RLR
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Okay, welcome to the forum and I've read your posting and concerns.
The fundamental difficulty being experienced here is due to the fact that you are afraid that something catastrophic is going to happen to you as a result of the palpitation events and this is entirely inaccurate. Realize that these events are not associated with any type of cardiac arrhythmia and furthermore, don't actually originate from within the heart at all but rather by stimulation of the vagus nerve. It's sort of the equivalent of a muscle twitch that you might experience elsewhere in the body with the exception that in this instance, the muscle happens to be the heart.
Vagus nerve-induced palpitations of this type are entirely incapable of causing you to suffer any type of cardiac event or transform your heart's rhythm into a dangerous arrhythmia. It's not medically possible because of the origin of the events themselves. In other words, you're in no actual danger whatsoever and you're going to live a long and normal life.
Realize that panic disorder, which by the way does not induce the palpitation events to occur, is a combination of neurochemistry and emotional state of mind. The brain reacts to sensory feedback and during heightened emotional stress, the body's sensory network can go awry and overwhelm the corresponding brain centers. The result is awareness to rapidly escalating sensations that collectively produce the belief of imminent doom or harm from an unknown source.
The affected individual begins expressing physiological changes in response to the sudden fear manifested and together with a mild imbalance in blood-gas levels and neurochemistry, the person experiences a threshold event, or panic attack. This event sort of reboots your system and within a few minutes most patients feel better, although reports of feeling washed out can persist for hours in some individuals.
It's important for you to understand that when you develop the perception that your life is imminently in danger, the brain also reacts in a very specific manner as a matter of survival instinct. Regardless of whether the perceived threat is real or merely imagined, the brain nevertheless responds accordingly and institutes changes in physiology necessary to best overcome the imminent threat or alternatively escape from it. It's known as a fight-or-flight response and it's clinical features are most often misinterpreted by those affected as symptoms of a serious disorder or disease.
The take-away message in my response to you is that fear is instrumenting the symptoms you are experiencing and once you can accept that you are actually in no danger, your nervous system will begin to down-regulate to a normal state more recognizable to you.
Overcoming panic disorder can be a challenge due to the impact it has on the individual relative to self-confidence and engagement in one's social life. Many persons resort to social withdrawal in order to avoid potential embarrassment of the unpredictable nature associated with panic attacks, as well as avoiding circumstances of helplessness. The need to remain within the safety of the home or nearby to emergency services is also of import in the minds of those suffering from panic disorder.
The key in making your way back to normalcy is to overcome the tendency in responding to irrational beliefs which have no basis in fact and to work toward defining the basis for the panic disorder. Many people experience difficulty with this particular task because the original event which provoked the panic disorder to manifest may be entirely unrecognizable or trivial and yet by virtue of the associated irrational fear, it's impact can be quite remarkable and persistent until resolved.
You're going to be just fine. Nothing dreadful is going to occur and you're going to live a very long and normal life. Spend some time visiting the forum and speaking with others, many of whom share your same difficulties.
Best regards,
Rutheford Rane, MD (ret.)
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