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Anxiety and Stress Disorders

Anxiety or Depression?

10/17/2008

Question:

I am 50 years old male with anxiety and stress. I developed the symptoms in 2006 when I did not get promotion though I deserved the most. I started becoming very emotional, very sensitive and in case I hear some news or view some secnes on the TV, I become emotional and tears rolled down my cheeks though after some time I wondered myself as to why I was on tears without apparent cause. I was put on Lexapro 10. After a years or so my symptoms vanished and internist started tapering of the dose and now I am completely off medicine since one month. Again since few days, I have the same pre treatment feelings : Excessive thinking, tears in the eyes without apparent cause, worrying over a trivial issue so on and so forth. Ineed your guidance as to how again it happened. My internist asked me to start Lexapro 10 and he told me to incerease it to lexapro 20 which will completely cure me of the present problem. Can you guide me as patient education and awareness. I shall be much obliged.

Answer:

Depression and anxiety are felt to have similar biochemical causes -- neurotransmitters (chemicals in the brain that help brain cells "talk" to each other) become imbalanced.  Therefore, there is often overlap between the symptoms of depression (sadness, tearfulness, inability to concentrate, lack of pleasure, change in appetite, change in sleep) and symptoms of anxiety (excessive worry, fears that interfere with normal activities, panic).

SSRIs (selective serotonin reuptake inhibitors), of which Lexapro is one example, are commonly used medications for both anxiety and depression.  They help to put neurotransmitters back into balance.  Treatment usually takes at least 6 - 18 months, often longer for anxiety than for depression.  As you found out, sometimes the only way to know if you need to continue your medication is that symptoms recur when the medicine is decreased or stopped.  Occasionally people need medication for longer periods of times - even several years or even indefinitely.

It is also important to consider counseling along with medications for treatment of anxiety and depression.  Studies have shown that the combination of medication and counseling (especially cognitive behavioral therapy or CBT) are more effective and for longer than either alone for anxiety. 

Don't forget about a healthy lifestyle as an adjunct to your treatment.  Getting plenty of sleep, exercising regularly, eating a healthy diet with lots of fruits, vegetables and whole grains, limiting alcohol and avoiding cigarettes and drugs like marijuana, cocaine and others will definitely help with both depression and anxiety.

Check out some of the web links and good luck.

Related Resources:

anxiety disorders of america
NIH NIMH anxiety
Depression screening test

For more information:

Go to the Anxiety and Stress Disorders health topic, where you can:

Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati