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Dr. Andrew Rynne

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Suggest treatment for hypochondriasis

Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 4958 Questions

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Posted on Fri, 11 Sep 2015 in General Health
Question: Hi,

This started way back in 2005 Feb wherein I had a bout of loose motion. It was very severe and during that phase I was going through online medical documentation and somewhere it was written that long term loose motion could be a symptom of aids. I was petrified and started panicking and could not share this with anyone. The stress was just building up and I could not handle it. I confided in my father and spouse and finally get a check done and everything was fine. I had visited a psycatrist and was given lonozep for one month and cipralex . I started with the medicine and had severe side effects and sexual problems. I stopped the medicine after 5 to 6 months. Then whenever I hear about cancel I used to feel I have cancer as I used to smoke. I constantly used to live in this fear and subsequently gave up smoking after which the fear subsided. Later I got involved in share trading etc and the issue had subsided. However last year Sep 2014 I was supposed to take a flight which was a ATR. I had got into the flight and suddenly felt suffocated and had to leave the plane as I had a panic attack. After that the problem of claustrophobia and the feeling of being low started. There were times when I used to feel like crying and also cried for no reason at all. I immediately consulted a psychiatrist and was put on stablon 3 times a day. I had started with it from October 2014 to May 2015. There was some improvement but the problem did not subside completely. I started with 12.5 mg of zaptra from May 2015 and continued till august 2015. The problem was I used to get a lot of sleep in the afternoon. I informed the doctor and he had changed the medicine to pexep 12.5. However this was not suiting me as I started feeling low again. The problem which I face now is that whenever I have to take a decision I think on both the sides and this causes anxiety. Whenever I have to take a flight I use 0.5 mg lonozep and things are fine. The doctor did not tell me the problem I am facing as I may research it and get stressed. I am currently back on zaptra ls. I hope I am on the right track.
doctor
Answered by Dr. Seikhoo Bishnoi 1 hour later
Brief Answer:
These symptoms suggest anxiety spectrum disorder

Detailed Answer:
Hello, thanks for asking from HCM for your health related queries

I have read your query in detail and I can understand your concern. First of all I'd like to tell you that these problems are not so serious and can be treated easily with medicines and Behavior therapy. Most of your symptoms are falling in anxiety spectrum disorders. The symptoms like anxiety related to getting AIDS or cancer occurred due to health anxiety or more specifically due to hypochondriasis. In hypochondriasis individuals have anxiety or fear about getting some serious illness, while at the same time they also have awareness that they couldn't get that particular illness.

Similarly panic attacks you had in plane were also part of anxiety disorder. The ambivalent thoughts or thinking on both sides are also part of anxiety. Ambivalence is seen commonly in Obsessive compulsive symptoms and is part of anxiety. So try to accept that you have anxiety disorder and it can be treated easily with medicines.

Now coming to treatment part. Treatment of choice for anxiety with such symptoms is SSRIs. Cipralax, Paroxetine or Zeptra all are SSRIs. In my opinion you are in right direction of treatment so no need to worry. Zeptra will help to reduce your symptoms and you will definitely feel better. For control of symptoms Lorazepam can be used on SOS basis. So remain relaxed, continue to take the medicines regularly and you will definitely feel better.

Thanks, Hope this helps you, if you have more doubts you can ask again.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi 24 minutes later
Thanks a lot DR. I am pretty normal for almost 3 weeks in a month and when I am in the midst of people I am fine. However in the nights I feel anxious. I am actually very emotional right from the beginning. Let me give an current example. I have my parents who live in another city and I am getting an offer to go to the U.S. for work. Now I am in a dilema that I don't want to leave my parents alone at the same time have the feeling to of going to the U.S. for a better lifestyle and career. Now I am not able to decide and is causing me anxiety . In the year 2011 I got stuck up in a lift and after that incident I always am scared of taking the lift and till the lift reached the floor my mind is scared that it my get stuck. The same happened in the flight too. It was hot and I had a feeling if I get stuck there is nonescape. However I have been working on this and getting to overcome this slowly. At times the sleep is very disturbed. I am very attached to my children and parents and rarely socialize much. I spend much of my time with family. I don't have many hobbies too. The earlier problem of contracting a disease is not there now but whenever I get fever or loose motion etc I start to panic and meet a couple of doctors and look for immediate solutions. I am basically very impatient. I also get scared that if I move to the U.S. then I may not get antibiotics and be able to take a appointment with a psycatrist soon and this may cause problems. There are many things in my mind which are causing a conflict and the is stressing me up. Basically my body is hard and not relaxed. I also tried doing the relaxation therapy with the help of a psycologist for some time but it did not work. I used to get more stressed. My psycatrist was advising me to either increase the dose of pexep to 25 mg if needed for the time being he suggested zaptra ls as I was getting sleep with 12.5 mg zaptra which I guess has 0.5 mg lonazep. I was also worried if this is habit forming.
Also wanted to check if this is completely curable. I would like to be in a normal state without relying on medicines. My doc was telling me that I need to be symptom free for 9 months to discontinue the meds. I do not wish to continue on meds for a long time
doctor
Answered by Dr. Seikhoo Bishnoi 6 hours later
Brief Answer:
Increased doses of Paroxetine will help you

Detailed Answer:
Hello again and thanks for asking again

The whole symptoms suggest anxiety only. Anxiety in lift, fear of getting trapped in lift is also part of anxiety disorder. The ambivalent thinkings, indecisiveness also occur in anxiety. Though I can't comment but try to get rid of anxiety before thinking to move to US. Though carrier options and life style is good there but at the same time your anxiety might increase there because of different work environments.

Zeptra is Paroxetine and Clonazepam only. Clonazepam is a habit forming drug but taking the drug in combination of Paroxetine wouldn't cause dependence. So there is no need to worry. For anxiety some times higher doses are needed and this is the reason your doctor is advising you to increase the dose of Paroxetine to 25 mg per day. This should help you.

After acute state is passed and symptoms improve then maintenance treatment should be taken for at least 6-12 months. So don't be stressed regarding treatment. Medicibes will not run for lifetime, the anxiety is treatable and with medicines most of individuals show improvement.

Thanks, Hope this helps you, if you have more doubts you can ask again.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi 41 hours later
Thanks Dr. I am not sure if I can avoid going to the US as it was me who initiated the process. I also wanted to check if it's safe for me to take a vitamin d supplement as the second time this problem started ( flight episode) was when I took a bit d supplement as suggested by a doctor as my vit D levels were low. I only hope the medical care facility in the US is good for anxiety problems and I hope this is not something which may get worser.
Also Dr I have 6 months for the transfer. Will I be able to get out of the anxiety in these 6 months. If things don't workout I am keeping my option of getting back to XXXXXXX open. Hopefully I will find a job when I get back.
doctor
Answered by Dr. Seikhoo Bishnoi 7 hours later
Brief Answer:
Vitamin D will help to reduce anxiety also

Detailed Answer:
Hello again and thanks for asking a follow up question

Don't anticipate that things will not work in USA. You are a educated and competent person and you will adjust in USA without any problem. No need to worry for that.

Yes you can start Vitamin D 60000 IU per week for at least 3-6 months and this will surely help you. Take the drugs as per prescription only.

Yes if proper treatment is taken then the anxiety will decrease in 6 months. Continue to do relaxation exercises to maintain anxiety free time.

Thanks, Hope this helps you. Still have more doubts please ask again. Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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