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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4468
Experience:  MD Psychiatry
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***Question for Dr. Kaushik ONLY please*** Hi Dr Kaushik, I

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***Question for Dr. Kaushik ONLY please***

Hi Dr Kaushik,

I know I’m back asking questions, but I have had a bad day so to speak, and I wanted to ask you a couple of questions about my condition, and possible future treatment.

I have returned to work after a week off (On holiday) and the first day was very hard, I am still worrying, and throughout the day I have had times when I feel okay, and able to cope, but then at moments I get a massive feeling of dread and feel like I will struggle to make it through the day…I keep telling myself in these moments
‘It will be okay etc’ but it’s very very hard…should I be taking a Valium at this point? or should I ride it out…also is this normal in GAD/OCD/Derealisation to feel like this throughout the day when I’m suffering – Sometimes okay and able to cope, then dwell on negative feelings and feel low again…what can I do to cope in these low times?

Also I failed to mention in my previous post that my GAD / Derealisation / Depersonalisation / OCD were initially brought on from a panic attack caused by taking ‘Speed’ (Amphetamine) – I never used drugs at all really, and this was one of my first (and last) experiences…I had a really bad ‘comedown and subsequently the massive panic attack which has led to my illnesses…

I foolishly started looking around on the internet again (I know I need to stop this) and found a topic where someone was saying that apparently Mental Health conditions brought on by a drug induced panic/anxiety attack are more likely to be long term/permanent than conditions brought on by none drug induced conditions (This was just a forum user) and now I’m worrying that because mine was drug induced it must be worse than a ‘normal’ occurrence? And I’m doomed to live with a worse version of my conditions forever due to the way it happened???

I guess what I’m asking about that is:

Does having a drug induced anxiety/panic attack actually cause you to start suffering from GAD/OCD/Derealisation, or would you always be susceptible to suffer from these and it simply brings them to the surface quicker – you were always likely to suffer from these conditions – just the panic attack brought them on quicker?

And is having drug induced mental illness worse than having it occur as a natural fashion, or does this not matter? I guess what I’m worrying about is that my case is worse than others as it was caused by drugs…and my prognosis is not as good as others.

Is there any medication you would suggest to help with the anxiety, I currently have valium, which helps, but I find by the time I recognise I need it, I’m already in major panic mode. I think I need more help medication wise.

And lastly, have you treated people who have suffered from some sort of long lasting derealisation? Have they been able to live a normal life?

Thanks doctor, I am confident I will get better, I just wanted a few more answers.


Greetings !


Welcome to the site.


Well first of all I will encourage you to think positively and do not just jump to hasty conclusions about the outcome of your conditions which I will reiterate have the potential for full recovery provided you follow the already discussed drug regime and patiently wait for the outcome.


Now coming to your questions.


-- Well you see it is actually the other way round to what you have been told about poor outcome of drug induced GAD/Panic disorder/OCD/ Derealisation as compared to the outcome of such conditions which are naturally occurring. You see drug induced conditions like the ones you are having are more likely to have a favourable outcome as compared to naturally occurring conditions because here stressor is known which is a drug so by keeping away the stressor the outcome becomes much better.


-- You see although these conditions can occur in any individual but there are certain individuals who are more susceptible to their occurrence when exposed to particular drug acting as a stressor, so yes some people are more vulnerable towards drug induced conditions than the rest.


-- Well I will suggest that you continue to use valium on PRN basis that is as and when required basis at times of overwhelming anxiety because one should never let go of a drug which has been helpful for your cause in the past.


I hope this helps.


Wish you all the best.



Customer: replied 3 years ago.
Hi and thanks for the swift response, I just wanted to ask a couple more things if that is okay.

Is there any evidence that GAD or derealisation caused by drugs as a pose to natural occurance, is more permanent? Or does it not matter the cause?

Also like I mentioned earlier During the day I feel very quite positive, but have moments of say 30 mins - 60 mins where I feel quite helpless and down (I think this is related to my anxiety and worry levels - and for instance reading something negative makes me feel very down) - Is this normal for my condition to feel okay and then low during the day? Going from feeling strong and okay, to having a few negative thoughts and feeling down...I know in these moments it will be okay, but it's still hard.

Thanks Dr.


No, unfortunately there is no such evidence which establishes that drug induced GAD/Derealisation as opposed to natural occurrence of these disorders more permanent. In fact as I had mentioned above too , clinically it is seen that drug induced GAD/derealisation comes with a better prognosis/ chances of better outcome in terms of full recovery as compared to the natural occurrence of the same.


Yes the Diurnal Variation as it is described clinically that is variation in your mood and feelings from high to lows is expected in your conditions. So this is not something abnormal but in line with your underlying conditions which shall go away once you start following the discussed strategy of management judiciously.


I hope this helps..


Wish you all the best.



Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4468
Experience: MD Psychiatry
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