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    Suggest treatment for severe anxiety

Posted on Mon, 7 Aug 2017 in Brain and Spine
Question: dear sir/madam
my question is about two things. please address both these points in detail.

(a) anxiety & mood swings. whenever i am talking to someone or going somewhere or doing something (whether i am talking to a new person or a known person / whether i am going to a new place or a regular place like office, stores, airports etc. / whether i am doing something new or a routine work) i tend to get excited a lot. when i try to talk, some kind of slight shivering will be there both in body & voice. mind thinks too many words in regular speed to speak but unable to deliver those many words in that speed, i end up talking unclear & mispronouncing words. i used to talk very clearly & with average speed a few years back. now i don't know what happened that i am even unable to talk clearly with my own family members because usually when we are doing something new or giving a presentation there may be chances that stage fear or other factors may affect but this even happens when i am talking to my 6 months old baby.

(b) i work in a marketing company & talking clearly & confidently is a must factor. this problem of mine is affecting a little to my career. also, as far as i have observed, while talking i feel that my tongue is not rolling how its supposed to role while talking due to which i end up talking incorrectly & mispronounce. i feel that my tongue gets heavy or thick. i don't know u understood what i am explaining or not. pls acknowledge. is this common or something major problem? because its very difficult to explain these when i consult a doctor. they may conclude in some other context & suggest something which is not going to help me.

i also consulted psychiatrists & they suggested me to keep calm & talk as slow as possible. i have already tried these things which hasn't helped.

(a) is happening due to (b) & (b) is happening due to (a)

how to fix problem (a) & (b)
Answered by Dr. Sudhir Kumar 2 hours later
Brief Answer:
Anxiety can aggravate an underlying speech disorder.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted your clinical details. Based on this, the main problem seems to be anxiety disorder, which can either cause speech problem, or aggravate an already existing speech disorder.

For anxiety/mood swings, you would need treatment with medications such as escitalopram (antidepressant), sodium valproate (mood stabiliser) and anti-anxiety medications (clonazepam). The final choice of medicines can be correctly made by a psychiatrist. In addition, counselling and psychotherapy would also help.

For speech disorder, you would need a detailed neurological evaluation by a neurologist. Also, as the speech problem is not present at all times, it would be useful to record a few samples of your speech when they are abnormal. The main speech disorder we are looking at is dystonia affecting speech muscles.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Prasad
Answered by
Dr. Sudhir Kumar


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