"Anxiety Physical Pain"

[Terry Dyroff]

I have “anxiety pain”. This is what I call it, but I’ve never talked to a therapist who seems to recognize it, so I’m posting a description to see if others have had the same experience. It feels like an “adrenaline rush” except at about 5% of the intensity you get if suddenly frightened, but constant. The pain is located primarily in my upper arms, but when severe can move into my chest area and even legs. The intensity varies and even though it hasn’t affected me throughout my life, I’ve had periods of it lasting a month or two every 5-10 years of my life since a serious depression/anxiety episode 40 years ago. I’m currently experiencing the longest lasting episode I’ve had – about 6 months. This began because of anxiety over a physical problem, but as often is the case, the concern that initiates the pain goes away and I’m left with this constant “aching”. I refer to it only as a pain because I’m not “anxious” about much of anything on a conscious level, nor am I depressed. I feel it is related to anxiety though for two reasons - the only two things that can relieve the pain are a good nights sleep or the drug clonazepam (Klonopin). I’ve tried and am trying other medicines designed to be taken regularly for depression/anxiety like Wellbutrin and Mirtazapine. It’s hard to tell whether these help or not because they are long-term, slow acting things, unlike Klonopin, which acts within a half hour and I can definitely associate the pain relief with the drug. So what I’d like to know to begin with, is there anyone else out there that has this symptom and, of course, what, if anything, have you found to help relieve the pain?

 

[triceps]

I have “anxiety pain”. This is what I call it, but I’ve never talked to a therapist who seems to recognize it, so I’m posting a description to see if others have had the same experience. It feels like an “adrenaline rush” except at about 5% of the intensity you get if suddenly frightened, but constant. The pain is located primarily in my upper arms, but when severe can move into my chest area and even legs. The intensity varies and even though it hasn’t affected me throughout my life, I’ve had periods of it lasting a month or two every 5-10 years of my life since a serious depression/anxiety episode 40 years ago. I’m currently experiencing the longest lasting episode I’ve had – about 6 months. This began because of anxiety over a physical problem, but as often is the case, the concern that initiates the pain goes away and I’m left with this constant “aching”. I refer to it only as a pain because I’m not “anxious” about much of anything on a conscious level, nor am I depressed. I feel it is related to anxiety though for two reasons - the only two things that can relieve the pain are a good nights sleep or the drug clonazepam (Klonopin). I’ve tried and am trying other medicines designed to be taken regularly for depression/anxiety like Wellbutrin and Mirtazapine. It’s hard to tell whether these help or not because they are long-term, slow acting things, unlike Klonopin, which acts within a half hour and I can definitely associate the pain relief with the drug. So what I’d like to know to begin with, is there anyone else out there that has this symptom and, of course, what, if anything, have you found to help relieve the pain?

Hi and welcome Terry. Am sure sorry you have to deal with your unusual pain symptoms. I've just got pains that I associate with general aging with no particular pattern. But I do take Klonopin for my anxiety. My initial thoughts include that at least you've found a medication that helps the pain and question the need for the antidepressants if you're not depressed. Can I ask the dosage you're taking of the Klonopin?

 

[Terry Dyroff]

I used to use one tablet (1 mg) only once every few weeks, mostly to help me sleep, but when the anxiety kicked in (I seem to get a bout of this once every 5 to 10 years), I began increasing it to where I'm taking a 1/2 mg every day. I'm trying to hold it at that. It does do wonders for the anxiety, but a major problem is that its effectiveness begins to wear off when you use it too much. I suspect age has something to do with my anxiety problems; I'm 73. I'm trying to find something else that will work, but so far, only a good night's sleep will do that (at least I can usually get to sleep although not always for very long). Thanks for your comments.

 

[triceps]

I used to use one tablet (1 mg) only once every few weeks, mostly to help me sleep, but when the anxiety kicked in (I seem to get a bout of this once every 5 to 10 years), I began increasing it to where I'm taking a 1/2 mg every day. I'm trying to hold it at that. It does do wonders for the anxiety, but a major problem is that its effectiveness begins to wear off when you use it too much. I suspect age has something to do with my anxiety problems; I'm 73. I'm trying to find something else that will work, but so far, only a good night's sleep will do that (at least I can usually get to sleep although not always for very long). Thanks for your comments.

Hi again Terry. I'm 66. I've been on medication for anxiety since I was in my thirties. My psychiatrist (who is an expert on both Klonopin and Xanax) told me that the physical addiction starts if you take more than 1.5mg/day. My two suggestions would be 1) feel free to get up to that level occasionally if needed and 2) do whatever is necessary to get decent sleep, be it sleep medication before bedtime or taking naps whenever you feel you can sleep. Sleep deprivation is one of the worst causes of enhanced anxiety (and possibly a source of your pain) so I take naps whenever I need to. .5 mg of Klonopin is supposed to last 10-11 hours and is what I take before bed and I usually sleep through the night. The two ant-depressants you mentioned are not primary anxiety reducing medications. The wellbutrin can be effective for quitting smoking (it's promoted as Zyban) but one of the main anti-depressants that help anxiety is Lexapro which is approved for anxiety treatment.

 

[Terry Dyroff]

Wow, that is hugely helpful, especially considering your long experience and that your psychiatrist is an expert on Klonopin. How long have you been using Klonapin it? Since your 30s? One concern is a reduction in efficacy. Normally I wouldn't worry about this because these episodes don't usually last for more than a couple of months. I have to think this time though that the Mirtazapine may have been a cause of the problem. In fact, the pain episodes have gotten less common with less intensity since going off that drug.

 

[triceps]

Wow, that is hugely helpful, especially considering your long experience and that your psychiatrist is an expert on Klonopin. How long have you been using Klonapin it? Since your 30s? One concern is a reduction in efficacy. Normally I wouldn't worry about this because these episodes don't usually last for more than a couple of months. I have to think this time though that the Mirtazapine may have been a cause of the problem. In fact, the pain episodes have gotten less common with less intensity since going off that drug.

Hope that information helps. Was on Xanax for many years before switching to Klonopin which has helped men greatly. I take .5 mg in the morning, one in the afternoon and one to help me sleep at night Been on it at least 10 years.

 

[Terry Dyroff]

Thanks a million! I know everyone's body chemistry is different, but I feel that if I could just go to two .5 mgs per day, it would take care of my problem. Of course I look forward to responses from others as well, but this certainly eases my concerns. I also suspect that reducing anxiety will in itself reduce anxiety, if you know what I mean.

 

[triceps]

Thanks a million! I know everyone's body chemistry is different, but I feel that if I could just go to two .5 mgs per day, it would take care of my problem. Of course I look forward to responses from others as well, but this certainly eases my concerns. I also suspect that reducing anxiety will in itself reduce anxiety, if you know what I mean.

From the spelling on my last post I can understand your confidence in my opinions. I absolutely agree that reducing anxiety by itself will further reduce anxiety and vice versa.

 

[Terry Dyroff]

In regard to my last comment, I always felt that my anxiety was somewhat like a sprained ankle or broken bone. Keeping it relatively immobile to prevent re-injury will result in the fastest heal. I wonder if there is research to support that with mental health issues. I can't help but believe it is true and would support treating anxiety with something that will reduce it rather than "gutting" it out. By the way, I don't know if this is permissible on this site, but I'd like to have the name and contact information for your "Klonapin expert" psychiatrist if you don't mind. Thanks, you've been a "ray of light" during a particularly dark time.

 

[triceps]

Hi Terry. My psychiatrist retired about 5 years ago. His name is Dr. James Rugowski and lives near Minneapolis. He was involved with Upjohn during the studies on Xanax prior to the FDA approval of it many, many years ago. Although he said I could contact him anytime, he never gave me his personal contact information. Like I said, the guy is pretty smart.

 

[Jones]

Can I weigh in here...I had a psychiatrist tell me that I could be on klonopin the rest of my life and that I didn’t need to take an antidepressant because I didn’t exhibit any depressive symptoms. I was elated because when I took klonopin I actually felt like myself again. Unfortunately, I had to take more and more to achieve the same success and I knew eventually it would stop working. I weened myself off and haven’t been on anything for almost four years. I know there are some who use it with regularity and have good success (Triceps), but there are others who don’t have that same luck. I’m not telling this to scare you, only to use caution when using consistently. This is a drug that was made to be used as a once in awhile or for a very short period of time. By the way, that psychiatrist who told me I could take the klonopin for the rest of my life, lost his license.

 

[Terry Dyroff]

Thanks. I think the key is that everyone's body is different. I didn't really need Klonapin before (I'm 73) this rather unusual bout that started about 6 months ago. The literature clearly points out that this drug "may sometimes cause addiction" and that it "may lose its effectivness, i.e., the patient may develop tolerance to the drug's effects. I think the key is that it has different effects for different people and that caution and a doctor's supervision are important. I'm trying to get an idea about what is a reasonable balance between what is safe and what is effective. I was limiting myself to two .5 mg pills per week and was pretty miserable most of the time a few months ago. Currently, I'm using .5 to 1 mg per day and feeling quite well. I'm aware that in the future, I might require more or, for like most of my first 73 years, require none at all. At the present time, my plan is to stay on .5 to 1 mg per day while my psychiatrist tries other long term medications that will work to prevent the anxiety. In short, everyone's comment is important. So - good or bad - do keep commenting.