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Suggest Treatment For Severe Anxiety

Posted on Mon, 27 Jul 2015

Question: HI there, my name is XXXXXXX and I am a 36 year old woman with a history of severe anxiety. eight years ago I started experiencing health anxiety after my mom had a stroke at 53 and my father died of esophageal cancer 2 years later and then a couple years later my husband was in a horrific car crash where a 50,000 lb steel coil feel off a semi truck onto his car, thank god he survived...I have suffered with bouts of health anxiety since. I have used Celexa in the past with success...I went off of the celexa because I thought I could cope without it and within three months my anxiety has come back 10 fold. I worry about my heart because I experience palpitations and SVT, I worry about my blood pressure because I have developed a phobia about having it taken at the drs....then I started taking it at home and became obsessed taking it up to 50 times a day ( it is normally in the 120's /70's at home for the record), I went back to my dr and he put me on lexapro ( cipralex in canada) because I was scared to take the Celexa again because I had read online that it can cause heart arrhythmias.....I am 12 weeks into the Lexapro and still have major anxiety ...the only thing that helps is the Ativan which I take occasionally when the anxiety is particularly bad.....I am seeing a therapist for CBT and she suggested that I get a referral to a psychiatrist who will be able to over see my mediations better than my family physician so I am awaiting an appointment. I am very nervous to see the psychiatrist and was wondering if you could tell me what happens at a first appointment with a psychiatist? Do psychiatrist do bloodwork or tests on me.....this makes me nervous due to my health anxiety....thanks so much for your time and response... XXXXXXX

Answered by Dr. Seikhoo Bishnoi (50 minutes later)

Brief Answer:
No need to fear from psychiatric consultation.

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. A lot of individuals have some sort of fear of getting some serious illness but if this fear start to hamper day to day routine and cause severe anxiety then it is advisable to go for treatment. You have fear of getting serious illness and have severe health anxiety. Celexa worked but was discontinued because of fear of cardiac arrhythmia because of this drug.

Lexapro or Escitalopram has not resulted in improvement even after 12 weeks so in my opinion there is need for change of drug or to add some augmentation drug to your therapy. Other drugs like Bupropion can be used along with Lexapro and this will help to reduce the anxiety related to health. In addition to this other SSRIs like Fluoxetine or Paroxetine can also help you. Both these drugs are known to reduce unwanted thoughts and will help to reduce the thoughts related to bad health. You can consult with your doctor for these drugs.

There is no need to fear from psychiatric consultation. In most of psychiatric consultations blood work or tests are not done. Psychiatric diagnosis are based upon detailed clinical history, mental status examination so in most cases blood work are not done. They will take detailed interview of you about your complaints, about their onset, about any stressor, about any past history or family history of mental illness. Then in MSE mental functions are assessed on basis on interview based tests. So no need to worry from psychiatric consultation, these are very easy.

Thanks, I hope this helps you. If you have more doubts please don't hesitate to ask again.

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (2 hours later)

Thanks for your response. It is much appreciated. Since I have had success with Celexa in the past would you recommend going back on that. I was afraid to take it but I was on it for four years with no problems. Do I need to worry about heart issues with it? I was taking 40 mg? Is Zolft good for health anxiety. I find I have ocd symptoms too such as obsessive thoughts and like taking the blood pressure over and over. What is the best med for ocd? I'm also afraid of meds that affect blood pressure.... Like making it too high... I also find that my anxiety increases ten fold the week before my period starts. Is this normal?

Answered by Dr. Seikhoo Bishnoi (7 hours later)

Brief Answer:
Health anxiety is related to OCD symptoms.

Detailed Answer:
Hello again and thanks for asking a follow up question

If we consider SSRI drugs then almost all SSRIs are safe. Celexa is also safe drug and it can help to reduce the health anxiety. So no need to worry about heart issues with it.

Zoloft is Sertraline and the drug is also a SSRI drug. The drug is considered as safest SSRI in heart disorders. The drug is very good drug for health anxiety. Health anxiety is hypochondrical ideas and these are related to obsessive ideas. This is the reason you are checking your BP again and again. This checking is similar to compulsions. Even Celexa, Zoloft or Lexapro in high doses are good medicines for OCD. These medicines would not affect your blood pressures.

Anxiety increasing almost during the time of ovulation could be related to some hormonal changes and this will decrease with he medicines and no need to worry. All these things are normal.

Thanks, Hope this helps you. If you have more doubts please ask again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (5 minutes later)

Thank you so much for your responses:) You have a very kind demeanour and "bedside manner") Thanks for making me feel better:)
XXXXXXX

Answered by Dr. Seikhoo Bishnoi (9 minutes later)

Brief Answer:
Wish you a good health.

Detailed Answer:
Hello again and thanks for appreciation.

Wish you a good health and remain relaxed.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar