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Had eosinophilia, miscarriage. Having headache, anxiety, delayed periods, depression, not responsive, stay bed-ridden. Reason?

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Practicing since : 2004
Answered : 1835 Questions
This query is for my wife XXXXXXX
The History- I am an ex Army Officer. I got Married in 2005 and immediately had to move to J&K as I got transferred there. I took a premature release in 2007. In May 2007(two years after marriage), XXXXXXX had a miscarriage and got bed ridden for a few months. I could not stay with her as I had to proceed for my further education. She stayed with my parents for some time and then with my in laws for 6-7 months. When I completed my education at XLRI and joined at Delhi. Ever since then, she has been falling ill at regular intervals due to one reason or the other like stomach upset/ pain, delayed periods, cold, fever, etc and everytime got bed ridden with negligible movement and non responsive to any family need. This would continue for a week to even 3-4 months and when she would recover she would start behaving normal attending all requirements. The same would again reoccur after some time (3-6 months and again the same repetition). She would not understand what was happening to her and complain of - Headache (blocked mind), anxiety with extreme anxiety at times, and stay bed ridden for months together. We got her treated by various doctors in Delhi NCR. Also thought that if we had a child thing would get right. Fortunately, we were blessed with a Baby girl in Jul 2009, the delivery was normal and also during the pregnancy she did not fall ill so seriously. But the cycle of illness started as usual after that.
At present she is unwell for past two months, it started with eosinophilia and cold which we got her treated for and results improved within 10 days but has still not recovered. I have read the common psychiatric symptoms written by you on WWW.WWWW.WW and feel most of it matches with that displayed by XXXXXXX
Her current symptoms-
• Anxiety, episodes of severe anxiety but no perspiration and sometimes with palpitation. Excessive worry
• Repetitive thoughts and actions associated with anxiety
• Frequent spells of unresponsiveness- she would say she does not understand anything and her mind seems to be blocked.
• Tension, lack of life satisfaction
• Sexual problems delayed cycles, lack of desire
• Sleep problems
• Headache, chronic pain and migraine
• Low and depressed mood, not frequent but does have crying spells, increase fatigability, negative thinking
• Fear, suspiciousness, muttering to self, unusual and odd thinking, irritability.
• Overcheerfulness, increase talk, decrease need for sleep, overspending, increase energy, ideas of increase self importance, increase religiosity, aggression – This is displayed when she is medically all right.

Please Advise.
Posted Sun, 26 May 2013 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:
•     33 year old female
•     Known case of abnormal periods
•     Total duration of illness 6 years
•     Episodic course of illness.

To describe condition of your wife, you have use the information provided on my website, in best way.

From the information it appear that your wife is suffering from bipolar disorder (Mood disorder). In Bipolar disorder patient has both manic and depression episode. It is a chronic illness. Average duration of depressive episode is 4-12 months and manic episode 3-6 months. This illness occur due to neurotransmitters imbalance in brain.

In depression most common symptoms are: low mood, decrease energy and negative thinking. In contrast, in Manic episode common symptoms are: over cheerfulness, anger, irritability, increase energy and decrease need for sleep. She also have some psychotic symptoms (like Fear, suspiciousness, muttering to self, unusual and odd thinking) which can occur with depression or mania.

Medicines are primary mode of treatment for this illness. Following medicines are well researched and found to effective for Bipolar disorder: Lithium, Valproate and Carbamazepine. These medicines also called as mood stabilizers and given for for long term to stabilize mood. They prevent both depressive and manic episode. Even if patient become ill while on medicine, illness is less severe and last for short period.

Out of these medicines patients got stabilized on one or combination of two medicines. Choice of medicine is depend on patient illness state (which can be assessed on interview only), side effect profile of medicine, and duration of illness, weight, age and sex of the patient. Sometime other antimanic agent needs to be added depending on the severity of episode and anti depressants need to be added during depressive episode.

So, it is advisable to visit nearby psychiatrist for her assessment and treatment as soon as possible.

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

Wish you good health.
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