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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes fear of disease or death, dizziness, heaviness in head and SOB?

Answered by
Dr.
Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2004 Questions

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Posted on Tue, 9 Dec 2014 in Mental Health
Question: Hello Doctor

I am 32 years XXXXXXX male , weighing 90 kgs and height is 165 cm.
Smoking (10 per day) , Drinking twice a week ( Party hard)

My Symptoms are:

Constant:
1. Fear ( Thinking of some disease or death) its been there for more than 10 years
2. Giddiness. From 2 years
3. Dullness or heaviness in the head. Some times mild headache
4. Gastric trouble. Spiky pain, Heaviniess in chest with pain or burning sensation.
5. Crawling sensations in my Head. Spinning lasts for a second or two.

Some times but frequent
6. Shaky hands and legs, feels like would loose balance.( But nothing happens)
7. Shortness of breath ( Not acute , but i can feel the difference.)
8. Lack of concentration, Irritability even to talk to people.
9. Sweaty palms and forehead at times.
Memory is weak , I forget things very easily.

The same symptoms occur when some times in large gatherings like a marriage functions or any important meetings.
All these days i am trying to manage it with that alprax 0.5 mg which gives me only a part of relief.
What medication should i take , do i have to undergo any tests.

I would brief about my previous health.

At the age of 21 , I had this sudden fear developed inside me , and I had a few head aches. I was worrying that some thing is wrong with my heart, and I did see a Cardiologist. A Master health check up was done in Apollo Hospitals. The doctor said every thing is perfect except a little rise in the Blood pressure ( 150/90) and the fast heart beat. He prescribed Atenolol 25 mg which I took for 4 years.

Later after few years,every thing was fine except for that fear I had developed about health and death. so I visited the doctor and again a master health check up was done. This time the Blood pressure was absolutely normal.
But he put me on Inderal 10 mg twice daily.
I did tell him about my fear , so he prescribed me Alprax 0.5 mg at night whenever required.Alprax 0.5 mg(taken at 8 pm ) seems to give me a 30% relief from my symptoms.

So I have been doing these master health check ups every year from then, and every time all the reports are normal and in the limits. Recently done Mri Scan and Endoscopy , Both reports are normal.

Now today, My symptoms have increased worsened and I am feeling more fear.
I am staying indoor at home most of the time, worrying that i may faint or might get a heart attack when i am out.
I Cannot sleep at night , but normally I could sleep at 3 am and wake up at 11.00 in the afternoon.

Fear and worry is constant all day and night. Even when i am at work , i do have this feeling back of my mind.
My work and social life is being affected immensely.
I am really confused and worried about my situation.

Present medications are:
1) Inderal 10 Mg twice daily
2) Alprax 0.5 mg or 0.75 mg before dinner
doctor
Answered by Dr. Shubham Mehta 56 minutes later
Brief Answer:
Change in medications is required.

Detailed Answer:
Hello
Welcome to HCM.
Thanks for mentioning your problems in detail. I have gone through it thouroughly and have following suggestion for you:

1. The symptoms which you have narrated point towards some of the anxiety spectrum disorders. The most probable in your case would be a phobic disorder or generalised anxiety disorder.

2. The foremost advice would be to quit smoking and stop drinking alcohol as these substances are proven anxiety provoking agents. So there are high chances that alcohol dependence or withdrawl can lead to such symptoms. If you find it difficult to stop alcohol and smoking on your own, you can visit a psychiatrist for de-addiction treatment.

3. Regarding treatment and medications, you would need drugs called selective serotonin reuptake inhibitors (SSRIs) like paroxetine or sertraline. These drugs will take care of almost all your symptoms like fear , short breath, disturbed sleep, irritability, low concentration and headache and giddines. The dose requirements would be defined as per need by your psychiatrist.

4. Tablet inderal (you might need a higher dose) would be required to control your tremors till the SSRIs show their effect (usually 10-15days).

5. For gastritis, an antacid like omeprazole would be enough.

6. Apart from drug therapy, some psychological treatments are also beneficial. These are cognitive behavior therapy and relaxation therapy like deep breathing and yoga. The relaxation therapies will improve your sleep as well. A psychiatrist or a clinical psychologist would be the best person for this.

Hope you find this information helpful.
Any further queries are always welcome.

Thanks.
Dr. Shubham Mehta.
Above answer was peer-reviewed by : Dr. Prasad
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