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Dr. Andrew Rynne

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Feeling fuzziness in head and unable to concentrate. Could it be social anxiety disorder?

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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Thu, 20 Dec 2012 in Mental Health
Question: I'm away from home, from the UK (I'm in France seeing friends) at the moment, and I'm worried. These past few days to a week, I've been feeling quite anxious, but its accompanied by this consistent feeling of being detached from my surroundings, like I've had one or two to drink. Its really distracting and intensifies when I'm anxious. I've been to A&E a couple of times in the last few weeks because this is affecting my day to day life and making me unable to concentrate, and the feeling of being separated from my surroundings is really upsetting. Its like a fog on all of my senses. I can see a doctor when I'm back in the UK but I'm hoping for some reassurance. Am I seriously ill or is this just an anxiety disorder? Do brain tumours, infections or bleeds present this way? I need to function as I have a lab report to hand in for university and a research presentation to hand in also next week and I can't even concentrate to write anything down. This constant fuzziness, like I'm separated from myself, its like strange self awareness coupled with anxiety and it varies in intensity.

I'm pretty scared about it all too.

My main concern is the fuzziness in my head, like its really getting to me and being a major part of my day. Its not even a mood change but it makes me anxious. Like people have emotional symptoms, this is physical, and I want to make sure its not an emergency.
I feel a lot less panicked, the fuzz has all but disappeared for the first time all day.

This came shortly after telling my friend that I'm staying with about my anxiety and me feeling ill. Social anxiety disorder or just convenience?

I'm a Medical and Pharmacological Sciences student, and reading my question now it must seem like a standard anxiety disorder case study. It makes me feel a bit stupid for paying for advice online, but at the time the fear was very real, and I'm sure it will be very real again at some point soon.

So I'd still benefit from a 2nd opinion on how I'm best to go about this. I plan on seeing my GP urgently on my return to the UK, and seeing if some counselling and medications (SSRIs i've taken before, maybe B-blockers?, any advice?) will help.

The feeling of anxiety was hard to control but the thing I'd like to get rid of the most is the accompanying "mind fog" it brings. I searched online and the closest description was the wiki article for a dissociation disorder, as it felt just like that; an anomalous self awareness of my own existence, and that i was in a dream or not there.

I'd still want to know if there's another medical condition that could present itself in this way, such as an endocrine response. A doctor last week at A&E described it as an adrenergic response to my own stress causing positive feedback.. but the mind fog that accompanied it was so unlike anything I've ever felt before.


All of this health worry started when I suspect I had my drink on a night out spiked a few weeks back and the day after I had very strong heart palpitations the day after prompting me to go to the hospital. They gave me diazepam and sent me home saying I'll be fine.

The sensations were unlike anything I'd felt before and so horrible, I thought I was on the edge of a really bad turn for the worse. Could it be the anxiety of experiencing such a horrible sensation, or something similar.

Thank you again for your time.
doctor
Answered by Dr. Jonas Sundarakumar 7 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you are quite distressed by your recent symptoms. The specific symptom worrying you a lot, which you describe as a 'sense of detachment from your surroundings', 'being in a dream-like state', 'mind fog' etc. seems to be indicative of phenomena called "depersonalization / derealization". Depersonalization is a sense of altered preception of oneself and derealization is a sense of altered perception of one's surroundings. These conditions are very often due to underlying anxiety / panic and stress-related disorders. The fact that this symptom worsens whenever you feel more anxious confirms this possibility. Sometimes, certain substances of abuse (like cannabis, coccaine, etc.) can also trigger such episodes. So, it is also possible that the recent intake of a spiked drink and the subsequent intense anxiety which you experienced could have trigerred this problem.

I would advise you not to get too worried and anxious about this for two reasons - 1) 'Coz it is not an emergency and not indicative of any serious medical problem like a brain tumour, CNS bleed, etc. 2) Getting more anxious about this will only tend to worsen this problem.

I would suggest that you try relaxation exercises like XXXXXXX breathing or progressive muscle relaxation and to distract your mind, in case you have any further such episodes. Talking to someone about your problems can offload emotional burden and help you feel more relaxed (which is why your symptoms have decreased after talking about this to someone). Avoid alcohol or any other drugs, as they are known to worsen anxiety. When you get back to UK, you can discuss this with your doctor and plan further treatment, if necessary.

Wish you all the best.

- Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(UK)
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Jonas Sundarakumar 6 hours later
Thank you for your reply.

How serious/hard to get rid of would you say that my symptoms are? One of the main things I feel is that sometimes the depersonalisation and derealisation is so bad that I'm losing my mind and I can't remember what it's like to feel normal. This feeling makes the anxiety worse.

I just want to be able to get rid of them so I can finish my degree and get on with my life. Anxiety has been a big part of it for about 3 weeks now and I was much happier without it.

Thanks again Dr.
doctor
Answered by Dr. Jonas Sundarakumar 6 hours later
Hello again,

The positive sign regarding the prognosis of your problems is that you have a good 'insight' into the psychological nature of your problems and are motivated to overcome them. These two factors are the crux in determining treatment outcome in such psychological disorders. Your symptoms are serious in the sense that they are causing you significant distress and dysfunction, but with appropriate therapy, they are not hard to get rid off. These symptoms of depersonalization and derealization, though may seem very scary to the person experoencing them, are not uncommon and do respond well to treatment.

Regarding treatment, scienticic evidence shows that in such disorders, a combination of medication as well as psychotherapy yields best and long-lasting results. So, with motivated efforts and appropriate treatment, I'm sure that you will be able to overcome your problems soon.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(UK)
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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