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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes stammering, fatigue and breathing problem while treating anxiety?

Answered by
Dr. Seikhoo Bishnoi


Practicing since :2007

Answered : 5171 Questions

Posted on Sat, 27 Aug 2016 in Ear, Nose and Throat Problems
Question: Hi Doctor,

i am 36 years old and having eating disorder problem and taking ant-anxiety daxid 150 mg per day. My major problem that i have a lot of stammering problem, speaking problem and when i dont eat or eat much, my stammering goes high and some times even i dont able to speak and it seems, i am not able to take breath properly and at that moment i am not able to speak. and i have to struggle a lot to come out the words and at that moment my face expression got worse and eyes are closed. i have a lot of heaviness in mind and not able to speak and because of that I am not participating in meetings on phone. In hindi, i always substitute the words when heaviness in mind goes high and not took breath properly. But in English, there is no substitution of words., so no option for english. and dont use english language. i am working professional and my work whole the day happens in english. and it becomes terrible for me to speak in english. and i always reply on email and chat. Whole the day i feel tiredness and laziness, and heaviness in head and taking lumia 60k, vitamin d3 and vitamin b12 tablets. but my biggest challenge is not able to speak. many times it has been observed, this is directly proportional to heaviness in head. i do pranayama to reducess heaviness and get effectiveness in stammering and speaking problem. but after few hours, it becomes as usual. 10 years ago, i went for speech therapist in govt hospital in XXXXXXX and they took my sessions to slow down in my speech and prolongation and speak like as singing. it was not much effective but helped. I am taking anti-anxiety medicines for last 9-10 years. but when i stopped medicines and changed doctor, speaking problem got worse. nowadays a lot of problem in speaking mostly in english. Even i am not able to speak my name in front of unknown, and when many people in front of me. One thing more, this problem in speaking arose 16 years ago because of so much depressions and eating disorder. And at that moment even i was not able to speak a single word even in front of my friend, my parents also. But in 16 years, after taking anti-anxiety medicines, pranayama, speaking problem gradually decreased. But still problem when attend meetings, on phone, in english. So please clarify, what i should do or where i should go? Before 16 years, I used to stammer very very less, can say 1-2 % But now more.

1. taking psychiatrist treatment
2. doctor also advised me for MRI brain
3. now to whom i should consult for speaking problem. Because when this anxiety disorder will remove, i dont know. it took my 16 years. now can take 1-2-3 years. but now i want urgent help in speaking issues. So please give best advise. where i should go in XXXXXXX or XXXXXXX if u suggest me to go to any specific doctor, in that case where i should go means in private hospital or govt hospital in XXXXXXX or XXXXXXX or should i meet any neurologists. Please give proper guidance.
Answered by Dr. Seikhoo Bishnoi 9 hours later
Brief Answer:
Visit a psychiatrist for help.

Detailed Answer:
Hi, thanks for asking from HCM for your health related queries

I can understand your concern. A lot of patients with problems related to anxiety and depression shows such symptoms. Stammering in your case is not persistent but occurring at some incidents only and this points more towards anxiety related reasons rather than neurological.

You are taking Daxid which is Sertraline and the drug is a SSRI drug. If that is not resulting in improvement then either the dose should be increased or it should be substituted by some other drug like Escitalopram or Fluoxetine. These drugs have good roles in controlling anxiety. Drugs like Propranolol can also be used in events that provoke excessive stammering.

I don't think there is any need for MRI if you have no neurological symptoms.

For speech problem I'd advise you to go to an ENT doctor and speech therapist first. This will help to rule out any problems related to speech centre. I don't think there is need to visit a neurologist. For best consultation visit Psychiatry department at GB Pant Hospital which is a government hospital.

Thanks, Take care. If you have more doubts please ask again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Seikhoo Bishnoi 8 hours later
Hello Doctor,

Good Morning and Thanks for reply.

1. First i dont have any type of anxiety now. But i have heaviness in head and because of that not able to take breath properly and words dont come from mouth and i stuck in sentence and second thing, major issues i dont have any physical hunger or appitite for last so many years and think about food and eat less and eat more. But now feel somehow good than before. Should i leave this daxid 150mg with sizondon .5 mg or continue. Becasue i am taking this for last 4 months.

2. Could u pls help me, where i should go for ENT and speech theraphy as govt college for audiology and speech as Janakpuri Super Speciality Hospital, Lal Bahadur Shastri Hospital or Pt. Deendayal Upadhyaya Institute for the Physically Handicapped or in any private hospital as XXXXXXX fortis, or medanta. Because i want to overcome this speech problem asap.

3. I took advise from my doctor that there is heaviness in head, because of that heaviness in whole body and not able to speak properly. So should i go for MRI or not. He advised me to go for MRI for ur own satisfaction. Now should i go for MRI or not? Because for last 16 years, heaviness in head and not able to speak and no physical hunger. But if i see my past, most of heaviness has gone. But somehow is there. So should i go for MRI or not?

Thanks for co-operation..
Answered by Dr. Seikhoo Bishnoi 17 minutes later
Brief Answer:
No need to go for MRI

Detailed Answer:
Hello again and thanks for asking again.

1) You are taking Daxid and Sizodone for four months only and though anxiety symptoms are under control still I'd not recommend you to stop medicines at this point. The symptoms like heaviness in head, difficulty in breathing, difficulty in finding words etc are persisting symptoms of anxiety only. Continue to take Daxid or if you are not finding much improvement then ask for some other drug with good efficacy.

2) Visit any good government hospital. The consultation might take time there but you will be given right advise.

3) I don't think there is need for MRI. MRI will come normal.

Thanks, Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Seikhoo Bishnoi 2 days later
Thanks Doctor for reply.

Good Morning.

and sorry for late query because i was not able to think, what i should write now. because i have asked many queries regarding this problem and took medicines from many doctors for last so many years, but i could not overcome completely by this problem. i will not say, that my condition is same as earlier and many years ago, definately condition is somehow good even fair but not better and best, because if i see my speaking problem today, i see, this become very bad. when psychiatrist doctor say to me, that i should go to speech therapist for speaking related issues, then i say every time, Sir, what is happening???? i dont have stammering problem, words are not coming from inside and forcefully i have to throw out the words. my face expressions become worse and eyes are closed, this is because of heaviness in mind.

2. why i need to take deep breath again and again to say something,

3. why and why always heaviness in mind or head, even after awaking in morning and after 10 hours sleep. doctors say, that i think, so there is heaviness in head. but why i will think, i dont have nothing to think. if i wake up in the morning after 8-10 years sleep, it means, no thinking, it means, there should not be heaviness, but heaviness is still there.

3. when i am in office and doing my work and job, why there is heaviness in head, even i am working without any thinking.

4. Even i am writing this query, still heaviness in head. why heaviness

5. if i am in the office or anywhere i need to take deep breathe to reduce heaviness in head and to speak something. people around me observe me and think why i am taking so deep breathe. i never see people around me to take deep breathe until they are doing pranayama or yoga or deep breathing exercise. But i think, that i am doing deep breathing XXXXXXX 6-7-8 and some times more in an hour whole the day.

6. And things become worse when i come from bowel movement and at that moment, head become more heavy and not able to speak. and at that moment no speech therapy works. and then i take deep breathing so many times and eat something to speak. so please tell me what is happening.

7. my speech is very much important for me and my job, where i have to communicate to clients on phone. and in this situation, i am not able to speak anything and on phone, i become so conscious at that moment because of heaviness in head. so you can think, my job is always in risk. and all these issues force me to think why this problem is not solved till now. even after 16 years, still i am saying that heaviness in mind. and this force me to go for MRI.
you can think, after taking psychiatrist treatment, still i am writing here.

8. In this age, when people of my age think about career, money, marriage, family, house and outer world, and i am doing nothing because of heaviness in head and not able to speak.

9. Sorry Sir, but really some times this raises question on medical science, what medical science is doing in this. there is no such medicine for mind and head that can cure the person in a day, week, months and even in a year, but not take complete life.

10. is there no such device or test that can measure the heaviness in head and mind as blood pressure machine or diabetes test, so that we can give correct dose of medicines to patients. as is given in other problems. on which basis psychiatrist doctors are giving medicines to patients. it means, patients are running whole life here and there, if he has any heaviness in head.

11. how many times, i will change the doctors. same story to different doctors.
Sorry to say Sir, somtimes i think, i have become doctor. :) Please dont mind.

12. if i see my past, i found, i have lost 16 years only in this heaviness and doing exercises, medicines, changing doctors,reading articles to find why this heaviness still persists. really sir, if this big time, if i gave my studies and career, i would have become IAS, IPS, or IITian or having a successful carrier. but belive on me, still struggling with this heaviness in head. but not same as earlier, when i was not able to speak even a single word because of a too much heaviness. but now heaviness in less but still there. i can say, if previous was 100 % in year 2002 and now is only 10-20% remaining. but how i can say, that earlier it was 100% and now is 10-20%. because in medical science, there is no such test or device that can measure, that how much heaviness is reduced.

13. But God grace and with all of your great support, now i m thinking or my mind started to think this realization that how i was busy in my head heaviness, laziness, tiredness, sleeping all the time and thinking all the time of Food (that was very major problem) and appetite (but still persists, because of no physical hunger). it means, now mind has started thinking in normal and correct way because of thinking less about food, appetite, hunger and less heaviness. but STILL heaviness is there and speaking problem (not stammering) is also there.

14. My current doctor say to me that i should meet to psychologist for CBT counseling for this issue. he will understand and solve the problem. but how psychologits will solve the problem, if there is heaviness in head all the time and because of that speaking issues. again time and money wastage.

15. Sir, is any other therapy apart from medicines available to overcome the problem. Please suggest.

16. Can Meditation cure this problem permanently?

17. how speech theraphy can resolve this problem, when this problem is direcly related to heaviness in head.

18. if i can speak very confidently and fluently in some other time in a day and at the sametime, i feel so consious and not able to speak, how speech theaphy will work, i think no.

19. whole life, i have to take medicines? if yes, then again, medical science seriously think, how a person can survive on medicines whole life.

20. one most important thing, I could never concentrate on studies, job, career in 16 years, so still I am on same page, where I was 10-12 years ago. what i do to create interest in study and job. i never grow in career, job and money in last so many years, because was busy in above things. so now how i study and job. because whenever i try to study for half an hour, this is like as so nightmare.

21.earlier doctor prescribed me 200 mg daxid (100mg-100 morning and night), but after taking this, a lot of tiredness and heaviness, and laziness and constipation also. so doctor reduced as 150mg (50-100). so should i increase this dose to recover soon or else.

22. Questions are more, but now i am stopping because will not take more time. now need MRI or not? :)

Thanks for co-operation...

Answered by Dr. Seikhoo Bishnoi 7 hours later
Brief Answer:
no need of MRI.

Detailed Answer:
Hello again and thanks for asking a follow up question

1) I am not saying that there is some organic problem of stammering but to rule out any rare possible organic cause one consultation of an ENT doctor is advised. The symptoms suggest social and psychological factors but still you should visit a speech therapist at least once.

2) The need of deep breath again and again is due to anxiety only.

3) 4) You have become aware of heaviness in mind. Due to that repetitive awareness that your mind is heavy the thing is not going out of mind. This is due to anxiety and mild depression only and not due to any other cause. Try to ignore this thing and you will feel better.

5) Avoid thinking what other are thinking. Other people are there to judge you and you should ignore this. Try to take deep breath slowly and this will help in calming you.

6) The relation of bowel with this breath is due to anxiety only. Treatment of anxiety will reduce these symptoms.

7) MRI will come normal still if you want to go for it you can get MRI done. But the problem as your history says is due to anxiety only.

8) Wait for some time. The anxiety will improve and your motivation will come back.

9) The medicines cause changes at receptor levels and this takes time. Exact psychopathophysiology of anxiety and depressive disorder is complex and even with best medicines available some individuals have difficulty in coming out of symptoms. Please consider consulting a different psychiatrist and start new drug therapy. This will help you.

10) No specific tests are there for that.

11) I can understand your anger but as I have mentioned earlier some individuals respond very late in treatment.

12) Try to forget the past and don't repent for that. Just keep focussing on your carrier and keep moving.

13) Along with medicines practice yoga and exercise daily. This will lift your mood.

14) CBT is a good option. In CBT faulty cognitive distortions and though processes are corrected in multiple sessions.

15) CBT with relaxation exercise is a good option.

16) Yes medicines can treat these symptoms fully.

17) Speech therapist consultation will rule out any organic cause.

18) The problem is due to social anxiety but still we should rule out organic conditions.

19) You will not have to take medicines for life.

20) The problem is due to anxiety but with treatment your symptoms will reduce.

21) If Daxid is not working then Escitalopram or Citalopram are good options. Combination therapy of SSRI with drugs like Bupropion help to treat resistant cases.

22) NO NEED TO GO FOR MRI in my opinion. :)

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

The User accepted the expert's answer

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