I have ADD and Anxiety and I'm also experiencing high blood pressure. What are my options?
I'm a 25 year old female who's never had high blood pressure until recently. About 6 months ago, a routine trip to a womens health clinic for birth control left me without birth control and having learned my blood pressure was too high to recieve any kind of hormonal birth control. I'd been under an enormous amount of stress prior to this, recently having had a pregnancy scare (hence my trip to the clinic) as well as a rocky few months losing my previous job (due to anxiety), starting a new job, and dealing with some major financial blows. Shortly after that trip, I began experiencing heart palpitations, and I was sure it was just anxiety, but they wouldn't really let up. I saw a doctor and was told my bp was on the high side but certainly not at any dangerous level, and was given 25 mg of atenolol for the heart palpitations, but not for the blood pressure. Since then, I've been to see another doctor who told me to take between 50 and 100 mg of the atenolol (for the palps) and also that my blood pressure was high but not high enough to worry about without first trying dietary and lifestyle changes. Since then I've been in the ER twice for intense back/chest pains and also dizzyness, all of which I attribute to untreated anxiety. Since finding out that my blood pressure is high, I've had countless paranoid thoughts about having a heart attack, stroke, aneurysm, etc, all of which I know, deep inside, is anxiety. I've had an anxious past, having breathing problems and 'air hunger' during times of stress since childhood, and recently I've had "mini" panic attacks, all since that first trip to the clinic back in July. I was also diagnosed with ADD and Anxiety back when I was 15, though never found an appropriate treatment and just kind of 'learned to cope.' Now that I'm an adult and seeing firsthand what anxiety, as well as my ADHD, is doing to me, my career, and to my family, I want and need help. I've seen doctors over the past months only to be left with a 'theres nothing wrong, just get rid of the stress, relax, etc' prognosis. Ive had bloodwork, EKGs, urinalisys,the works performed between the two ER visits and the doctors visits I've had. I've even seen an endocrinologist about possible issues with my thyroid that could cause changes in blood pressure, heart palpitations, etc, as i've been experiencing them. I'm just kind of at my wits end, and I'm sick of worrying about my health. I want to get my ADHD under control but I'm not sure if stimulant medication is okay with my supposed high blood pressure, and I'm not even really convinced I have high blood pressure, aside from the anxiety possibly pushing it higher. I guess my questions are this:
Is it possible that an extended period of anxiety could raise my blood pressure from the upper end of normal to 'high?' If I can find a doctor who is willing to treat my anxiety, will I likely see a drop in blood pressure? Also, is stimulant medication for ADHD safe to take if blood pressure is controlled? I've used wellbutrin in the past for anxiety and ADHD with very little success, and prior to all these other issues I was considering stimulant medication. Am I completely out of the running as a candidate for these meds? I'm fairly confident that many of my anxiety issues are closely tied to my ADHD, but I know its hard to seperate the two. I guess I'm just confused as to where I should even start, since every doctor I meet basically asks me state my 'cheif' complaint...but I don't even know myself. To top it all off (and to add to the stress) I'm now out of a job, have no insurance, and have no way to pay for extensive testing, and what I have invested in so far hasn't shown me anything I can actually work with. I really don't know where to start!
A- Anxiety has profound effects on the body. We know that its role in the "fight or flight" response leads to constriction of blood vessels and contraction of muscles so it is easy to understand how blood pressure can be affected. If you have not been evaluated by a mental health professional and are not in treatment, now is the time to do so. Find a local health department or clinic that provides services for the uninsured and make an appt. There are cognitive and behavioral approaches that require no medication. If you need medication a mental health provider will be best able to consider this complex set of issues that you are presenting.
Rick Wirtz
Rick Wirtz is a Psychologist, not a Psychiatrist. Although the majority of Psychologists are not authorized to prescribe medications or give you specific advice about them, they typically have experience working with patients who take a variety of medications. The response above is not intended to diagnose or treat any medical or mental disorder. Any information given in a post about medication is for educational purposes only and primarily to aid you in having an informed discussion with your own physician.
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