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Suggest Treatment For High BP And Depression
Question: Hello. The problem concerns my mother. It's been a year since my dad started having major financial troubles, and it's not becoming any better. Throughout this year mum has become even more sensitive than she already is. Her BP rises to 200/120, this happened four times in one year and every time i take her to the hospital so they managr to lower the insanly high BP. Yesterday after a series of events she started crying endlessly, and hallucinating a bit. I gave her a tranquiliser so she would sleep and she did. When she woke up she's like depressed all day long. Please help me. I don't know what to do. I can't see my mum like that..
Brief Answer:
Hi dear, find detail answer below.
Detailed Answer:
Hi XXXXXXX
I admire your concern.
I understand her feeling and emotional disturbance.
I have undergone all your concern and i guess there are many possibilities behind her emotional outbreak.
1st that you have said social and financial issues make her psychologically weak and lead to stressful living.
At the some extent she is able to handle it her own way and bear emotional pressure without any symptoms.
But at some stage she can not able to handle and it comes out.
I can not say it is depression because depressive disorder can diagnose by presence of persistent low mood through out the day for at least two weak along with lack of interest and XXXXXXX sleep disturbances, decrease appetite etc.
Some time in elder age it presented with crying and emotional liability.
So if all above presence since two weak then you need to consideration about depression and consult psychiatrist near by.
But possibilities of stress reaction is more than depression and this kind of condition can be treated with mild dose of SSRI and benzodiazapine.
2nd thing i m more worried about her blood pressure. Constant high blood pressure can lead to lacunar infarct in brain area which can produce same feature that i have mentioned earlier.
For that need to take medicines regularly and need to do CT scan to check any damages due to high blood pressure.
3rd is may be it is starting of dementia and condition like Alzheimer but require detail about her memory and attention. XXXXXXX mental status examination (MMSE) can give rough idea about it.
In short you have to consult psychiatrist and neurologist if problem persist and more emotional disturbances.
Still if you have a query then feel free to ask.
Happy to help you.
Thank you.
Best wishes for her and get well soon.
Hi dear, find detail answer below.
Detailed Answer:
Hi XXXXXXX
I admire your concern.
I understand her feeling and emotional disturbance.
I have undergone all your concern and i guess there are many possibilities behind her emotional outbreak.
1st that you have said social and financial issues make her psychologically weak and lead to stressful living.
At the some extent she is able to handle it her own way and bear emotional pressure without any symptoms.
But at some stage she can not able to handle and it comes out.
I can not say it is depression because depressive disorder can diagnose by presence of persistent low mood through out the day for at least two weak along with lack of interest and XXXXXXX sleep disturbances, decrease appetite etc.
Some time in elder age it presented with crying and emotional liability.
So if all above presence since two weak then you need to consideration about depression and consult psychiatrist near by.
But possibilities of stress reaction is more than depression and this kind of condition can be treated with mild dose of SSRI and benzodiazapine.
2nd thing i m more worried about her blood pressure. Constant high blood pressure can lead to lacunar infarct in brain area which can produce same feature that i have mentioned earlier.
For that need to take medicines regularly and need to do CT scan to check any damages due to high blood pressure.
3rd is may be it is starting of dementia and condition like Alzheimer but require detail about her memory and attention. XXXXXXX mental status examination (MMSE) can give rough idea about it.
In short you have to consult psychiatrist and neurologist if problem persist and more emotional disturbances.
Still if you have a query then feel free to ask.
Happy to help you.
Thank you.
Best wishes for her and get well soon.
Above answer was peer-reviewed by :
Dr. Prasad
Hello doctor,
Thank you for the detailed reply.
Regarding your question about her memory & focus capabilities, they're fine. She seems to be attentive, remembers everything. My wedding is in one month, she recalls all the details, everything we need to do, etc. Her situation makes me want to postpone my wedding as I cannot travel and leave her like that. I feel as if this thought makes her feel even worse. I don't know how to treat her, I don't know how can I help.
We did an Echodiagram, an ECG and both were fine. Doctor said her heart was fine. We didn't do the Ct scan though.
One thing i forgot to mention. Her eyes hurt her whenever she has a headache, when her BP rises, and when she is sad.
Is there anything that I can do from my side to make her feel better? She seems to be not interested in anything that i ask her to do. I try to let her meet her friends and go out, sometimes she is better afterwards but when we go home always she is sad and quiet again. Please help me doctor, my mother means everything to me.
Thank you for the detailed reply.
Regarding your question about her memory & focus capabilities, they're fine. She seems to be attentive, remembers everything. My wedding is in one month, she recalls all the details, everything we need to do, etc. Her situation makes me want to postpone my wedding as I cannot travel and leave her like that. I feel as if this thought makes her feel even worse. I don't know how to treat her, I don't know how can I help.
We did an Echodiagram, an ECG and both were fine. Doctor said her heart was fine. We didn't do the Ct scan though.
One thing i forgot to mention. Her eyes hurt her whenever she has a headache, when her BP rises, and when she is sad.
Is there anything that I can do from my side to make her feel better? She seems to be not interested in anything that i ask her to do. I try to let her meet her friends and go out, sometimes she is better afterwards but when we go home always she is sad and quiet again. Please help me doctor, my mother means everything to me.
Brief Answer:
Hi Find detail answer below.
Detailed Answer:
Hi dear
Good to see you again.
I appreciate your reply.
But still it causes doubt in my mind because she has eye sight problem also which might indicate pressure changes in blood vessels in eyes.
This can be ruled out with eye fundus examination which rule out any pressure changes in vessels as well as in brain.
You need to go for this both investigation 1st those are fundus examinations and CT scan.
Emotional and mood liability is the part of depression and any organic brain changes due to pressure.
This can be treated with mild dose of tab sertraline 25 to 50 mg in the morning daily. And if require mild dose of benzodiazapine like tab etizolam 0.5 mg as and when require but avoid routinely.
But it will covers her mood and emotional expression only. We have to reach up to root cause. For that Follow what i said.
1st be clear that nothing major changes in brain then we will able to start proper treatment of psychological disturbances.
Do behavior changes like
keep her busy.
do pleasurable things.
Make home environment appropriate to her mood.
Encourage her to do her hobbies.
Take proper sleep and diet.
Mild walking and exercise can help.
Try to make her happy and never let her alone.
Support her psychologically and socially.
Never be aggressive in front of her.
All this make changes in her mood and might help in her emotional problems.
Thank you.
Hope for the best.
Hi Find detail answer below.
Detailed Answer:
Hi dear
Good to see you again.
I appreciate your reply.
But still it causes doubt in my mind because she has eye sight problem also which might indicate pressure changes in blood vessels in eyes.
This can be ruled out with eye fundus examination which rule out any pressure changes in vessels as well as in brain.
You need to go for this both investigation 1st those are fundus examinations and CT scan.
Emotional and mood liability is the part of depression and any organic brain changes due to pressure.
This can be treated with mild dose of tab sertraline 25 to 50 mg in the morning daily. And if require mild dose of benzodiazapine like tab etizolam 0.5 mg as and when require but avoid routinely.
But it will covers her mood and emotional expression only. We have to reach up to root cause. For that Follow what i said.
1st be clear that nothing major changes in brain then we will able to start proper treatment of psychological disturbances.
Do behavior changes like
keep her busy.
do pleasurable things.
Make home environment appropriate to her mood.
Encourage her to do her hobbies.
Take proper sleep and diet.
Mild walking and exercise can help.
Try to make her happy and never let her alone.
Support her psychologically and socially.
Never be aggressive in front of her.
All this make changes in her mood and might help in her emotional problems.
Thank you.
Hope for the best.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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