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D.Antonio, MD;MS
D.Antonio, MD;MS, Doctor
Category: Mental Health
Satisfied Customers: 2
Experience:  Doctorate of Medicine USC,Psychiatry Residency Morehouse,APA AstraZeneca Fellow,Master's Science-Bio
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My sister has been suffering from a number of phobias and depression

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My sister has been suffering from a number of phobias and depression for years without being properly diagnosed and adamantly refusing help from any Psychiatrist/Therapist/ Doctor. 15 months ago she developed a painfull acid reflux condition which eventually led to surgery. She says it hasn't worked. Her surgeon says it has. One of her phobias is emitophobia, fear of vommiting. This phobia stops her from going in cars/ on transport/ taking medications/ she is unable to attend appointments. She is in unbearable pain from the acid. She can't move, she sleeps propped up in a chair. She desparately needs help. She phoned me last night crying hystericaly to say 'goodbye'. She wants to end it all. I begged her to be sectioned/ hospitalized but she refuses. She is 27, Lives with my parents (who have become her 24 hour carers)in Harrow UK
Submitted: 7 years ago.
Category: Mental Health
Expert:  D.Antonio, MD;MS replied 7 years ago.

Thank you for coming to Your sister seems to be in a difficult situation medically and psychiatrically. Although no one can force treatment on her, if she appears to be a danger to herself (threatening suicide) or a danger to others, then she may need to be involuntarily committed to a hospital. Laws may differ in the United Kingdom on how to commit someone to the hospital, but usually this is done through the court system, or by calling the police if she is an immediate threat to herself. She can then be evaluated by a doctor. Unfortunately if she is not a threat of harm to herself or others, she cannot be comitted to involuntarily. The medication Lorazepam she is taking is commonly used for anxiety, this medication can potentially be dangerous in conjunction with large volumes of alcohol or other respiratory depressing substances. Your sister needs support from her family at this time, individuals with chronic medical illnesses often develop depression. Untreated depression can make treatment for other conditions much more difficult. As far as phobias, these are usually treated by exposure therapy where she would be gradually introduced to the thing she is afraid of, but this needs to be done by a professional. As far as her acid reflux, the severity suggest that she has/had Zollinger Ellison syndrome, characterized by pancreatic tumor that causes the acid producing cells in the stomach to produce acid at a maximum or possibly G cell hyperplasia (acid producing cell overgrowth). Usually these are treated with proton pump inhibitors such as omeprazole or IV pantoprazole for acute control of acid symptoms. Usually if it is determined to be caused by a tumor, surgical resection is used to resect the primary tumor. These tumors can potentially metastasize, or spread to other places, and cause these as well as other symptoms potentially. Although without further testing or objective data, it is impossible for me to tell you what is the cause of her acid reflux, at least knowing what could be wrong could encourage her to seek treatment. Another option may be finding a doctor that does home visits. I hope this answer is somewhat helpful, and thank you for your question.

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