Stress, Anxiety, and Tension: When to Seek Help - Psychiatry

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Stress, anxiety, and tension?


Hello, doctor.
I would like to consult whether my following conditions are influenced by a mental health issue and whether I should seek medical help for improvement.
I apologize for the lengthy content...
I easily feel nervous and stressed, experiencing symptoms such as hand tremors, voice shaking, and hyperventilation (sometimes leading to asthma attacks).
I have had several emergency treatments for hyperventilation and asthma, especially before exams.
I am a repeat examinee, and during this year of preparation, I have gained at least 15 kilograms.
I frequently experience gastrointestinal discomfort (such as bowel sounds, constipation, and diarrhea), but these occur intermittently and are not severe.
I also feel hungry easily, and my appetite has increased.
My hair loss is significant; my scalp is visibly noticeable even when my hair is not tied up.
I have difficulty concentrating, cannot sit still, and often feel lower back pain, limb soreness, and constant fatigue.
My memory has worsened; if I am interrupted while doing something, I easily get distracted and forget.
Before two major exams, I experienced unexplained fevers a few days prior and had to go to the emergency room, but after receiving IV fluids, the fever subsided without any identified issues.
My parents, concerned about potential physical problems, had me checked, but various specialists indicated that I might be prone to stress, so they did not provide any other definitive treatments.
Previously, I was cheerful, positive, and enjoyed socializing, but recently I find it hard to control my emotions, becoming irritable over minor issues and feeling anxious and fearful about many future matters, often wanting to cry.
At the same time, I have been avoiding social activities as much as possible, unsure if it is due to fear or fatigue from dealing with them, which makes me reluctant to face them.
Additionally, I have vivid dreams and poor sleep, often related to exam preparation scenarios.
I feel that I have become very anxious and cannot tolerate any stimuli.
I thought these conditions would improve after the exams, but there has not been any substantial change; aside from feeling slightly more relaxed, I still feel fatigued.
Although I have some leisure time, I remain uninterested in anything and feel apathetic.
I dislike this version of myself; I have never understood what it feels like to be under pressure, yet others always tell me to relax, not to stress, and to adjust myself, so I have been unsure whether I need to seek help from a psychiatrist.
I hope you can provide me with some lifestyle advice.
Thank you very much...

Selina, 10~19 year old female. Ask Date: 2020/02/26

Dr. Zhang Gengjia reply Psychiatry


Dear Selina,
From your description in your letter, I can clearly sense your discomfort and anxiety.
It is difficult to determine the exact nature of your discomfort and diagnosis at this moment, but it is likely related to anxiety combined with depression or anxiety disorders.
In addition to an EEG, the psychosomatic department can arrange for an evaluation by a psychologist, which may help us understand your psychological state better.
Psychological therapy may also be arranged.
As for medication treatment, there are currently many options available, which can help avoid inappropriate choices or side effects.
Our clinic has outpatient services available from Monday to Friday in the morning and afternoon, and on Saturday mornings and national holidays, except for Sundays, there are also physicians available for consultations.
I recommend that you consider coming to the clinic for a thorough evaluation to tailor the most suitable treatment plan for you.
I believe there is a good chance to improve your discomfort.
Wishing you good mental and physical health.
Sincerely,
Dr.
Cheng, Psychiatry

Reply Date: 2020/02/26

More Info


It sounds like you are experiencing a significant amount of stress and anxiety, which is affecting various aspects of your life, including your physical health, emotional well-being, and social interactions. Based on your description, it is important to recognize that what you are going through is not uncommon, especially for someone under the pressure of exams and other life stressors. However, the symptoms you are experiencing—such as trembling, excessive sweating, digestive issues, hair loss, difficulty concentrating, and emotional instability—suggest that you may benefit from professional help.

Firstly, it’s crucial to understand that stress and anxiety can manifest in both physical and psychological ways. The symptoms you mentioned, like hand tremors and shortness of breath, could be signs of anxiety attacks, which can sometimes mimic asthma symptoms. The gastrointestinal discomfort, including constipation and diarrhea, is also commonly associated with stress, as the gut is highly sensitive to emotional states. Weight gain can occur as a result of stress-induced changes in appetite and metabolism, or as a coping mechanism where individuals turn to food for comfort.

Given your situation, seeking help from a mental health professional, such as a psychologist or psychiatrist, would be a wise step. They can provide a thorough assessment of your mental health and help determine whether you are experiencing an anxiety disorder, depression, or another condition. Treatment options may include therapy, medication, or a combination of both. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety, as it helps individuals identify and change negative thought patterns and behaviors.

In addition to professional help, there are several self-care strategies you can implement to manage your stress and anxiety:
1. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, and yoga can help calm your mind and reduce anxiety. These techniques can help you become more aware of your thoughts and feelings, allowing you to respond to stressors more effectively.

2. Regular Exercise: Physical activity is a powerful stress reliever. It can help improve your mood, reduce anxiety, and promote better sleep. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Healthy Eating: A balanced diet can have a positive impact on your mood and energy levels. Try to incorporate whole foods, such as fruits, vegetables, whole grains, and lean proteins, while limiting processed foods and sugars.

4. Sleep Hygiene: Establish a regular sleep schedule and create a calming bedtime routine. Avoid screens before bed and consider relaxation techniques to help you wind down.

5. Social Support: While you mentioned withdrawing from social activities, maintaining connections with friends and family can provide emotional support. Even if it feels challenging, try to reach out to someone you trust and share your feelings.

6. Limit Caffeine and Alcohol: Both substances can exacerbate anxiety and disrupt sleep patterns. Consider reducing your intake to see if it helps improve your symptoms.

7. Set Realistic Goals: Break tasks into smaller, manageable steps to avoid feeling overwhelmed. Celebrate small achievements to boost your confidence.

8. Journaling: Writing down your thoughts and feelings can be a therapeutic way to process your emotions and identify triggers for your anxiety.

It’s important to remember that seeking help is a sign of strength, not weakness. You deserve to feel better and regain control over your life. If you are unsure about where to start, consider reaching out to a school counselor or a trusted adult who can help guide you in finding the right resources. Your mental health is just as important as your physical health, and taking steps to address your concerns is a positive move toward healing.

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