What Happens When You Go to the ER with Anxiety?
Anxiety and panic attacks are no joke. While almost everyone has anxiety or stress at some point in their lives, the National Institute of Mental Health (NIMH) estimates that roughly 19% of the U.S. adult population experiences anxiety in a given year. Furthermore, almost one-third of adults will be diagnosed with an anxiety disorder at some point in their lives.
When it comes to anxiety, you may experience a range of possible symptoms at different severities. In fact, the differences are measurable. The NIMH estimates that:
- Roughly 43% of individuals with anxiety live with mild impairment
- Almost 34% of adults with anxiety experience moderate impairment
- Nearly 23% of those with anxiety have serious impairment
However, no matter how severe your diagnosis or impairment, anyone with an anxiety disorder – or even without – can experience an anxiety attack (also known as a panic attack). The symptoms of a panic attack often come on suddenly and can be very alarming. In fact, many of the symptoms of a panic attack mimic more serious medical concerns, such as a heart attack. These include:
- Shortness of breath
- Chest pain
- A pounding heart
- Intense fear, terror, or dread
- Fear of dying
- Muscle aches or pains
These panic attacks can be so severe that their sufferers often join the nearly 20% of people with anxiety who learn what happens when you go to the ER with anxiety.
Patients Who Go to the ER for Anxiety
Of course, with such intense symptoms possible, it’s no surprise that many individuals having an anxiety attack end up in the emergency room (ER).
Study 1: Anxiety Attacks Are a Common Occurrence at the ER
(https://pubmed.ncbi.nlm.nih.gov/30714607/)
In fact, a controlled study (study with one test group and one control group) published in the peer-reviewed journal Emergency Medicine Journal found that in one community, 18% of patients checked into the hospital or emergency room in a 120-day period presented with symptoms of anxiety attacks. The study concluded that anxious patients may be more likely to seek medical help through the ER rather than their GP (general practitioner).
Study 2: Hospitals See Panic Attack Patients Often
(https://pubmed.ncbi.nlm.nih.gov/1351703/)
A secondary study was run by collecting data from the patients assessed at the Emergency Departments of the University Hospital of Verona (north of Italy) over a period of five years. This study found that, across all departments, the hospital reported 3,771 cases of a panic attack or panic disorder in 60 months. Furthermore, the study also discovered that roughly 20% of these patients – about 750 – visited the emergency department each year.
So, then, the question becomes: what happens when you go to the ER with anxiety?
What Happens When You Go to the ER with Anxiety?
The short answer is: a lot. The main priority for ER doctors is to make sure that nothing life-threatening is happening. As a result, even if they suspect a panic attack, they will likely gather information and run tests to rule out other concerns.
Taking Your History
Typically, this means first taking a patient history to ensure that they have accurate information. If the symptoms are severe enough, however, they may wait until you’ve calmed down.
They may perform a quick physical exam, including a visual inspection. They may also take basic vitals such as your:
- Heart rate
- Blood pressure
- Temperature (if applicable)
Once the doctors have these vital signs, they can safely move onto the next step(s).
Bloodwork and EKGs
Many ER doctors like to double-check that an anxiety attack is not actually a heart attack, blood clot, or even a collapsed lung, as they share many of the same symptoms. As such, they’re likely to do two things in tandem. The first is to send some of your blood to the lab and check for factors that may indicate a heart attack or blood clot. Then, they may hook you up for an EKG.
Typically, you’re likely to have an EKG if you present with symptoms such as chest pain or abnormal heart rhythms. An EKG (also known as an ECG), or electrocardiogram, is a machine that measures the electrical signals in your heart. This non-invasive treatment can be used to detect the symptoms of a heart attack or narrow arteries, both of which can mimic anxiety.
Chest X-Rays
In some cases, especially those presenting with shortness of breath, the ER doctor may also send you off for a chest X-ray. This non-invasive procedure uses small doses of radiation to get a glimpse of what’s happening in your body. While a panic attack won’t show up on an x-ray, other medical problems – such as pneumonia or a collapsed lung – can.
Prescriptions
Assuming that the doctors rule out a heart attack, one of the next steps is to offer medication. Your doctor may also offer medication when you first check-in or at any point in the diagnostic process, depending on your history, symptoms, and other concerns. Depending on the severity of the anxiety, as well as the patient’s history, doctors may write a prescription for:
- Antihistamines, such as hydroxyzine
- Beta-blockers, like propranolol
- Immediate relief drugs such as benzodiazepines, including
- Xanax
- Klonopin
- Valium
- Ativan
- An anxiolytic-like Buspar (buspirone)
Typically, taking a strong anti-anxiety drug such as a benzodiazepine is enough to ease the symptoms of an anxiety attack. Sometimes, doctors will write a prescription for a couple of extra pills in case you have increased anxiety when you leave the hospital, too. However, this isn’t the last of what happens when you go to the ER with anxiety.
Referrals
Most of the time, ERs are limited to resources for mental health patients. Depending on the severity of the panic attack, the ER doctor may send you to a mental health facility for further evaluation. But, barring high levels of anxiety or suicidal thoughts or actions, this is usually a last resort.
Instead, your ER doctor may write you a referral to a GP (general practitioner) or a psychiatrist if you don’t have one already. These mental health professionals will be better equipped to help you handle your anxiety – so next time, you don’t have to go to the ER.
References
- https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
- https://www.webmd.com/anxiety-panic/hospital-for-panic-attack
- https://pubmed.ncbi.nlm.nih.gov/30714607/
- https://pubmed.ncbi.nlm.nih.gov/1351703/
- https://www.mayoclinic.org/tests-procedures/ekg/about/pac-20384983
- https://www.webmd.com/anxiety-panic/guide/understanding-anxiety-treatment