Anxiety Disorders: Symptoms, Treatment, and Recovery Insights

Anxiety disorders and unexplained physical symptoms?

Hello, doctor.
My medical history is as follows: I took medication for anxiety and depression for six months a year ago.
After feeling better, I stopped taking the medication on my own for a year.
During that year, I felt completely normal until the last few months when, for some unknown reason, my anxiety seems to be recurring.
This is accompanied by sudden sensations of heat and tingling in my forearms and calves, along with a burning sensation in my upper body, which is quite severe.
Can anxiety or depression cause these symptoms? If not, what should I do, and which specialty should I consult for further examination?
Additionally, I would like to ask about H45 Escitalopram (Epram) and 953 Clonazepam (Rivotril).
If taken long-term for six months to a year or more, can they cure anxiety? Will long-term use lead to dependence or addiction? If I feel that I have recovered, can I stop the medication on my own? Will there be side effects or the emergence of other conditions after discontinuation?
I also want to know if anxiety can be completely cured and whether it is possible for it not to recur.
Since I have switched to a new medication, I am concerned about potential side effects and the risk of developing other issues.
I apologize for any repetitive questions, and thank you for your help!

Niming, 60~69 year old female. Ask Date: 2014/02/17

Dr. Ding Shuyan reply Psychiatry

Hello, it seems that you are similar to the person who asked a question on February 12.
You are of the same age, and the content of your questions is almost identical.
Regarding your concerns, you can refer to the response I provided on February 12 about "recurring symptoms." The physical symptoms of anxiety can indeed manifest as the discomforts you mentioned.
However, since you are 62 years old, it is essential to rule out other potential medical conditions.
You should schedule an appointment with a physician who can help assess your situation.
There is no single medication that we can definitively say will be effective for anxiety disorders, nor can we guarantee a specific timeframe for recovery; this is a limitation of current medicine.
However, collaborating well with your physician and maintaining a positive mindset without doubting the doctor or the medication can help avoid wasting time and may lead to quicker improvement.
I have encountered many individuals who have taken misguided paths, but due to space constraints, I cannot provide examples.
Anxiety disorders inherently involve psychological factors.
For instance, when flying, if you completely trust the pilot, you can relax and enjoy a movie or sleep; however, if you are worried about the pilot's potential negligence leading to a crash, the entire flight will be uncomfortable.
I sense that you may not fully trust the physician treating you and prescribing medication.
Similarly, when asking an unfamiliar doctor online, you may not completely trust my response either.
Your continuous questioning in search of answers does not seem to bring you genuine peace of mind.
I have noticed that some individuals' anxiety stems from perfectionism, seeking perfect health without illness, accurate diagnoses, flawless medications that are non-addictive and free of side effects, and a guarantee against future relapses.
While this desire may be achievable, it could take 20 years or even 50 years, but it is certainly not attainable right now.
If you have doubts about medication, you might also consider alternative approaches such as psychotherapy, relaxation training, or exploring a religion that you can accept, which can provide a sense of comfort.
Letting go of self-imposed anxieties is also highly recommended.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2014/02/17

More Info

Understanding anxiety disorders is crucial for effective management and recovery. Anxiety disorders can manifest in various ways, including both psychological and physical symptoms. Common psychological symptoms include excessive worry, restlessness, difficulty concentrating, irritability, and a sense of impending doom. Physically, individuals may experience symptoms such as muscle tension, rapid heartbeat, sweating, trembling, fatigue, and sleep disturbances. In your case, the sensations of heat and tingling in your limbs, along with the burning feeling in your upper body, could be manifestations of anxiety, but they may also warrant further investigation to rule out other medical conditions.

Given your history of anxiety and depression, it’s not uncommon for symptoms to re-emerge, especially after a period of remission. Stressful life events, changes in routine, or even hormonal fluctuations can trigger a resurgence of symptoms. It’s important to consult a healthcare professional, preferably a psychiatrist or a psychologist, who can evaluate your current symptoms and provide a comprehensive treatment plan.

Regarding your medication, Escitalopram (H45) is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat anxiety and depression. Clonazepam (953), on the other hand, is a benzodiazepine that is effective for short-term relief of acute anxiety symptoms but carries a risk of dependence if used long-term. While SSRIs like Escitalopram can be effective in managing anxiety symptoms over the long term, they may take several weeks to show their full effect. It’s essential to follow your doctor’s guidance regarding the duration of treatment and any adjustments needed based on your response to the medication.

Long-term use of Clonazepam can lead to tolerance, meaning you may need higher doses to achieve the same effect, and dependence, where you may experience withdrawal symptoms if you stop taking it suddenly. If you feel that you have recovered and wish to discontinue medication, it is crucial to do so under the supervision of a healthcare provider. They can help you taper off the medication safely to minimize withdrawal symptoms and monitor for any resurgence of anxiety or other mental health issues.

As for the possibility of "curing" anxiety disorders, it’s important to understand that while many individuals can manage their symptoms effectively and lead fulfilling lives, anxiety disorders can be chronic conditions. Some people may experience periods of remission, while others may have recurring episodes. The goal of treatment is often to reduce symptoms to a manageable level and improve overall functioning rather than to eliminate the disorder entirely.

In addition to medication, therapy, particularly cognitive-behavioral therapy (CBT), has been shown to be effective in treating anxiety disorders. CBT helps individuals identify and challenge negative thought patterns and develop coping strategies to manage anxiety. Lifestyle changes, such as regular exercise, a balanced diet, adequate sleep, and mindfulness practices, can also play a significant role in managing anxiety.

In summary, it’s essential to consult with a healthcare professional to address your current symptoms and medication concerns. They can provide personalized guidance based on your specific situation. Remember, recovery is a journey, and seeking help is a vital step toward regaining control over your mental health.

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