Q. Why am I stressed a lot and unhappy too?

Answered by Dr. Kumarshri Shriniwas Saraswat and medically reviewed by iCliniq medical review team.


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Image: Why am I stressed a lot and unhappy too?

Hello doctor,

I am a 26 year old male. My weight is 60 kg and height is 5'8". I grown up with great responsibility of family, but never fulfilled it up to the mark besides living my life in fear from society. I managed good academics and some standard over time. But, I have also developed very poor social skill, dependency to some extent and fear while facing anything new. I do not want to move from a situation where I have fixed myself.

Three years before I had a breakup and also was idle without job. This had caused me severe stress and crying episode about which I did not share with any one. I got job, but did not feel happy about it. The emptiness and worry followed me. I got into another relationship which was lovely. I got involved in alcohol drinking and smoking. I faced a time where job stress killed me every day and I detached myself from everyone, felt emotionless even with my family, drowsiness and no sense of reality. I became so casual that only thing I wanted is nothing should worry me. If anything worried me I tried to solve it immediately with a step which might be job threatening. I lived without any pleasure, confidence, goal and routine. I did live my life, but never felt any connection as I have become a robot. Forgetfulness, short term memory loss and no attention or interest at all. Today I have improved myself and do not drink regularly; I do exercises, do talk with family and some friends, watch television and got a better job. But still, I am not happy. My forgetfulness and excessive worry is with me still. I find that my brain is continuously busy in something, but I am not aware of that. I feel very tired and lazy. Socially frightened, poor, and I am not clever enough. However, I am very polite, helpful to others and have good moral value. I found that I have not added a strong value and get easily convinced, irritated and people make fool of me. It is like I have got stuck and trapped and I have not moved on. I want to put an end to this. Please help me.

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Dr. Kumarshri Shriniwas Saraswat
Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology, Sleep Medicine


Welcome to icliniq.com.

I have gone through your query in detail and would like to summarize your current symptoms:

  • Feeling sad, excess worries, poor cognitive abilities (memory and thinking), social anxiety (fear of people), reduced energy levels (lazy and tired), low self-confidence and feeling of guilt and worthlessness are all typical symptoms of depression (major depressive disorder).
  • Your past history suggests that you are suffering from this for almost three years and it was more severe in between with symptoms of lack of motivation, lack of pleasure, indulging in smoking and drinking.
  • The simple and effective way out of depression is antidepressant medicines. They are safe, will act quickly and help in majority of cases.
  • There are lots of the other option like counseling (cognitive behavior therapy) and electroconvulsive therapy, but medicines are most practical for your current condition.
  • For symptoms of depression along with anxiety including social anxiety, selective serotonin reuptake inhibitors (SSRI) classes of antidepressants are most effective.
  • I would like to start you on Escitalopram 10 mg and wait for 15 days and then adjust dose accordingly. Clonazepam needs be taken at a dose of 0.5 mg for 15 days alongside and then stopped.

Along with medicines, here are few tips for better results:

  1. Stay away from alcohol as it will cause as well as worsen depression.
  2. Do 30 minutes of physical activity like cycling, jogging and swimming daily. It increases the levels of feel good hormones in your brain.
  3. Do deep breathing techniques like the 4-7-8 technique which you can find on the internet. Practice it for a minute, do four to five times a day.
  4. Devote some time for a hobby which gives you a sense of pleasure.

Differential diagnosis:

Social anxiety disorder.

Probable diagnosis:

Major depressive disorder.

Treatment plan:

Antidepressant medicines and lifestyle changes.

Preventive measures:

Avoid alcohol and increase physical activity.

Regarding follow up:

Follow up if you have any queries to a psychiatrist online.---> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


Hello doctor,

I took the medicine which has been suggested to me. However, one breakup occurred in taking medicine. There has been very much improvement. I feel only slight clarity, but memory and clear thinking still disturbing. This has happened after a long time that for one or two moment I felt connected to myself, but it happened only one or two times. I feel slight improvement in laziness, but still suffering from procrastination. There is slight improvement in moods, but it is totally instable. Maximum time I am not sad but serious, bored, disturbed, frustrated and sometimes sad too. At this point, I cannot comment on my social anxiety. There is slight improvement in excess worry. My brain feels relaxed some of the time which was not there before. I do not know whether I feel guilty or not. Self-confidence remains the same. Above all, I am still lost and not able to find myself as there is a shadow in my brain which is stopping me to have the clarity. Improvement is there which is a happy feeling for me. I am looking forward for your advice.


Dr. Kumarshri Shriniwas Saraswat
Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology, Sleep Medicine


Welcome back to icliniq.com.

  • It is nice to hear that you are improving. This is known as a response. You are improving, but far from being completely better. This much is expected in 15 days.
  • Now, the next step is to double up the dose of Escitalopram, take 20 mg at night from today.
  • Also half the dose of Clonazepam, which means half tablet of 0.5 mg at night.
  • Try to abstain from drinking as much as possible and follow up after another 15 days.

Revert back after 15 days to a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


Hello doctor,

I have been given Nexito forte which consists of Escitalopram 10 g and Clonazepam 5 g in a single tablet. How can I double Escitalopram and take half of the Clonazepam tablet? Another prescribed tablet is Folic acid. Kindly guide.


Dr. Kumarshri Shriniwas Saraswat
Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology, Sleep Medicine


Welcome back to icliniq.com.

  • The Clonazepam (0.5) tablet can be broken and taken half, while the Escitalopram 20 mg tablet should be taken.
  • Along with this, I will also suggest some vitamin tablets next time.

For further doubts consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

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