How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask DR. EHTISHAM Your Own Question
DR. EHTISHAM
DR. EHTISHAM, Doctor
Category: Medical
Satisfied Customers: 2482
Experience:  MBBS, FCPS
41140702
Type Your Medical Question Here...
DR. EHTISHAM is online now

I have been suffering with severe anxiety and depression to

This answer was rated:

I have been suffering with severe anxiety and depression to the point where I wake up in the morning trembling, sweating, heart racing/palpations/chest pain, extreme fatigue & severe diarrhoea and the wanting to be sick however I just urge. I feel my body is shutting down as I am unable to physically drag myself out of bed until 3/4pm in the afternoon and not able to cloth or shower . I can’t eat or drink anything. Then around this time something seems to switch and by the evening I am to mange to drink a cup/coffee or two and have a light bite to eat. I seem to then want to be hyper and not want to go to sleep as i 1, know I will wake up feeling terrible again the next morning and 2, tmy symptoms are less severe so I can function for 3/4 hours of the day. I have been on sertaline 50mg since 2005. My Dr increased my dose to 100mg at the beginning of Dec to no affect. It was increased again to 150mg at the end of Dec but it made no difference so he had changed my meds to Miztazapine 15mg on Tuesday however I have had to reduce my Sertaline first to 50mg for 7 days before I can start them. Do you think it’s to do with my Cortisol levels that are making me feel so unwell and what do you suggest.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with your reply momentarily.

Do you have your thyroid function tests done recently as well ?

Since how long you are on sertaline ?

Regards

Customer: replied 1 month ago.
Thank you. I hope you can help.

I will try my best

Customer: replied 1 month ago.
I have had my thyroid checked at ED and was advised this was ok. My surgery is doing a blood test on Monday to check for diabetes however they is it. I would like them to check my cortisol level but they are reluctant to do this. Thank you

Have they checked your female hormone panel as well ?

Regards

Customer: replied 1 month ago.
Sorry, meant to say, been on Serataline since 2005 but was increased beginning of Dec to 100mg them end of Dec to 150mg.? Just been getting worse so Dr had told me to reduce to 50mg for 7 days the start Mirtazapine. Thank you.
Have they checked your female hormone panel as well ?Regards
Customer: replied 1 month ago.
Not sure what a female panel is? I had a sub total hysterectomy in Sept however I still have one ovary.
Customer: replied 1 month ago.
I stil ovulated as still have slight spotting 28 days since the operation.

Thanks for the information

I would agree adjusting your drugs as advised by your doctor but in the mean while would suggest that you should have your female hormones estrogen/progesterone and cortisol checked as well

It is possible that you only have depressive illness and anxiety but a secondary reason like hormonal disturbance needs to be ruled out and treated in the mean time

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
Would a hormonal disturbance cause all these symptoms?

Yes it can

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
My anxiety and depression was brought on by being in hospital in Nov as I had C.Diff and Shiga coil. I still have problems now but been told it can take months for the good bacteria to settle down. Is that correct? Sorry, for so many questions?
Customer: replied 1 month ago.
Just another question, why would I feel slightly human again later in the day?

A hormonal variation can be responsible for change in symptoms at some specific time

When treated with antibiotics the normal good bacteria also die and take months to recover

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
Last question, I only went down from 150 to 50 on Wednesday on sertaline. I did miss a dose yesterday. When is it safe for me to stop them and start the Mirtazapine?

You can start Mirtazapine in a couple of days

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
I am still a bit confused. So do I need these corisol and hormone test urgently? It’s not life threatening or anything is it.
I don’t understand why I would get such severe symptoms if it was just anxiety/depression? Sorry, panicking a bit now. Just want reassuresnce. Thank you

Not urgently but when you go to your doctor next visit you should request these

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
Thank you.Can you just answer- can severe aniexty/depression cause such harsh symptoms as these?.

Yes unfortunately they can

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
Thank you for your time. I will book in for some test if my GP will allow me to have them done. If they refuse-do you know what I can do to get these done?

Hopefully they will request it

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
Hopefully they will. If not can I insist? Thank you for your time.

Yes you can specially the female hormone test

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
Thank you. You have been very helpful & helpful. Just a final question, do u have to worry about dehydration as I am not drinking anything until 3/4pm each day?.
Customer: replied 1 month ago.
professional.

Yes i would worry and would suggest that you should take as much fluid as possible when you are up

Please do let me know if you have any more question

Regards

Customer: replied 1 month ago.
Ok, thank you. I will try.

You are welcome

Please take a while to rate this answer

Regards

Customer: replied 1 month ago.
Thankyou.

My pleasure

Regards

DR. EHTISHAM and other Medical Specialists are ready to help you
Customer: replied 1 month ago.
You have been so good at listening. I have got more advice from you than I have from my GP in six weeks. Thank you.