Anxiety: Symptoms, Treatment Options, and When to Seek Help

Is this anxiety disorder? How should it be treated? (Psychiatrist or school counselor)

Hello, doctor.
Although I used to occasionally feel intense fear when thinking about death, I would often recover after a short period.
However, in recent days, I have been experiencing this feeling multiple times a day, and I truly feel like I can't take it anymore.
The thought that my family will eventually leave me, and that I too will one day be gone, brings back that deep-seated fear.
I experience sweating in my hands and feet, nausea, and sometimes I feel like crying at night.
I often react by getting up and walking around or talking to myself, telling myself to stop thinking about it! But after a short distraction, I find myself falling back into that feeling.
For most of the past few days, I have been feeling this fear, and I suddenly find many aspects of life uninteresting.
At the beginning of winter break, I was reading every day and learning a second language, but now, because I am constantly immersed in this fear, I don't want to do anything.
Sometimes I feel hopeful about the future, but now I am filled with fear and become overly fixated on small issues.
For example, when I feel slightly unwell, I keep searching online for information, feeling anxious and often affecting my sleep (1-2 hours of searching makes me tired and gives me headaches).
I have never seen a doctor before, and even when I fixate on small issues, I would wake up without feeling much.
Recently, I feel like I can't bear this feeling about death any longer.
I can only see a psychiatrist after the New Year.
Will simply taking medication help? (Does medication change the endocrine system to deceive the brain, or does it "treat" the brain?) Or do I need psychological therapy? (Will the psychiatrist refer me to counseling? I want to utilize the hospital's insurance-covered psychologists.
The school's counseling services won't be available until school starts in two weeks, but I feel like I can't hold on that long.) Thank you, doctor.

Tòngkē, 10~19 year old female. Ask Date: 2016/02/10

Dr. Liang Sunyuan reply Psychiatry

Many people experience anxiety about death, but the forms and intensity of this anxiety can vary widely.
Clinical findings suggest that the best strategy for coping with death anxiety is to live life fully, making the most of every moment and engaging in activities that truly matter to you.
Those who are least fearful of death are often those who have lived their lives well.
If you are concerned about the possibility of losing a loved one, start treating them well right now; express your love and let them know how important they are to you, so that no regrets are left behind.
Sometimes we know what we should do, but we struggle to do it and may not even recognize our blind spots.
In such cases, psychological counseling or therapy can be beneficial.
If there are severe symptoms of depression or anxiety, medication may also help alleviate these symptoms.
Typically, psychological therapy in general hospitals under health insurance requires a referral and may involve a waiting process.
For school-based counseling resources, it is advisable to consult the school counseling office, as the availability of services may vary between institutions.
Wishing you all the best.

Reply Date: 2016/02/10

More Info

Hello! Thank you for reaching out and sharing your feelings and concerns. It sounds like you are experiencing significant anxiety and distress, particularly related to thoughts of death and the fear of losing loved ones. These feelings can be overwhelming and can affect various aspects of your life, including your motivation and ability to enjoy activities that once brought you joy.

Understanding Anxiety and Its Symptoms
Anxiety is a natural response to stress, but when it becomes excessive or chronic, it can lead to anxiety disorders. Common symptoms of anxiety include:
1. Physical Symptoms: These can include sweating, trembling, rapid heartbeat, nausea, and fatigue. You mentioned experiencing sweating in your hands and feet, as well as feelings of nausea, which are typical physical manifestations of anxiety.

2. Emotional Symptoms: Feelings of fear, apprehension, and a sense of impending doom are common. Your fear of death and the thought of losing family members can create a cycle of anxiety that is difficult to break.

3. Cognitive Symptoms: This includes obsessive thoughts, such as fixating on small discomforts or health concerns, which can lead to excessive research and worry. This behavior, known as health anxiety or hypochondria, can further exacerbate feelings of anxiety and disrupt your sleep.

4. Behavioral Symptoms: You may find yourself avoiding situations or activities that trigger your anxiety, which can lead to isolation and a decrease in overall quality of life.

Treatment Options
When it comes to treating anxiety, there are several options available, and often a combination of treatments is most effective:
1. Medication: Medications such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines (like Ativan) can help alleviate symptoms of anxiety. While medications can help manage symptoms by altering neurotransmitter levels in the brain, they are not a cure. They can provide relief and allow you to engage more fully in therapy.

2. Psychotherapy: Cognitive Behavioral Therapy (CBT) is particularly effective for anxiety disorders. It helps you identify and challenge negative thought patterns and develop coping strategies. A mental health professional can guide you through this process, and many psychiatrists can refer you to a therapist who accepts insurance.

3. Lifestyle Changes: Incorporating regular exercise, a balanced diet, and mindfulness practices such as meditation or yoga can significantly reduce anxiety levels. These practices can help ground you and provide tools to manage stress.

When to Seek Help
Given the intensity and frequency of your symptoms, it is crucial to seek professional help as soon as possible. If you feel that your anxiety is becoming unmanageable, or if you have thoughts of self-harm or suicide, please reach out to a mental health professional immediately.
You mentioned that you are unable to see a psychiatrist until after the New Year, but if your symptoms worsen, consider seeking help from a general practitioner or an emergency room. They can provide immediate support and may be able to prescribe medication to help you cope until you can see a specialist.

Conclusion
Your feelings of fear and anxiety are valid, and it’s important to address them with the help of professionals. Medication can be a helpful tool, but it is most effective when combined with therapy. It’s also essential to practice self-care and reach out to supportive friends or family members during this challenging time. Remember, you are not alone in this, and there are people who want to help you navigate through your anxiety. Please take care of yourself, and don’t hesitate to seek the support you need.

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