Ask me anything!

[RealisticTrain]

Hello Daniel,

Thank you for taking the time to listen. For the past 3 months, I have been dealing with high anxiety. My anxiety leads me to Google what I am experiencing / feeling in search of answers. Unfortunately, Googling anxiety also has brought me to some dark places. I often worry that I may be developing Schizophrenia or another serious psychotic illness because my anxiety symptoms mimics these conditions closely. For instance, I get dizzy, emotional, detached from reality, blurred vision, feelings of fear that I may accidentally harm someone, etc. when going through these anxiety spells.

Is there anything I can do to either confirm or deny that I am developing a psychotic illness? Do those with psychotic illnesses know they are developing psychotic illnesses?

BTW - I am currently seeing a Therapist

Hi,

The absolute worst thing you can do is consult "Dr. Google", because what tends to happen is that you'll get directed to sites or pages that link the worst possible scenario to the symptoms you type in. Someone with a simple rash due to an unknown allergic reaction will convince themselves that they undoubtedly have skin cancer. And while its not impossible, it's highly unlikely.

Conditions such as schizophrenia have a lot of factors that need to be taken into account for an official diagnosis. So the fact that you might have some of those symptoms, does not mean you fit the full criteria. Again, the best way to know this for sure is to see your therapist and be completely transparent with them in regards to what you're feeling.
- Dr. Dan

[RealisticTrain]

Hi Daniel,
Thank you for lending your expertise to this message board. I had a question about medication. I've been taking 60 mg of Cymbalta for over two months now for anxiety and depression. I had an appointment with my doctor yesterday for a med check. My anxiety has improved but I've still had a handful of panic attacks over the last two months. On the depression front I've gone from being depressed most of the time to fluctuating between depression and a neutral mood where I'm basically apathetic. I'm stuck in the neutral mood more often than not.

My doctor decided to prescribe Buspar in addition to the Cymbalta because I've been exhibiting signs of agoraphobia (which I have a history of) and I also have a slew of phobias. My script is for 10mg and I'm supposed to take them 3 times a day. I was wondering if there is a high risk of serotonin syndrome taking Cymbalta and Buspar at the same time? If so what kind of symptoms should I look out for?

A few additional details: I've been seeing a therapist since April. Previous meds that I have used (but am no longer taking) are: Paxil, Effexor and Lexapro.

Hi there,

Buspar is relatively safe when combined with other antidepressants, in prescribed doses. Serotonin syndrome is generally rare and only happens with very high amounts of serotonin increasing drugs. The doses you described do not seem too high as to cause serotonin syndrome. Please take this with a grain of salt however, and make sure to consult with your own doctor, as I do not know enough about your medical history or other conditions to know for sure how likely or unlikely you are to develop adverse effects. Let me know if there is anything else I can help with.
- Dr. Dan

[RealisticTrain]

My question is a topic called Post anesthesia anxiety in General Discussion if you could check it out would greatly appreciate it

Hi,

The fear of losing consciousness is very common, and can be a trigger for anxiety.

Medically speaking, it is almost impossible to just suddenly stop breathing, especially if you are generally healthy. That being said, there are a variety of respiratory tests you can ask your doctor for that can confirm you're healthy and ease your anxiety.
- Dr. Dan

[aml0017]

Hi Dr. Dan,

What is your opinion on the effect of hormones on anxiety/depression in women. I ask because I have a lot of the symptoms that come with endometriosis/pcos but have never been diagnosed with either as I have no ultrasound evidence of cysts/endometrial tissue growth. Other than that, I have pretty much all the other symptoms like irregular periods, weight gain, insulin resistance, excess hair growth on face, thinning hair on scalp, and of course anxiety/depression. I currently take birth control and spironolactone, no meds for anxiety/depression. I am working on losing the weight and getting healthier also. I have also had thyroid testing with no irregularities.

I have discussed these issues with my gynecologist. How much of an impact can hormones and hormonal imbalances have on mood, especially anxiety?

[gemma1788]

Hi Dr Dan,
Can you please tell me if Lexapro has an effect on the QT interval at a dose of 10mg in a normal young healthy female? I'm a little nervous after reading about it but most of the literature is in relation to overdoses of lexapro, rather than at therapeutic dose.
Thanks so much,
Gemma

[RealisticTrain]

Hi Dr. Dan,

What is your opinion on the effect of hormones on anxiety/depression in women. I ask because I have a lot of the symptoms that come with endometriosis/pcos but have never been diagnosed with either as I have no ultrasound evidence of cysts/endometrial tissue growth. Other than that, I have pretty much all the other symptoms like irregular periods, weight gain, insulin resistance, excess hair growth on face, thinning hair on scalp, and of course anxiety/depression. I currently take birth control and spironolactone, no meds for anxiety/depression. I am working on losing the weight and getting healthier also. I have also had thyroid testing with no irregularities.

I have discussed these issues with my gynecologist. How much of an impact can hormones and hormonal imbalances have on mood, especially anxiety?

Sincerest apologies for the delay. Holiday's are always busy at the clinic, plus even doctors need vacations!

Unfortunately, your question is beyond the scope of what I can effectively tell you without knowing you, your medical history, or any diagnostic tests you've taken. While it is certainly true that hormones play a huge role in our development and that imbalances may have significant implications, there is just not enough information here for me to be of any assistance.

There have been "some" reports that certain types of birth control may have negative psychological impacts, but they are generally safe, especially if you don't have any other side effects from taking them, and if you take them as scheduled.

You'll have to work more closely with your doctor on this. If it really concerns you, demand to see a specialist. Good luck, and happy holidays!
- Dr. Dan

[RealisticTrain]

Hi Dr Dan,
Can you please tell me if Lexapro has an effect on the QT interval at a dose of 10mg in a normal young healthy female? I'm a little nervous after reading about it but most of the literature is in relation to overdoses of lexapro, rather than at therapeutic dose.
Thanks so much,
Gemma

Apologies for the delay.

I know that in some cases, ssri's prescribed with thiazides (used for high blood pressure) may cause a slightly prolonged QT interval, but if you're only taking lexapro that possibility is much lower. This also depends on whether or not you have any pre-existing heart conditions, or if you're taking any other medications. Whatever the case, there isn't much I would be able to help you with in this capacity. All I can say for sure is that Lexapro -along with many other proven anti-depressants- is generally safe if you've got a healthy heart, especially at low to moderate doses. Again, this is not always the case, and you'll have to consult further with your doctor on this.

Don't read too much into what you see on the Internet. More often that not, the information there can be misleading and only causes more anxiety for you. Hope this helps. Good luck, and happy holidays!
- Dr. Dan

[bethanycaitlin17]

Hey Daniel I really could do with some help

For quite some time now -at least 8 months- Ive had these sudden overwhelming feelings of fear. It feels like somebody is watching me, and I find myself constantly looking up and around at my surroundings to relax myself that nothings there. It's a genuine feeling of fear, I don't know what it is but like I go really cold and my heart beats really fast and i tend to feel sick and i start to get very breathless, and i really dont know what it is at all - and its also badly messing with my sleep pattern, as it is almost impossible to fall asleep, i have to keep opening my eyes to check nothings there. This sounds so pathetic i know, im sorry :-( I could really use some help in trying to fimd out what this is - i really need to get it solved as my lack of sleep is now interfereing with my schoolwork and grades significantly. Thank you -and apologies for any errors, its 1_20 am and its hard to see my key board -

[RealisticTrain]

Hey Daniel I really could do with some help

For quite some time now -at least 8 months- Ive had these sudden overwhelming feelings of fear. It feels like somebody is watching me, and I find myself constantly looking up and around at my surroundings to relax myself that nothings there. It's a genuine feeling of fear, I don't know what it is but like I go really cold and my heart beats really fast and i tend to feel sick and i start to get very breathless, and i really dont know what it is at all - and its also badly messing with my sleep pattern, as it is almost impossible to fall asleep, i have to keep opening my eyes to check nothings there. This sounds so pathetic i know, im sorry :-( I could really use some help in trying to fimd out what this is - i really need to get it solved as my lack of sleep is now interfereing with my schoolwork and grades significantly. Thank you -and apologies for any errors, its 1_20 am and its hard to see my key board -

Hi Bethany,

First of all, it is important for you to understand that these irrational fears you feel are extremely common and are anything but "pathetic".

In reality, what you are describing is textbook anxiety. You see, fear is the negative psychological connection you have with something, while anxiety is your body's response to that fear. So when you are afraid, your body enters what's known as "fight or flight" mode. In other words, you are preparing to either face this threat (or perceived threat), or you are ready to run from it. It's an instinctual human reaction that has helped us survive since the dawn of mankind.

In any case, your mind floods your body with adrenaline, tightening your focus and awareness. This is why when you're anxious, you can't stop thinking about whatever it is that you are afraid of, no matter how hard you try. Adrenaline also makes your heart beat faster, your breathing becomes short and frequent, and your palms start sweating. All of these things that your body is doing that frighten you actually have a practical purpose; for example, sweaty hands improve your grip, increased heart rate and breathing provide temporary energy, etc..

I may be getting a bit off topic, but it's important you understand these things. The best tool that anyone can have against anxiety is knowledge; in other words, knowledge that what you are going through is completely normal, safe, and reversible.

I suggest seeing your doctor and asking if he or she can recommend a psychologist that you can further talk to about this. I feel that CBT treatment might help you a lot. Simply put, it's a non-medical treatment option that can train your mind to change its way of thinking about certain things, such as fears or phobias.

Good luck and stay safe. Let me know if you have any other questions.
- Dr. Dan

[bethanycaitlin17]

Hi Bethany,

First of all, it is important for you to understand that these irrational fears you feel are extremely common and are anything but "pathetic".

In reality, what you are describing is textbook anxiety. You see, fear is the negative psychological connection you have with something, while anxiety is your body's response to that fear. So when you are afraid, your body enters what's known as "fight or flight" mode. In other words, you are preparing to either face this threat (or perceived threat), or you are ready to run from it. It's an instinctual human reaction that has helped us survive since the dawn of mankind.

In any case, your mind floods your body with adrenaline, tightening your focus and awareness. This is why when you're anxious, you can't stop thinking about whatever it is that you are afraid of, no matter how hard you try. Adrenaline also makes your heart beat faster, your breathing becomes short and frequent, and your palms start sweating. All of these things that your body is doing that frighten you actually have a practical purpose; for example, sweaty hands improve your grip, increased heart rate and breathing provide temporary energy, etc..

I may be getting a bit off topic, but it's important you understand these things. The best tool that anyone can have against anxiety is knowledge; in other words, knowledge that what you are going through is completely normal, safe, and reversible.

I suggest seeing your doctor and asking if he or she can recommend a psychologist that you can further talk to about this. I feel that CBT treatment might help you a lot. Simply put, it's a non-medical treatment option that can train your mind to change its way of thinking about certain things, such as fears or phobias.

Good luck and stay safe. Let me know if you have any other questions.
- Dr. Dan

Thank you so much for the help, I#ll look into it all now - thank you so so much :')