Will CBT/ERP help with this?

[Juliex]

Hi everyone

I'm not sure this is part of my ocd but if I describe it perhaps you might be able to help me identify if it is.  

It's about a medical issue.  I've been having a lot of skipped heartbeats.  I've had reassurance in the past from my GP, other GP's, 2 cardiologists....and I've had numerous tests.  However, I've just had another spate of them, more frequent than ever, so I went to see a private cardiologist (as I could see him the next day) and he, as well as giving reassurance, agreed with me that it would be a good idea for me to have an echocardiogram.  This looks at the structure of the heart and if that is normal, then the skipped beats are usually always benign.  He said it's not necessary to have this test but that he agreed with me it would hopefully give further peace of mind.

Well I'm not sure when I'll have that test as I can't afford it privately....so waiting...

But I noticed a pattern in my thinking that suggested my OCD is playing up here too.  Here's the pattern:  I get a heart skip or flutter, I worry because I don't know exactly what kind it was so I can't check it against descriptions of benign or bad ones, or my heart races so I'm too scared to check my pulse (so I don't know the exact rate and can't check which type of palpitation it is)....basically I struggle with the uncertainty triggered by a heart skip/flutter...

If I remember correctly a book by Dr Jonathan Grayson says right at the beginning that you have to be prepared to accept the absolute worst in order to begin recovering from the OCD.  So....does that mean (if this is my OCD at work) I have to accept the possibility of sudden death, due to not identifying the symptoms correctly, not getting help on time, etc

When I'm having intrusive worries that perhaps these palpitations will get worse at work tomorrow because it's a long day and a long commute, should I just agree with that and tell myself that yes, perhaps they will increase, yes perhaps I will have a major heart race thing go on and call out the ambulance again like I did after my last commute last week, yes perhaps it will take 3 hours to arrive like it did then, etc (I can't go on as it makes me to anxious)

I have also got a diagnosis of PTSD due to seeing someone die of a heart attack, so of course this isn't all OCD, but I can see the pattern playing out. My compulsions, when I've had a symptom, is the trawl the internet trying to look for why it's not serious this time, etc....

I'm going to go ahead with medical tests and follow doctor's advice, etc, but my doctor has retired now and I don't feel safe with the others.  That's partly me and partly that all the doctors now in my GP surgery don't have the same level of experience as the doctors that used to be there. 

Another intrusive thought is that if I DID need an ambulance I've pretty much had it because the one I called last week took 3 hours to arrive.  They told me over the phone that I needed to be seen within the hour, I told them I didn't have a car at the moment, they said they would send out an ambulance.  If I'd have known how long it would take I might have called a taxi - but being in a panic, I didn't and just waited. Scared.

Thanks for reading.  Should I get started on ERP? (I know how it works, but I will ask my GP if I can see someone also).

(by the way this is the first time ever I've called an ambulance for myself, sorry if it looks like I wasted their time, I had a very fast pulse that came on out of the blue after weeks of skipped beats.  I may be approaching the start of menopause and it could be that, but my symptoms were scary enough to call an ambulance, but I don't usually make a habit of this!)

 

 

 

Edited April 9, 2017 by Juliex

[OceanDweller]

Hi Julie

Emergency service response times aside(!), there is much about your post that is a lot less baffling than you're currently recognising.

OCD plays upon our fears. The fact that you were traumatised by witnessing a cardiac death plays right into its mischievous little hands.

As for acceptance, therein lies the solution to all anxiety problems. We each of us fear some things more than others. You're extremely scared of having a heart attack, the poster before you may be insufferably afraid of cheating on their partner whilst intoxicated. Personally, I fear vertigo (because of the helplessness and terror I felt during an attack sixteen years ago). Any one of these eventualities could befall you, I or billions of others at any time. The reason that the entire world isn't constantly petrified is that most folk are prepare to accept uncertainty. They know the odds of something catastrophic happening to them today are very long indeed.

I cannot say with any certainty whether having this latest test will provide you with any reassurance. What I do know is that you will never be absolutely sure. About anything. Because that's life.

I might suggest returning to your GP and requesting a referral for CBT. Though I'd be surprised if it took less time to arrive than the echocardiogram. Still probably less frustrating than waiting for an ambulance though!

[chaosed]

on a side not, have you checked your magnesium levels?

[Juliex]

The person who died was my dad.  The strongest, bravest person I knew.  Yet it got him.  That's part of the problem, the other part is that I'm 50% of his genes.

Not afraid of being dead.  Afraid of dying like that.  The process.

I have to get through this week.  I have a commute to do on wednesday.  Last week I had a racing heart AFTER my commute.  I think due to tiredness and eating late (possibly a mild infection).  

I'm already thinking of how to prevent the same thing happening this time.  :-(  And dreading the commute, not starting it, but coming home that night....

So I have to tell myself that yes, it could all happen again....and begin the process of acceptance...

Is that the best way to handle this?  My brain is in extreme anxiety.. Perhaps I even have to tell myself that I'm going to have extreme anxiety and that this may trigger off more heart racing etc.

 

[taurean]

I have a heartbeat rhythm issue that showed up in an electrocardiogram around 4 years ago which was part of the regular health screening that came via my work. 

I could see it on the printout and the nurse referred it to the in-house cardiologist then and there, so that when I saw the doctor at the end of the healthscreen tests to review the findings, she said the cardiologist had confirmed it was OK. 

I mentioned it to my own doctor later - he was sent a copy of the results of the healthscreens - and he also confirmed all was well. 

So I don't give it any concern - had treatment been needed they would have told me and my doctor would have arranged it.

I get increased blood pressure and heartbeat when OCD strikes, but the doctor and I know this is down to anxiety.

I don't have health OCD, I trust my medical advisers - so I don't make my symptoms, the results of the OCD when it strikes, worse by worrying or awfulising about them. 

Certainly CBT is likely to help you with your issues. Bear in mind that ERP is a part of CBT, not separate to it - it's part of the B - behavioural - element, where we are taught to apply what we have learned about the cognitive - thinking - side of OCD in order to make changes with a view to taking the power out of intrusions and thus easing down anxiety. 

Edited April 9, 2017 by taurean

[Juliex]

41 minutes ago, chaosed said:

on a side not, have you checked your magnesium levels?

Thanks.  Haven't had levels checked, but I bought some supplements today.  I'm not getting a lot of skips atm, but had loads for the last 3 weeks.  It does seem to be affected by hormones and possibly hormone changes, but will see if the magnesium helps.....it might calm me down at least (though only anxious because of the skips)

I had read that Taurine and L'Arginine combined could eliminate heart skips (a paper written by George Eby, but not sure of his background, etc.)  I did try it once before and actually they did stop.  But I found the L Arginine acted like a beta blocker and made me incredibly lazy!  Then I weaned myself off it and the skips didn't return for years.

[Juliex]

25 minutes ago, taurean said:

I don't have health OCD, I trust my medical advisers - so I don't make my symptoms, the results of the OCD when it strikes, worse by worrying or awfulising about them. 

Certainly CBT is likely to help you with your issues. Bear in mind that ERP is a part of CBT, not separate to it - it's part of the B - behavioural - element, where we are taught to apply what we have learned about the cognitive - thinking - side of OCD in order to make changes with a view to taking the power out of intrusions and thus easing down anxiety. 

Thanks taurean.

Part of the anxiety is that my arrythmias haven't been captured on a monitor yet.  I'd like them to be seen and be told they're ok, but I do take your point that you're not anxious about it.  Actually I was told there were a few pauses on one of my readings, and not to worry, and I don't because I don't feel them...

But I think you're saying this does have the flavour of OCD about it?  So I might tackle this week with an ERP approach....with my other OCD issues, ERP works in half a day.  I actually respond really well to it and to distraction (counting backwards, etc), which is why I haven't been here much.  But it is OCD that I have, I was diagnosed.  I think I usually have it mild, (for my other issues) but it doesn't feel mild at the time.  Thanks  :-)

(trust me I've still had it really bad, really been terribly down and have had months of it in the past, just over the years I've found ways to manage it that are effective)

 

Edited April 9, 2017 by Juliex
add something

[PolarBear]

Julie, it seems that you have been spending an inordinate amount of time researching about your heart and skipped beats. You've received assurances from several doctors that you're fine but still you want another opinion. This all sounds like OCD to me and your actions seem like compulsions.

What if you get the EKG, it turns out fine but the doubt comes back again? At some point you have to say enough is enough and put a stop to all of this.

[Juliex]

Thanks PolarBear

This is what I thought might be happening, that I'm engaging in compulsions, but I didn't realise until today, probably because the symptoms are real (i've been told that by the doctor), I forgot about my ocd brain.

[Juliex]

So today has been awful so far.

I had chest discomfort while eating a sandwich at lunch time.  It was the first thing I ate and I've had this discomfort before when delaying eating.  It was so uncomfortable, with palpitations that I stopped eating the sandwich.

I called the GP.  I couldn't go in to see him, the secretary said they have a triage system which means they speak on the phone first and if they want to see you they will arrange it.  I explained my symptoms to him.  He didn't know about Printzmetals Angina (chest discomfort on eating due to coronary spasm) and looked it up.  I think that's what I had.  It's now 4 hours later and my chest still aches from that episode.  If I had a car (I don't at the moment) I'd go to A & E and get checked out.  No point calling an ambulance because the whole thing scares me and it may not come for ages anyway.

But I've spoken to cardiologists who looked at my dad's case.  They said he should have called an ambulance, even for an ache in the chest.  So I know the drill.

The GP said he's willing to take a risk that these are anxiety symptoms.  But he admitted that GP's take a lot more risks than the specialists because they usually see milder cases than the specialists.

So I don't know what to do, just keep sitting here crying, wishing there was someone here with me who was strong enough to help me, but no one's here.  I'm the strong one for everyone at the moment.  There's no one I can call.

Then I think I should be brave and get a taxi to A&E.  But it's a lot to do when you feel rubbish....I just wish the ache would go down. 

I don't want to go to work tomorrow, I'm a partner with someone on a small business, so in theory I could rearrange tomorrow, but I'd have to call that person and they're having a hectic day, so I think it would be a stressful conversation.  

I just feel paralysed.

Edited April 10, 2017 by snowbear
Trigger warning removed as the forum does not condone them

[Juliex]

One of the things that's difficult is that I don't have a car.  Having a car would make things easier as I could take myself to A&E, rather than call an ambulance that may not come, think you are using up resources for someone else (if you're not as sick as you think you are), or get a taxi and have to talk to the driver all the way there when you're not feeling up to it.

Also I understand the doctor thinking this is all anxiety, but I can't bring on the chest discomfort, that happens by itself.  :-(

The only thing that I'm hanging onto is that I get this sometimes at this time of the month (all be it milder usually) and so it may be hormonal and less of a worry

[Juliex]

They have ECG machines at the GP surgery.  I don't understand why a doctor can't ask you to come in and do an ECG.  The doctor seemed so confused as to what he should do about my symptoms, he just expressed his confusion saying it's hard to know in this situation.  In other words I need to make my own decisions and I'm just sat here paralysed, which is not the best reaction to this.

[Juliex]

By the way I know no one here can decide if this is real or not.

I was just posting here as I'm keeping an open mind that this is anxiety (although chest pressure on eating is not, but it may not be serious).

It's the anxiety aspect I'm trying to treat here too.

I've told myself that perhaps I will make a mistake and not get seen on time....etc.  Making me nervous thinking it all through though.  Any tips on that would help.

[Juliex]

So I thought I'd read about panic attacks, of course this was a compulsion.....and reading about them brought about more anxiety because there were articles saying that panic attacks can be linked to heart attacks and can be the forewarnings of a heart problem.

So my compulsion backfired on me, like it often does.

Oh well, I have to go out now and walk to the shops, maybe it will kill me doing it (I can't believe I typed that) but I have to get on with living while I'm here.

[Juliex]

Sorry to post again but it is helping me to work on it here.

I've cancelled work for tomorrow, the person I work with was happy to rearrange.  So I've took something off my plate.  

I've worked out that there is a direct bus route to a 'nicer' A&E if ever I needed it (nicer because my dad wasn't at that one)

And I have spent the last hour noting the negative thoughts and countering them with 'yes, that could happen,' and really going there in my mind.  It's horrible.

Chest discomfort is still there.  That's it for now..

[snowbear]

Hi Julie, I'm sorry you're having an anxious day. 

It's interesting that your chest pain started at lunchtime while eating a sandwich, yet you immediately assumed it was cardiac related. It doesn't seem to have crossed your mind that it might have been simple indigestion. I'm not saying it's one or the other, or even just a muscular pain from anxiety, but this is an example of how OCD fears focus on just one explanation (the most feared, worst scenario case) when there are in fact many possibilities and most of the alternatives are benign. It's useful to remember this when you need to take a step back from the OCD to gain some perspective. 

You've engaged in a lot of compulsions today - googling symptoms, thinking continually about your heart, cancelling work commitments and even making preparations to visit an alternative hospital if needed. All these acts are compulsions designed to reduce anxiety. Some seem to have temporarily worked for you while others backfired immediately, but you know in the end that all compulsions backfire, because they maintain your belief there is something justifiable to worry about.

You may have noticed I've edited some of your posts today to remove the trigger warnings. This is because what is seen as a trigger to one person likely won't be to someone else, and anything - literally anything in the world - can be a 'trigger' to somebody. So we don't permit trigger warnings on the forum. All they do is reinforce in your mind that there is something to be scared of while not protecting anybody else. 

Where do you go from here? Stop. Take a deep breath. Re-focus. 

Try to disengage from the thoughts about your heart and today's ache in your chest. Use distraction to take your mind off it and see if it eases as a result. (Which it very likely will if you relax and successfully distract yourself.)  

Take away a lesson from today that compulsions don't help in the end. Next time resist doing any googling, intensive thinking about your heart, or avoidance behaviour such as cancelling commitments and looking for a nicer hospital.

You mentioned noting the negative thoughts and accepting they could happen which sounds like a form of ERP.  So are you seeing a therapist at present? It may be a good idea to discuss with him/her some alternative behaviours to adopt next time you get chest ache so you manage the anxiety more appropriately (whether it turns out to be heart or anxiety related.)  

[Juliex]

thanks Snowbear

apologies for the trigger warnings.

I thought I was being anxious when my dad had 'indigestion,' it was a heart attack that killed him. 

Discomfort in my chest doesn't feel right to ignore.  it only calmed down after 12 hours.

After taking my beta blocker before bed.

But I could go on......part of the problem is that I DON'T go and get efficient help.  I could have gone to the hospital and not rely on a GP, then I would have got an ecg and a blood test.  Maybe that's compulsions, but it would have been logical ones that would put the argument in my head to bed one way or the other.  I think the OCD is keeping on because it knows not every stone has been turned on this.  

I have really tried to refocus but the sensation in my chest has been there the whole time.  Makes it difficult to practice dealing with anxiety.

Apart from my hormones being all messed up at the moment, I do have to tell myself that this has all happened in a cluster, and may be part of the anxiety playing out.  But I know what I'm feeling in the chest.

Today I'm telling myself to just gently get dressed, have a slow walk around to my mum's, see my dog (who always makes me laugh) and not do compulsions............But my brain keeps saying 'that chest sensation was real and you know it.'  And it's true.  I know without a doubt it was real, it's not ocd it was real.  It's just whether it's serious or not is the question and my anxiety about getting anything done about it.

 

 

 

 

 

 

 

[Juliex]

Spent the afternoon at my mum's with the dog, after having cancelled a work meeting today.  After a few hours I became more myself, more spontaneous, laughing at the dog, chatting away, etc.

In the back of my mind is that chest sensation.  I know I've had it before during my period but it was very intense yesterday.  That may have been anxiety or worse.  Still surprised the doctor didn't understand it because it wasn't classic of heart problems, or whether, even if it was, they don't do anything unless you are full on dying...getting that impression.  That may be my anxiety.  He was a nice doctor just seemed at a loss as to what to do.  As if he was wondering 'is this real or not?'

Anyway I got home and felt as though I was improving.  Sorry for the TMI but my period is coming to an end and the symptoms, as usual, seem to be receding with it...

More wobbly tonight, haven't eaten nearly enough today, but still better than yesterday.  

Reason for posting.  Wondering if the time at my mum's made me feel better because of it being two things:  Distraction and No Compulsions taking place there.

 

 

[snowbear]

6 hours ago, Juliex said:

Maybe that's compulsions, but it would have been logical ones that would put the argument in my head to bed one way or the other.

Stop right there. There is no such thing as a logical compulsion.  OCD thinking twists things to make them seem logical in order to justify compulsions. It's never logical if you apply non-OCD thinking (identify the flaw in the thought process.)

And no amount of reassurance is ever going to put the argument in your head to bed. Next chest ache you get you'll be back to square one, wanting another ECG and blood tests to reassure you that pain isn't your heart.

Reassurance doesn't work. If you want to this cycle of anxiety and OCD thinking to end you need to do some cognitive work and change the way you think about what it means to have chest pain.

6 hours ago, Juliex said:

my brain keeps saying 'that chest sensation was real and you know it.'  And it's true.  I know without a doubt it was real, it's not ocd it was real.  It's just whether it's serious or not is the question and my anxiety about getting anything done about it.

This shows there's a problem with the stories you're telling yourself. You need to listen closely to what you say in your head. Think about the message the words convey and what underlying beliefs they reveal/reinforce. Then ask yourself if those beliefs are valid.

The reality of the pain was never an issue. So why are you talking to yourself in a way which suggests it's only OCD if you imagine the pain and justifiable worry if the pain is real? That's a compulsive thought process attempting to justify being anxious every time you feel pain just because it's there. 

There are many causes of chest pain and many types of chest pain. Some need urgent attention, some aren't urgent but shouldn't be ignored, and some are completely harmless and more nuisance than worrying. But in your head 'chest pain = chest pain = urgent and serious heart pain' until proved otherwise.

This belief that all chest pain must always be treated as if it was serious heart pain until proved otherwise isn't true. But believing it's true sets you up for having to feel anxious and having to do compulsions to look for proof.

The same belief causes you to make further interpretations - that hospital tests are the right treatment and doctors who don't react to your symptoms as you do must therefore be either confused or negligent (since they aren't treating it as serious or looking for proof that it's not.) According to your belief system an ECG and blood tests are essential to rule out heart problems, so the way you see it is how could they possibly know there's nothing to worry about?

The problem lies in the belief. You're responding to each episode of chest pain as if your belief was true, not questioning yourself to see if it's valid or has developed out of fear and OCD thinking twisting things. 

Not all chest pain is heart related. Chest pain can often be diagnosed as non-cardiac without tests. 

Tackle the underlying belief you adopted in response to your dad's unfortunate death to release yourself from the obligation to always feel anxious and to do compulsions looking for proof that your very real pain is non-serious.

[Juliex]

On 4/11/2017 at 22:26, snowbear said:

Tackle the underlying belief you adopted in response to your dad's unfortunate death to release yourself from the obligation to always feel anxious and to do compulsions looking for proof that your very real pain is non-serious.

Snowbear, I really appreciate the time you took to respond and your response was very insightful and clearly had me all sewn up, lol, you were spot on about my beliefs.

The thing is those beliefs developed following analysis of what happened to my dad, by 2 cardiologists.  So the beliefs are based on what they have said should happen where there's chest pain (of any sort).

The concern is that I'm in sheer terror about it.  :-(  The compulsion, as I believe you rightly said is 'looking for proof' that my 'very real pain is non-serious' - but not by having the courage to go and have the tests.....just by phoning a GP who is clearly powerless to do anything unless I went and collapsed at the surgery.  (after all he/she can't send every anxiety or chest pain case to hospital).  I just want everyone to tell me everything's ok.  It's actually childish, even if it is part of the ptsd and ocd.  It's not going to help me.  

My knowledge should benefit me, but instead the fear is in charge and it doesn't have the courage to go get tested, get it over with and come home, hopefully with clear results.  I'm concerned that one day my fear will put me in danger due to this (by not seeking help when I need it).

I suppose some might say that at least I called a GP and got advice and then latched onto his suggestion of anxiety.  But I have seen enough to know that this could easily be said to someone with a serious heart issue by mistake. 

Anyway, today I tackled the OCD by telling myself I could have allotted compulsion time at 2pm when I was on lunch.  Not before.  Of course by 2pm I had other things on my mind, so I changed the time to 4pm, and on and on....so it's now gone midnight and I didn't do any compulsions.  It has meant that I got work done and was more productive.  Sorry for TMI but I think it's also hormonal, my period actually stopped today and I actually felt physically stronger, so that impacted on my mind and lowered my anxiety levels.  It's still all there but not doing compulsions has kind of 'shelved' it.

 

 

[Juliex]

Well the approach of giving myself a 'rumination time' seems to be helping.  By the time I get to that time, I'm usually in a better mental state and don't feel the need to do it, so just put it off again.

I think, regardless of what my health is and I don't know for sure, that I want everything to be ok, I want that certainty and I'm struggling to function with uncertainty.  That is very typical of how my ocd plays out on other issues.  I want to know 100% that everything's ok and yet I know you can't get that sort of guarantee.  Knowing that means I am struggling to live with not knowing.

So it's possible that my ocd has become active, as it's the same pattern.

 

 

 

Edited April 16, 2017 by Juliex

[Patricia]

My OCD has plagued me for years and lots of areas of my thinking is the uncertainty if something is real or true ..Your views and visions can become very distorted and out of control..It all comes down to Anxiety which OCD feeds from.... Reassurance for me never helped only made me disbelief my thoughts and actions more..It can at times control lots of little areas of my thinking and i doubt myself often..I've been told it is a complex condition but is treatable with the right Therapy...For me CBT was a good approach and gave me some great tools to take back with me ..You have to put in some work and it can be hard but you can improve your thoughts and behaviours with CBT..It may not work for everybody and it's not cured me but i did benefit from this approach..I to had a similar worry to yours more so when i was younger and i would check if my heart was still beating and think the worsed was going to happen..I had tests and it was a simple heart block which poses no threat to your health..I'm not saying this is your case and I'm sorry you witnessed the passing of your father which can't of been easy ...The constant worry you are feeling increases your Anxiety and for me periods of prolonged stress and worry also gives me palpatations and chest pain which is uncomfortable..I really hope you get the help you need to feel sure about yourself again ..?

[Juliex]

On 4/18/2017 at 20:50, Patricia said:

My OCD has plagued me for years and lots of areas of my thinking is the uncertainty if something is real or true ..Your views and visions can become very distorted and out of control..It all comes down to Anxiety which OCD feeds from.... Reassurance for me never helped only made me disbelief my thoughts and actions more..It can at times control lots of little areas of my thinking and i doubt myself often..I've been told it is a complex condition but is treatable with the right Therapy...For me CBT was a good approach and gave me some great tools to take back with me ..You have to put in some work and it can be hard but you can improve your thoughts and behaviours with CBT..It may not work for everybody and it's not cured me but i did benefit from this approach..I to had a similar worry to yours more so when i was younger and i would check if my heart was still beating and think the worsed was going to happen..I had tests and it was a simple heart block which poses no threat to your health..I'm not saying this is your case and I'm sorry you witnessed the passing of your father which can't of been easy ...The constant worry you are feeling increases your Anxiety and for me periods of prolonged stress and worry also gives me palpatations and chest pain which is uncomfortable..I really hope you get the help you need to feel sure about yourself again ..?

Thanks Patricia

My pattern seems to be that I want complete certainty.  I've got some evidence of the health of my heart, but not all the evidence needed.  I have to pay for quicker tests.  I'm not worried about that but I'm worried about having the tests, so that and the fee is delaying me.  If I wasn't so worried, I'd pay the fee, the fee is secondary to the worry.

Do you really get chest pain when anxious?  I get chest discomfort if I miss a meal, or delay a meal, and then eat....I think it's all adrenalin (I was told it gets released if you're hungry) but obviously worried it's angina, especially if my heart skips at that time too which it often does.

I've decided to go back to my GP on monday and let them know just how distraught I am.  I have a long commute again this week and it seems whenever I exert myself I get more symptoms, (not walking or anything, but being busy) so I'm dreading it.

This problem (to me anyway, I'm open to all other views and do really try to process them) is worse because I'm too anxious to seek help.  I'm not just talking about with the heart thing, I'm talking about any illness.  If I'm ill I hide away and suffer, I can't talk to anyone, I can never go to others for help when in a panic.  Others talking to me just makes it all worse.  But of course its actually maladaptive to be like that.  I need to explain this to the doctor, that I've suffered now for weeks because I can't seem to ask anyone for help.

 

Edited April 22, 2017 by Juliex

[Juliex]

Something I might add though.  I take inositol, 1 gram a day for ocd. (obviously people need to do their own research and seek their own medical advice about this if they were considering it, it's not for everyone).........but all the while I've had all these problems I was on a different brand......today I travelled into another town to get the brand I am used to and strangely I felt I had a 90% improvement an hour after taking it.  I actually went and visited family when before I just wanted to hide in my home.  So I'm wondering if the different brand I'd been taking wasn't being absorbed as well or something....I've had this suspicion before.  I guess time will tell after a few days back on my usual brand, but the relief from anxiety, excessive anxious thinking (almost every thought I was having) and yes, even my heart palpitations, was really significant and more than I would have expected even if it were placebo effect.  I really hope that will be the reason for all of this...

[PolarBear]

What are you going to do if you pay for more tests and they come back showing that everything is okay? Are you going to finally let it go or are you going to do even more compulsions?