To Dr. Seikhoo Bishnoi Dear Doctor I Think I Am

Posted on Mon, 5 Nov 2018

Question: To Dr. Seikhoo Bishnoi

dear doctor

i think I am suffering from anxiety. i am finding it difficult to deal with things which I already know. for example while talking to my friends over the phone or even face to face, i get nervous thinking what they may think when i talk. whether they may think "this guy is speaking as if he knows everything" or "this guys knows nothing. he is so dumb". these thoughts run across my mind & I end up talking incomplete words & sometimes I stammer & sometimes i end up with slurry speech.

my mind thinks too much beyond what is required i think. that is making all these i think. also i want to tell you about my mood, confidence dips, fluctuates within no time.

for example when i go to relatives house, or office or a shopping mall-while entering, i will be with full confidence, walking freely, making eye contact, walking straight like a model on the ramp.

within 15-20 minutes, i start feeling down thinking about negative things or most probably thinking too much (mind starts thinking future with negativity. what if people feel that my clothes are not good, what could have they thought, what if they think i am not telling truth, the way i talk may not be good, i may look funny, i am looking fat, my hairstyle is not good etc etc).

negative thoughts, stage fear or general fear & less confidence is making me feel that I am not good enough, i am good for nothing, other people present themselves so good but i am like this.

This is troubling me a lot & making me feel down all the time. pls help me with this.

THANK YOU

Answered by Dr. Seikhoo Bishnoi (57 minutes later)

Brief Answer:
Could you please elaborate the symptoms.

Detailed Answer:
Hello thanks for using ask a doctor service

I can understand your concern. The symptoms you've mentioned are definitely due to some anxiety. This could be social anxiety most likely but can be obsessive anxiety too.

Negative thoughts, ideas of being judged, feelings as if what others will about you, loss of confidence etc occurs in social anxiety.

Could you please elaborate more-

- Do you have any issues in taking with unknown people or in talking with your boss or a person who is XXXXXXX to you or in talking with ladies?

- What kind of symptoms do you develop? Apart from multiple thoughts in mind do you feel any symptoms?

- What do you do to prevent these symptoms or to calm yourself once you develop these symptoms?

- Have you ever taken any medicines for these symptoms?

Thanks.

Please provide details in follow up.

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

Follow up: Dr. Seikhoo Bishnoi (3 hours later)

Below r the answers to ur questions:

1. Yes doc. I face this problem while talking to unknown people, while talking to ladies & also while talking to people whom I know (who r smart, over talkative, superiors & seniors). I feel that they may gauge my intelligence, I think they may not like my talk, I will be in a state like ... Whether I am talking sense or not.. etc.

Also... I think my face will be expressionless. Example.. even if I am angry or sad or happy, I can't keep my face serious, sad or smiling respectively. I don't know how to explain this. I hope u r understanding.

2. Apart from multiple thoughts, I have observed that my heart beat goes high, sometimes my palms sweat, & I stammer, i dont talk clearly (slurry speech) , unable to express myself though I know the answers (answers will be on my mind but can't talk those effectively )

3. I won't be able to handle those situations though I prepare myself before encountering those kind of situations (I try to prepare my mind by convincing not to worry, not to think too much etc.) but it won't help

4. I haven't taken any medicines for this

Pls help me come out of this so that I can be what I am & be calm & yet effective..

Answered by Dr. Seikhoo Bishnoi (14 hours later)

Brief Answer:
The symptoms suggest social anxiety only.

Detailed Answer:
Hello again, thanks for providing details

The symptoms you've mentioned are more of social anxiety. Social anxiety is seen in a lot of individuals. But fortunately with behaviour therapy with relaxation exercises and medicines this can be treated easily.

Medicines like SSRIs can help in anxiety. Sertraline, Paroxetine, Fluoxetine etc can help to treat the underlying anxiety. For incidents that result in exacerbations of anxiety Propranolol can be used. The drug can be used on SOS basis and will help you. You can talk with a psychiatrist for this.

Try to engage yourself in meditation and yoga. This will help to reduce the anxiety. Progressive muscle relaxation exercises too have great roles in beating anxiety.

So just remain relaxed, the condition can be treated and you will lead a normal life.

Thanks.

Still have doubts please ask again.

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

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

sir, thanks for your reply.

I work for a marketing team & I am currently posted in a remote place where I have no good specialists nearby. That is why I posted the question online to you.

At least if you help me with the medicine name, I will be grateful to you. Also pls suggest the exact tablet (how much mg) with details like whether it should be taken in morning /noon /night, before /after food etc. so that I will visit a General Practitioner to get a prescription.

Answered by Dr. Seikhoo Bishnoi (5 hours later)

Brief Answer:
Sertraline can be used.

Detailed Answer:
Hello again

I personally like to prescribe Sertraline for my patients. Sertraline is started with 25 mg and the dose should be increased to 50 mg after a week and then if needed can be increased to 100 mg after 2 weeks.

The drug is usually taken in evening after dinner.

On SOS basis Propranolol in dose of 20 mg can be used.

You should visit a registered doctor for evaluation and prescription.

Thanks.

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

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