Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you are in a lot of distress after the recent turn of events. Now, cocaine is indeed associated with a variety of psychiatric problems. Particularly,it is well known to precipitate or 'unmask' underlying anxiety problems and result in many types of anxiety disorders. Now, regarding your physical symptoms such as dizziness, disorientation, nausea, etc., it is important to understand that anxiety can not only manifest itself as psychological symptoms but also as physical symptoms. You have also mentioned that MRIs and CTs have failed to detect any medical / neurological cause for your physical symptoms. In such cases it is likely that certain neuro-chemical imbalances in your brain (which are found in anxiety disorders) can be causing you to have a heightened perception of sensations, thereby resulting in these symptoms. Now, this does NOT mean that 'everything is in your head' and that you are simply being over-anxious and 'imagining' the symptoms. The neuro-biological co-relation between anxiety disorders and 'somatic' or bodily symptoms is well established. In this conditon, these neuro-chemical imbalances cause the person's pain and other sensory thresholds to get lowered and he / she starts percieving abnormal pain or sensations when there is no major underlying pathological stimulus. Moreover, when there are chronic, unresolving physical symptoms for which a definitive medical cause cannot be established, soon the person develops distress and anxiety due to the undiagnosed symptoms and this anxiety itself then starts worsening the symptoms more. Soon this becomes a viscious cycle, leaving the person in extreme suffering.

You have also personally experienced that your symptoms had subsided after therapy and you say that you were doing pretty good. So, I think it is very likely that the recent onset of diziness after the ear problem is also anxiety-related. It is very unlikely that a small external injury to your ear (with a q-tip) could have immediately caused the dizziness. So, firstly, I would advise you not to worry about this and get excessively concerned that you may be having a ear abnormality which could have resulted in all your symptoms.

Secondly, if your anxiety or associated physical symptoms are distressing, it may be worthwhile to take some treatment for the same or have a few more sessions of psychotherapy. Certain types of antidepressant medication like Mirtazapine or Duloxetine are particularly effective in treating somatic manifestations of anxiety. Mirtazapine has a specific beneficial effect in controlling nausea and dizziness due to a specific serotonin (5HT3) receptor action. There are also certain specific psychological therapies like CBT (Cognitive Behavior Therapy) or Relaxation therapies like progressive muscle relaxation, biofeedback, etc. which will help you handle the anxiety as well as control the physical symptoms.

In addition, following a healthy lifestyle, with a balanced diet and regular physical exercise everyday will also help you with your problems. You can also try simple relaxation techniques like XXXXXXX breathing, yoga, etc. So, please stay positive, try to ignore or distract yourself from the worrying or anxious thoughts and try to keep yourself engaged and active with something always. I would advise you to consult a psychiatrist for a detailed psychological assessment and to plan further treatment options. With appropriate treatment, I'm sure you will be able to overcome your problems soon.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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Hello again,

It is very likely that cocaine has triggered your new set of symptoms. Cocaine is a psychoactive drug which has extensive effects in the central nervous system and hence can cause a variety of psychological and physiological effects. Especially, in a "vulnerable" or "pre-disposed" individual (i.e. in an individual who already has pre-existing psychological problems and some degree of neuro-chemical abnormalities), cocaine can cause worsen these imbalances and result in severe symptoms. However, this doesnt mean that any permanent brain damage has necessarily been caused and therefore, with appropriate treatment, these neuro-chemical imbalances can be brought under control. So, regular treatment and psychotherapy will definitely help you get these symptoms under control.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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