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Suggest Remedy For Stress Related Anxiety And Nervousness
Question: I have been under a lot of stress over the past 2 years ( some good...some not) recently( for a month) I have had some physical symptoms: difficulty breathing, uncontrollable crying ( this just started this week), extreme nervousness and jitteriness. I don't have any health problems. 33 yr old female, I smoke and drink coffee ( have cut back in light of these "attacks")
I cannot focus and am worried or nervous almost all the time. I'm in my last semester of Nursing school...and it is preventing me from studying effectively. I have 3 small kids and it is affecting the quality of their care as well ( in the sense that mommy is always worried and "no fun")
I am not a nervous person in general and have no history of anxiety. I can see that this is the result of stress in my life, but am having difficulty regulating as of late. I
I cannot focus and am worried or nervous almost all the time. I'm in my last semester of Nursing school...and it is preventing me from studying effectively. I have 3 small kids and it is affecting the quality of their care as well ( in the sense that mommy is always worried and "no fun")
I am not a nervous person in general and have no history of anxiety. I can see that this is the result of stress in my life, but am having difficulty regulating as of late. I
Brief Answer:
Some information on medications that might help you.
Detailed Answer:
Stress can surely bring on panic attacks, generalized anxiety and nervousness. I remember having some of this before my first boards as a medical student.
If I were to see you I would prescribe two things:
1. A benzodiazepine such as lorazepam or alprazolam. This will help control the anxiety immediately. They can be sedating, but will help right away.
2. An antidepressant/antianxiety medication such as an SSRI or other class of this type of medicine. An SSRI that has one of the best side effect profiles is Lexapro (escitalopram) and one of the earliest onset of actions. As you may know, this type of med does not kick in for a week or two (on the shorter end for Lexapro, much longer for Prozac). But they will help decrease the overall anxiety once they do. You can continue to use the benzodiazepine while you are on the antidepressant. In time you will probably need less or none of the benzo.
Taking a vitamin B complex would be a good idea too, but will not have the impact that these meds will. Also exercise (if you have time for this!) and talking with someone such as a counselor may be helpful.
If there is any way you can just get away from studies and other responsibilities for a day or two, that may be helpful, as it sounds like the effects of this stress has not affected you until recently and may be more temporary. I realize that may not be possible with your studies.
I hope this information helps. Please let me know if I can provide further information or help.
Some information on medications that might help you.
Detailed Answer:
Stress can surely bring on panic attacks, generalized anxiety and nervousness. I remember having some of this before my first boards as a medical student.
If I were to see you I would prescribe two things:
1. A benzodiazepine such as lorazepam or alprazolam. This will help control the anxiety immediately. They can be sedating, but will help right away.
2. An antidepressant/antianxiety medication such as an SSRI or other class of this type of medicine. An SSRI that has one of the best side effect profiles is Lexapro (escitalopram) and one of the earliest onset of actions. As you may know, this type of med does not kick in for a week or two (on the shorter end for Lexapro, much longer for Prozac). But they will help decrease the overall anxiety once they do. You can continue to use the benzodiazepine while you are on the antidepressant. In time you will probably need less or none of the benzo.
Taking a vitamin B complex would be a good idea too, but will not have the impact that these meds will. Also exercise (if you have time for this!) and talking with someone such as a counselor may be helpful.
If there is any way you can just get away from studies and other responsibilities for a day or two, that may be helpful, as it sounds like the effects of this stress has not affected you until recently and may be more temporary. I realize that may not be possible with your studies.
I hope this information helps. Please let me know if I can provide further information or help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am assuming that this is the response most physicians would have? I am going to find a GP to go to late next week, although quite frankly I get sick at the idea of describing my anxiety to anyone (hence the decision to go this route for now). Any chance this could resolve on its own or at least not escalate?
Brief Answer:
It is hard to know.
Detailed Answer:
It is possible it can improve on it's own. Usually if there is some finite stressor that resolves, it can improve on it's own. For example, after I was done sitting for boards, I was still somewhat shaky and hyper alert for a few weeks but then it resolved.
Your own past experience with dealing with stress and anxiety will dictate to some degree how you will do. It doesn't sound like you have had this sort of thing happen before and that can be a good predictor for resolution.
Some people get considerable relief with non-pharmacological interventions such as regular exercise and talk therapy.
Given your not wanting to sit and talk about your anxiety to anyone, consider making a copy of the history you provided here (above) and bringing that in to the doctor. Although he or she may still have a few questions, it will cut down on how much you have to explain and give you some control over the situation.
It is hard to know.
Detailed Answer:
It is possible it can improve on it's own. Usually if there is some finite stressor that resolves, it can improve on it's own. For example, after I was done sitting for boards, I was still somewhat shaky and hyper alert for a few weeks but then it resolved.
Your own past experience with dealing with stress and anxiety will dictate to some degree how you will do. It doesn't sound like you have had this sort of thing happen before and that can be a good predictor for resolution.
Some people get considerable relief with non-pharmacological interventions such as regular exercise and talk therapy.
Given your not wanting to sit and talk about your anxiety to anyone, consider making a copy of the history you provided here (above) and bringing that in to the doctor. Although he or she may still have a few questions, it will cut down on how much you have to explain and give you some control over the situation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I appreciate all your suggestions and recommendations ( I picked up a b complex vitamin this morning) I have one more idea to run by you and a question to go with it. Could anemia cause this kind of exacerbation of anxiety? My diet is bordering appalling, up until about 4 months ago I have been either pregnant or breastfeeding ( so I was taking prenatals) for 4 years.
If iron deficiency could be causing my physical reactions to stress and I added a supplement to my diet, how long before I could expect to feel changes and is there anything I should consider before adding an iron supplement?
Thank you in advance
If iron deficiency could be causing my physical reactions to stress and I added a supplement to my diet, how long before I could expect to feel changes and is there anything I should consider before adding an iron supplement?
Thank you in advance
Brief Answer:
Yes, anemia can cause some anxiety symptoms.
Detailed Answer:
I'm sorry I was not able to respond sooner - my computer router was not working.
Yes, anemia can cause some of the symptoms of anxiety. There is overlap in symptoms.
How long it will take for an iron supplement to help anxiety symptoms if there is anemia can vary, but you might start to feel overall stronger or less fatigued within a few days. I could not find specific information on how long it might take to decrease the anxious symptoms.
When you go in to the doctor, if he/she doesn't propose it already, ask for a complete blood count to be done, which will give an indication of whether there is anemia. If there are signs that there are (such as a low hemoglobin, and changes in MCV), then iron studies would be useful. Or maybe the doctor would be willing to just check iron studies while getting the initial labs.
I would also recommend TSH and thyroxine levels when getting the blood work. Abnormal thyroid levels (in either direction) can cause anxiety too.
Another thing to check is your blood sugar. A fasting blood sugar is best.
It sounds like you have not had much time for nurturing your own health, given your history of pregnancies in the past 4 years. If at all possible, try to improve your nutrition with a balanced, less processed diet and avoidance of refined carbs such as sugars, sodas, fructose corn syrup, etc. Sugar intake can cause rebound hypoglycemia with anxiety in some people.
And if at all possible, get as much sleep as you can - 8 hours ideally. Sleep deprivation can definitely exacerbate depression and anxiety.
You didn't mention alcohol, so I am assuming that is not an issue, but alcohol can make anxiety and depression worse - both drinking it and stopping it abruptly.
You are already decreasing your caffeine and tobacco use, so that is good.
Yes, anemia can cause some anxiety symptoms.
Detailed Answer:
I'm sorry I was not able to respond sooner - my computer router was not working.
Yes, anemia can cause some of the symptoms of anxiety. There is overlap in symptoms.
How long it will take for an iron supplement to help anxiety symptoms if there is anemia can vary, but you might start to feel overall stronger or less fatigued within a few days. I could not find specific information on how long it might take to decrease the anxious symptoms.
When you go in to the doctor, if he/she doesn't propose it already, ask for a complete blood count to be done, which will give an indication of whether there is anemia. If there are signs that there are (such as a low hemoglobin, and changes in MCV), then iron studies would be useful. Or maybe the doctor would be willing to just check iron studies while getting the initial labs.
I would also recommend TSH and thyroxine levels when getting the blood work. Abnormal thyroid levels (in either direction) can cause anxiety too.
Another thing to check is your blood sugar. A fasting blood sugar is best.
It sounds like you have not had much time for nurturing your own health, given your history of pregnancies in the past 4 years. If at all possible, try to improve your nutrition with a balanced, less processed diet and avoidance of refined carbs such as sugars, sodas, fructose corn syrup, etc. Sugar intake can cause rebound hypoglycemia with anxiety in some people.
And if at all possible, get as much sleep as you can - 8 hours ideally. Sleep deprivation can definitely exacerbate depression and anxiety.
You didn't mention alcohol, so I am assuming that is not an issue, but alcohol can make anxiety and depression worse - both drinking it and stopping it abruptly.
You are already decreasing your caffeine and tobacco use, so that is good.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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