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Suggest Treatment For Generalized Anxiety Disorder, PTSD And Bipolar II Disorder

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Posted on Tue, 10 Feb 2015
Question: I arrived at your chat room first. The topic was illness, and illness was the reason why I sought help. In addition to Generalized Anxiety Disorder, PTSD, and Bipolar II, I have chronic and acute physical health issues. I'm sick and tired of being sick and tired. And, I just need to hear that it is close to normal.

Here are my anxieties: I'm anxious that I won't be able to pay my bills, because I don't get sick pay, and my paychecks are nearly nonexistent right now. I can't go to work when I'm ill, because I work with people who are 75-103 years of age, and a person in that age group can quickly die if he or she gets sick with what I've been experiencing. I'm afraid all this time off will finally lead to employment termination, which would mean I can't meet my family obligations. Then they would be enraged at me and expect the impossible. I'm in over my head.
doctor
Answered by Dr. Ravi Soni (15 minutes later)
Brief Answer:
It is difficult to understand

Detailed Answer:
Hi, thanks for writing through HCM.

I have read your query and your medications tried part also. I am not able to understand that whether you have taken guiafenesin and codeine as a treatment or you have habit of using it and now you are searching for detoxification?

Do you have allergy from something? what do you mean by acute and chronic physical health issues? Give some details so that I can give you some opinion.

Life is uncertain and mysterious. So it is absolutely normal to be sick, but finding the reason and treating it must be the priority.

You have said that you have GAD, PTSD, bipolar II, have you ever taken any psychiatric consultation and treatment?

I am waiting for reply. Wish you good health.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Ravi Soni (30 minutes later)
After using every remedy of which I'd heard, I went to my doctor for help. He wrote a prescription for me to suppress the cough. The prescription was for guaifenesin and codeine cough syrup. He asked me if I handled it well, and I replied the same as I am replying now. "Probably. I couldn't be sure, of course, because I'd never used codeine previously." By the time I finished the syrup, my cough and other symptoms were gone. A few days later the lung congestion began again, and I returned to my doctor, because I was concerned that something worse than a cold or flu was happening; I'd already been ill for a month prior to seeing him the first time. He renewed the prescription, but I didn't buy it, because my insurance wouldn't authorize payment. "OK, can you help me with my lungs some other way?" So, no I'm not addicted to codeine. I'm also not addicted to alcohol. Having 3 cups of boiled wine, 3 shots of brandy over 3 days at the recommendation of my landlady, and, at my mom's recommendation, one hot toddy in six weeks was unusual for me. Usually, I drink less than this amount in an entire year, because I don't like the flavor of alcoholic beverages.

If I need detox, it is because I take lamotrigine for Bipolar II and Tylenol PM with Melatonin to help with fibromyalgia pain and sleep problems. They are hard on my liver. I do take Parotid, an herbal, to help my liver detox. I haven't been able to afford my usual herbs: milk thistle, nettles, or dandelion root. Even if I could, I hate swallowing pills; I have problems swallowing, and pills upset my stomach. The body usually heals itself, but my liver is sluggish, because I was born with XXXXXXX Syndrome. It is a condition that is caused by the absence of an enzyme, which leads to jaundice in men, and, as far as I know, there have been no studies in its ramifications on women.

Yes, I got a variety of psychological counseling over 20 years. It included talk therapy, Gestault workshops, emotional freedom technique (tapping), and on and on, with one counselor and many counselors and support groups.

Before settling on the correct diagnosis, I was improperly diagnosed and treated for a variety of other mental conditions. Those treatments worsened my symptoms. After hitting upon Lamotrigine, everything turned around for me mentally.

Then my son committed suicide, and there is just so much a medication can do to help with the grief. The only grief support group in this area meets too late in the evening; I'm too exhausted to attend. There used to be an online support group, but it closed. I'm not very good on the Internet, especially when I'm ill.
doctor
Answered by Dr. Ravi Soni (30 minutes later)
Brief Answer:
Physical illness can provoke the psychiatric symptoms

Detailed Answer:
Hi, thanks for writing again.

I am very sorry to hear about your son and your illnesses. Some people have lots of happiness and XXXXXXX while others are searching for it, but life and it's circumstances are always unexpected. In such a situation I can advice you nothing but a hope and faith in god.

If you doing well on lamotrigine then you have to continue it with permission of your doctor. If you are feeling very much depressed and anxious then an antidepressant can be added to your current drugs after discussion with your doctor. If your lung problem is still continuing then I can not help you with that because I am not specialized with it, but going through primary investigation like chest X-ray and blood counts will help in deciding the exact aetiology.

You are already on so many drugs, so I don't want to suggest you more but if possible half an hour walking in the morning, relaxation exercises like meditation, recreational activities, indoor games that you can play with your family, interaction with friends and family, taking part in activities that you are capable of, social outings will help a lot. Sharing your feelings with friends and family will make you relax.

Hope I have tried to answer your query. If you do not have further query then close the discussion and rate the answer.
Wish you good health.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ravi Soni (4 hours later)
Thank you, Dr. XXXXXXX for your earnest reply.

I do believe in God. What I believe is based basically upon visions, not books of theology. Forty years of spiritual research had been done to come to understand those visions. Afterward, my son's death broke my "spirit", leaving me vulnerable. It was predominantly because I was re-reading Proverbs in late December-- that I ran across the verse saying grief can break the spirit, and another verse that said a little wine can lift/ heal the spirit --that I chose to follow my landlady's advice to drink a little wine. It is because I believe in God that I prayed.

I see my doctor every 3 months for blood work to see how my thyroid is doing; I've hypothyroidism, and we keep a close eye on the hormone levels. Other labs are also run at some of those times. I don't know if blood counts is part of any of those labs. I do know that XXXXXXX Syndrome makes a person jaundice due to the high death rate of red blood cells and resulting hyperbilirubinemia. It can result in anemia, which it did a lot during my menstruating years. However, since those years are behind me, I see no shortage of iron now, except when I spend a long period of time at a high elevation, where the bone marrow slows down its red blood cell production.

The docs and I have tried a variety of medications for depression and high cholesterol in addition to what I'm already using. We keep returning to what I've listed, because my liver cannot tolerate anything else. It is one of the reasons why I turned to homeopathic remedies, since they are not circulated through the liver. They are based upon biophysics instead, and they use the same principles as acupuncture, acupressure, and various other energy-based complementary medicines.

I don't go outside unless I'm in the desert, because I'm allergic to grass, or some of the molds that grow upon them, and locust trees, which grow profusely here and other areas of the USA that have a lot of rainfall. In the desert I don't encounter locust trees, and the arid climate helps me breathe better.

I don't have enough energy to accomplish all the things that are expected of me, let alone anything like recreation activities. My friends live 3500 miles away. Even when I lived near them, I often didn't have enough money to participate in any recreational activities... with them. My family is verbally abusive. Their needs and wants leave me in chaos. I cannot predict when I'll have time to myself. It was very nice to meditate in the past. I used to meditate at the same times each morning and evening. I cannot do it at the same times now, and I have difficulty relaxing enough to settle into a position for meditation.

My work is my primary arena for emotional support. Every resident and many staff members understand my problems, especially the grief. They also appreciate everything that I give to them. They validate what I feel, and they give positive feedback to me. My vocation is in Activities. My job includes teaching a foreign language, doing sing-alongs, trivia, crossword puzzles with a group, playing games, crafts for a model railroad club and making things for kids in need.... Work, therefore, provides all my recreational activities, and if I lose my job, I lose my support, my recreational activities, and my means for affordable transport to go anywhere for other support or recreational activities. On the emotional, mental, physical, financial, and even spiritual levels, I cannot afford to lose my job, and illness is threatening it.

The problems seem to center in my lungs, which you stated is not something you can address. One associate told me that one major physiological response to grief is lung difficulties. Though I'm sure grief doesn't help my lungs, there are plenty of other reasons why I have lung problems. I used to fight forest fires and scuba dive; both activities are detrimental to the lungs.

Multiple x-rays have indicated no pneumonia, emphysema, or lung cancer. I've never smoked any cigarettes. I have always had asthma, and my late husband and late father smoked. Whenever I am exposed to an allergen, strenuous exercise, environmental chemicals (such as petroleum vapors at the gas station, tobacco, nail polish remover...), emotional distress, influenza or other lung-affecting illnesses, the asthma kicks in. Almost without fail, I then get chronic bronchitis. It can last for months, and it weakens my immune system. Moreover, many years ago, when I was only 16 years of age, I was exposed to Agent Orange when it flashed, setting my body aflame and causing the toxic vapors to pour into my lungs. I'm wonder if my lungs are scarred, something I doubt anyone would be able to determine until after I die and receive an autopsy. And, before I knew any better, as a teenager, I cleaned house by mixing ammonia and bleach, which produced mustard gas.

As far as I know, there is no cure for lung damage done by fire fighting, scuba diving, Agent Orange, or mustard gas. Maybe there is remediation for second-hand smoke.

Sometimes, just a little compassion is enough to rise like the XXXXXXX Thank you. XXXXXXX

doctor
Answered by Dr. Ravi Soni (11 hours later)
Brief Answer:
You really are a brave woman

Detailed Answer:
Hi, thanks for writing again and your words of appreciation.

I feel sorry because I am not able to help you.
If your lungs have been scarred then it would have shown in routine investigations and chest Xray.

Some of the autoimmune disorders also include multisystem involvement and you might have one.
Gilbert's disease is sometimes associated with chronic obstructive pulmonary disease [asthma], there are studies published. Your respiratory problems may be related to that.

Hope I have done my best. If you do not have further query then close the discussion and rate the answer.
Wish you good health.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Ravi Soni

Psychiatrist

Practicing since :2010

Answered : 538 Questions

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Suggest Treatment For Generalized Anxiety Disorder, PTSD And Bipolar II Disorder

Brief Answer: It is difficult to understand Detailed Answer: Hi, thanks for writing through HCM. I have read your query and your medications tried part also. I am not able to understand that whether you have taken guiafenesin and codeine as a treatment or you have habit of using it and now you are searching for detoxification? Do you have allergy from something? what do you mean by acute and chronic physical health issues? Give some details so that I can give you some opinion. Life is uncertain and mysterious. So it is absolutely normal to be sick, but finding the reason and treating it must be the priority. You have said that you have GAD, PTSD, bipolar II, have you ever taken any psychiatric consultation and treatment? I am waiting for reply. Wish you good health.