Hello,

Thanks for posting your query.

From the description that you have provided it seems that you are too self conscious and anxious about what others are thinking of you.

You do have a stressful personality and loosening up a little bit will help you.

To help this problem you can take a few measures-

1.Check your caffeine intake-Avoid drinking too much tea, coffee or cola.

2.Avoid alcohol and cigarette smoking.

3.Try physical exercise like aerobic exercises daily for twenty minutes.

4.Avoid your worries and problems or solve them with the help of your family and friends.

5. Learn controlled breathing.

6. Do simple relaxation exercises like yoga, meditation, etc.

In drug treatment two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines are used and for long term relief most commonly SSRI (selective serotonin reuptake inhibitors) are used. SSRI takes around 3-4 weeks to show its effect and behaviour therapy also takes weeks to show its effect. All these treatment need to be taken under supervision of psychiatrist.

Hope this answers your query. I will be glad to answer the follow up queries that you have.

Wishing you good health.

Regards.

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Hello XXXXXXX,

Thanks for writing again.

I apologize for not being able to clear your doubts initially, I greatly appreciate your knowledge in this matter.

I understand your concern and I can only guess how frustrating it should be to live with such a condition.

Based on the description provided by you - which is rather exhaustive and accurate, I feel that you might be suffering from a condition called cataplexy, which is an associated condition, or I would rather say it is a part of the condition which you are already diagnosed to have - Narcolepsy.


I'm giving you an excerpt on Cataplexy.

""Cataplexy is a sudden loss of muscle tone that leads to feelings of weakness and a loss of voluntary muscle control. Attacks can occur at any time during the waking period, with individuals usually experiencing their first episodes several weeks or months after the onset of Excessive Daytime Sleepiness. But in about 10 percent of all cases, cataplexy is the first symptom to appear and can be misdiagnosed as a seizure disorder. Cataplectic attacks vary in duration and severity. The loss of muscle tone can be barely perceptible, involving no more than a momentary sense of slight weakness in a limited number of muscles, such as mild drooping of the eyelids. The most severe attacks result in a complete loss of tone in all voluntary muscles, leading to total physical collapse during which individuals are unable to move, speak, or keep their eyes open. But even during the most severe episodes, people remain fully conscious, a characteristic that distinguishes cataplexy from seizure disorders. Although cataplexy can occur spontaneously, it is more often triggered by sudden, strong emotions such as fear, anger, stress, excitement, or humor. Laughter is reportedly the most common trigger.

The loss of muscle tone during a cataplectic episode resembles the interruption of muscle activity that naturally occurs during REM sleep. A group of neurons in the brain stem halts activity during REM sleep, inhibiting muscle movement. Using an animal model, scientists have learned that this same group of neurons becomes inactive during cataplectic attacks, a discovery that provides a clue to at least one of the neurological abnormalities contributing to human narcoleptic symptoms.""

Cataplexy is a part of Narcolepsy, since you are already suffering from Narcolepsy the possibility of you also having cataplexy is high.

Hence I suggest you to review with your neurologist, and discuss the issue in detail. I recon your neurologist would adjust the doses of your medication and add a newer medicine so that you are not hindered by this condition in your daily life.

The treatment options include tricyclic anti depressants, MAO inhibitors and psychotherapy.

Hope my answer is helpful. Please do write back if you have further queries.

Wishing you a trouble free speedy recovery.

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Hello.
Thanks for the follow up.

Heart is a smooth muscle organ. Cataplexy affects skeletal muscles only.

Wishing you good health.
Take care.
Regards.

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