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Anxiety, panic attacks, suicidal. On anti depressants. Low BP, rapid heart beat. How can I relieve myself?

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Dr sahab, i am in toronto, canada but m from india. I am a medical doctor also, and am going through serious mental trouble.
got married 11 years ago by parents force. I had an affair with a classmate at medical college, but never had any sexual relations, he did not marry me and left me, that left a very XXXXXXX impact on my mind and i had tried to suicide, and had an episode of fits and was on anti depressant xet for 2 years after this.
With my parents force i got married to my cousin with whom i lived in a joint family in the same house, i could never develop feelings for him and could not devote myself as a wife, i have a 9 year old daughter also.
I survived for about 9 years in it being very unhappy both emotionally and sexually although my husband is a very good person and is very good to me, but some how we could not click together as husband wife inspite of having all physical relations normally.
One day my old classmate from school showed up on my facebook who used to love me when we were small, he told me he still loves me and he was looking for me when getting married, somehow i started a relation with him through emails and phone. It did not last long only in 3 months his wife came to know and he shut all doors on my face as he had done love marriage with his wife and didnt want to hurt her. I was shocked and had not the energy and practice to cope with such a situation, i got severe anxiety and panic attacks, my feet and hands would get freeze cold, and my mind will be so much at unrest that i could not concentrate on anything at all. it was a very pathetic condition.
then my boyfriend from my previous life came into my life again, and said he had done a great mistake and still loved me a lot and he wanted me to marry him, i always loved him wholeheartedly, so i got involved with him in no time and was ready to marry him, i dont know what went wrong with him, he refused after 6 months of intensive involvement, although all relation was on phone only, as he is still in india, i was again in shock and all the time when i was in relation with him, i would get severe panic when he would not pick my phone up, i would keep calling 50 or 100 times at a stretch but he will not pick up and my feet and hands would get very cold, and low blood pressure, fast heart beat and mental cloudiness as if i was going to die. I had to take xet 12.5mg sustained release again for 6 months and then slowly i began to wean it off the medication.
And i had decided that i will never get involved again with any man, but i got involved again through facebook and in about 2 months met him and spent a night with him and had physical relation also. He is the first man that i had physical relation other than my husband. He is 10 years younger to me and told me before hand that he will not marry me, everything wa going fine between us through messages and phone that we did 3 times every single day, when my love and feelings for him started to deepen and i started to ask him for marriage or leaving me altogether. He used to say that he loves me very very much and that he could not sleep if he did not talk to me for one night and i was his life but he cannot marry me and will marry with his parents choice. This hurted me everytime and inspite he wanted to keep the relationship going. He would never agree on my leaving him and going away from him, he would beg me not to do so.
One day i cried a lot before him and asked him to help me as he will not marry me and my love for him was growing deeper day by day and i could not attend my family, only used to be in his thoughts everytime, but he never showed the type of love that he wrote or spoke. His actions never matched his words.
He told me next day that he had decided that we will stop daily contact and will only contact through phone once a week, although i asked him to stop it completely, but he refused and we decided that if one of us will miss the other too much we will come up and let the other one know about it and get back as before to daily communication. I always cared a lot for him and took extra care not to hurt him and worried a lot for him, as he had been through a break up previously too. i used to feel for him more than myself. So after this decision, i missed him very badly and had panic again and i called him up to tell him that i am miising u and please come back like we were before this decision. But he was completely changed, he said no i will not agree on it now, and u forget me that is better. I said ok thats is what i wanted now u are saying to me that forget me, so dont blame it on me afterwards, that i took the decision, then he said i will agree on taliking like before as we used to every single day on one condition that u will never speak about us getting away from each other for good in life, and if you say u will have to assume that i died for u and then i will never talk to u again. I promised him and we continued but this incidence shook me very badly as that day i kept pleading him to talk to me and he would disconnect my call and then not pick up, and this led to panic again in me badly.
Next day when i spoke to him and i asked him that how come he loved me so much and he was ok after this decision and not missing me, he said yes he was ok and not missing me and also said that my love for him was much more than his love for me, i was shocked as if the floor had been pulled from under my feet,that day i realized that he did not love me at all.
I asked him if he was coming back to me by force then better that he did not come at all, and he said no he was doing it wholeheartedly and not by force. But i had realized the fact that he did not love me as much as he said.
I had asked him his facebook password and he had refused that hurted me badly, and i got suspicious if he was keeping this type of relationship with some other girls as i read some comments from some girls on his facebook.
I decide dto check on him by a fake facebook id and sent him friend request, he accepted it and in the beginning he said he was not interested but slowly he began to chat with me on this fake id. But soon with my style of writing he came to know that it is me, i aske dhim if he had a girlfriend and he refused and then i asked him for sex, he agreed to have sex with me on webcam and in india as i told him that i will be coming to india after 10 days. he also mentioned my pet name to me on fake id, that he thinks that i look like XXXXXXX on webcam, (gudiya is my pet name).
I acted as if i did not know anything at all, then he called me on my phone and asked me where i was, i said i am attending my classes, he said r u attending class or u r operating internet on ur phone. I refused and acted that i did not know anything.
Then in another 5 minutes i called and asked him what he was doing at night so late, he said m watching cricket with brother, then i got angry and i owned up that it was me that he was chatting to and he was not watching cricket.
I also said that he has lessened his respect in my eyes as under fake id, when i asked if u have a girfriend, he bluntly refused and this hurted me a lot, i told him and then i said go to hell in anger, he disconnected the phone saying some bad words for me. I wrote a line to him in message that do not ever call me or message me again. Then i called him back ( i m stupid), and said why he disconnected the phone like this , he siad u just wrote dont call me ever again, then he sweared on god and his mom that he knew it was me that he wa talking to and that is the only reason why he talked of sex to me under fake id, and he was right as he had caught me that it wa me to whom he was talking to.
He said u needed to test me, well hats off to u, now u never call me again and never message me, he said u r cute to test me in this silly way, ui caught u in no time, i told him that i did not lie to him as i owned up in no time within a day that it was me.
but he kept saying that from now on dont call me ever again. I did not plead with him and said ok i will not call him.
when i got home i sent him a mail that was longer than this message itself and explained every single place where he hurted me.
But the problem is taht i am in wait for him to come back to me, as everytime i only go after him pleading to come back and saying sorry, he never does that,
now i am having taht stiff neck, with cold feet and hands and anxiety and dont know how to cope that i have lost him for good this time, cant figure out if he will call again or not.
Kindly read my whole message to be able to help me properly. I desperately need your help, i am ready to take some more sessions if needed and medicine that will really help me come out of this panic and this coping up of a lossof love.
I loved u with very pure heart but I think u have not seen and known pure love. I had told u that I will love u to extremes but when I find that my love is one sided, it is bound to stop as I do not believe in one sided love as it is a waste of emotion, time and energy.
If I love someone than only if that person deserves my love. For u I was unsure if u loved me or not, if u were deceiving me by saying I love u or deceiving me and urself both, I was quite unsure, and may be in ur case u were actually deceiving both of us, because the reality is that u do not love me at all. And it took me some time to realize this fact and accepting was more difficult than realizing it.

U had been giving indications to me that u r faking love for me but I kept ignoring them until it became so evident that I could not ignore it anymore.

1. When u said after we had fallen in love for each other that no matter what I will not marry u, was actually the first indication but I let it go thinking that u had cleared this before our relation began. No, but I was wrong, because that was BEFORE we loved, n it was only liking, but after when one falls in love with a girl n says that u r my life n i cannot live without u n u r this n that etc etc than the automatic first thing that comes to the tongue of the man in love is that no matter what u have to marry me as i want to spend my whole life in ur love with u n i cannot even think of living this life without u.

2. When u said I love u n I promise that I will not do love marriage but will do arrange marriage with my parents choice. The very saying of these words from ur mouth r actually denying ur own words that u love me, if u love me how can u think of marriage with another girl, u can only think so if u r insane or highly crooked person.

3. When u said that U knw I am pregnant with ur child and u love me but u will not have any love n feelings for this child as this is not out of nikah with u were the most disgusting and disrespectful words i ever heard for myself from anyone.

4. n not only this u said that if bcoz of this child if I am in trouble ever u will not be responsible and u will not support me.

5.Also u said clearly that if I am caught keeping this relation with u than also u will not come forward to accept me. All risk is mine n look at me for what type of man I was taking all this risk n giving my love.

6. when u refused facebook password was the last and clear indication that u dont love me AT ALL. becoz that was not even close to being precious in comparison to my love for u. It just made it clear that u have many things to hide n u have been faking love with me.

7. let me tell u also about this fb account, it was in my name as sadafgudiya for all my relatives and family friends, i had told them a month earlier that i am deactivating my account and will close it. Yesterday when i was abt to deactivate it, i thought of checking u n i changed the name on the account, place , details etc etc and sent u request with 100% confidence that u wil NOT accept it.
I was very happy til yestaerday afternoon tht u didnt accept it, when i saw in the evening that u did accept it, it hurted me really much.
Then i spoke to u as gulnaz, but on my side i was 101% sure that i was speaking to rizwan shah to whom i belonged completely and who was mine completely, there was no risk n doubt, so i had no resevations in speaking to u abt sex or anything thats why i offered u as not even a porn girl wil offer, bcoz i knew its u.
But on ur part u only had a very strong intuition or inkling that it is me, but if 1% or 0.1% or 0.0000% if it was not me than u were actually speaking all that with a stranger.
Now imagine if u had tried this on me, n u tested me, n i knew with strong intuition or i was sure that it is u that i am speaking to and i had spoken like u did, I m sure u wud have killed me as even if there was slightest chance that it was not u but sumone else than u wud have been severely hurt by my action. Same happened here. If u knew it was me, u shud have stopped me then and there saying XXXXXXX i knw its u, stop pretending.
Also if u tested me like this, i wud not have mind it =or got angry on u, bcoz insecurity is part of love and i wud be so confident in my love for u, that i wil always win no matter what and how u tested me, coz i am honest n loyal to u.
When i was angry tday i said once go to hell, n u disconnected the phone and said sumthing fucking ----
u have all the right to say sumthing bad to me when u r severely angry and u have used words for me, n i have alwayz respected ur anger also as it is a part of love too, but i do not have any right to say anything at all , ever. only bcoz i am a girl subdued by u, but remember i am human too.
tday u said it 3-4 times that i shud not call u or msg u anymore, this time u asked me to do this n i wil do it, to respect what u said. i said it too but in hurt did not mean it and u knw this very well, but this time I wil not come after u begging that plz talk to me although i have no ego at all but u do tremendously bcoz its ur wish now n m happy abt it.
u also said tday that i shud have asked my friend or cousin to test u over a period of 15 days, NO i respect u and have kept ur respect very high in my heart mind and soul and in front of my friends or cousin, i can never let ur respect down by asking them to do such a thing ever. cant even dream of it. if i had used u and made fun of u in front of my friends or cousin that aah this boy is mad after me, than in this case i cud have asked them to test u.
n i did not lie to u as i could not hide this action of mine for even a day, n i owned up n told u that i did so n so....this is not lying....if u understand....
AND Now know this also that since our last fight, we had discussed that we will try once a week talking and if one of us will miss will let the other know abt it,
i missed u and in my SIMPLICITY N INNOCENCE i called u to tell u that i was missing u badly, n ur reaction to that was so disgusting treated me like a dog, and u used the word DECISION there
i cud not go away from u for so long only BCOZ I KEPT THINKING AND WORRYING for u that u should not be hurt by me as u used to say that u cannot sleep if u do not talk to me, n i am ur life etc etc, in just 4 hours everything vanished in thin air as if it was never there.
next day when i spoke to u , uPULLED the floor from beneath my feet by accepting truthfully that u were allright without me n were not missing me and my love for u was much more than ur love for me, i REALIZED that very same day that u do not love me otherwise how u could have been ok without me, i came back to my senses and reality. and realized what i have been doing to myself and that i should stop worrying for u and caring for u too much like i alwayz did.
that very same day i took the ring out of my finger realizing that there was no relation between us as it was only from my side not urs. if it was true love u could not be ok in 4 hours or 4 years.....
thats when the idea of testing u came to my mind, otherwise i had been trusting u alwayz blindly, thats why i slept with u ( its the biggest proof of a girls trust for a man)

Now u think of the above feelings when u get time, read it over n over again n find out for urself if u loved me or u faked love n if u faked love why u did so? If u had some other intention of getting things money etc and using me for sex, i would not have refused u n I would still have given u eveything that u had asked me but u did not have to fool me with I love u. (although i hated to mention abt things and money and sex, but had to coz this is my last msg to u in this life). whatever i did was not in foolishness, but in purity of my love, the things that i have given u have drops of my love for u and those r filled with feelings for u, keep the jacket or phone in ur hand close to ur face and smell it, u will feel my love flowing through u bcoz thats the type of feeling and love that i gave those to u.

inspite of the hurt that u gave I kept on because of the fact that I loved u just tooo much, but as I realized the facts it got over.
There r 2 types of hurt in life that one can give to the other, first is small ones that r very easy to let go with just a little effort and the others leave a lifelong imprint on one mind n soul.
Read the above points n find out for urself if these would have left an imprint on u if said by ur lover to u in case u were me

Today I am no more but my last msg wil be there, so as to let u know my final feelings for u n what I went through with u.

Please do not play with human feelings with these precious words I love u n specially u should never use them bcoz u dont even knw what it means and what is the depth of these words. People like u r stones n can never understand and experience what true love is even if it comes their way, they r unlucky n cannot recognise it and cannot value it. If u loved me do not call me bitch, etc bad names and remember me with respect as i wil alwayz respect u, n plz dont make fun of me in front of ur friends, i trust u and have alwayz trusted u whole heartedly.

U must be wondering that why i am writing such a long msg to u when we have broken up...its bcoz i strongly believe in this saying
If you leave someone at least tell them why, because what's more painful than being abandoned; is knowing you're not worth an explanation.

n this explanation is not to come back to u or to compulse u to come back to me, NO its just to give u due respect that u deserve.

So XXXXXXX, wish u very best of luck in ur life, live a happy life, enjoy but be careful when dealing with emotions of other people and never take baddua from any person who loves u, as it wil not let u live a happy life. Although i wil not and can never give u baddua only dua for u.

i also have a family history of schitzophrenia, i am scared that i should not start this disease due to this mental pressure and panic.
Posted Wed, 23 May 2012 in Mental Health
Answered by Dr. Ashish Mittal 11 hours later
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
• 37 year old female medico
• Known case of anxiety and depression
• Family history of schizophrenia
• Complaints of: anxiety and panic in relationship conflict

You have given very nice scientific description of your problem. The length of your query show severity of distress in your current life. Your query is one of the longest query on WWW.WWWW.WW

You are married and any extra marital relationship has consequence on your marital life and child life. So, you need to be cautious for any such relationship.

From your history it is clear that you become extremely anxious and panic whenever there is stress in your relationship. Considering history of self harm ideation, anxiety, panic and depression, I favor continuing treatment with anti depressants in your case. Untreated symptoms usually increase stress and it is risk factor for developing schizophrenia considering family history of schizophrenia in your case.

Every individual have different personality. In your case it appear that you are a sensitive person and impending loss create huge distress to you. Same time other person (your friend) do not experience similar stress. That is why he do not show behavior as expected by you.

In view of severity of relationship conflict, you should receive continuous in person counselling from nearby trained psychologist. Before counselling you may also need personality assessment so that counselling and problem solving sessions can be modified according to your need. Remember personality assessment and counselling take time and several sessions may require, but results are great, so you have to be patience. Same time you need to continue your antidepressant medication under psychiatrist supervision.

In spite of all these problem and above solution, following measures will help you greatly:
-Maintain your proper routine
-Sleep on time
-Milk and fruits in diet
-Daily morning brisk walk or aerobics
-Involvement in some outdoor game

I hope this information has been both informative and helpful for you. In case of any specific doubt, I will be available for follow ups.

Wish you good health.
Above answer was peer-reviewed by
Follow-up: Anxiety, panic attacks, suicidal. On anti depressants. Low BP, rapid heart beat. How can I relieve myself? 5 hours later
dr sahab how do i come out of this situation when he has left me in just a second and whatever words he had no meaninng to him, i m unable to take this hurt.
i will abstain from any extramarital affairs for sure but it did not happen by choice.
secondly, if u can suggest a better antidepressant than the one i m taking that will help me with this type of hurt.
yesterday also after so much happening i ws getting compulsed to write n call him to say sorry for testing u n sorry that i hurted u, i m more concerned for his hurt than mine n m scared to lose him, but he is gone. this is kind of anxiety as far as i feel, dont know if i m right or not?
also if u can suggest some medicine tht i can take to reduce the need for sex.
i can get the antidepressants from india whatever u suggest.
can i get counselling n personality assesment online through skype or through phone, from u, i ill appreciate ur help in this regard.
kindly do answer me regarding antidepressant pills which one best in my type of case n for sexual drive reduction n also about counselling n personality asssesment through u
thanks n with regards
Answered by Dr. Ashish Mittal 18 hours later
Hello again,
Thanks for follow up,

First, You need not to worry about obsessive compulsive symptoms, as you are messaging repeatedly to prevent loss.

Personality assessment:
-Personality assessment done by clinical psychologist or trained psychiatrist. It may take several days to make final impression.
-Following tests are used to assess personality which is administered by trained psychologist: Clinical interview, Sentence completion test, Rorschach Inkblot Test, Thematic Apperception Test (TAT), Minnesota-Multiphasic Personality Inventory (MMPI) and several other tests. To administer test in person presence is must.
-Psychotherapeutic treatment started after assessment in form of counselling therapy.

Anti depressant:
In your case Fluoxetine (20-40mg will be better. But take it under supervision of some psychiatrist. It have side effect in form of decrease libido, which is desired by you. You can also use benzodiezepines like clonazepam in case of excessive anxiety for short term.

How to handle current situation:
-Follow measures as given above and primary reply.
-Keep your self busy with family members and child. Pass time in reading, watching TV/movies.
-Get your net disconnected for few days
-Do not strive to make your presence noticed..Just make your absence felt by not communicating to him.

In Last: Believe on yourself, medicos known to come over adverse situation in life and you will also do same and REMEMBER time heals many give the time, some time.

Wish you great health and life.
Above answer was peer-reviewed by
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