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What Causes An Exaggerated Startle Response While Treating Anxiety Disorder?
Question: Hi , I am a 26 year old male, otherwise physically fit. I was diagnosed with depression and anxiety attacks 5 years back , which is why I was on antidepressants and the problems over time went away and the medications were tapered off. However I have the anxiety attacks back, and this time with extremely bad startle response. When someone knocks on my door a bit loudly, I get really scared and startled or someone taps me from behind, the same thing happens.. It is so bad I keep headphones plugged in most of the time to prevent me from getting startled.. I wanted to know will getting startled time and again have an adverse effect on my heart in the long run?Or can I get a heart attack in the process? I realize this is anxiety in itself but I cannot help it.. Also suggest how could I get rid of this problem..
(Also, I am on Fluoxetine and Escitalopram daily , and Metoprolol Succinate 25 mg tablets for high blood pressure,which I have been taking from the last 5 years. From recent visits to the doctor's office, I have normal bp. And also five years ago, I had done a full heart report including lipids and echocardiogram and ecg, everything came out to be normal )
(Also, I am on Fluoxetine and Escitalopram daily , and Metoprolol Succinate 25 mg tablets for high blood pressure,which I have been taking from the last 5 years. From recent visits to the doctor's office, I have normal bp. And also five years ago, I had done a full heart report including lipids and echocardiogram and ecg, everything came out to be normal )
Brief Answer:
I think it is better to change to propranolol from metoprolol
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
First of all as you know startle response is part of anxiety disorder and there is nothing specific about it. Alike other anxiety symptoms it does not cause heart attack although people fear of heart attack due to anxiety symptoms.
Presence of Blood pressure may be related to anxiety and it is good idea to get it treated irrespective of your age. I am also of the opinion that rather than metoprolol it is good idea to shift to propranolol. This is because propranolol have effects on blood pressure as well as anxiety. As this is prescription medication it should be approved by your treating doctor. It is possible that with change of this medication you may shift to only one antidepressant rather than two (escitalopram and fluoxetine).
To conclude it can be said that startle reaction itself unlikley to damage your heart directly.
I hope this assists you.
If you need to know more feel free to contact me.
not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
I think it is better to change to propranolol from metoprolol
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
First of all as you know startle response is part of anxiety disorder and there is nothing specific about it. Alike other anxiety symptoms it does not cause heart attack although people fear of heart attack due to anxiety symptoms.
Presence of Blood pressure may be related to anxiety and it is good idea to get it treated irrespective of your age. I am also of the opinion that rather than metoprolol it is good idea to shift to propranolol. This is because propranolol have effects on blood pressure as well as anxiety. As this is prescription medication it should be approved by your treating doctor. It is possible that with change of this medication you may shift to only one antidepressant rather than two (escitalopram and fluoxetine).
To conclude it can be said that startle reaction itself unlikley to damage your heart directly.
I hope this assists you.
If you need to know more feel free to contact me.
not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the reassurance doctor..
As I said, in my last two visits to the doctors chamber in the past year, my blood pressure readings came out to be normal.. So that means it is under control .. So should I still ask my doctor to change it to propranolol?
Also, there are some hypnotheraphy videos available on Youtube.. like https://www.youtube.com/watch?v=ftdhA7zpVE4&index=12&list=PLO9OtUmChpP_Po7RGMHFJ4kNbavmHhYhJ..
Is it a good idea to watch them to cure my anxieties?
As I said, in my last two visits to the doctors chamber in the past year, my blood pressure readings came out to be normal.. So that means it is under control .. So should I still ask my doctor to change it to propranolol?
Also, there are some hypnotheraphy videos available on Youtube.. like https://www.youtube.com/watch?v=ftdhA7zpVE4&index=12&list=PLO9OtUmChpP_Po7RGMHFJ4kNbavmHhYhJ..
Is it a good idea to watch them to cure my anxieties?
Brief Answer:
Please read below
Detailed Answer:
Hello,
Thanks for reverting back to me.
I understand the blood pressure is under control but my purpose here is to supplement anti anxiety effect with a medication which is useful in blood pressure. Propranolol acts both on anxiety as well as blood pressure so it is possible to get double effect with single medication.
Regarding hypnotherapy yes there is definite role of it in treatment of anxiety but it should be used under supervision of your therapist. It is not a good idea to use hypnotherapy all alone as it sometime it exacerbates anxiety symptoms.
In my opinion Cognitive behavior therapy is better option if you are using it allalone in compare to hypnotherapy.
I hope this assists you further.
Thanks and regards.
Please read below
Detailed Answer:
Hello,
Thanks for reverting back to me.
I understand the blood pressure is under control but my purpose here is to supplement anti anxiety effect with a medication which is useful in blood pressure. Propranolol acts both on anxiety as well as blood pressure so it is possible to get double effect with single medication.
Regarding hypnotherapy yes there is definite role of it in treatment of anxiety but it should be used under supervision of your therapist. It is not a good idea to use hypnotherapy all alone as it sometime it exacerbates anxiety symptoms.
In my opinion Cognitive behavior therapy is better option if you are using it allalone in compare to hypnotherapy.
I hope this assists you further.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor..
But how can I use Cognitive Behaviour Therapy alone? Can you suggest some ways?
And also, I get really really startled every time someone knocks on my door.. Like literally scared for a split second.. The same as we get scared when watching a horror movie. That doesn't damage the heart , right?
I want a reassurance one more time..As to say, is watching horror movies also okay?
But how can I use Cognitive Behaviour Therapy alone? Can you suggest some ways?
And also, I get really really startled every time someone knocks on my door.. Like literally scared for a split second.. The same as we get scared when watching a horror movie. That doesn't damage the heart , right?
I want a reassurance one more time..As to say, is watching horror movies also okay?
Brief Answer:
It does not affect in that way
Detailed Answer:
Hello,
Thanks for reverting back to me.
I like to assure you that heart ailments are completely different from what we get in anxiety. The extent of heart ptoblems due to startle response or anxiety is similar to other disorders and never to the extent perceived among lay persons in the society.
Regarding CBT I do not think you should use it alone as the severity of sympyoms unlikely to respond to CBT alone.
I hope this assists you further.
Thanks and regards.
It does not affect in that way
Detailed Answer:
Hello,
Thanks for reverting back to me.
I like to assure you that heart ailments are completely different from what we get in anxiety. The extent of heart ptoblems due to startle response or anxiety is similar to other disorders and never to the extent perceived among lay persons in the society.
Regarding CBT I do not think you should use it alone as the severity of sympyoms unlikely to respond to CBT alone.
I hope this assists you further.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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