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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Panic Attacks, Avoids Social Situations, Irritable And Anxious Of Visiting Doctors, Shaking Feet, Vigourous Rubbing Of Hands. Histroy Of Admission In Mental Hospital. Curable?

Hi, My dad is 60 years old and his "Nerves are Bad", or at least thats what he calls it. When he was a teenager he was put into a mental hospital because of his panic attacks. They treated him poorly and gave him a very powerful medication that had unwelcome side effects and did not help. Because of this he refuses to see a doctor. He has been on social security/disability ever since and has not been able to hold a job my entire life. My father avoids most social situations and any situation where he may have to speak to someone and answer questions, in fact, I must be careful speaking with him, because even discussing the possibility of a job interview or a doctors visit can trigger a panic attack. He even gets incredibly irritable, nervous, anxious and angry if a stranger like a tax consultant or insurance broker or someone will be coming to the house later. I have noticed that when forced to be social, a few beers is all it takes for him to act pretty much normal. He is still a bit shy, but no panic attacks, and he will even tell jokes and perhaps even make friends. This tells me that the condition must be treatable (although obviously not with alcohol). Other symptoms include shaking his feet a lot and vigorously rubbing his hands together. He also would spend a lot of time pacing around the house drinking coffee. Now that he is getting older I am extra worried about his health since he is afraid to see a doctor so I am looking for somewhere to turn. Do you have any advice?
Thu, 25 Apr 2013
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Psychiatrist 's  Response
Hello
Welcome to HCM

He was most probably suffering from anxiety disorders with panic. It may be a possibility that due to psychopathology of anxiety disorder he had some bad experiences with medicines. But surely he is having anxiety. He is shy, don't interact much with other people, he has shakiness in his feet. Excessive coffee intake further potentiates such symptoms. I would like to advise you to take him to a Psychiatrist for evaluation. Many medicines have been launched recently for anxiety and panic attacks which have almost nil side effects. SSRIs such as Fluoxetine, Sertaline etc are very useful medicines for anxiety. Apart from that relaxation therapy, progressive muscle relaxation exercises, breathing exercises etc will boost his confidence.
Hope it solves your query.

Thanks
Dr. Seikhoo Bishnoi, MD
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Psychiatrist Dr. Jonas Sundarakumar's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

From the description of your dad's symptoms he is likely to be suffering from a phobic-anxiety disorder. Like you have mentioned, such conditions are treatable. There are effective treatment options - in the form of medication and psychotherapy, which can help him overcome these problems.

If he aversed to the idea of seeing doctor or taking medication, then he can see a psychologist and try psychological therapies. There are several behavioural therapies and relaxation techniques which can help him deal with his symptoms effectively.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

There is no alternative to Psychiatric consultation... family and friends must convince him...

A bad experience, once, is no excuse to avoid it.
If one is hit by an auto-mobile, it is no excuse to avoid auto-mobile for ever - as a matter of fact, he should look for and catch one (say, an ambulance), to go the hospital for treatment.

Psychiatry is well advanced and he has an excellent chance of improvement.
Discuss with local social organisation or his friends methods to convince him / if necessary compel him?

Wishing speedy recovery
God bless
Good luck
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Psychiatrist Dr. Srikanth Reddy's  Response
Hello,
Thanks for choosing health care magic for posting your query.
From the description that you have given it appears that your father is actually having an anxiety disorder like phobia. Anxiety disorders do moderate on taking alcohol but obviously that's not a solution.
Drinking coffee will increase the problem and should avoid it. Its difficult to suggest you the treatment as he doesn't want to see a doctor.
Probably you need to convince him that his behaviour is troublesome for himself and for the others. If he agrees he should visit a psychiatrist who can treat him in two ways:
1) Exposure and response prevention and graded exposure with systematic desensitization.
The other way would be
2) Medications: Paroxetine, venlafaxine, escitalopram, fluoxetine. These medications along with clonazepam and propranolol immediately before the troubled situation can help your father a lot.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy

Wish you good health,
Dr. Srikanth Reddy M.D.
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Panic Attacks, Avoids Social Situations, Irritable And Anxious Of Visiting Doctors, Shaking Feet, Vigourous Rubbing Of Hands. Histroy Of Admission In Mental Hospital. Curable?

Hello Welcome to HCM He was most probably suffering from anxiety disorders with panic. It may be a possibility that due to psychopathology of anxiety disorder he had some bad experiences with medicines. But surely he is having anxiety. He is shy, don t interact much with other people, he has shakiness in his feet. Excessive coffee intake further potentiates such symptoms. I would like to advise you to take him to a Psychiatrist for evaluation. Many medicines have been launched recently for anxiety and panic attacks which have almost nil side effects. SSRIs such as Fluoxetine, Sertaline etc are very useful medicines for anxiety. Apart from that relaxation therapy, progressive muscle relaxation exercises, breathing exercises etc will boost his confidence. Hope it solves your query. Thanks Dr. Seikhoo Bishnoi, MD