Anxiety Disorders: Signs, Symptoms, and Treatment Options

Is it anxiety disorder?

Hello Doctor: I currently have a boyfriend of eight years.
At the beginning of our relationship, he would often call me (on a landline), and he always claimed that he could hear other voices on the line.
I said there was no one else, and I didn't pay much attention to it, but he insisted that he could always hear someone and that this person knew everything about him.
His family mentioned that this had happened before when he was in graduate school.
Throughout our relationship, there weren't any significant issues until June of last year, when one Saturday he suddenly came to see me, but I was out and unable to meet him.
After he returned to the north, he became very different...
He suddenly stopped calling me and said, "Aren't you married? How can you call?" No matter how I explained, he wouldn't listen.
We ended up having a big fight, and he claimed that the news on TV reported it, so how could it be fake? He also said he saw someone come to my house to propose, even though all of this was unfounded, he was very certain.
After two or three months, I learned that he was unable to work and had resigned.
Although he returned to work, he couldn't hold a job for long.
By the end of last year, he seemed to be doing better.
He reached out to me and said he had seen a doctor who diagnosed him with "anxiety disorder." The doctor said as long as he sleeps well at night, he would be fine, and prescribed him relaxants and anxiety medication.
However, sometimes he still complains of headaches, says he can't see clearly, or claims there are people in his car (when there aren't), and he also suspects that someone has planted a listening device.
What should I do, Doctor? Recently, I heard about a treatment called "retrograde neurotherapy" that is said to be helpful for his condition and only requires two sessions to be effective.
Will he experience a relapse? Will he need to take medication for life, as he still talks to himself? Is retrograde neurotherapy expensive? I would appreciate your guidance! Thank you!

Xiao You, 30~39 year old female. Ask Date: 2006/09/20

Dr. Duan Yongzhang reply Psychiatry

Hello! It seems that your boyfriend's condition is somewhat different from typical anxiety disorders, as he is experiencing symptoms such as paranoia, talking to himself, and perceiving things that should not exist.
He is even unable to maintain his work at this point.
These symptoms may briefly occur in extreme anxiety states but are more commonly seen in individuals with brain injuries, substance use, or conditions like schizophrenia and delusional disorder.
However, an accurate diagnosis can only be made through an in-person evaluation by a physician.
I recommend that you accompany him to a psychiatric outpatient clinic for evaluation.
You can personally ask the doctor for their opinion and provide additional information for their consideration.
As for whether he will need to take medication for life, this varies from person to person and should be discussed with the attending physician.
Regarding "retrograde neurotherapy," I am not very familiar with it, so I cannot address that question.
However, this method is not currently a standard treatment in psychiatry, and its actual efficacy may require more research data for validation.
Thank you for your inquiry.

Reply Date: 2006/09/20

More Info

Understanding anxiety disorders, particularly in the context of your boyfriend's experiences, requires a nuanced approach that considers both the psychological and physiological aspects of these conditions. Anxiety disorders encompass a range of symptoms and can significantly impact an individual's daily life, relationships, and overall well-being.

From what you've described, your boyfriend appears to be experiencing symptoms consistent with anxiety disorders, possibly accompanied by elements of paranoia or delusional thinking. His reports of hearing voices on the phone, believing that someone knows all his personal information, and experiencing significant distress when he perceives threats that are not present (like the idea of someone proposing to you) suggest that he may be dealing with a more complex mental health issue.

Signs and Symptoms of Anxiety Disorders
Anxiety disorders can manifest in various ways, including:
1. Physical Symptoms: These can include heart palpitations, sweating, trembling, muscle tension, headaches, and gastrointestinal issues. Your boyfriend's complaints of headaches and feeling unwell could be linked to his anxiety.

2. Cognitive Symptoms: This includes persistent worry, difficulty concentrating, and irrational fears. His belief that he is married and cannot call you, despite your explanations, may indicate a cognitive distortion often seen in anxiety disorders.

3. Behavioral Symptoms: Avoidance of situations that trigger anxiety is common. If he is withdrawing from social interactions or work, this could be a coping mechanism to manage his anxiety.

Treatment Options
1. Medication: It sounds like your boyfriend has been prescribed anxiolytics and possibly antidepressants. These medications can be effective in managing symptoms of anxiety but often require careful monitoring by a healthcare professional. The concern about needing to take medication for life varies from person to person; some individuals may find that they can taper off medication after a period of stability, while others may need long-term treatment.

2. Psychotherapy: Cognitive Behavioral Therapy (CBT) is particularly effective for anxiety disorders. It helps individuals identify and challenge irrational thoughts and develop coping strategies. If your boyfriend is open to it, therapy could provide him with tools to manage his symptoms more effectively.

3. Alternative Therapies: You mentioned "逆行性神經療法" (regressive neural therapy), which may refer to various alternative or complementary therapies. While some individuals report benefits from such treatments, it's essential to approach them with caution and ensure they are used alongside conventional medical advice. The efficacy and cost of these therapies can vary widely, and they should not replace evidence-based treatments.

Prognosis and Relapse
Anxiety disorders can be chronic, with periods of exacerbation and remission. While your boyfriend may experience improvements with treatment, there is always a risk of relapse, especially if he encounters significant stressors or does not adhere to his treatment plan. Regular follow-ups with a mental health professional are crucial to monitor his condition and adjust treatment as necessary.

Conclusion
Supporting your boyfriend through this challenging time is essential. Encourage him to maintain open communication with his healthcare providers and to adhere to his treatment plan. It may also be beneficial for you to seek support for yourself, as caring for someone with a mental health condition can be emotionally taxing. Understanding anxiety disorders and their treatment options can empower both of you to navigate this journey together.

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