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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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I was at the flyers game last night and at the end of the

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I was at the flyers game last night and at the end of the overtime loss my ribs, back, sides and chest got tight. It lasted until I got home and took lerazopam and went to sleep. I woke up today and still feel uncomfortable. A little tight feeling. I have been to the Er before with the chest x rays, ecg, blood work and all came back normal. The dr.s say I have anxiety disorder. It was a stressfull exciting game and my question is would that cause me to get those body tight feelings. Is that part of my general anxiety disorder to get like that during that type of emotional event. I also get like that at court, I am an attorney. What stinks is I used to go to games and not have to worry about these feelings. I just want to enjoy and not have these feelings.
Submitted: 7 years ago.
Category: Mental Health
Expert:  Doctor Blake replied 7 years ago.

Good morning!

Thanks for writing to JA.

Glad to hear that you made it to the Flyers game - and that you're getting out! Some people diagnosed with a Generalized Anxiety Disorder (GAD) can develop Agoraphobia, or a fear of leaving home. You're doing yourself the BEST service you can by getting out there and living life, going to work, and having fun!

Your symptoms may well be related to anxiety or GAD.

Please understand that it would be inappropriate and unethical to diagnose over the internet (and across the Atlantic ocean). This being said, your first course of action is to be certain that there is no medical cause that could explain your hyperventilation. An initial conversation with your GP will help to rule out any physiological/medical causes.

If your GP has ruled out any/all medical causes for this, you should discuss with him Hyperventilation Syndrome. This is *not* a mental illness, but is considered to be many in the mental health field to be a particular manifestation of a Panic Disorder.

I have personally treated this condition with a young man (aged 13) and found using traditional CBT techniques, he was able to return completely to normal functioning within 5 sessions. (Your case may be different - but this is very *very* treatable!)

As an anxiety disorder, GAD has been described as the "catch all" term to describe an individual with nonspecific or global anxiety that can, at times, reduce functioning in certain areas. Folks with GAD are prone to develop more specific anxieties around specific events than the normal population, and may develop more "specialized" anxiety disorders over time. As one of the Anxiety Disorders, GAD is felt to be related to applying the wrong response to a given situation. That is, fear is an adaptive function that all animals (human and otherwise) are born with... it is an innate reaction - but can be learned in response to certain situations/events. When fear (the response) comes at the right situation (a hungry saber-toothed tiger standing in front of you), you're doing GREAT! Fear makes you move (fight or run for your life)! When fear (the response) comes at the wrong situation (at the grocery store or on an elevator or driving down the highway, for example), you're not doing so great - and you need to relearn when/how to apply fear as originally intended.

Research has consistently demonstrated that treatment plus medication is more effective than medication alone or treatment alone for anxiety. Further research has shown that Cognitive Behavioral Therapy (CBT) is the most effective form of psychological treatment/intervention - particularly in dealing with anxiety disorders (like GAD).

A licensed psychologist/psychotherapist with specific training in CBT modalities would be able to address your concerns. I would encourage you to find a licensed mental health professional with whom to work, employing CBT. Be sure when you speak to a possible licensed mental health professional that s/he employs CBT techniques - not just "influences from CBT" or "an eclectic approach."

With regard to medical treatment, many/most physicians appear to begin with a Selective Serotonin Reuptake Inhibitor (SSRI) to treat anxiety. Because I am not an MD, it is beyond my purview to address medication concerns, however.

Again, the mantra of years of research says: medication or treatment alone is not as effective as both working in tandem. Some research has also indicated that insight-oriented talk therapy is counter-productive with some forms of anxiety disturbance... it actually exacerbates the condition(s) So, seek out a CBT therapist who will provide targeted, efficient, and effective therapy - not someone who signs you as a "lifer." If you're going to a therapist for years, something about the therapy isn't working.

Your psychiatrist *may* know of a CBT licensed mental health professional. Please make certain, however, that they employ CBT practices.

Thanks. I hope you're well and that this was helpful.

* FEEDBACK ENCOURAGED. Please contact me prior to leaving negative feedback so that we can resolve the matter. I am eager to work with all JA clients to provide them with useful/helpful answers. Thanks again.

Customer: replied 7 years ago.
I also have OCD. I did not have the chest rib tighness until I was leaving the game and had to deal with my ocd, touching things a number of times, not touching things, ect. Very frustrating. Thereafter, the feelings came. Maybe that had soemthing to do with it. At the game and all the way up to the time I left the building I was fine.
Expert:  Doctor Blake replied 7 years ago.

Just FYI...

...the best treatment for OCD, besides SSRI medication, is Exposure with Response Prevention (ERP). This can be administered by a CBT therapist.

Best of luck to you.

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