I have extreme anxiety and unable to sleep.I also have IBS.Please help.

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns.

First of all, I would like to inform you that from the described symptoms it seems that there is Generalized Anxiety Disorder with panic attacks. Both of these disorders fall under a broad category of anxiety disorders. The condition is so disabling that many patients with this disease get significant difficulty in doing day to day activities. As I can see your symptoms are quite distressing, it is clear that you need help to cope with these symptoms. Untreated anxiety disorder lowers the quality of life, and over time it becomes difficult to treat when compared to new onset disorder.

Regarding treatment, it can be treated by either medications or psychotherapy. Among the medications, SSRI (Selective Serotonin Reuptake Inhibitors) are generally effective in this condition. Examples of SSRI include Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, and Sertraline. They show improvement after using these medications for at least 4-6 weeks.

Among psychotherapy, Cognitive Behavior Therapy (CBT) is most commonly used and it takes about 8-12 sessions of one session per week lasting for one hour. Although definite treatment is required from a psychiatrist, before you could make an appointment with a psychiatrist, I recommend the following things for better management of anxiety symptoms and stress arising from them.

1. Ensure intake of adequate quantity of fiber.
2. Ensure adequate water intake: Follow the rule of 1 which I usually advise. 1 glass of water 1 hour before and 1 glass of water 1 hour after every meal. This will ensure adequate consumption of water.
3. Early morning exercise: Brisk walking for 30 minutes at a stretch preferably in the garden will be very helpful.
4. Avoid tea, coffee, nicotine, and alcoholic beverages: If at all you want to drink something, drink fresh lime water. It is very much refreshing.
5. Start your day with a glass of lemon water with 2 spoons of honey added to it.
6. Do not take work so seriously:
7. We all have the feeling to excel in our respective fields and do not spend adequate time with our self trying to understand our own needs.
8. Spend time with your family and friends.
9. While working take frequent regular breaks.
10. Avoid late night socialization.
11. Steam inhalation before going to sleep will be very refreshing.
12. Multivitamin and calcium supplement.
13. Meditation and yoga will help you a lot.

These are simple measures which will help you a long way when practiced regularly.

Hello,

Welcome back to icliniq.com.

It is difficult to know why there is a loss of appetite and pain but, it is commonly observed that persons with a generalized anxiety disorder can develop any abdominal symptoms including abdominal pain and loss of appetite.

In IBS (Irritable Bowel Syndrome), antidepressants are quite effective, and the majority of patients with IBS respond to Fluoxetine, an SSRI commonly used for the treatment of anxiety disorders.

From the available literature and research, it can be said that antidepressants will be effective in your condition if there is no organic pathology and if the pain is due to anxiety disorders (which is common).

In my view every symptom is urgent and if not treated it becomes part and parcel of life leading to compromise in quality of life. Since it is possibly part of the anxiety spectrum, there are no additional medicines required to manage it (high probability).

I hope this answers your question.