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Causes and symptoms of depression,BIPOLAR DISORDER and anxiety

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I am 19 soon to be 20. I have a history of un diagnosed mental issues that family believes to be depression or bi-polar disorder. Aside from that I medicate with medical cannabis to relieve both the depression and knee pain I have from a recent surgery. I have medicated for roughly 2 years and never had any problems. Recently I had an episode where I had what i believe was a panic/anxiety attack. My heart felt like it was gonna stop beating and it felt like I was gonna die. I was scared mostly by the shortness of breath and the slight sharp pains when taking a deep breath. Of course my biggest fear is that it isn't anxiety and that it is something wrong with my lungs or heart. I stopped medicating for the past 5 days but the symptoms still come and go, mostly when I am thinking about it the most or home alone. The symptoms I get while at work or just during the day is a feeling as though I have to try hard for a breath, a sometimes sharp pain when breathing in deep. And that feeling as though my heart could stop any minute. I don't take any other medication aside from melatonin to help me sleep. I have never drank or taken any form of drugs. Cannabis has been my only medication and has been amazing at helping, but I am worried it may have caused a problem in my physical or mental health. I am also worried it is my habits seeing as I recently moved out of state on my own with my girlfriend, got my first job working as a motion graphics artists where I get a lot of judgement and don't eat the best, I am 5'7 155lbs. I have always had a history of very bad and dark thoughts about myself which is why I am leaning towards anxiety but still it lingers in the back of my head that it is my health. Knowing what the cause of this will hopefully relieve my anxiety or prove to me that its my health and warrant a doctor visit.

Category: Psychiatrist

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Thank you for using for posting your query.

I have gone through your question in detail and I can understand what you are going through.

Before I can proceed with my opinion, I have a few queries.

1. How long do these panic attacks last? Do they resolve spontaneously?

2. What dose of cannabis have you been taking? Are you still on it or off it?

3. Do you take caffeine? If yes how much?

4. Any family history of psychiatric illness?

Hope to hear from you at the earliest.

Kind regards,

Dr. Srikanth Reddy MD.

Patient replied :

The symptoms often last all day and usually go away once I become distracted with work or at home. They seem to get worse specifically when I have nothing to do and my mind is allowed to wander. My dosage is hard to explain but it's around 1gram a day depending on the severity of my depression. I haven't had any for around 5 days because the symptoms can get worse. I hate caffeine personally and only have it occasionally. I do have a rather large history of mental illness in my family. Depression is big on my moms side and social anxiety is very big on my dad's side.


Thanks for all the additional details. 

The symptoms that you have are basically panic attacks. However, it would be wise to get an EKG and Echocardiography done. If these reports are normal (mostly they will be) then you will be reassured and there will be nothing much to worry. This is a disorder of anxiety and occurs because of imbalance of certain neurotransmitters in the brain, especially serotonin, noradrenaline,  and dopamine to some extent. Cannabis is not considered a good option for this illness. Medicines are the best options to take care of these symptoms. Paroxetine is the the most popular medicine and my drug of choice. I generally prescribe my patients 12.5 mg per day at night which takes care of their anxiety symptoms. Also certain medicines like propranolol and clonazepam can be given as required when there is a panic episode or a situation where a panic attack can occur.

Also there is an option of cognitive behavioural therapy (CBT). This therapy is provided either by a psychologist or a psychiatrist, in which the therapist identifies impaired cognitions (thoughts) and tries to correct them. They are 15-20 min weekly sessions and there should be around 8-10 sessions to help you with your illness.

Hope this was helpful.

If you have any further query, do let me know.

Dr. Srikanth Reddy
Category: Sexologist
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
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