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What Is The Treatment For Anxiety?

Posted on Mon, 27 Jan 2014

Question: Hi, 3 months ago, I was under sever stress and that because one of my articles has been rejected. During that time, my wife and I was talking about her previous pregnancy. And from no were I get a thought that I'm not the biological father of my beloved son. I love my son so, so much but I can't remove this thought from my head. I start taking Paroxetine 40mg O.D. Within a month I felt some enhancement of my thought, but still it there. Do I have COD? I'm really tired. Thank you

Answered by Dr. Manisha Gopal (25 minutes later)

Brief Answer: Changing the medicine will help Detailed Answer: hello XXXXXXX welcome to HCM! I have read your question carefully and from that it looks that you had a thought ( that you are not a biological father of your son) out of nowhere. Even taking paroxetine didn't help. I think it is not depression / anxiety and due to same reason, paroxetine is not working. Had I been treating you, I would have gone to add something like: low dose resperidone or olanzapine. The point that it was a "de novo thought", out of nowhere, under condition of severe stress, can be pointed as a mono symptomatic delusion. There are many cases when such one thought creeps in mind and doesnt get resolved with anti depressants. It is due to fact that- it is not due to depression / anxiety, but spontaneous and irrelevant. It doesnt look like OCD as well. It has some what different presentation. Moreover, with paroxetine- there would have good response uptill now. So, I would advice you to see your doctor and discuss starting the above said medicine. This medicine will not do any harm to you, but help your disturbing thought. This thought will initially break in its strength and finally dissolve with time. Donot worry please, it is well treatable. Many times one drug doesnt show desired result, but changing or adding different drug helps. Hope you get well soon Please feel free to ask for more clarification If you feel satisfied, then kindly rate the answer Dr. Manisha Gopal MD psychiatry

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Manisha Gopal (20 hours later)

Dear Dr. XXXXXXX Thank you for your answer. However, I think I did not give you a clear view about my case. This felling has not come from nowhere. The story is as follows: 1- I was under extreme stress. 2- At that time I was talking with my wife regarding her previous pregnancy which was on 2005. 3- Before she get pregnant she was travelling with her mom, sister and our daughter. 4- After 3 weeks from her arrival to our home, my wife did a pregnancy test and she discovered she was pregnant. At the same day we travelled to U.K and stayed there for 3 years. Before three months, we were talking about this and she told me " Once I came from the travel, we directly went to U.K I said "you did the pregnancy test on the day of our travel to U.K. then how come this is my son?" she get very angry. But after that she said to me "yes I remembered now. We stay 3 weeks before we travel to U.K" From that time (about 3 months) till now, I'm still thinking about it, that I'm not the biological father. although I think this idea is a silly one because I do trust my wife too much. And I know she will never ever do anything like that (we have been together for more than 15 years now). Yet, this idea still in my mind (This idea increases when I'm a lone or under stress and completely disappear when I'm busy or do works). Also, I would like to tell you that, I love my son very, very much. I can't imagine my life without him for a second and every one know this. I hope I clarified my story. Kind regards,

Answered by Dr. Manisha Gopal (32 minutes later)

Brief Answer: The explanation helped, please read below Detailed Answer: hello, It is good that you gave a full description of the situation which were there when the idea emerged. I have read it thoroughly. The point that you love your son is no doubt aggreable and also that your wife is true to you, but you also cannot deny the fact that this idea is always with you in your mind, and it comes to you on and off, ( stress increases it) that you are not his father. I can see that the idea was not de novo, but it is firm and fixed despite the facts of life in front of you...you seem to rationalise yourself with the belief ( that your wife is good and you love your son ) but it still creeps up and maintain its status. The intensity and persistence of this thought makes me want to treat it with a different clas of drug. I would like to know if you remain anxious or sad? or are you usually fine except this idea ( may be referred to as an-over valued idea) is the only disturbing thought? The point that paroxetine ( which is a good molecule in itself) has not helped -also make us treat this idea in your case as something to be more than that. it is very commonly seen that one or two such beliefs are found in an otherwise very normal and successful person, but with medicine they respond very well. There are several cases when people have lived with such beliefs for many years when just by chance this is recognised and treated. Not treating it will not harm you or your family ( as I can feel it is a closer knit one) in any way, but if you want to get rid of it - I would look to add something like resperidone/ olanzapine / aripiorazole... your doctor would know about them.. Hope you understand why I reached to this conclusion, pleas feel free to ask more queries for clarification Dr. Manisha Gopal MD psychiatry

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Manisha Gopal (1 hour later)

Dear Dr. XXXXXXX Many thanks for your reply. I'm usually anxious person. And get stressed very easily. Kind regards,

Answered by Dr. Manisha Gopal (2 hours later)

Brief Answer: Wish you good health Detailed Answer: Thank you too... Anxiety is a two egded sword, one side it helps person to rise in life, be successful and perform his best....but when anxiety goes out of control, becomes problem itself... With medicines, try out pranayama, it will be good for you..will also help in handling day to day stress. PS- pranayama is ancient Indian yogic technique of breathing; can be learned easily from net. Wish you good health Dr. Manisha Gopal MD Psychiatry

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Manisha Gopal (8 hours later)

Many, many thanks Dr. XXXXXXX for your advice. One last thing I would like to take your opinion about. Do you think doing a DNA test for me and my Son will help me forgetting this thought? Kind regards,

Answered by Dr. Manisha Gopal (2 hours later)

Brief Answer: Don't do anything in hurry Detailed Answer: Hello, Well as you know that DNA testing is a final & objective method to determine ones parentage. And definitely the result will be exact and of course he will turn out to be your baby. But do you think your wife and your son would ever be able to forgive you for doing this thing? Like every coin, this situation has positive and negative points,,,,please consider every thing before moving ahead with this test. I would not suggest you to do anything directly which might spoil the family bond. Hope you got this point. Please feel free to ask more questions for clarification Dr. Manisha Gopal MD Psychiatry

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Above answer was peer-reviewed by : Dr. Prasad