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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4514
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hi,I am having physical symptoms of OKMH0916217

Resolved Question:

Hi, I am having physical symptoms of anxiety and would like some advice. A few weeks ago, my DR scared me by telling me my symptoms seemed like MS or some autoimmune disease ( I have burning in my chest, neck and legs). My MRI was clear, and so was my EMG. It was as I thought, I am healing from a disc protrusion. Trouble is, now they are suggesting anti depressants. I feel great other than the burning feelings, still doing my normal things.

Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Z replied 10 months ago.

Dr. Z :

Hello I believe i can help you with your concern

Dr. Z :

I am so sorry that you are having these symptoms, I can imagine how this is distressing you

Dr. Z :

So are you concerned about the physical symptoms of anxiety and how it effects you or are you concerned about taking an antidepressant?

Dr. Z :

Also there is an off label medication called Gabapentin that can be used for anxiety and may help with the burning feelings you are having as well because Gapapentin is used for individuals with severe neuropathic pain, which has been described as burning feelings.

Dr. Z :

Also there are therapeutic techniques that can help with anxiety as well and help lessen your physical symptoms.

Dr. Z :

The best type of therapy for anxiety is called Cognitive Behavioral Therapy (CBT). CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen

Dr. Z :

So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more objective and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

Dr. Z :

In addition, these two worksheets are very good at helping lessen anticipatory anxiety and helping you focus on the big picture and the objective/positive thoughts and outcomes.

Dr. Z :

Also individuals with severe anxiety also have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your anxiety better.

Dr. Z :

These two books are also really effective in helping manage anxiety

Dr. Z :

This is a link for something called Progressive Muscle Relaxation that can help you create a long term calm by using muscle tension and release techniques; it can help manage your anxiety better and is very similar to a style of meditation.

Dr. Z :

If you do choose to use an antidepressant, I would like to recommend Lexapro (10-20mg), Zoloft (150-200mg), or Paxil (25-40mg). These are considered the best antidepressants, based on efficacy, for anxiety.

Dr. Z :

I see that you are offline right now, but when you get back online I would be very interested in continuing this discussion with you and talking about anything further you would like to share regarding your concern, so if you respond in the chat box I will be able to get back to you as soon as possible.

Customer:

Hi, I was sent an email to say that I could not ask another mental health question. That is why I went offline, and did not wait for your reply.

Dr. Z :

Well i got a code saying that this question was permissible. It is true that subscribers usually can only answer one mental health question a month, but because I got the code from administrators saying okay, then you can ask your question if you wish.

Customer:

Oh good.

Customer:

I read your comments above, and appreciate the information. I bought the Anxiety and Phobia Workbook. I'm not sure how it applies to me cause my anxiety reaction was from thinking I was going to have MS, and be disabled - I have two small kids and this sent me in a tailspin for two weeks until my MRIs were done.

Customer:

The burning started and now I cannot get it to stop.

Customer:

Otherwise I feel bright, happy, and want to get back to normal things.

Dr. Z :

Oh so your anxiety was a response to thinking you had an MS diagnosis, I understand now. I thought you had the anxiety symptoms before the MS was even considered.

Customer:

No, the burning started the day of my EMG, and then got worse when the physiatrist told me I was normal but needed a brain MRI.

Customer:

Then my GP told me my symptoms seemed like MS, not a disc protrusion.. and then all hell broke loose with my emotions. MRI comes back, no MS, and a disc protrusion that is healing.

Dr. Z :

Okay, so now that MS has been rules out you are still having the burning sensation?

Customer:

Yes, because now they tell me that the burning is anxiety.

Dr. Z :

Physical symptoms of anxiety can occur in all shapes and sizes, so it may be a possibility.

Customer:

I don't even like to take advil. But now, I need an antidepressant for months. all over this scare.

Customer:

I knew I needed help when I could not stop crying and losing it, so I asked my DOC for help, she prescribed cipralex. Made me a zombie. I could not eat, or stay awake- nauseous.

Customer:

I have a 2 yr old, a 7 yr old, a leadership job, and a husband. Cannot be a zombie

Dr. Z :

I understand that, then maybe the medications are not the best route for you at this point. The therapy techniques I offered to you can be very effective for relieving your anxiety, although this will take time for it be effective as therapy takes time.

Dr. Z :

Also you mentioned that you tried Ativan, how was that for you?

Customer:

OK. I took an ativan on Saturday night in hopes to break the panic cycle, and it seemed to work. No pain on Sunday, maybe a tingle here and there. But I focused on breathing, being distracted and staying positive- the pain stayed away.

Customer:

But I went to bed Sunday night as I was dead tired, and did not take another one.. woke up twice with actual panic attacks. So eventually took another one at 3 am when relaxing did not work.

Dr. Z :

Okay, well the Ativan is very good for he anxiety attacks you mentioned. You may want to consider switching to Klonopin as this has a significantly longer half life then the Ativan and the anti-anxiety benefits of the medication can last longer for you.

Customer:

Can I take Klonopin short term, and not have to be medicated for months or years?

Dr. Z :

Most benzodiazepines should be taking short term, so yes you can take these short term. And in the mean time practice the therapy techniques in the books and links I showed you, so that you will not be reliant on the medication. Then when the techniques become more ingrained in you, you can slowly wean off the medication as you will not need it anymore.

Customer:

Ok, of the anti-depressants you mentioned, which has the least side effects?

Customer:

I will only use the benzodiazepines for up to three weeks, and then if I'm not relying on the techniques, I will ask for something else.

Dr. Z :

Well actually the one you mentioned Cipralex (Also called Lexapro) has the least side effects, but that did not react well with you. The Zoloft should not have as many side effects as the Paxil, but everyone reacts differently to the medication, this is why the developers create so many different kinds of SSRI antidepressants. So I would try the Zoloft if you are going with the antidepressants.

Dr. Z :

If you are afraid about being addicted the benzodizepine, you can try Gabapentin like I mentioned. This is a non-habit forming anti-anxiety medication

Customer:

Thank you, XXXXX XXXXX me some excellent advice. I will start the techniques and I start counseling on Weds.

Dr. Z :

Anytime, I am glad that I was able to help you. Is there anything else I can do to assist you tonight?

Customer:

No. Thank you. I will have to read your links, and try some techniques. Cheers.

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4514
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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