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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Anxiety, Mind Not Getting Relaxed. Treatment?

hello my name is Alison, I recently experienced a traumatic event. I know I have anxiety but now its out of hand I m pacing the floors, food makes me sick, I m uncomfortable all the time. The biggest problem is my mind wont shut off I tell myself to stop and my thoughts creep back in. My daughter is also experiencing anxiety at school she hides in the bathroom at lunch and before school. If I cant control myself how am I going show my daughter how to control herself . My reasoning or rational thought process is not working. If I m feeling pressure I cant make a decision and if I do its is wrong. Its like being in panic mode all the time. I feel that life is slipping away and happiness is forever gone. I know I need help but where? The doctors here are only out for money no one really cares
Thu, 7 Nov 2013
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Psychiatrist 's  Response
Dear Alison,
thank you for your query. From your description, it appears that you are suffering from Generalised anxiety disorder (GAD) with anxious ruminations along with some components of Major Depressive Disorder.
However, Obsessive Compulsive Disorder (OCD), a disease characterised by repetitive, intrusive, distressing, irrational thoughts, images or impulses (regarded as products of patient's own mind), needs to be ruled out before making a final diagnosis in your case.

If I would a seen a patient with your complaints, I would have first confirmed the diagnosis by a detailed work up including thorough history taking and mental status and physical examination. If confirmed, I would have started with an SSRI (antidepressant) like Sertraline or Paroxetine or Escitalopram along with a benzodiazepine like Clonazepam or Etizolam to decrease the anxiety and induce sleep. Over weeks, I would have escalated the dose of SSRI and deescalated the dose of benzodiazepine.
I would have also suugested a behavior therapy, like biofeedback, as means of non pharmacologic treatment to aid the management.

Please remember that GAD is a very common disorder encountered in clinical practice, and most cases are manageable with 6- 8 months of compliant therapy.
Therefore, I would request you not to lose hope, and to consult a competent psychiatrist near you for detailed evaluation and management of your problem. Moreover, I would also suggest you for an evaluation of your daughter for any anxiety disorder or depression, as these are quite common in children and need a detailed evaluation and treatment as soon as possible.

Hope I've been able to satisfy your query. Please feel free to contact me for any further clarifications. best wishes,
Dr. Sourav.
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Have Anxiety, Mind Not Getting Relaxed. Treatment?

Dear Alison, thank you for your query. From your description, it appears that you are suffering from Generalised anxiety disorder (GAD) with anxious ruminations along with some components of Major Depressive Disorder. However, Obsessive Compulsive Disorder (OCD), a disease characterised by repetitive, intrusive, distressing, irrational thoughts, images or impulses (regarded as products of patient s own mind), needs to be ruled out before making a final diagnosis in your case. If I would a seen a patient with your complaints, I would have first confirmed the diagnosis by a detailed work up including thorough history taking and mental status and physical examination. If confirmed, I would have started with an SSRI (antidepressant) like Sertraline or Paroxetine or Escitalopram along with a benzodiazepine like Clonazepam or Etizolam to decrease the anxiety and induce sleep. Over weeks, I would have escalated the dose of SSRI and deescalated the dose of benzodiazepine. I would have also suugested a behavior therapy, like biofeedback, as means of non pharmacologic treatment to aid the management. Please remember that GAD is a very common disorder encountered in clinical practice, and most cases are manageable with 6- 8 months of compliant therapy. Therefore, I would request you not to lose hope, and to consult a competent psychiatrist near you for detailed evaluation and management of your problem. Moreover, I would also suggest you for an evaluation of your daughter for any anxiety disorder or depression, as these are quite common in children and need a detailed evaluation and treatment as soon as possible. Hope I ve been able to satisfy your query. Please feel free to contact me for any further clarifications. best wishes, Dr. Sourav.