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Feeling uneasy and weak all the time
It's started 3 months back suddenly at some time of day I feel very very extreme uneasy from middle of abdomen till neck and something around neck , nausea like feeling , hands and legs shaking , extreme weakness and fatigunes though I have gastric and acidity but these symptoms never showed up , i feel like I will faint , and if one day I drink alcohol than the next day became worse chest conjetion and pain sometimes but I feel very extreme useasy around my neck don't know what that is but very uncomfortable like it will break and dizziness , I did my ecg , cbc , echo , brain mri , vitamin , mineral test ultra sound of abdomen , chest xay, liver , urine , kidney test, magnesium , d , all the test but everything came normal . Please help me wht is happy do I need to do any other test ?? some suggested me for psychiatrist , the psychiatrist suggested me ethilam and vonoprazan for one month after that still I have symptoms suggested me d ventin 60 taken 27 days but still I have symptom
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Based on the history and extensive normal investigations, this presentation is most consistent with panic disorder / anxiety disorder with prominent autonomic (somatic) symptoms, possibly worsened by alcohol, gastric reflux, and health anxiety.
Features supporting this:
• Sudden episodic onset, feeling of impending fainting/death
• Chest tightness, neck discomfort, tremors, dizziness, nausea
• Normal ECG, ECHO, MRI brain, labs, imaging
• Worsening after alcohol
• Partial / slow response to psychiatric medicines (needs time & dose optimization)
No evidence currently suggests a cardiac, neurological, or metabolic cause.
Next Steps
1. Continue psychiatric treatment – antidepressants (like Vortioxetine/Desvenlafaxine) need 6–8 weeks for full effect; do not stop early.
2. Add Cognitive Behavioral Therapy (CBT) – very important for panic disorder.
3. Avoid alcohol completely (major trigger).
4. Screen for GERD & panic overlap – trial of PPI + lifestyle changes if not already done.
5. If symptoms persist:
• Thyroid profile (TSH, FT4)
• Plasma metanephrines only if attacks are very episodic with sweating/palpitations (low suspicion)
Health Tips
• Panic attacks are distressing but not dangerous
• Repeated tests will increase anxiety, not relief
• Regular sleep, caffeine reduction, breathing exercises help
• Sudden chest pain with collapse, true loss of consciousness, or neurological deficit → ER immediately
Overall prognosis is good with consistent treatment.
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