • Heart palpitations, unusual heart rhythm or “pounding” heart
  • Shortness of breath or feeling like you will suffocate
  • Overwhelming fear of impending doom
  • Numbness and tingling in your arms, legs or face
  • Uncontrollable shaking, shivering or trembling
  • Fear of dying
  • Profuse sweating, hot flashes, or chills
  • Nausea, upset stomach, inability to eat
  • Feeling dizzy, lightheaded or faint
  • Feeling detached from reality

In addition, panic disorder can occur with other masked disorders which are often missed during a medical or psychological evaluation. Panic disorder may be associated with OCD, depression, substance abuse and alcoholism.

Atlanta Panic Attack Psychiatrist

Dr. Darvin Hege, MD, PC, is a well respected Atlanta panic attack psychiatrist with over 25 years of experience. Dr. Hege’s evaluation and subsequent diagnosis or multiple diagnoses is vital in developing a successful treatment and medication regime for panic disorder where the goal is to help you function without fear in everyday life situations.

Panic Attacks And Depression

Panic attacks can be devastating for those suffering from the condition. Attacks come at random and can occur frequently or can have long periods of time between episodes. The fact that attacks can't be anticipated causes more anxiety. Ultimately, two thirds of the people who have a panic attack will be diagnosed with a panic disorder within a year following their first attack, and half of those who go through a panic attack will develop clinical depression within a year. It seems that panic attacks and depression often go hand in hand.

The first thing to do after experiencing a panic attack is to go through a medical evaluation so physical conditions can be ruled out as the cause of the panic attack. Overactive thyroid, heart problems, too much nicotine or caffeine, certain medications, and abuse of alcohol or illegal drug use can cause symptoms similar to panic attacks. Scientists aren't sure what causes true panic attacks. They may be caused by chemical imbalances in the brain. Sometimes panic attacks are an inherited condition. Many times there is no physical reason for an attack, but it is best to get medical help to rule out physical causes.

Repeated anxiety attacks can cause depression and panic attacks can turn into a panic disorder. The anxiety of wondering if another panic attack is on the way causes severe stress and sometimes thoughts of suicide in people who suffer from them. Since panic attacks are frighteningly similar to symptoms of serious medical conditions such as heart attacks, people naturally become more anxious that their attacks may be life-threatening. The lack of control that sufferers go through is often depressing as is the fact that they can't anticipate an attack. If a person has lived with panic attacks for a while, the anxiety they feel can give them low self-esteem or may lower their self-image which also can result in depression. Panic attacks and depression combined can make people feel like they are in a downward spiral that can never be escaped.

When panic attacks and depression occur together, it is best to get help from a qualified psychiatrist. Early intervention can help the person before the condition affects their lives too much since often people will avoid the places or situations they feel bring on their panic attacks, leading to a decreased quality of life. Depression is a serious condition and needs to be treated separately from the the panic attacks. But, anti-depression medication, certain types of psychotherapy, or a mixture of the two can effectively treat the individual who suffers from panic attacks and depression. Dr. Darvin Hege, an Atlanta-based psychiatrist, says "addressing the core panic disorder or other condition with the vast selection of tools with which psychiatrists are familiar will likely result in relief and success."

Dr. Darvin Hege has 25 years of experience dealing with patients who have panic attacks and depression simultaneously. He offers evening and weekend office hours at his Atlanta, GA practice. Call today at 770 458-0007 for an evaluation for relief of your panic attacks and depression and for help deciding the most effective and safest treatment. 

Panic Attacks At Night

Panic attacks are common for many people. It doesn’t matter where you are or what you are doing – a panic attack can come on randomly and disrupt your day (or night). Over 6 million Americans suffer from panic attacks and between 44 percent and 71 percent of those people have also experienced panic attacks at night.

While it would seem that people should have more anxiety during the day, due to stresses of work and home, panic attacks at night are more common than you would think. Panic attacks at night are characterized by waking abruptly from sleep in a state of anxiety, and for no obvious reason. Episodes of panic attacks at night are generally over within ten minutes or so, but those few minutes can set the tone for sleeplessness the rest of the night. The physical symptoms of a panic attack include a sense of impending doom combined with a pounding and rapid heart beat, sweating, shakiness or dizziness, a feeling of shortness of breath or hyperventilating, and sometimes either chills or flushing. It can be hard to go back to sleep after the body is revved up from the attack. Also, the sense of panic during an attack is increased by the knowledge that these same symptoms can be signs of more serious conditions, such as a heart attack, which raises the person’s level of anxiety.

Part of the distress of panic attacks at night is the sense of loss of control. Patients suffering from an attack may also feel the night brings with it a sense of being defenseless while unconscious (sleeping) and the thought that something might happen while they are most vulnerable. Panic attacks at night can be precipitated by events that happened during the day. Things that happened during the day may be revisited at bedtime, causing anxiety before sleeping. Events at home may leave an emotional imprint on the mind, causing the patient to be more anxious than usual. Even eating late at night just before going to bed can keep the sufferer awake and make them more prone to panic attacks at night.

There are some things people can do to help them deal with panic attacks at night:

  1. Learn and practice calming techniques like yoga, tai chi, and meditation.
  2. Learn and practice slow, deep breathing exercises.
  3. Reduce stress at night by taking time to relax and forget the worries of the day before retiring to bed at night.
  4. Develop healthy eating habits and exercise programs to help reduce stress.

If these techniques are not enough to help you deal with panic attacks at night, counseling and medication are an important next step. Find a therapist who has experience in dealing with panic attacks at night. Treatment such as cognitive behavior therapy and anti-anxiety medications can alleviate or eliminate panic attacks for most people. Dr. Darvin Hege provides help for panic attacks in the Atlanta area. Dr. Hege most commonly prescribes Xanax XR, Klonopin, Zoloft, Prozac, Celexa, Lexapro, Paxil, Effexor, or Cymbalta for panic attacks at night. For more information from Dr. Hege about panic attacks and the most effective medications for stopping panic attacks at night, go to thePanic Attacks Information page on his website.

Although having panic attacks at night can be a frightening experience, they aren’t something you just have to live with. Medications, therapy, and stress reduction can help sufferers face the night without fear.

Dr. Hege has 25 years of experience dealing with patients who have panic attacks at night. Call him today at 770-458-0007 for an evaluation for relief of your panic during the night, and for help deciding the most effective and safest treatment.

Panic Attacks And Menopause

First of all, let's agree that menopause is no walk in the park for many women. Their hormones are constantly fluctuating back and forth, they have hot flashes and mood swings, and they either can't sleep or they wake up with night sweats. Add in anxiety and panic attacks and many women will feel like they are going right over the edge. Panic attacks and menopause just don't mix well.

Simple anxiety is something everyone experiences on occasion. We all stress over projects at work or issues at home. But, panic attacks are anxiety attacks on steroids. A panic attack can make the sufferer feel like they are having a heart attack! The most common symptoms people have with panic attacks are racing heart beats or heart palpitations, chest pain or discomfort, a feeling of shortness of breath or choking, sweating, dizziness or feeling lightheaded or faint, and unnatural fear and anxiety. To get an idea of what a panic attack is like, think about how you feel when you are cut off by another car and narrowly miss hitting someone or something. Now, multiply that feeling tenfold!

Women who are experiencing a panic attack are likely to breathe shallowly and rapidly. Their racing heartbeat makes them more upset, and the terror and fear that something horrible is happening to them only increases their panic. Panic attacks are not triggered by something in the environment around the sufferer or by something they did; rather the attacks begin for no apparent reason and are as likely to affect someone who is sitting calmly while reading a book as they are to affect a woman in a stressful situation.

While people can be prone to panic attacks at any stage of life, women are more likely than men to suffer from them, and panic attacks and menopause seem to go hand in hand. Many women today are stressed out and overworked, and put themselves at the back of the line behind family and work needs. When women enter perimenopause and menopause, their bodies begin to have hormone imbalances. It is believed that these hormone imbalances, coupled with stress, are at least partially to blame for an increased susceptibility to panic attacks.

Many women will go through perimenopause and menopause, and panic attacks will only happen once or twice during the entire process. For other women, menopause and panic attacks will become a way of life until menopause is completed. For these women, medication may hold the answer to getting them through this troubling time of life.

Dr. Darvin Hege, an Atlanta, GA psychiatrist says "there are two classes of anti-panic medicines that are highly effective. They are Benzodiazepines (Group 1) which consist of Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), Tranxene, Serax Valium, Librium, and others, and Antidepressant/Anti-panic medicines (Group 2) consisting of SSRI's (Zoloft, Prozac, Paxil, Celexa, Lexapro, and Luvox) and tricyclics (Tofranil, nortriptyline, protriptyline, Elavil, Sinequan, Surmontil, and others)." Dr. Hege further notes that "the most important difference between Group 1 and Group 2 is that medicines in Group 1 work much quicker, i.e. stop panic attacks in twenty minutes to a couple of weeks in worse cases. Group 2 requires 1-8 weeks to be effective. However, Group 1 can be physically addictive. Group 2 medicines are just as likely to stop all panic attacks as Group 1 after a lag period. The lag period is 1-3 weeks to the onset of reducing the severity and frequency of attacks. It takes Group 2, 3-10 weeks to totally stop all panic attacks in 70% of patients. Most people need to be on medicine for at least 1 year to significantly reduce the risk of relapse back into panic attacks soon after stopping the medicines."

Menopause and panic attacks are not something that women just have to "put up with". For those women who suffer relatively few attacks, natural therapies or stress reduction can help. Yoga, meditation, and exercise can help calm otherwise frantic lifestyles. Just the simple fact of knowing what a panic attack feels like can help women respond less negatively if they have one. For those women who can not deal with the anxiety and fear that a combination of menopause and panic attacks can bring on, there is relief in the form of counseling and medication.

Dr. Darvin Hege has 25 years of experience dealing with patients who have panic attacks and menopause simultaneously. He offers evening and weekend office hours at his Atlanta, GA practice. Call today at 770 458-0007 for an evaluation for relief of your panic attacks and for help deciding the most effective and safest treatment. >

Panic Attacks And Pregnancy

Panic attacks and pregnancy simultaneously create risks for the fetus. Stress and anxiety in the mother increase adrenaline and cortisol that can reduce oxygen to the fetus and contribute to risks during labor and delivery. The peak age of onset is in the 20s and more women than men get panic attacks. Therefore, the incidence of panic attacks and pregnancy together is elevated. The prevalence of panic attacks and pregnancy is about 1 to 2%.

In a retrospective study of first onset of panic attacks in childbearing age women, 10 times as many women reported their first panic attack occurred in the first trimester of a pregnancy. Other retrospective studies suggested that breast-feeding reduced the risk of panic disorder during the postnatal period and weaning increased the risk. If a woman has had panic attacks before pregnancy, studies have suggested that they may have worsening of the panic attacks during pregnancy and/or the postnatal period if the panic disorder was severe.

Medical causes of panic attacks need to be ruled out. These include thyroid disorders, anemia, preeclampsia, and pheochromocytoma. Comorbid psychiatric conditions frequently underlie panic disorder. These include mild bipolar disorder, depression, ADHD, other anxiety disorders such as PTSD, generalized anxiety disorder, or alcohol or drug abuse or withdrawal.

Panic attacks and pregnancy present challenges for treatment. Self-care strategies include elimination of caffeine, reduction of sleep deprivation, and relaxation techniques. Non-medication therapy with cognitive behavioral therapy with a professional therapist may be effective.

Medication treatment for panic attacks and pregnancy are often very helpful, but risk and benefit analysis include the following: as mentioned in the beginning there are medical, physical development, labor and delivery, postpartum, and later physical and mental developmental risks for the baby when the mother is having uncontrolled panic attacks during pregnancy, postpartum, and early childhood stages.
Now I will address some of the concerns of taking medication during panic attacks and pregnancy. Medications that help panic attacks the quickest are benzodiazepines. Benzodiazepines include Xanax, Klonopin, Ativan, Valium, Librium, Tranxene, and Serax. There was at least one study suggesting an increased risk of cleft palate if Valium is used during pregnancy. That suggestion was about a 1% risk. SSRIs retrospective studies have not suggested any congenital malformations except possibly in Paxil. Hence, the other SSRIs are first choice. These include Prozac, Zoloft, Celexa, and Lexapro. The drawback of the SSRIs are that they require one to two weeks of administration before getting any benefit and one to two months before getting full benefit against panic attacks. Withdrawal or discontinuation symptoms of any of these medicines in the baby after delivery are additional concerns.

Dr. Hege has 25 years of experience dealing with patients who have panic attacks and pregnancy simultaneously. Call today at 770 458-0007 for an evaluation for relief of your panic during the planning or managing of a pregnancy or postpartum, and for help deciding the most effective and safest treatment.