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Suggest Treatment For Severe Anxiety

Posted on Wed, 23 Apr 2014

Question: Hi Sir, Good Day. I am a male. I have a indefinite fear that I will infect my family. The incident which has brought me to this scenario. I have done all test's with the help of my sister she is working in a blood bank all negative but fear is permanent I had a unprotected oral with a massage lady on (24 Nov 2013). Hiv test's 1.rapid test after 15th day exposure -negative 2. Cmia test after 17th day exposure -negative 3. Id XXXXXXX after 20th day - not detected (Appollo) 4.Elisa ( 4 generation as informed by lab to me ) - 33rd day Non - Reactive . 5.Id XXXXXXX after 57th day - not detected (Appollo) Exactly 90 days after my exposure: 6. Rapid card which they use in my sister's blood bank =negative 7. Cmia Method ( Hiv 1 & 2 ) = .17 (Non-reactive) 8. Hiv 1 & 2 + P 24 = Negative ( In a different lab ) VDRL: 15th day -Negative 76th day -Negative ( rapid Twice ) Urine Culture & Sensitivity: ( Gonorehea & Chamildiya ) 15 th & 17 th According all the health board's in the world I have done the final test at 90th day also but still I fear I have some thing inside me hidden that will infect my wife . Thing's putting me in pressure: 1.As me and my wife planned for 2nd kid this year end it has put me in more pressure. 2.Country I live does not allow to do HIV test they will deport me immediately if I am infected. 3.Too much reading in internet about HIV and testing guidelines. 4.Shame and fear if I am infected. 5.Getting bad dream every day like my wife is tested +VE for HIV during pregnancy test. 6.Afraid to go near my present KID I might infect her. 7.Cannot control my self from reading about HIV in internet. Remedies I tried to come out of this : 1. Meet a doctor in UAE he also said I am free and over tested nothing to worry can plan for second kid. 2. Had discussion with Dr XXXXXXX in Health care for past 3 month's he said I am totally worrying unnecessary. 3. Had discussed with another doctor in other web site he said no one in the planet has ever got HIV from oral so nothing to worry top of that I have had 8 negative test's so far which is a standing proof I did not catch it . 4. My sister is experienced in blood for past 16 year's she has done the confirmatory test twice for me to convince but I am not. 5. She conducted 2 to 3 tests in her lab in front of me it is also negative but I still fear. 6. Had all the symptoms in my body after the incident like RASH,FEVER,COLD,LYMP NODE swelling which makes me more difficult to get convinced with the result. Kindly help me with this question's Doctor : 1. How to come out of the fear 2. How to stop searching net about HIV ( tried reading book's no help ) 3. How to believe my result 4. How to stop this bad dream of infecting my wife and kid. 5. If my results are conclusive why I had all this symptoms suddenly in my body after this incident? Note : I had the habit of having chewable tobacco for past 12 years stopped it on November'13 if it has anything to do with this scenario. Kindly check the conversation I had with Dr XXXXXXX you will understand how much pressure I was and the complete story is there in detail. Waiting for Reply Thanking XXXX

Answered by Dr. Jonas Sundarakumar (1 hour later)

Brief Answer: Need more information... Detailed Answer: Hello and welcome to Healthcare Magic. Thanks for your query. I understand that that you are going through an extremely difficult and distressing time due to the fears that you have described. Though it is normal for everyone to have some doubts, anxiety and fears, in your case this seems to be very excessive and unwarranted. As you have already mentioned, after 8 negative tests and after being reassured by different professionals, you are still unable to overcome your fear. Moreover, this also seems to be resulting in a lot of dysfunction and distress in your day-to-day life in many ways. In my opinion as a psychiatrist, this type of irrational doubt or fear can be due to an "obsession" or an "overvalued idea". In order to figure out your problem better, please clarify the following information for me: Do you keep getting irresistible thoughts, again and again, that you are infected? Do you realize that these thoughts or ideas may be unecessary or irrational? Do you try to resist or stop this type of thinking? Currently, how convinced are you that you are infected with HIV? (Give me a percentage) After knowing that all tests are negative and after many people (including doctors) telling you that there is nothing wrong with you, how convinced are you about that? (Give me a percentage) Do you have any other similar fears or doubts? Please get back to me with these answers so that I can help you better. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jonas Sundarakumar (18 minutes later)

Hi Dr XXXXXXX Thank you for the quick response to give the detailed answer for the question's Do you keep getting irresistible thoughts, again and again, that you are infected? Ans: In a day may be 4 to 5 times when I am ideal Do you realize that these thoughts or ideas may be unnecessary or irrational? Ans: one part I have gained knowledge from net I know that I had the least risk for HIV transmission in the world no one has got infected in this sexual act. so I think some time you are alright you have 8 negative test result and 2 confirmatory test like XXXXXXX is negative so you don't have HIV . But when i have some boils or rash or some abnormal thing happening in my body my mind is automatically getting connected with hiv. Do you try to resist or stop this type of thinking? I went for a devotional trip recently for 10 days I was relaxed and once I came back to Dubai I am again starting thinking about HIV. Currently, how convinced are you that you are infected with HIV? (Give me a percentage) 20% After knowing that all tests are negative and after many people (including doctors) telling you that there is nothing wrong with you, how convinced are you about that? (Give me a percentage) 95% ( my sister is working in blood bank for past 16 years as chief in Chennai she has done all possible measures to convince me but I am not.. she has done all the variety of test's available in HIV testing and other STD's as well ) Do you have any other similar fears or doubts? As me and my wife are planning for the second kid it is putting me in more pressure that I will infect her and my to be child. I consulted another doctor HGM but he was very straight told me you should have counseling and told me to try some counting exercise but its not helping me. Kindly help me with some solution

Answered by Dr. Jonas Sundarakumar (8 hours later)

Brief Answer: Advised medication and psychological therapy... Detailed Answer: Hello again, Thanks for your clarifications. Firstly, let me reassure you once again that you don't need to worry at all about being infected with HIV. This has been proven beyond any doubt by the numerous negative tests. Regarding your question about your symptoms like the fever, cold, rash and lymph node swelling - these are very non-specific symptoms and can very well occur due to any ordinary viral fever also. Moreover, the fact is that when our mind is fearful and worrying about 'diseases' and 'symptoms', we subconsciously tend to become more aware of even minor bodily symptoms, which we would otherwise not give much inportance to. Now, from the description of your fear and worry about being infected, my opinion is that you have developed what is called a "hypochondriacal fear". This is basically a severe form of health anxiety, where the person starts believing and worrying that they have some disease. Since this seems to be affecting you so much and causing you so much of distress, I would advise you to take professional help from a psychiatrist. There are medication which can help decrease your anxiey and fears and help your mind to relax. In such cases, a specific type of psychological therapy called Cognitive Behaviour Therapy has been proven to be very effective in changing your mindset and this type of thinking. So, I would strongly advise you to see a psychiatrist in your place in order to plan further treatment. Moreover, if you continue to be in this state of stress and tension, this will affect your mental health even more and may even result in family problems. So, please don't hesitate to get the necessary help and treatment. With appropriate Therapy, I'm sure that you will be able to overcome this problem soon. I would also suggest that you try relaxation techniques or yoga or meditation to help relax your mind. The more you spend time on researching and focussing on your problem, the more your fear and anxiety will increase. So, try to keep yourself distracted and occupied with your work and family committments. This may be difficult initially, but if you remain persistent and with additional treatment / counselling, you will be able to achieve success. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jonas Sundarakumar (35 hours later)

Hi doctor, Thank you I am going to chennai to meet doctor and take 1 more test so let me see wether my mind is getting convinced ...some thing I have in mind I have started the habit of talking to my self and convincing arguing +ve and -ve of my test results .. Is it advisable its helping to relax but I feel it should not take me to different problem .. Regards XXXXXXX

Answered by Dr. Jonas Sundarakumar (12 hours later)

Brief Answer: Can try reasoning out with yourself and relaxing.. Detailed Answer: Hi XXXXXXX I think that it may be a good idea to logically reason with yourself and convince yourself that the fears or doubts that you have are unecessary. Hopefully, you will soon be able to accept the fact that your fears are baseless and you'll be able to put your mind to rest. Another suggestion is to try not to give in to your fears - for example, do not try avoiding your wife and children for fear of "infecting" them, because the more you avoid, the more your fears will get re-inforced. And like I said before, try to keep yourself occupied and your mind engaged, so that your mind will not wander away to such thoughts. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar