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Suggest Treatment For Loss Of Concentration While Studying
Question: Hi Doctor , I am a 30 year Old Male ; I need help/guidance with concentration problem that I encounter very frequently .Firstly, I am an average student with big ambition.I haven't performed well in academics ( in college) and do not do a very challenging job. Now that I want to improve my learning skills and get an MBA degree to move ahead in life as well as in career , I am facing this strange concentration problem .
Everytime I sit to study for the exam I start to feel as if some thing is moving ( slowly ) just behind my back . I do not feel any physical sensation ,but I get a feeling as if there is some kind on "line" behind the back , and this feeling in turn makes it difficult for me to concentrate on the subject . I used to have this problem since I was in school ;this happens only when I am trying to concentrate on the subject in hand . I have not encountered such sensation when at work ,where I do lot of reading .
my studying has become a pain now . I can’t comprehend the nuances of the texts on the exam because of this problem . I lose my concentration easily and start to feel irritated .
I have another problem that I cannot focus after 40-50 mins . I start to become restless and start to shake my leg vigorously( I do shake my leg in general very often ) . If i force my self to sit any longer , I feel difficulty in breathing . This is hampering my preparation for a crucial 4 hours exam . Its been one year I have been trying to over come this problem , but I have failed in every attempt . I started to believe it s a neorological problem .
I have tried everything from deep breathing to meditation . I have also tried L-tyrosine , 5HTP , fish oil , phosphotidyl serine , Brahmi , nothing seems to give any result . I don't know if visiting a psychiatric or neurologist is going to help.
Kindly let me know if I can try any safe medication for few weeks to see if these symptoms subside ?
I am thinking of trying Sulbutiamine, but I am not sure if that is the right move . I am here to get some professional advise on the condition . Kindly suggest .
PS : I sleep well (7-8 hours) ; exercise regularly ,and eat healthy diet.
Everytime I sit to study for the exam I start to feel as if some thing is moving ( slowly ) just behind my back . I do not feel any physical sensation ,but I get a feeling as if there is some kind on "line" behind the back , and this feeling in turn makes it difficult for me to concentrate on the subject . I used to have this problem since I was in school ;this happens only when I am trying to concentrate on the subject in hand . I have not encountered such sensation when at work ,where I do lot of reading .
my studying has become a pain now . I can’t comprehend the nuances of the texts on the exam because of this problem . I lose my concentration easily and start to feel irritated .
I have another problem that I cannot focus after 40-50 mins . I start to become restless and start to shake my leg vigorously( I do shake my leg in general very often ) . If i force my self to sit any longer , I feel difficulty in breathing . This is hampering my preparation for a crucial 4 hours exam . Its been one year I have been trying to over come this problem , but I have failed in every attempt . I started to believe it s a neorological problem .
I have tried everything from deep breathing to meditation . I have also tried L-tyrosine , 5HTP , fish oil , phosphotidyl serine , Brahmi , nothing seems to give any result . I don't know if visiting a psychiatric or neurologist is going to help.
Kindly let me know if I can try any safe medication for few weeks to see if these symptoms subside ?
I am thinking of trying Sulbutiamine, but I am not sure if that is the right move . I am here to get some professional advise on the condition . Kindly suggest .
PS : I sleep well (7-8 hours) ; exercise regularly ,and eat healthy diet.
Brief Answer:
Consultation with psychiatrist will surely help
Detailed Answer:
Hello XXXXXXX,
Thanks for writing to us.
I understand your concern and appreciate your attitude towards your career.
I read your problem. From narration I guess there is possibility of attention deficit disorder(ADD) or some type of performance /anticipatory anxiety.For specific evaluation of your problem detail history and mental status examination as well as if needed some psychological testing required.
If there is ADD methylphenidqate can help but this medicine can be purchased with written prescription only.
If anxiety problem, clonazepam 0.25 or etizolam 0.5 morning and afternoon can help.Before exam you can also take this medicine or propranolol 20 mg to overcome breathing and other anxiety problem just before exam.
No one can concentrate continuously for more than 45 minutes. We need a break of 10-15 minutes to start again.
Whatever you have tried are the supplements and no evidence of them as proven treatment.
Your sleep and diet are good, you are doing exercise and meditation..all these suggest your problem is not severe at all. You need counselling regarding your problem.
To help you more I need some information:
Your education history(profile with results of significant exams), family history, work history, any stress history:social,personal,economical and any current issue in life if you are facing apart from problem you narrated here.Your exact location.
I will be happy to help further,
Regards,
Dr.Chintan Solanki.
Consultation with psychiatrist will surely help
Detailed Answer:
Hello XXXXXXX,
Thanks for writing to us.
I understand your concern and appreciate your attitude towards your career.
I read your problem. From narration I guess there is possibility of attention deficit disorder(ADD) or some type of performance /anticipatory anxiety.For specific evaluation of your problem detail history and mental status examination as well as if needed some psychological testing required.
If there is ADD methylphenidqate can help but this medicine can be purchased with written prescription only.
If anxiety problem, clonazepam 0.25 or etizolam 0.5 morning and afternoon can help.Before exam you can also take this medicine or propranolol 20 mg to overcome breathing and other anxiety problem just before exam.
No one can concentrate continuously for more than 45 minutes. We need a break of 10-15 minutes to start again.
Whatever you have tried are the supplements and no evidence of them as proven treatment.
Your sleep and diet are good, you are doing exercise and meditation..all these suggest your problem is not severe at all. You need counselling regarding your problem.
To help you more I need some information:
Your education history(profile with results of significant exams), family history, work history, any stress history:social,personal,economical and any current issue in life if you are facing apart from problem you narrated here.Your exact location.
I will be happy to help further,
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello Dr. XXXXXXX . Thank you for the response . I will try to be to give some minute details to help you make your diagnosis as accurate as possible .
Technically speaking , I am average in academics and this is the reason I want to make significant improvement in my career before it gets too late . That being said , I am not stressing myself out . I am making every effort ( taking help from tutor and doing self study ) to improve . My concern is with focus .As i mentioned in the previous post I feel as if there is some kind of movement happening in the back and this makes me feel discomfort ;mostly happens only when I am trying to study and sometimes read , but not when I am watching TV or doing other leisure activities.
I perform well at work (IT indust) and get plenty appreciations , though I feel the nature of the work is not very challenging.
Coming to my personnel history , my mother had psychiatric problem when I was at school . I am not sure about the exact diagnosis but the cause of depression . Though , it was gone for a year it appeared few times the year after the diagnosis . She is doing fine for 5-6 years now without any medications . Also, she is of the personality who doesn't pay much attention . Unfortunately , my father and sister( married) are diagnosed with Cancer and the thought of this stresses me out . I sometimes feel good about myself and most of the times I feel really pathetic ( because of the family health condition) . I feel as my life will is wasted ,and I am going to lose everything shortly , including my dreams .My feel really depressed about the thought . I am assuming its natural given the circumstance . But , I never get suicidal thoughts ; just depressed and cry...
I am also starting to panic lately , for e.g I hired a one on one tutor to prepare myself for the exam and when the tutor asked me set of questions pertaining to the subject I panicked and could not even understand a single line . That never used to happen before ( 2-3 years back ) ; I am gradually experiencing the same at work . However, I could read & understand the passages when Studying alone . Why is this happening in my head ?? is this a kind of Panic attack ?
considering all the above factors , I still keep the compose ,and I do not let outside thoughts come near to me ,but the Gmat exam is for 4 hours duration with two 8mins break in between and the lack of concentration( sensation that something is moving behind my right to left shoulder ) as well as feeling of restlessness in just 40-50 mins is making me more depressed .
Is it ADD ? I do not know if there a way to diagnose ADD in adults in XXXXXXX .
methylphenidate has adverse side effects per my understanding .
Are the dosage of clonazepam 0.25 or etizolam 0.5 safe to be used for short duration and okay in my condition ? You mentioned propranolol but it is mentioned in website that propranolol should not be used by asthma patient ,which I am . Kindly let me know.
Thanks !
Technically speaking , I am average in academics and this is the reason I want to make significant improvement in my career before it gets too late . That being said , I am not stressing myself out . I am making every effort ( taking help from tutor and doing self study ) to improve . My concern is with focus .As i mentioned in the previous post I feel as if there is some kind of movement happening in the back and this makes me feel discomfort ;mostly happens only when I am trying to study and sometimes read , but not when I am watching TV or doing other leisure activities.
I perform well at work (IT indust) and get plenty appreciations , though I feel the nature of the work is not very challenging.
Coming to my personnel history , my mother had psychiatric problem when I was at school . I am not sure about the exact diagnosis but the cause of depression . Though , it was gone for a year it appeared few times the year after the diagnosis . She is doing fine for 5-6 years now without any medications . Also, she is of the personality who doesn't pay much attention . Unfortunately , my father and sister( married) are diagnosed with Cancer and the thought of this stresses me out . I sometimes feel good about myself and most of the times I feel really pathetic ( because of the family health condition) . I feel as my life will is wasted ,and I am going to lose everything shortly , including my dreams .My feel really depressed about the thought . I am assuming its natural given the circumstance . But , I never get suicidal thoughts ; just depressed and cry...
I am also starting to panic lately , for e.g I hired a one on one tutor to prepare myself for the exam and when the tutor asked me set of questions pertaining to the subject I panicked and could not even understand a single line . That never used to happen before ( 2-3 years back ) ; I am gradually experiencing the same at work . However, I could read & understand the passages when Studying alone . Why is this happening in my head ?? is this a kind of Panic attack ?
considering all the above factors , I still keep the compose ,and I do not let outside thoughts come near to me ,but the Gmat exam is for 4 hours duration with two 8mins break in between and the lack of concentration( sensation that something is moving behind my right to left shoulder ) as well as feeling of restlessness in just 40-50 mins is making me more depressed .
Is it ADD ? I do not know if there a way to diagnose ADD in adults in XXXXXXX .
methylphenidate has adverse side effects per my understanding .
Are the dosage of clonazepam 0.25 or etizolam 0.5 safe to be used for short duration and okay in my condition ? You mentioned propranolol but it is mentioned in website that propranolol should not be used by asthma patient ,which I am . Kindly let me know.
Thanks !
Brief Answer:
No ADD, Anxiety-depression likely,need evaluation
Detailed Answer:
Hi,
Thanks for good information.
Your feeling of movement in the back is either due to muscle twitching and awkward position of cervical muscles or an anxiety features while reading. Cervical spine x ray, physical examination of local part and evaluation of your posture are required to correct this problem.
Your narration, average in academics and good skills and appreciation at work are suggestive of you have good attention and concentration quality in other areas and this features almost rule out diagnosis of ADD. So methylphenidate is not needed right now.(Just for you information: yes your view about ADD and medication is right. However ADD is under diagnosed in XXXXXXX I came across to such CME recently and then I got 2 patients diagnosed with that. Yes, Methylphenidate has side effects but it is not like that everyone suffers from side effects. Under medical supervision it is good medicine and quite effective in ADHD.)
Your personal history narrating your family issues and your status are suggestive of some depressive features. Crying, hopelessness and worthlessness require to be evaluated in detail for severity. But I can say you have stress back of mind and due to that you become anxious sometimes and mostly that is one of the reasons you are not able to concentrate at study.
Considering your age and work, I think you have restarted study after sometime of job(it is not continuous I guess). This may be the one reason for your problem and panic symptoms.
I really admire your efforts to fight with the situations and because of that I think you are still stable and doing work regularly. Just keep your efforts continue.
If you are known case of asthma, avoid propranolol. Clonazepam and etizolam are quite good medicines without dependence potential. You can surely use for short duration for symptomatic relief.
In your case low dose SSRI like escitalopram can help as well as psychotherapy like CBT (cognitive behaviour therapy) insight orient psychodynamic psychotherapy can also be helpful. For that confirmation of diagnosis of depressive-anxiety spectrum disorder is to be done by a psychiatrist after detail mental status examination.
I found your location in XXXXXXX If you live in XXXXXXX there are many private psychiatrists as well as NIMHANS is the apex institute of mental health in XXXXXXX you can consult there.
As other efforts you are doing well, medicines would help you more. As well as I recommend one book, “Feeling Good by XXXXXXX Burns” to read which might help you.
I hope this will help you, I will be glad to answer if needed.
Regards,
Dr.Chintan Solanki
No ADD, Anxiety-depression likely,need evaluation
Detailed Answer:
Hi,
Thanks for good information.
Your feeling of movement in the back is either due to muscle twitching and awkward position of cervical muscles or an anxiety features while reading. Cervical spine x ray, physical examination of local part and evaluation of your posture are required to correct this problem.
Your narration, average in academics and good skills and appreciation at work are suggestive of you have good attention and concentration quality in other areas and this features almost rule out diagnosis of ADD. So methylphenidate is not needed right now.(Just for you information: yes your view about ADD and medication is right. However ADD is under diagnosed in XXXXXXX I came across to such CME recently and then I got 2 patients diagnosed with that. Yes, Methylphenidate has side effects but it is not like that everyone suffers from side effects. Under medical supervision it is good medicine and quite effective in ADHD.)
Your personal history narrating your family issues and your status are suggestive of some depressive features. Crying, hopelessness and worthlessness require to be evaluated in detail for severity. But I can say you have stress back of mind and due to that you become anxious sometimes and mostly that is one of the reasons you are not able to concentrate at study.
Considering your age and work, I think you have restarted study after sometime of job(it is not continuous I guess). This may be the one reason for your problem and panic symptoms.
I really admire your efforts to fight with the situations and because of that I think you are still stable and doing work regularly. Just keep your efforts continue.
If you are known case of asthma, avoid propranolol. Clonazepam and etizolam are quite good medicines without dependence potential. You can surely use for short duration for symptomatic relief.
In your case low dose SSRI like escitalopram can help as well as psychotherapy like CBT (cognitive behaviour therapy) insight orient psychodynamic psychotherapy can also be helpful. For that confirmation of diagnosis of depressive-anxiety spectrum disorder is to be done by a psychiatrist after detail mental status examination.
I found your location in XXXXXXX If you live in XXXXXXX there are many private psychiatrists as well as NIMHANS is the apex institute of mental health in XXXXXXX you can consult there.
As other efforts you are doing well, medicines would help you more. As well as I recommend one book, “Feeling Good by XXXXXXX Burns” to read which might help you.
I hope this will help you, I will be glad to answer if needed.
Regards,
Dr.Chintan Solanki
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank for a detailed analysis , Dr. XXXXXXX I would go for a consultation in a month's time . Meanwhile , Can I take etizolam 0.50 mg ,morning and afternoon ( i.e 1 mg ) per the recommendation and see whether the anxiety and the related symptoms subsides ?
Should I take it daily for 2 weeks( as I want to take it for short duration ) and then stop or should I decrease the dosage gradually? Also, should it be taken with food ? I am also hoping this would not cause any withdrawal or dependency after I stop taking it . Can I use it later in case symptoms resurface . Kindly suggest me a safe recommended dosage .
Should I take it daily for 2 weeks( as I want to take it for short duration ) and then stop or should I decrease the dosage gradually? Also, should it be taken with food ? I am also hoping this would not cause any withdrawal or dependency after I stop taking it . Can I use it later in case symptoms resurface . Kindly suggest me a safe recommended dosage .
Brief Answer:
You can take medicine as mentioned below
Detailed Answer:
Hi,
Thanks for follow up.
First of all I would like to mention that any medicine must be taken with written prescription as our XXXXXXX laws not mention any online prescription.
Etizolam is very good anti anxiety medicine and I am using since more than 3 years and normally every day I write one prescription on that. My clinical experience tells that it is easily tolerable and with least side effects.99% patients tolerate it without any side effects. I usually prescribe in dose of 0.25 morning and noon. In your case considering your problem I suggested 0.5 two time.If you feel any sedation you can reduce to 0.25 two times otherwise continue with 0.5 for 2 weeks and decrease gradually by taking 0.25 two times for 1 week and then 0.25 in the morning for one week.You can take with or without food, it doesn't matter.No specific and concerned dependency or withdrawal is there.
You can take if recurrence is there , however it is symptomatic, treatment better to go for curative treatment later on and think that there will be no recurrence.
All the best & regards,
Late me know your progress
Dr.Chintan Solanki
You can take medicine as mentioned below
Detailed Answer:
Hi,
Thanks for follow up.
First of all I would like to mention that any medicine must be taken with written prescription as our XXXXXXX laws not mention any online prescription.
Etizolam is very good anti anxiety medicine and I am using since more than 3 years and normally every day I write one prescription on that. My clinical experience tells that it is easily tolerable and with least side effects.99% patients tolerate it without any side effects. I usually prescribe in dose of 0.25 morning and noon. In your case considering your problem I suggested 0.5 two time.If you feel any sedation you can reduce to 0.25 two times otherwise continue with 0.5 for 2 weeks and decrease gradually by taking 0.25 two times for 1 week and then 0.25 in the morning for one week.You can take with or without food, it doesn't matter.No specific and concerned dependency or withdrawal is there.
You can take if recurrence is there , however it is symptomatic, treatment better to go for curative treatment later on and think that there will be no recurrence.
All the best & regards,
Late me know your progress
Dr.Chintan Solanki
Above answer was peer-reviewed by :
Dr. Prasad
Thank you Doctor . unfortunately , none of the medicines are available without prescription . I feel hesitant to visit a psychiatrist in person and explain my situation all over again , and chances are the doctor might suggest a different medication .You seem to be located in Gujrat . Is there any over the counter medicine that I can ask for immediate relief or any psychiatrist you know I can visit in XXXXXXX .Kindly let me know .
Brief Answer:
propranolol is the alternative
Detailed Answer:
Hi,
Thanks for follow up. Yes it is limitation that most of the drugs used in psychiatry cannot be given without prescription. One option is you can take propranolol sustain release preparation 40 mg in the morning after breakfast, it will help in anxiety and headache symptoms and mostly it will be available without prescription.(trade name: betacap tr/sr, provanol sr/tr).
I do not know personally any private psychiatrist in banglore. But yes you can visit NIMHANS as I mentioned before, I met many faculties there, they are quite excellent. I am sending link to find psychiatrist in banglore through healthcaremagic. You can choose near your vicinity. http://doctor.healthcaremagic.com/doctors/Psychiatrists-in-Karnataka/L18885S35.
Almost all doctors are good in my opinion. In particular, to psychiatrist you should go without hesitation and tell your problem with minute details to get best outcome.
All the best & regards,
Dr.Chintan Solanki.
propranolol is the alternative
Detailed Answer:
Hi,
Thanks for follow up. Yes it is limitation that most of the drugs used in psychiatry cannot be given without prescription. One option is you can take propranolol sustain release preparation 40 mg in the morning after breakfast, it will help in anxiety and headache symptoms and mostly it will be available without prescription.(trade name: betacap tr/sr, provanol sr/tr).
I do not know personally any private psychiatrist in banglore. But yes you can visit NIMHANS as I mentioned before, I met many faculties there, they are quite excellent. I am sending link to find psychiatrist in banglore through healthcaremagic. You can choose near your vicinity. http://doctor.healthcaremagic.com/doctors/Psychiatrists-in-Karnataka/L18885S35.
Almost all doctors are good in my opinion. In particular, to psychiatrist you should go without hesitation and tell your problem with minute details to get best outcome.
All the best & regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Dr. Solanki . I have couple of followup questions .
I took betacap TR 40 ( per the recommendation in the above post ) , and I really felt calm and composed during the otherwise stressful moments . I don't know if it was a placebo effect,but I certainly felt the difference .
Firstly , In general, when giving presentations I feel terribly nervous , dry mouth , anxious and shaky . But , after taking betacap , I felt really calm and I did not even feel nervous or shaky .Instead, I was eager to give presentation and observe the effect .
Secondly, I was able to socialize nicely and strike conversation with strangers briefly without getting anxious and nervous . This was a very important change . Since, I generally find it hard to socialize and get nervous occasionally .
Furthermore , I took a mock exam ,which was 4 hours long , and during this period I did not feel restlessness ( i noticed a 40 points increase in the exam )
Just to add, I have a shy personality and rarely socialize. Given the family condition ( as I mentioned before) the feeling has aggravated. I don't feel like making friends and interact much . I always worry about my future and the feeling just makes me more and more sad . so , One day I feel good about myself , the next day worried and nervous . I have accumulated a lot of negative thoughts for years , and I want to overcome this feeling now .
I am don't know if betacap I meant to act in a way I have described , but I certainly felt less worried . My question is -What is the safe recommended dosage to take betacap Tr 40mg? Should I take it as and when needed in my situation or should I follow a regimen.
I took betacap for last 3days , but did not take it today ( 4th day ).
my next question is -can I benefit from the book “Feeling Good by XXXXXXX Burns” to overcome my timid personality & extremely negative thoughts that have accumulated over the years ? I have bought the e-book and started to read , but little skeptical since I have read many self help book in the past without much effect . However, getting advise from a professional like you makes me feel positive ...
Or do you recommend visiting NIMHANS to get help via medication . I have started to believe medication can help me overcome a lot of negativity in my brain ,in the same note I want be diligent and take it per the professional advise .
Kindly suggest. The feelings I have described has impacted my professional and personnel life .
I took betacap TR 40 ( per the recommendation in the above post ) , and I really felt calm and composed during the otherwise stressful moments . I don't know if it was a placebo effect,but I certainly felt the difference .
Firstly , In general, when giving presentations I feel terribly nervous , dry mouth , anxious and shaky . But , after taking betacap , I felt really calm and I did not even feel nervous or shaky .Instead, I was eager to give presentation and observe the effect .
Secondly, I was able to socialize nicely and strike conversation with strangers briefly without getting anxious and nervous . This was a very important change . Since, I generally find it hard to socialize and get nervous occasionally .
Furthermore , I took a mock exam ,which was 4 hours long , and during this period I did not feel restlessness ( i noticed a 40 points increase in the exam )
Just to add, I have a shy personality and rarely socialize. Given the family condition ( as I mentioned before) the feeling has aggravated. I don't feel like making friends and interact much . I always worry about my future and the feeling just makes me more and more sad . so , One day I feel good about myself , the next day worried and nervous . I have accumulated a lot of negative thoughts for years , and I want to overcome this feeling now .
I am don't know if betacap I meant to act in a way I have described , but I certainly felt less worried . My question is -What is the safe recommended dosage to take betacap Tr 40mg? Should I take it as and when needed in my situation or should I follow a regimen.
I took betacap for last 3days , but did not take it today ( 4th day ).
my next question is -can I benefit from the book “Feeling Good by XXXXXXX Burns” to overcome my timid personality & extremely negative thoughts that have accumulated over the years ? I have bought the e-book and started to read , but little skeptical since I have read many self help book in the past without much effect . However, getting advise from a professional like you makes me feel positive ...
Or do you recommend visiting NIMHANS to get help via medication . I have started to believe medication can help me overcome a lot of negativity in my brain ,in the same note I want be diligent and take it per the professional advise .
Kindly suggest. The feelings I have described has impacted my professional and personnel life .
Brief Answer:
good going, carry on
Detailed Answer:
Hello,
Thanks for follow up.
I congratulate you for some positive changes. I appreciate your attitude that how you see your problem.
Propranolol (betacap) is very good drug for social anxiety. Whatever you felt with that is purely its effect, not placebo.
I suggest keeping a diary and noting these positive changes what you have mentioned. With repeated success in presentation and other aspects, you can read, judge and understand your behaviour and can get confidence with this diary. This strategy will help you to get rid of the medicines.
You narrated that some negative feelings are still there and personality problem of socializing. I think if you can try on your own to interact with others more and to change your behaviour what you want to change, there are chances that you can do it on your own. If by chance you cannot, with professional help you can do for sure considering your motivation.
Now answers of specific questions.
Yes betacap is safe overall. It can be taken up to 80 mg in a day. You can take it on required basis, when you feel that you will be in that situation in which it is helpful. You should take it at least two hours before anticipating situation.
Book, “Feeling GOOD” is not just book. In our term we call it bibliotherapy. You just not to read it , but follow and do the lessons what it mentions. It will be helpful for sure if you can digest it well. Specifically it will help to change negative though pattern. From personality point of view I cannot say at this point that it will be helpful or not.
You have just begun to move on right path, carry on; there will be more improvement and milestones.
If you feel improvement gradually, no need to visit doctor at present.If you feel there is no progress or worsening, visit doctor soon.
Hope you have got answers of your questions, I will be glad to answer if needed.
Regards,
Dr.Chintan Solanki.
Http://bit.ly/drchintansolanki (for asking me question directly)
good going, carry on
Detailed Answer:
Hello,
Thanks for follow up.
I congratulate you for some positive changes. I appreciate your attitude that how you see your problem.
Propranolol (betacap) is very good drug for social anxiety. Whatever you felt with that is purely its effect, not placebo.
I suggest keeping a diary and noting these positive changes what you have mentioned. With repeated success in presentation and other aspects, you can read, judge and understand your behaviour and can get confidence with this diary. This strategy will help you to get rid of the medicines.
You narrated that some negative feelings are still there and personality problem of socializing. I think if you can try on your own to interact with others more and to change your behaviour what you want to change, there are chances that you can do it on your own. If by chance you cannot, with professional help you can do for sure considering your motivation.
Now answers of specific questions.
Yes betacap is safe overall. It can be taken up to 80 mg in a day. You can take it on required basis, when you feel that you will be in that situation in which it is helpful. You should take it at least two hours before anticipating situation.
Book, “Feeling GOOD” is not just book. In our term we call it bibliotherapy. You just not to read it , but follow and do the lessons what it mentions. It will be helpful for sure if you can digest it well. Specifically it will help to change negative though pattern. From personality point of view I cannot say at this point that it will be helpful or not.
You have just begun to move on right path, carry on; there will be more improvement and milestones.
If you feel improvement gradually, no need to visit doctor at present.If you feel there is no progress or worsening, visit doctor soon.
Hope you have got answers of your questions, I will be glad to answer if needed.
Regards,
Dr.Chintan Solanki.
Http://bit.ly/drchintansolanki (for asking me question directly)
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you for the response . The change in the feelings that I mentioned was when I took proranolol . Is it safe to take it once or twice a week for months without developing any side effects ?
Can the occasional intake of propranolol reduce/cure the social anxiety or do I have to take it regularly in order to make my anxious feelings go away .
I always thought I would have to live with anxiety & nervousness for the entire life ,but the medication did work in a way I never imagined. I do not want to dabble with the medication , but looking at the benefit after taking it I would like to know if the frequency of intake I mentioned can be considered safe?
Kindly Advise .
Can the occasional intake of propranolol reduce/cure the social anxiety or do I have to take it regularly in order to make my anxious feelings go away .
I always thought I would have to live with anxiety & nervousness for the entire life ,but the medication did work in a way I never imagined. I do not want to dabble with the medication , but looking at the benefit after taking it I would like to know if the frequency of intake I mentioned can be considered safe?
Kindly Advise .
Brief Answer:
you can take it for long weeks..months..depends...
Detailed Answer:
Hi XXXXXXX,
Yes, it is absolutely safe to take it even daily if you have tolerated well when it was started.
We used to give in case of headache called migraine daily. I use as second choice after etizolam in anxiety. In both indication it is given daily.I have given it up to 1.5 years without any significant side effects. Just take it with milk or some food to prevent hypotension if you take daily.
If you feel fine and more efficient with it, better to take it daily in minimum dose which is effective.
No, it is absolutely nothing like that it is lifelong problem. Continue medicines for at least 3 months, during which you can do your task effectively and boost up your confidence. Just note down all successful incidences and revise it. This will help in future to reduce and stop medicines. Continue measures I described before.
And yes please go for thyroid function test once(morning blood sample preferable) to rule out it as cause of your anxiety, if you have not checked before.
Regards
Dr.Chintan Solanki.
Http://bit.ly/drchintansolanki
you can take it for long weeks..months..depends...
Detailed Answer:
Hi XXXXXXX,
Yes, it is absolutely safe to take it even daily if you have tolerated well when it was started.
We used to give in case of headache called migraine daily. I use as second choice after etizolam in anxiety. In both indication it is given daily.I have given it up to 1.5 years without any significant side effects. Just take it with milk or some food to prevent hypotension if you take daily.
If you feel fine and more efficient with it, better to take it daily in minimum dose which is effective.
No, it is absolutely nothing like that it is lifelong problem. Continue medicines for at least 3 months, during which you can do your task effectively and boost up your confidence. Just note down all successful incidences and revise it. This will help in future to reduce and stop medicines. Continue measures I described before.
And yes please go for thyroid function test once(morning blood sample preferable) to rule out it as cause of your anxiety, if you have not checked before.
Regards
Dr.Chintan Solanki.
Http://bit.ly/drchintansolanki
Above answer was peer-reviewed by :
Dr. Shanthi.E
I did a a blood checkup in july . And my thyroid function test results were -
T3 89.36 ng/dl
T4 6.60 ug/dl
TSH 7.433 uIU/ml
The TSH level was little high compared to lab benchmark , but I do not think it to be alarming .
Coming to my problem: I am still struggling with low mood , feeling low esteem and then getting anxious . Though the effect is not very profound . I think there is an imbalance in seretonin level in my brain since childhood.Since I could relate while searching in internet many feelings to depression (mild/moderate) .
For e.g when I wake up in the morning I feel good for an hour . I would prepare myself to go to gym at work to do some exercise and on the way I suddenly start to feel sad ( that I do not have a good future , that I am an underachiever in life , and my family condition ) so I directly go to my work place instead of going to gym . I then start to feel tensed about the situation ...this is just an example to show how I feel
Is there a low dose SSRI or other medication that I can safely try for few weeks to see if I can elevate my mood ? I am asking because I have elaborated my history to you , also you know my personality to some extent .so you would be able to know the condition from your experience .
on a side note , I do not want to depend on any medication for long ,moreover I have no addiction problem ( I don't drink or smoke ) . I want to get some relief from the low feeling .
Aside, I can only avail OCT medication after consulting you . Kindly let me know there is something I can try to alleviate the low feelings.
Thank you again for all the valuable advise .
T3 89.36 ng/dl
T4 6.60 ug/dl
TSH 7.433 uIU/ml
The TSH level was little high compared to lab benchmark , but I do not think it to be alarming .
Coming to my problem: I am still struggling with low mood , feeling low esteem and then getting anxious . Though the effect is not very profound . I think there is an imbalance in seretonin level in my brain since childhood.Since I could relate while searching in internet many feelings to depression (mild/moderate) .
For e.g when I wake up in the morning I feel good for an hour . I would prepare myself to go to gym at work to do some exercise and on the way I suddenly start to feel sad ( that I do not have a good future , that I am an underachiever in life , and my family condition ) so I directly go to my work place instead of going to gym . I then start to feel tensed about the situation ...this is just an example to show how I feel
Is there a low dose SSRI or other medication that I can safely try for few weeks to see if I can elevate my mood ? I am asking because I have elaborated my history to you , also you know my personality to some extent .so you would be able to know the condition from your experience .
on a side note , I do not want to depend on any medication for long ,moreover I have no addiction problem ( I don't drink or smoke ) . I want to get some relief from the low feeling .
Aside, I can only avail OCT medication after consulting you . Kindly let me know there is something I can try to alleviate the low feelings.
Thank you again for all the valuable advise .
Brief Answer:
Repeat Thyroid test, Escitalopram can be taken,
Detailed Answer:
Hello,
Thanks for query again.
Your July thyroid report is inconclusive. T3 and T4 are within normal range but TSH is high. High TSH means hypothyroidism and it is one of the reasons for depressive symptoms. So please go to do fresh report again.
Please do not go into detail about your situation with help of internet from psychiatry point of view. (If my computer is not working properly or I want to make some application, I can search regarding that on internet but cannot make it without experience.)
As Google provide the information, it does not treat the patients.
It is really difficult to get any drug for psychiatry disorder OTC in current time. You need to consult psychiatrist.
I prefer Escitalopram (SSRI that I use in young people)10 mg to start with for your depressive features. It will help you. It is not at all going to cause dependence and you can stop it in future with help of psychiatrist.
Regards,
Dr.Chintan Solanki.
Repeat Thyroid test, Escitalopram can be taken,
Detailed Answer:
Hello,
Thanks for query again.
Your July thyroid report is inconclusive. T3 and T4 are within normal range but TSH is high. High TSH means hypothyroidism and it is one of the reasons for depressive symptoms. So please go to do fresh report again.
Please do not go into detail about your situation with help of internet from psychiatry point of view. (If my computer is not working properly or I want to make some application, I can search regarding that on internet but cannot make it without experience.)
As Google provide the information, it does not treat the patients.
It is really difficult to get any drug for psychiatry disorder OTC in current time. You need to consult psychiatrist.
I prefer Escitalopram (SSRI that I use in young people)10 mg to start with for your depressive features. It will help you. It is not at all going to cause dependence and you can stop it in future with help of psychiatrist.
Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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