<s>[INST] Hi, My name is Olivia. I am 18 years of age. The beginning of 2009 I feel ill, severe stomach pains, nausea, diarrhea, vomiting, and fainting. I was hospitalized 3 times for these symptoms and came up with no answers (except a very unstable blood pressure, low electrolytes and somewhat abnormal heart rate) I was checked for these afterwards and they came up normal. I was sent to my doctor who blamed my symptoms on Anxiety, sent me to a mental health office and presribed me Nexium to help with the symptoms, which it did, but only with the indigestion, the rest of the symptoms stayed and has made it difficult for me to even get a job and complete schooling but I dealt with it as best I could, thinking it was only Anxiety, and at the time was seeking help for. I was born with a hurt murmur and i ve always had Palpitations but recently i ve been getting new symptoms which have been bothersome and I have not tried to contact my doctor for fear of being shunned because of my age and given the same diagnosis. I ve always had a healthy lifestyle of good eating and exercising. I ve found that my normal strong heart palpitation has been more frequent and has actually grown weaker. During activity just from standing and walking it will Palpitate heavily, i ll have trouble breathing, dizzniess, lightheadedness, my ears will ring and I ll have a strong urge to lay down. My heart will beat fast and then slow at random then Palpitate, at unpredictable times such as laying down watching a movie, playing computer games etc but when laying down it is more a struggle to breathe, followed by chest and back discomfort and often with pressure at the same time my heart will be Palpitating. I ll have days where this happens and I can t seem to be able to concentrate on anything and my boyfriend noticed that my circulation has been bad such as freezing and blue fingers and toes as well as the area around my mouth turns blue. I find it hard to talk as well for I can t seem to get enough air even saying simple things. I was never really a smoker but I had smoked for about a month (a pack which I didn t finish) before these symptoms became more noticeable, I had a blood test and it was revealed that I was quite Anemic, I am on an iron supplement and my periods have always been very light. I would go on ignoring these symptoms but they ve been persistent and i m getting impatient. Can you tell me if i m just being silly or should I be worried? P.S. I m not sure if this is related, but i m constantly having to pee in the middle of the night which is more bothersome than anything. I have been checked for diabetes and it came up normal. I do not drink alot of beverages during late night, I only drink water during the day and that s it, though if I drink more in a day the more likely I am get up more often in the night. Thank you for your time, Olivia. ( YYYY@YYYY ) [/INST] Hi, Olivia; thanks for the query & it's indeed sad to know that you are suffering from so many symptoms without any diagnosis or relief from medications. Based on your age (18 years only) & so many investigations till date which were normal (apart from reduced hemoglobin); you are suffering from a disorder known as Generalized anxiety disorder (GAD) which is characterized by pervasive ever encompassing anxiety/worries about day to day trivial things accompanied by multiple non-specific physical symptoms like palpitations, racing heart, choking sensations, Chat Doctor.  Fortunately treatment of GAD is fairly simple. You need to take 6-9 months course of medications like Fluoxetine, paroxetine, Escitalopram, venlafaxine, venlafaxine based on your clinical profile & tolerability. Plus substitute these medications with adjunctive medications like Mizoram, clonazepam, diazepam, pregabalin etc. Also, there is a very good but slightly underused medication by name Buspirone which takes a little longer (6-8 weeks) to show its beneficial effects but gives reliable potent relief! Besides, supplement these medications with mindfulness based relaxation & counselling techniques offered by Psychiatrist & Psychologist. Just get a thyroid profile done to rule out hyperthyroidism which can mimic these symptoms. Contact your Psychiatrist or get back to me for further help. Good Luck </s>