What Is The Cause And Treatment For Stress And Anxiety?

Posted on Wed, 29 Oct 2014

Question: My son will be 20 on 11/26/94. He is 6'2", 185 pounds and until the last three to four months has always been blessed with good health. Also, until a few months before three-to-four months ago, he rode his bicycle extensively and sometimes competitively in a youth cycling club. But right now, he is always pale; dark circle under the eyes, and can't rest. He will go 20 hours without sleeping. And unlike in prior times, he doesn't bounce back from not getting enough sleep... his eyes stay dark, his skin stays pale, he is listless. Tonight, no caffeine in 24 hrs I believe, his heart rate is 96; his conditioned heart rate used to be literally under 50, even as low as 44 per minute. He has always his whole life been prone on occasion to nearly fainting if he got up too fast, and a couple months ago, experienced a kind of dream where he thought he had a heart attack. What could be the matter with my up-til-now pretty healthy son? He has had a big change in his life, well two changes, the loss of his school chums, as he did not finish high school and is no longer associated with any school, and the loss of his riding club about two years ago. We have always had a great deal of stress in our lives, with lots of poverty, sometimes eating at the local Soup Kitchen, and so forth. But not for the past year or so as I have had steady full time work now for 18 months. Tell me please what I need to get him checked out for and what should we be looking for first? Also, he did have his first serious relationship with a girl his age last summer. And, we live in XXXXXXX and I wonder about the parasite Chugas that is making its way up to the states with the rising tide of immigration from Mexico.

Answered by Dr. Manisha Gopal (4 hours later)

Brief Answer:
this looks more like stress related

Detailed Answer:
Hello,

I have read the query and from the life history mentioned here, Im of opinion that this is not chugas parasite;
and there is a strong possibility of stress (leading to anxiety and depression) causing all this.

The point that he has no school, club and old friends anymore are significant stress in themself which can bring about such changes.

Patients , espically yongsters need not tell all what they feel about their losses or many times they themselves do not know the reason if their problem. He gets less sleep, is anxious mostly (usually in anxiety patient has difficulty in sleeping), is lying awake for hours, reduced appetite( is frequently seen)- leading to weight loss, the black circles around eyes are related to sleep deprivation.

In anxiety patient has complain of pulsating heart/ palpitation/ and feeling of racing heart rate....this is one of the commonest reasons for which family and patient himself feels he had a heart attack.
The heart rate can reach beyond 100beats /min in many cases..so, almost all features point towards anxiety and stress as the reason behind your son's current condition.

Drugs like- escitalopram or sertraline are good and safe in such cases and response come in few days. For initial week or so he should be getting a sedative to give neurons rest.

P.S -- just rule out any substance abuse by him.

If you are very worried: get an ECG to rule out cardiac cause.

Please see a psychiatrist and get him assessed once. With proper meds he will surely show improvement and get back to what he used to be earlier. Dont worry.

Wish you good luck.
please feel free to ask more questions for clarification.

Dr. Manisha Gopal
MD Neuropsychiatry

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Manisha Gopal (16 hours later)

GREAT ANSWER, great tone and sensitivity - thank you. I will give a great review. My only follow-up question is this: Do you know of any doctors just like you in XXXXXXX Springs? I need a good, well-rounded doctor for myself. I am getting XXXXXXX looked at next week for a basic physical and will pursue what you said, probably basic exam/bloodwork for nutritional-health, ECG, then rec for good psych. Thank you again.

Answered by Dr. Manisha Gopal (10 hours later)

Brief Answer:
get tests and make lifestyle changes

Detailed Answer:
Hello,

It was because of your detail history in the query that I was able to help properly and connect the main points. So,the credit also goes to you!

Please also focus his diet and life style changes along with drugs (once he starts getting better). Include more green salads, more sporuts servings, reduce fat contents in food, more nuts un breakfast; exercises, socialising, outdoor games etc. All these will increase happy hormones in brain and potentiate meds.

Do get his TSH levels, serum b12 level and complete blood counts when you start his meds as they can be disturbed at present and correcting them wil help a lot.

Im sorry, im not aware of doctors in XXXXXXX

Dont worry, he will surely get better and will get back to his previous self with medicines and life style changes.

Wish you god health.
Please feel free to ask more questions for clarification.

Dr. Manisha XXXXXXX
MD Neuropsychiatry

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