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Suffer from panic attacks, depression and stomach problems. Have smoking addiction. Are these related?

Dec 2014
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Practicing since : 2007
Answered : 2893 Questions
hi, i have been smoking since 2011 and i want to quit. on an average i smoke about 10 to 12 ciggarettes a day. in between i stopped for 3 months since i was suffering from panic attacks. i started again but cant seem to quit. Sometimes i smoke in the middle of the night. i feel extremely tired and dazed every morning. Does smoking lead to acidity or anxiety induced acidity? Somedays i have bad stomach upsets .When i drink alcohol , then i easily finish 2 packs which happens on weekends only. i am still on pills for panic attacks and depression . is it advisable to smoke under medication? sometimes when i overdo on ciggarettes i feel extremely scared of experiencing a heart attack? what are my chances of suffering from heart attacks and cerebral haemorrhage ? what should i do to quit? will pranayam help? do you think i may relapse back to depression and panic disorder because of my smoking problem ?
Posted Mon, 8 Apr 2013 in Smoking and Alcohol Addiction
Answered by Dr. Seikhoo Bishnoi 54 minutes later
Welcome to Health Care Magic

First of all a brief summary of your symptoms-
Smoking is a bad habit. You have been smoking since 2011. Quit it successfully for about 3 months because of panic and anxiety attacks and then again started. You feel extremely tired and faxed every morning. In other words you have non refreshing sleep. You also take alcohol and have bad stomach upsets. You are having history of depression and panic attacks. You are on medicines of these diseases.

Now coming to your questions-
- Smoking itself increases the chances of acidity. Anxiety causes butterfly sensation in epigastrium and it further increases acid secretion. Both are risk for acidity.

- Smoking is not advisable in treatment of depression because a number of medicines have interaction with smoking. Smoking may increase or decrease their levels. So it may become a reason of poor effectiveness of drugs.

- Smoking increases the risk of arteriosclerosis and atherosclerosis. Both are blood vessel diseases. So over all risk of cardio vascular side effects is increased by smoking as compared to general population. Both smoking and alcohol (even occasional) are harmful.

- Now coming to final question. Smoking a cigarette cause addiction of nicotine. Nicotine is main ingredient of cigarette. It is a highly addictive substance. First step in quitting cigarette is to have enough motivation to quit. A lot of individuals thought of quitting just because of social or family pressure. You should have a strong drive to quit.
When an individual stop smoking, in first few days because of absence of nicotine in blood causes withdrawal symptoms. It may present as irritability, poor concentration, headache, drowsiness, restlessness and increased anxiety. So to prevent this a lot of nicotine replacement therapies are available. Nicotine based gums are available in chemist shops. They can be taken during initial stages to replace nicotine. Gradual tapering of nicotine gum can be done easily.

Other medicines as Buspirone and Verenicline (chempix) can also be used to reduce craving after smoking cessation. Even buspirone is also a good anti depressant drug. So you can take it with consultation of your psychiatrist for depression as well as smoking cessation.
These medicines are given for at least 6 months to 1 year in order to maintain sustained de addiction.

Apart from medicines there are Behavioral methods. Meditation and pranayam will help to sustain motivation. You should try Progressive Muscle Relaxation technique and Deep Breathing exercises to decrease anxiety associated with withdrawal. These can be learn from any good Psychologist.

- Smoking and depression are inter related in your situation. Due to depression and anxiety you tend to smoke, and after smoking you feel guilty which further increases anxiety and depression. So a vicious cycle of depression anxiety and smoking is there. You have to break this cycle. So visit your psychiatrist ASAP and motivate yourself for de addiction.

Hope I cleared your doubt, If you have more questions you can ask again. If you are satisfied with conversation please review.

Dr. Seikhoo Bishnoi MD
(Consultant Psychiatrist)
Above answer was peer-reviewed by
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