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Suggest treatment for anxiety during pregnancy

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Psychiatrist
Practicing since : 2005
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Hello, I needed to get a few questions answered. I've been going through a lot lately. My mom passed away 2 months ago, I have a baby on the way, etc. Last Saturday I woke up, and felt off balance. Not dizzy, just off balance. It eased up through the day. On Monday I went to the doctor and she said everything sounded good, and I didn't have a sinus infection. I've been very stressed out lately and I have a fear of dying. I'm a hypochondriac. The feeling in my head comes and goes. It's kinda feels like my head is very foggy and I get a upset stomach sometimes. I'm afraid I have a brain tumor. Are these signs of it or is it just stress and anxiety? Please help
Posted Tue, 5 Aug 2014 in Mental Health
 
 
Answered by Dr. Sunil Gupta 13 minutes later
Brief Answer:
Please see details below.

Detailed Answer:
Hi,

I went through your query and can understand your concerns regarding your symptoms.

From what you have mentioned, it seems that you are quite preoccupied with a lot of stuff and that is making you tensed resulting in anxiety. The feeling of being off balance can very well be due to anxiety. You really don't have to worry about brain tumor. Rather, you should focus on getting rid of your anxiety.

You have mentioned that you are a hypochondriac. I would have liked to know if you have been diagnosed by someone or you have made a self diagnosis. One thing is clear, you worry a lot.

The best thing to deal with your current condition is to start treatment. Medications like selective serotonin reuptake inhibitors (SSRIs) which include escitalopram, paroxetine, etc would be really helpful in your condition. You can also opt for cognitive behavior therapy which consists of sessions focusing on learning relaxation and trying to change the maladaptive thought pattern that is leading to symptoms. In addition, you should start exercising daily which will help you relax.

I do hope that I was able to help you out. Please feel free to ask any further queries that you might have.

Best wishes,

Dr. Sunil Gupta

Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for anxiety during pregnancy 35 hours later
Thank you doctor, and I appreciate the quick response. Like stated earlier, I've always had a fear of the doctors. Whenever something I thought was seriously wrong I always confided in my mom, and she would always reassure me that I would be ok. She was right 100%. Now that she is no longer here, I have nobody to go to, so I appreciate you understanding where I'm coming from. Four years ago I was diagnosed with a slight thing of anxiety. My doctor prescribed me alpralozam. The pills expired in 2012. They helped cause they just took the edge off. My grandmother, grandfather, uncle, and mom have passed away within these past 3 years. It's too much to handle all at once. They all went into the hospital, and never made it out, so that's the way my mind thinks. I think if I go into the hospital, that I'll never make it back out. Yes, I know it sounds crazy, but that's how I think. About a month ago I had this slight pain between my thumb and index finger. Again, nothing serious, probably just a bruise, but I took it to the extreme. First thing I did, was search up online if there are glands in your hands. Of course there are, so right away I think it's a swollen gland and something is wrong. I worried about that for a couple days, and must have tensed myself up so bad that my fingers started to ache and hurt. So, right away I start thinking the worse. Why are my hands and fingers hurting now. I worried about that for a week. Sure enough the pain between my thumb and finger, went away. This brings me up to now, where I must've worried myself so much about my fingers and hands that it cause what I hope is anxiety. About a week after all of this happening, I woke up last Saturday and stood up and felt like I was off balance. Nothing serious, figured it was just allergies. It got better throughout the day, and would come and go. Again, thinking crazy, got it in my head that it was something serious, like a brain tumor, brain hemorage, etc. I would constantly search up symptoms of all those things and worry myself day in and day out. This past Monday, 2 days after this occurred I sucked it up and went to the doctor. She checked me out. My BP was 115/75, my lungs and heart both sounded good. I explained this situation and she said to just relax myself. Once I left that doctors office, I didn't feel a thing. I felt like myself. Sure enough, as time went on, that feeling came back. It sucks and I hate it. That's how this whole past week has been. I wake up, and im fine. As the day goes by, I start worrying that the feeling is going to come back. Because I worry, the feeling comes back. It's like a catch 22. During the week, Monday through Friday I woke from 2:30 to 11 at night. I stay busy at work, and for the most part I feel fine. Once we take a break, even though the people I work with talk to me, it's in the back of my head that what if it comes back, and sure enough iy does. It seems like once my mind starts to wander, it comes back. This past weekend it was tough too, especially yesterday. I was fine and then once I sat down with my girlfriend, my mind started going. I had the worst naseau, and I had minor little headaches. I honestly don't know what to do, and I worry myself everyday that I have something seriously wrong with me. I'm so afraid of cancer and always think I have a brain tumor or something wrong inside my head that is going to kill me. What are the main symptoms of a brain tumor? Do you think it's anything to be concerned about? Or is it just all in my head? Like I said, it's more of a foggyness feeling. Thanks again doctor, hope to hear from you soon.
 
 
Answered by Dr. Sunil Gupta 1 hour later
Brief Answer:
I don't think you have brain tumor.

Detailed Answer:
Hello,

Thanks for following up and providing me more details regarding your condition. I can appreciate your being concerned, specially after all the situations that you have been through.

From what you have mentioned, it is clear that you are suffering from a condition we term as health anxiety. Its about remaining preoccupied with certain set of symptoms and not able to distract oneself from them. It is certainly affecting your life and causing you distress.

You also seem to be having anxious personality traits which makes you worry a lot. The recent life events, your mother passing away and hence you losing your one source of seeking comfort has only aggravated the anxiety.

Your remaining concerned that you have brain tumor is also a part of your current syndrome. The symptoms that you have mentioned are all very clear manifestations of anxiety. Regarding brain tumor, the exact symptoms vary from person to person. Some people remain asymptomatic for long period of time, others develop seizures, headache and finally development of altered consciousness. I don't think that you have anything to be concerned about. You just have to relax and focus more on getting rid of anxiety rather than on the physical symptoms. I know its easier said than done, but we have to start working on it.

As I mentioned in my last response, I feel you should certainly consider starting treatment without any further delay. Treatment with medicines like escitalopram or paroxetine would certainly be helpful. I would however try not to restart alprazolam or any other benzodiazepines again. They are no doubt very effective medicines, but provide relief only symptomatically, rather than taking care of the disorder. Moreover, long term intake of benzodiazepines increases the propensity of being dependent on them. They can be used for short periods though to get relief from acute anxiety.

You should also start doing some relaxation exercises as well. Meditation, jogging, progressive muscular relaxation will be helpful. You can also consider writing a diary daily which will help you ventilate your emotions and feel better.

I do hope that I was able to help with your query. I will be glad if I can be useful further and will try my best to help you out with your doubts.

Best wishes,

Dr. Sunil Gupta

Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for anxiety during pregnancy 23 hours later
Hello Dr. XXXXXXX Thank you again for all of your input from my previous questions. I appreciate it. You answered all of my questions, but I feel like I'm leaving things out. If you don't mind, I'd appreciate it if you take the time to read this. My whole life I've been a hypocondriac. I've always thinked of the worse being wrong with me. When I would get a sore throat, I thought I had throat cancer. When I had a headache, I thought I had head cancer. You get the picture. I've always hated going to the doctor. These past 3 years, I have lost both grandparents, my uncle, and my mother this past April. Both my uncle and mom, we're always afraid of the doctor, and never went. Because of that, their health deteriorated so quickly, that when they got help, it was too late. All 4 of them, went into the hospital, and never made it out alive. Because I'm so obsessed with my health, I believe that if I don't go to the doctor, or I ever go in to the hospitsl, that I'll never make it out alive. When my mother was alive, and I ever worried about something being wrong with me, she always reassureed me that I was perfectly fine, and nothing was wrong with me. She was always right. Now that my mother is no longer here, I feel hopeless, and have nobody to go to. I have no brothers or sisters, and my girlfriend can only tolerate it so much. This all started about a month ago. I was sitting outside when I felt what felt like a bruise between my thumb and index finger. Nothing serious, just felt like a bruise. Of course, I go to my worst enemy.....the Internet. I search everything up on the Internet, and of course most of it is wrong. I searched up if we have glands in our hands. Of course the WebMD said yes. That's literally all it took. Right away, I think I have a swollen gland in my hand, and that that's a sign that something is wrong in my body. I worried about that day in and day out for about a week. I feel like I tensed myself out so much that the following week my hands and fingers started hurting and aching. This would happen from time to time. This lasted for a week until on XXXXXXX 23rd I woke up and felt dizzy/off balance. This lasted throughout the day. I've been dealing with this for about 2 weeks now. Each day I worry more and more. These are the symptoms I have. Minor headaches that go away with advil. I haven't had them in about 2 days. My ears would hurt from time to time. They no longer hurt. I've had episodes of foggyness everyday for the past 2 weeks. That's what scares me the most. Is that anything to worry about? I've had slight nausea, and I have pins and needless in my hands and feet from time to time. Do all these symptoms have to do with stress? I went to a counselor this past week, cause this is getting out of control. I'm obsessing over this, and I feel like it's all in my head. Do I have anything to worry about as far as brain cancer, a brain hemorrhage, or v swelling of the brain? Or is this stress and anxiety? Thank you for listening to me.
 
 
Answered by Dr. Sunil Gupta 2 hours later
Brief Answer:
Your symptoms are due to anxiety and stress.

Detailed Answer:
Hello,

Thanks for following up. First of all let me assure you that you can ask me any doubt and I will try my best to clear it. You don't have to hesitate asking me any question.

I did go through your question very carefully. As I said in my last response, it is very clear that you are a person who gets anxious very easily and most of the anxiety is related to health concerns. It is very understandable in the light of the fact that you have seen your close ones through bad times and that has left a negative impression on your mind.

By definition, yours is a disease where you will get very anxious by the slightest of symptoms and think of it due to a very deadly condition. In your case, most of the times it is cancer.

Currently you are definitely very tensed and anxious. The loss of your mother has definitely left a deep impact on your mind and deprived you of one constant support. All this has led to increase in anxiety which is leading to the symptoms that you have mentioned.

Anxiety is a condition which consists of a vicious cycle. Being tensed causes anxiety and that further leads to symptoms. These symptoms leads to worsening of anxiety and the cycle keeps on repeating.

Your feeling dizzy, having headache, feeling foggy, nausea, pins and needles sensations are all manifestations of anxiety. More you focus on the symptoms, they will worsen even more. You don't have any underlying neurological condition to worry about and I am sure that with proper treatment you anxiety will go off too. Its high time you seek psychiatric consultation for your problem. You definitely need treatment now, better now than later. Just going to a counselor might help you slightly, but I will insist on a proper psychiatric evaluation and treatment with medications.

I do hope that you are able to get over your worries soon. Please let me know if I can be of further help. It will give me immense pleasure to be able to help you out.

Best wishes,

Dr. Sunil Gupta



Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for anxiety during pregnancy 31 hours later
Thank you doctor, and I appreciate your response. I must say, the whole day yesterday, and up till now 11:00 am I have not had the foggyness in my head. Slight dull achy head pain, but that's very minor. I've only had 2 times that I felt nauseas, and that passed with stomach medicine. I've started taking 2 types of vitamins everyday as well. Their called St. John's Worts and Green Tea vitamins. They seem to be helping a little bit. So I got passed that so far, and that seemed to go away. Now of course something else pops up. Like I stated above, for the past 3 days I've had pins and needles in my hands and feet. It's not like when your laying on a body part and you get pins and needles. It's more of the sensation being there. Sometimes I feel like it's going up my arms and legs. It's not full blown, but just an annoyance. Can this be from stress and anxiety as well? Of course I looked it up and it says it can be diabetes, heart failure, etc. Now I'm worried again. It's mainly in my hands and on the bottoms of my feet. Do I have anything to worry about? I'm getting worried it's something serious. Please help. What can this be?
 
 
Answered by Dr. Sunil Gupta 14 minutes later
Brief Answer:
Its is due to anxiety/stress.

Detailed Answer:
Hello,

Thanks for following up and your kind words of appreciation. I was glad to note that your symptoms of fogginess and head ache have decreased. Its also nice to know that you have started taking something for your symptoms and that they are helping. However, I would still reiterate my position that you need to get your health anxiety treated rather than treating the individual symptoms. And I really hope that you do that sooner than later.

Regarding the pin and needles sensation, its true that it can occur due to diabetes. But than, it is also a very common symptomatic manifestation of anxiety. You really don't have to worry about anything. Its not serious and you don't seem to have a physical condition. I am sure even you know that. Its just your health anxiety that is causing all these symptoms. The best way to know is to start treatment with selective serotonin reuptake inhibitors. Once your anxiety is taken care of, I am sure you will get relieved of these symptoms as well as you will find relief in your constant worries regarding your health.

Anxiety manifests with a lot of symptoms, most of them mimicking some physical disorder. Increased heart beat leading to feeling that something is wrong with heart, headache and dizziness leading to belief that something is wrong with brain, pin and needle sensation, gastric symptoms, etc are just some of the symptoms of anxiety and stress. You just need to relax and get your anxiety treated. I am sure you will do really well with adequate treatment.

I do hope that I was able to allay some of your anxiety. Please let me know if I can be of any more help. I will be glad if I can be of further help to you. In case you don't have any more doubts/queries, please close the discussion and rate the answer.

Best wishes,

Dr. Sunil Gupta


Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for anxiety during pregnancy 53 minutes later
Ok thank you. Like I said, it's more of a tingling feeling I have. Wouldn't I have more symptoms if I had diabetes? Like you said previously the stuff you said to treat my stress and anxiety, can I buy that in the store or it has to be prescribed? Why can't I just be normal? I feel like it goes from one thing to another......
 
 
Answered by Dr. Sunil Gupta 13 minutes later
Brief Answer:
You'll need to visit a psychiatrist for medicines

Detailed Answer:
Hello,

Diabetes is a condition which can remain asymptomatic for quite some time. You will generally have many other symptoms of diabetes before you develop the pin and needles or tingling sensation. Increased thirst, increased frequency of urination, etc do occur earlier. Pin and needle sensations occurs only in very long standing uncontrolled diabetes in which there is diabetic neuropathy. So, as I said, you don't have to worry about it. Your cold and sweaty palms and feet are also due to anxiety.

The treatment for anxiety will include prescription medications. I would suggest you seek a psychiatric consultation for the same. It will help in complete evaluation of your condition as well as getting the medications. It will also be required that you be on regular follow ups for assessment of improvement and dose adjustments as required. Had I been your psychiatrist, I would have started you on one of the selective serotonin reuptake inhibitors like paroxetine.

With proper treatment, I am very sure you will be able to conquer your anxiety and worries. So, rather than worrying about it, start treatment as soon as possible.

Please don't hesitate in asking any queries or doubts that you might have. I will try to answer and help you out in the best possible way.

Best wishes,

Dr. Sunil Gupta
Above answer was peer-reviewed by
 
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