
Suggest Treatment For Suicidal Thoughts While Having Anxiety And Depression

I am back again. This time with more problems.
I am extremely sorry that this time also I couldn’t consult a doctor in my hometown. It is my fault. Everything is going wrong now. Actually I desperately needed that consultation. I thought before consultation discusses with my wife and after hearing her opinion then go to a doctor. That was my plan. Therefore I didn’t take appointment fo any doctor. But unfortunately nothing happen. My wife didn’t ask a single question about my problems. On the first day when I reach there surprisingly I was ok. Free from all kind of tension, DP/DR, obsession etc. That may be the reason why she didn’t ask a single question. But from the second day problems started slowly, but I didn’t had that guts to discuss with my wife as she kept quiet. Exactly one week before on Monday I was in my home with my mother, wife and kid. Means I was in the most suitable place that is my home with my most valuable three persons in my life. Then also I had problems. Actually I was crying on that day with tension. I know very well that if I discuss anything about my problems she will also starts crying. That prevents me from disclosing her. So days are gone and my problems increased and in Friday evening she asked me why you are looking so gloomy, what’s the matter. I said that I had a plan of consult a doctor but that didn’t happened. Only by hearing that she started crying, crying like a small baby. Then how can I convince her about my problems, my DP&DR feelings I don’t know. I am sure that if I asked her about two, three days before she would have given permission but I asked her on Friday and Saturday I had to return from there. Still I tried to contact a good doctor there but she gave me appointment on January 1st week. So on Saturday I returned from there without any development rather with increase tension. I also had planned to discuss with my brother and my mother in law. But my brother was not there and I had very small s=discussion with my mother in law in the Saturday morning, I couldn’t share all things just two three sentences and she replied me that you have no problems from our point of view; you are creating problems by too much of thinking. So don’t think too much that was her reply.
One more thing is that I just shared my suicidal thoughts with my wife and she asked me that how can you think like that after thinking about our child. And mother in law said that my wife complained to her that I didn’t disclose about the problems before marriage. So I thought she is keeping some distance from me. So I have a feeling that the kind of support I expect from my wife will not get me.
Bow I am in a position that I don’t know what to say. Actually I am in apposition with huge amount of anxiety, depression and slight DP/DR and obsession feelings also. I am really tensed by thinking that after went to hometown stayed there almost one week, still I couldn’t consult a doctor there, By thinking like that my tension is increasing too much. I had lot of crying spells. Right now also I am crying. I am afraid that I may lose control and my mood will convert in to psychosis mood. What is next I don’t know. Really thinking about to end life. After one month I will again go to my hometown to bring back my family. But I don’t know that I will be alive till that time.
Shall I go to a psychiatrist in XXXXXXX sir.
XXXX
Sir
I am ready for videochat at any time from today onwards
yes you can consult someone in XXXXXXX if feasible
Detailed Answer:
Hello XXXXXXX
It is ok that you could not consult doctor in your hometown. Considering your suicidal thoughts I request you not to act on any such thoughts. Your problem is absolutely treatable. Life is precious. You are physically fine almost. And there are medicines which can give you relief. So please give yourself sometime to come out of your problem.
In our society still stigma against psychiatric problems are there though it is reduced significantly. You cannot make understand your wife about your problem as it is difficult for you. But yes doctor can convince her if you can both consult together.
One point is also there that you are thinking much and over concerned about your problem and that is creating more disturbance. I can understand that it is difficult for you to control but you can do up to some extent.
I will arrange video chat as soon as possible. I have to do it from my home as at hospital network is not proper.
For a while best option is to consult psychiatrist in XXXXXXX There should be no hesitation to take medicine at this point as you are disturbed much. Short term anti anxiety medicine will of course help.
I am writing our past communication for your help.
"Pune has lots of psychiatrists. You can find the names with following link.
http://doctor.healthcaremagic.com/doctors/Psychiatrists-in-Pune/L18934S35/20
I recommend Dr. Dhavle and Dr. Deshmukh. "
I will be happy to help further.


Thank you so much for your reply.
Exactly what is mean by short term anxiety treatment sir? Which medicine is using? What will be the duration? After the medication only I go for CBT or I can do CBT in conjunction with the medicine.
Whether the DP/DR is taken care by short term anxiety treatment or I have to treat it separately. Nowadays my problems are starting with DP/DR and then anxiety increases. When I was in my home DP/DR were there but magnitude was very less means in a controllable manner. DR was almost absent. But as I reached here, may be because of loneliness DP/DR increasing. And because of that anxiety also increasing. DP/DR can treat as a part of CBT?
When I was in XXXXXXX for two days official meeting on 14th and 15th of December DP/DR was completely absent. But anxiety with going crazy feelings (means I will do something abnormally) was there. But that lasts for only two days.
Now I am pretty much sure that I have to take treatment whether with medicine and therapy or medicine alone or therapy alone that I don’t know. But I am sure that I need some professional help to come out of this problem permanently. But the real problem is convincing my family especially my wife and their parents. They are still saying that I am creating problems by too much of thinking. Yes my problems are increasing with too much thinking but the root cause is not that thinking that I know.
Sir for eg. If I do medication for six months or one year then go for CBT (either with medication or after medication) then can I live a normal life for the rest of the time without any therapy and medicine? Can I have normal life like my brother or brother-in-law (for eg.)
Thanks
XXXX
Posted By : Naresh
Sir
My DP is increasing terribly. I had brief sleep now. As I wake up from the sleep I had a feeling that where is I am, Who am I like that. This is horrible sir.
My wife is very well aware that I am disturbed. But she didn't ask a single question to me till now. She is really keeeping distance fro me. This is also disturbing me a lot sir
XXXX
Sir
Just now I had dinner with my best friend here. I already shared my problems with him in feb 2015. After that nothing shared with him. My wife is also not interested in discussing this thing with many people. But today he asked me why you are looking so much gloomy then I discloesd him about my problems, except DP/DR. I don't know how he will take if I tell anything about DP/DR. Rest of the things I discussed with him and after listening me he told that I am not seeing any serious problems in you. You are discussing with me for the last one hour and I felt that I am listening from a completely normal man. So don't think too much, evetyhing will be ok like that. Everybody is telling like that, few hours before I had small discussion with my wife and she again telling that you are creating problems with too much thinking. But actual problems I am facing knows only by me or may be you too.
medicine wiil help
Detailed Answer:
Hi,
Good morning and sorry for delayed response. Short term anxiety means clonazepam or etizolam like drug to make you relax fast. You can start CBT after you become relax.
Dp/DR can respond to these medicines. However if your DP/DR are your thoughts and in excess, you may need some other drug like fluoxetine to control them.
Yes medicines will help. You can start if you wish. Later on when you feel improvement you can ask your wife/family that you have been improved and problem was there. She can be convinced later on with help of doctor.
Yes with successful CBT you can live normal life later on as it basically changes your thinking pattern.
Do not think what your wife is thinking at present as due to anxiety it may be your wrong perception.
Your friend and wife are right on their part that your problem is due to your thinking. But actually they are not aware that thoughts you are having are not in your control otherwise there should not be any problem. I can understand your feelings. That is why I feel that medicines will help to give you some relief and then you can control your thinking.
Have you decided to consult someone there or not?
I have suggested thealife(alfa- theonine by Sun pharma). It is just supplement, not medicine. It helps in anxiety. Start with 100 mg now. You can avail it without prescription. You can ask some chemist to bring it for you.
Good day.


You know that I am anxious than a normal person. So lot of questions coming from my mind. I am just asking to you. Please consider it patiently.
Regarding DP/DR you mentioned earlier that it is not treatable with medicine. While I am searching on the internet there also mentioned that it is not a neurological problem, so medicines will not help to control DP/DR. And sometimes you mentioned medicine fluoxetine. But when I searched on the internet this medicine is using for depression. Actually antidepressants are using to treat DP/DR sir. I am confused.
My problems are now both anxiety and depression. So I am confused that for what I have to take treatment first. Whether concentrate on anxiety first or DP/DR. That is also a big question for me.
But one thing is that I am suffering from anxiety since 2001 but DP/DR came in this year only that is also two months ago. But DP/DR dominates over anxiety.
Regarding my future life you not mentioned clearly that normal life is possible after treatment. You mentioned that I can live normal life if CBT is successful. Otherwise what sir? Why I am asking is as a professional you may know several patients who completed their treatment and living a normal life. From your experience you can clearly say that na sir. You mentioned successful CBT several times. How can I know that before going to a therapist CBT become successful?
In my family and her family this is the first time necessity of psychiatrist/psychological treatment comes. So nobody knows what to do exactly, nobody is having any experience.
I watched many TV programs in my regional language where good professionals discussing various mental disorders but never I saw a program on DP/DR. Why sir? Psychiatric community doesn’t consider this as a serious mental disorder. You also said that in your professional experience never treat a person with severe DP/DR.
I have not planned yet to consult a doctor in XXXXXXX That may happen in this month.
Sir
One more thing I heard is that DP may occur as a result of prolonged anxiety. May be that is happened in my case. If it is like that then by treating anxiety this DP will also cure na sir.
xxxxxx
treating anxiety and depression will treat Dp/DR
Detailed Answer:
Hi,
Gm. Your questioning in details suggests that your cognition is very well and overall you are able to think well.
Your one problem is thinking in details about your DP/DR, its treatment and future apprehension. Whatever you mentioned in last para is absolutely right that treating anxiety will stop DP/DR.
Yes you read it right that DP/DR is really not a serious thing. In your case its excess in frequency and lots of thinking about the same is obsessive phenomenon. You feel anxiety about the same. And overall feeling of some depression has appeared. Fluoxetine is a good drug for obsessive thoughts and it is overall good anti anxiety and anti-depressant that is why I suggested in your case. After stability you can control and avoid DP/DR on your own.
Considering your long history it seems that anxiety episodes are there. In such patients medicines give good response. However after stopping medicines episodes may come again and which again can be treated with medicines. Few patients who try cognitive behavior therapy and can apply it in life effectively do not need medicine again. And gradually they can live life without medicine and later on without any anxiety problem also. You did not have consult psychiatrist personally and taken medicine. You also hesitate to take medicine so CBT is the only option to cure your problem at present. That is why I mentioned after successful CBT. Otherwise many patients are there who are taking medicines regularly and living normal life.
If you did not find anywhere that DP/DR is serious thing then you should digest and accept that fact and be more positive that your problem is not serious as it is reality. Your major problem is concern about DP/DR rather than Dp/DR themselves.
Hope you have clarity about your doubts now.
Do not hesitate to ask your doubts if any.
Take care.


I am lot more confused now after read your answer.
Now you said that as I have prolonged anxiety history I have to take medicine to control anxiety and after it disappears I can stop medicine. Then you said that there is chance of again it comes so at that time also I have to take medicine. Means from now onwards I have to take medicine to control anxiety and as it disappears stop medicine then if it comes back again I have to take medicine and so on. Am I right sir?
But my question was not like that. My question is once I finished one course of medicine and my anxiety and DP/DR under control then if I go for CBT (successful CBT) then can I live for the rest of my life without any medicine or therapy. Means is there any chance of permanent relief? Or after successful CBT is there any chance of again it will come back.
And one more thing I asked was, from your professional history can you say that some of your patients are now living normal life without any medicine after successful treatment. Or all are living normal life but with regular medicine only. If answer is feasible only then sir.
Regarding my DP sir it is not coming like episodes, it is with me for the whole day for almost all the time whatever I am doing whatever I am thinking always it is associated with some kind of DP feelings/thoughts. Actually I cannot describe exactly how it feels? But one thing I can say that when I am talking with my wife on XXXXXXX my DP was completely absent also when I am with my friends in the evening DP almost absent. When I was in my home for last one week DP was there but magnitude was very less. Mostly when I am alone DP increases considerably. Actually now I can say that anxiety is almost reduced. The anxiety now I am having is wholly depends on DP thoughts. I have a feeling that I am not like before when I was completely normal. May it will reduce when I join my family in the next month.
One more thing is that can I choose exclusive CBT if therapist agrees. I heard about one therapist in XXXXXXX Mr. XXXXXXX Bapat. Shall I have a try sir?
One more thing not regarding me regarding my wife aunt’s problems. Today morning only I came to know about her problems from my wife. After her daughter’s marriage she is living with her husband in XXXXXXX and daughter is in XXXXXXX For the last four five months she is complaining about severe body pain. Consulted many doctors in XXXXXXX and done several diagnosis but nothing came out. Still she is saying that she has severe body pain. Finally doctor said that her problem may be mental, please consult with a psychologist and give her counseling. But she is hesitant to go to a mental professional and asking that am I mad? Is it hypochondraisis sir. She was living with her daughter for the last 25 years in banaglore and now she is far away from her. Is that the reason sir?
May be I am your first online patient with this much of chat.
Wish you happy and prosperous new year 2016..........
xxxxxxx
your problem is curable, Happy New year
Detailed Answer:
Dear Mr. XXXXXXX
You misunderstood. I wanted to say that medicine can treat/control your problem but it does not mean medicine can cure. With medicine if CBT is applied it can cure the problem and you will not need medicine.
No there is no chance of recurrence if you successfully treated with CBT. And in that case no medicine will be needed. You can control your thinking and your problem can be solved without any medicine. You can live normal life.
Yes many patients with anxiety disorder can live normal life without medicine when they are treated successful with medicine and psychotherapy. I have seen such type of many patients.
From your history your DP seems like obsessions. It is good that when you are with someone or your mind is busy with some work you do not have such feelings. When you are alone and not doing anything the problem is there. This means your problem is not serious and seems curable with psychotherapy.
Yes you can exclusively select CBT. I am not aware about Mr. XXXXXXX Bapat. But of course you can check his degree and qualification let me know. Or else you once meet him and share experience with me.
Your wife’s aunt problem is likely somatization disorder, hypochondriasis (illness anxiety disorder) or depression. Yes separation from beloved person can cause such problem. First she needs to accept that she has some problem which needs psychological intervention.
Yes you are the first patient with such long chat consultation. Many are there with long follow up but not so much. But I also like to interact with you and I am sorry that I am not able to provide video chat consultation. I think this Sunday we can. I will let you know.
You can rate this query if you wish after reading the answer.
All the best and take care.
Wish you and your family happy 2016.

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