Distress and Burnout: A Guide to Mental Health Issues

Q: Distress and Burnout: A Guide to Mental Health Issues

Hello： You mentioned an experience of fainting; did you lose consciousness? Fainting can have many causes： cardiac issues, neurological problems, low blood pressure, hypoglycemia, anemia, a fright response, and other psychological or psychiatric disorders could all be potential f

Derealization and fatigue?

Hello Doctor, I previously fainted for no apparent reason, but tests could not identify the cause.
Subsequent blood tests, EEG, and echocardiograms showed no abnormalities, only slightly low blood pressure.
That experience left me very fearful, and recently while browsing in a bookstore, I suddenly felt like I was about to lose my mind and faint again.
I tried to control myself with sheer willpower and hurried home to lie down and rest, but I experienced severe diarrhea (watery).
The next day, I immediately went to see a doctor.
Since that incident, I have been experiencing persistent tinnitus and excessive sweating in my hands and feet.
In September, I had an X-ray and a check-up with a family physician, and blood tests showed normal thyroid function.
The doctor prescribed Alprazolam 0.5 mg, advising me to take half a tablet every night, but my condition has not improved after a month.
I often have dry eyes, a tingling sensation in the back of my head, light sensitivity, and excessive sweating in my hands and feet.
I feel very unreal and often have racing thoughts, making it hard to concentrate.
For example, just thinking about feeling like I'm about to lose control makes me feel like I'm really going crazy.
Friends say I always look worried and seem very tired.
Now I even have dark circles under my eyes! What should I do? Is this panic disorder or a problem with my autonomic nervous system? Thank you for your response.

Mr. K, 20~29 year old female. Ask Date: 2004/10/22

Dr. Lin Yanhong reply Psychiatry

Hello: You mentioned an experience of fainting; did you lose consciousness? Fainting can have many causes: cardiac issues, neurological problems, low blood pressure, hypoglycemia, anemia, a fright response, and other psychological or psychiatric disorders could all be potential factors.
Based on your description, it seems that many tests have been conducted, which may have ruled out some causes.
Additionally, your described situation suggests the presence of emotional disturbances (anxiety disorders) that may be affecting various autonomic nervous system responses.
Medication can improve some symptoms, but if complete recovery is not achieved, in addition to considering medication adjustments, it may be beneficial to modify your lifestyle, explore any current stressors or troubling issues, and I recommend consulting a psychiatrist for a thorough evaluation.
It is important to understand that while you are focused on your physical symptoms, your emotional distress may actually be contributing to those physical symptoms.
Learning how to relax, along with medication treatment, should lead to improvement.
Dr.
Lin

Reply Date: 2004/10/22

More Info

Hello, thank you for sharing your experiences and concerns regarding your mental health. It sounds like you are going through a challenging time, and it's important to address these feelings and symptoms appropriately. Based on what you've described, it seems you may be experiencing a combination of anxiety, potential panic attacks, and possibly symptoms related to stress or burnout.

Firstly, the symptoms you mentioned, such as feeling faint, experiencing high-pitched ringing in your ears, excessive sweating, and a sense of unreality, can indeed be associated with anxiety disorders, including panic disorder. Panic attacks often manifest with physical symptoms that can be alarming, such as heart palpitations, shortness of breath, dizziness, and gastrointestinal distress, which may explain your episodes of severe diarrhea. The fact that you have a history of low blood pressure could also contribute to feelings of lightheadedness and faintness, especially during stressful situations.

Your experience of feeling like you are "about to go crazy" and having difficulty concentrating can be indicative of heightened anxiety levels. It's common for individuals under significant stress to feel overwhelmed, leading to a cycle of worry that can exacerbate physical symptoms. The presence of dry eyes, sensitivity to light, and a general sense of fatigue further suggests that your body is under stress, which can affect your overall well-being.

Given that you have already consulted with a physician and have undergone various tests to rule out other medical conditions, it may be beneficial to explore additional support options. Here are some recommendations:
1. Therapy: Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders. A therapist can help you identify negative thought patterns and develop coping strategies to manage anxiety and panic symptoms. They can also provide a safe space for you to express your feelings and fears.

2. Medication Review: Since you have been prescribed Alprazolam (Alpraline), it’s important to follow up with your healthcare provider regarding its effectiveness. If you have not noticed any improvement after a month, your doctor may consider adjusting the dosage or trying a different medication. Sometimes, medications for anxiety and panic disorders can take time to show their full effects, or a different class of medication may be more suitable for you.

3. Lifestyle Modifications: Incorporating regular physical activity, a balanced diet, and adequate sleep can significantly impact your mental health. Exercise, in particular, is known to reduce anxiety and improve mood. Mindfulness practices, such as meditation or yoga, can also help ground you and reduce feelings of panic.

4. Stress Management Techniques: Learning relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, or guided imagery, can help you manage acute anxiety symptoms when they arise. These techniques can be particularly useful during moments when you feel overwhelmed.

5. Support System: Engaging with friends or family members who can provide emotional support is crucial. Sometimes, just talking about your feelings can alleviate some of the burdens. Consider joining a support group where you can connect with others who are experiencing similar challenges.

6. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust your treatment plan as necessary. If your symptoms persist or worsen, do not hesitate to seek immediate medical attention.

In conclusion, while it is understandable to be concerned about the possibility of panic disorder or autonomic nervous system issues, it is crucial to approach your situation holistically. By combining therapy, medication management, lifestyle changes, and support, you can work towards regaining a sense of control over your mental health. Remember, seeking help is a sign of strength, and you deserve to feel better.

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