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What Causes Anxiety After Having Stroke?
Question: I had a stroke 8 months ago and have no physical deficit but I have incredible anxiety and guilt. I have suffered the anxiety approximately a month after the stroke but it has taken a definitive change lately with severe guilt anxiety over the last month or so dragging up historical things which have never worried me but now they taking on enormous significance. Do you think it is the last stage of my anxiety. I have to try and trust the judgement of my family. What else can I do?
Brief Answer:
You can be treated, what is dose and frequerncy of current medicines
Detailed Answer:
Hello,
Thanks for writing to us.
I can understand your concern. Anxiety after stroke is common occurrence.
Sometime it is due to apprehension of future stroke attacks and sometime due to neurological changes occurred in brain during stroke.
It is good that you have no physical deficit.
You seem to be suffering from anxiety with depression as there is excessive guilt and worries about minute things.
Please let me know the dose of your tablets and frequency of diazepam, temazepam, phenargen and avanza and since when are you taking the same?
If possible please upload reports of brain CT scan or MRI if you have.
Anxiety and depression can be treated after stroke. I prefer Sertraline (Zoloft) in this type of cases.
Of course you should trust your family and treating doctor.
Provide some more information about your symptoms also.
- What type of guilt do you have?
- Give examples of some things which are historical and you are worried about
the same.
- Do you have blood pressure or Diabetes? If yes , what medicines are you taking for that?
Waiting for your reply to help you further.
Regards,
Dr.Chintan Solanki.
You can be treated, what is dose and frequerncy of current medicines
Detailed Answer:
Hello,
Thanks for writing to us.
I can understand your concern. Anxiety after stroke is common occurrence.
Sometime it is due to apprehension of future stroke attacks and sometime due to neurological changes occurred in brain during stroke.
It is good that you have no physical deficit.
You seem to be suffering from anxiety with depression as there is excessive guilt and worries about minute things.
Please let me know the dose of your tablets and frequency of diazepam, temazepam, phenargen and avanza and since when are you taking the same?
If possible please upload reports of brain CT scan or MRI if you have.
Anxiety and depression can be treated after stroke. I prefer Sertraline (Zoloft) in this type of cases.
Of course you should trust your family and treating doctor.
Provide some more information about your symptoms also.
- What type of guilt do you have?
- Give examples of some things which are historical and you are worried about
the same.
- Do you have blood pressure or Diabetes? If yes , what medicines are you taking for that?
Waiting for your reply to help you further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dose rates. Diazepam 5 mg at night. Avanza 45 mg at night. Temaze 20 mg at night and phenergan 20 mg at night. I have no diabetes or high blood pressure. I Am on plavix and Crestor for stroke prevention. The stroke was in the thalamus which is very close to the limbic system. Example of guilt are relationships I had before I was married and business deals that were tough but legal. I went back to my specialist yesterday and he said the guilt is diagnostic for depression and I am reaching the final stage of my rehab. He has put me on lithium 250 mg XXXXXXX for 3 days and then bd because I was having some very dark thoughts.
Brief Answer:
I prefer sertraline, dose of lithium should be increased
Detailed Answer:
Hi,
Thanks for information. Sorry for delayed response.
You have been given sufficient dose of Avanza.
It is good that you have no diabetes or blood pressure.
Plavix(clopidogril) and Crestor (rosuvastatin) are routinely given in patients of stroke.
Diagnosis of depression is there so lithium can help. But 250 mg a day is not sufficient dose in my opinion, it should be increased. Lithium is proven medicines in depression with suicidal thoughts. You mentioned 'Dark thoughts' , does it mean thoughts of suicide?
If anxiety symptoms are there with depression I prefer sertraline instead of lithium.When anxiety symptoms are too severe, initial low dose anti anxiety medicines in day time from benzodiazepine group (like clonazepam or lorazepam) can also help.
Simultaneously psychodynamic psychotherapy for guilt should also be done to reduce need of medicines.
Hope this answer is helpful.
Feel free to discuss further if any query.
Take care.
I prefer sertraline, dose of lithium should be increased
Detailed Answer:
Hi,
Thanks for information. Sorry for delayed response.
You have been given sufficient dose of Avanza.
It is good that you have no diabetes or blood pressure.
Plavix(clopidogril) and Crestor (rosuvastatin) are routinely given in patients of stroke.
Diagnosis of depression is there so lithium can help. But 250 mg a day is not sufficient dose in my opinion, it should be increased. Lithium is proven medicines in depression with suicidal thoughts. You mentioned 'Dark thoughts' , does it mean thoughts of suicide?
If anxiety symptoms are there with depression I prefer sertraline instead of lithium.When anxiety symptoms are too severe, initial low dose anti anxiety medicines in day time from benzodiazepine group (like clonazepam or lorazepam) can also help.
Simultaneously psychodynamic psychotherapy for guilt should also be done to reduce need of medicines.
Hope this answer is helpful.
Feel free to discuss further if any query.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The lithium is now 250 mg bd after initial XXXXXXX What is pschyodynamic pschyotherapy?
Brief Answer:
it is good that dose of lithium has been increased
Detailed Answer:
Hello,
Thanks for follow up.
It is good that dose of lithium has been increased. Optimum dose should be around 600 to 900 mg per day. Hope you will get benefit from lithium.
Psychodynamic psychotherapy is designed to help patients explore the full range of their emotions, including feelings they may not be aware of. By making the unconscious elements of their life a part of their present experience, psychodynamic therapy helps people understand how their behavior and mood are affected by unresolved issues and unconscious feelings.
In psychodynamic therapy, therapists help people review emotions, thoughts, early-life experiences, and beliefs to gain insight into their lives and their present-day problems and to evaluate the patterns they have developed over time. Recognizing recurring patterns helps people see the ways in which they avoid distress or develop defense mechanisms as a method of coping so that they can take steps to change those patterns.
Alternative therapy is also there called CBT - Cognitive behavior therapy.It focuses more on pattern of thinking of patient currently.
Hope this answers your query. I will be happy to help further.
Wish you good health.
it is good that dose of lithium has been increased
Detailed Answer:
Hello,
Thanks for follow up.
It is good that dose of lithium has been increased. Optimum dose should be around 600 to 900 mg per day. Hope you will get benefit from lithium.
Psychodynamic psychotherapy is designed to help patients explore the full range of their emotions, including feelings they may not be aware of. By making the unconscious elements of their life a part of their present experience, psychodynamic therapy helps people understand how their behavior and mood are affected by unresolved issues and unconscious feelings.
In psychodynamic therapy, therapists help people review emotions, thoughts, early-life experiences, and beliefs to gain insight into their lives and their present-day problems and to evaluate the patterns they have developed over time. Recognizing recurring patterns helps people see the ways in which they avoid distress or develop defense mechanisms as a method of coping so that they can take steps to change those patterns.
Alternative therapy is also there called CBT - Cognitive behavior therapy.It focuses more on pattern of thinking of patient currently.
Hope this answers your query. I will be happy to help further.
Wish you good health.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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