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Suggest ways to handle stress

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Posted on Mon, 18 May 2015
Question: I have been employed full time for nearly 3 years at my career. However, from time to time I call in sick to work due to personal stress. I know that i do this more than I should, but the stress of my personal problems are so overwhelming that some days no matter how hard i try i cant force myself to go in to work and end up calling in sick. Is this something i need to address with my doctor regarding stress leave or what do
I do. I work at a very reputable organization and do not want to lose my career due to my personal stress overbearing me.
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Answered by Dr. Manisha Gopal (1 hour later)
Brief Answer:
it is quite common presentation and can be helped

Detailed Answer:
Hello,

I have gone through your question carefully and from that it looks as if the stress is getting diffcult for you to handle now...you havent told if the stress is also related to work or just coz of family?

The best part is that you do recognize that taking frequent leave of work is bad and that your problem needs urgent sorting for your good future.
For any successful treatment is the will to get well..and you have that..so, please be confident .

Its important for me to know few things before proceeding in the right direction..these will help me to diagnose or rule out some illness. Please tell if-

1. You feel sad or anxious, more than required .? Or, what is your predominant mood these days?

2. do you feel lethargic and drowsy or heavy even after little work?

3. How is your sleep? Same, reduced or increased? Is it refreshing for you?

4. For how long are you feleing stressed?

5. Have you checked for thyroid or any other blood test?

6. And how are your periods?

7. Do you still enjoy your hobbies which you used to do earlier?

8. Do you feel you get angry/ become irritable frequently?

Please answer the above questions in detail so that I can help you.

One thing which I want to tell you before hand is that you can be treated and the symptoms which you are having are very commonly seen in clinical settings...so, no worries at all..

Wish you good luck.
Dr. Manisha Gopal
MD Neuropsychiatry

Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Manisha Gopal (9 hours later)
Hi there

Thank you so much for your answer. The stress is mainly from my family life.

1. I do feel sad a fair amount as i have been struggling with eating disorders the past few years and have gained weight recently which makes me depressed.
2. I am constantly fatigued
3. I have alot of trouble sleeping and rarely feel refreshed after
4. Stressed every day lately
5. No blood tests
6. I am on seasonique so i get them every 3 months
7. Yes
8. Yes
9.
doctor
Answered by Dr. Manisha Gopal (23 minutes later)
Brief Answer:
its depressive disorder- escitalopram can help

Detailed Answer:
Hello

From your answer it is apparent that you have a depressive disorder...may be moderate type. Along with this, you also have some kind of eating disorder and are on OCP for preventing pregnancy.

There can be few things-

1 the seasonique is the one which either gave you depression ( as birth control pills are found culprits many time..). So, just check it if the mood problem began after taking them or had that increased after starting them.. if it is any of the above factor- talk to your doctor of giving you some non hormonal contraception choices or an IUCD ( non hormonal type).

2. The eating disorder can be related to depression as well...and vice versa can giev rise to each other.
So, when we manage depression properly- eating problem also gets controlled.

3. Your activity level can be a problem...when the weight increases-it is either due to lack of activity or increased eating. The imbalance of input and output leads to weight increase.

4. Sleep and irritabilty have a direct link with depression. So, treating depression will take care of sleep, irritation, lethargy as well.

5. Drugs like sertraline or escitalopram are mild and safe to be used in depressive disorder. They are non sedative and require a sleeping pill for initial few days at night to correct sleep.
For insomnia I usually prefer zolpidem 10mg- it is safe and non addicting and patient is able to quit it within 1-2 weeks.

6. Please get Complete blood counts, TSH, LFT, sr. Creatinine, sr. Cholesterol, sr. Vit B12 and Vit D levels. Treat if they are disturbed.

7. You must start doing some kind of exercise- walk or jogg or join a gym or just running...and try not to be alone.

8. Eating disorder can be related to personality issues as well- here therapy plays a crucial role along with medications. So, if possible enter into therapy sessions with a trained councellor or a psychiatrist.

I hope the reply is useful for you.
Feel free to ask more questions to clarify any doubt.

Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Manisha Gopal

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Practicing since :2005

Answered : 947 Questions

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Suggest ways to handle stress

Brief Answer: it is quite common presentation and can be helped Detailed Answer: Hello, I have gone through your question carefully and from that it looks as if the stress is getting diffcult for you to handle now...you havent told if the stress is also related to work or just coz of family? The best part is that you do recognize that taking frequent leave of work is bad and that your problem needs urgent sorting for your good future. For any successful treatment is the will to get well..and you have that..so, please be confident . Its important for me to know few things before proceeding in the right direction..these will help me to diagnose or rule out some illness. Please tell if- 1. You feel sad or anxious, more than required .? Or, what is your predominant mood these days? 2. do you feel lethargic and drowsy or heavy even after little work? 3. How is your sleep? Same, reduced or increased? Is it refreshing for you? 4. For how long are you feleing stressed? 5. Have you checked for thyroid or any other blood test? 6. And how are your periods? 7. Do you still enjoy your hobbies which you used to do earlier? 8. Do you feel you get angry/ become irritable frequently? Please answer the above questions in detail so that I can help you. One thing which I want to tell you before hand is that you can be treated and the symptoms which you are having are very commonly seen in clinical settings...so, no worries at all.. Wish you good luck. Dr. Manisha Gopal MD Neuropsychiatry