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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 55979
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I am 58 and menopausal and I suffer a lot of anxiety and low

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Hi I am 58 and menopausal and I suffer a lot of anxiety and low mood and nerves of the stomach so bad in the mornings I can't eat any breakfast as I feel quite sick with nerves .I'm currently taking 2 20mg of fluoxetine a day but it's not having much effect on me .What can I do ? Or what can I take to make thing better ?
JA: How long have you been dealing with this? Is there anything in particular that seems to make the symptoms better or worse?
Customer: IVE been feeling this way for just over five weeks .My mother was ill and got taken to hospital and I care for my dad whose blind .My stomach hasn't been right since she went into hospital.
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: No not that I know of .

The best way to deal with anxiety is a comprehensive approach. It can be treated by the following measures by yourself;

1) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT); done by a psychologist but there is an internet-based approach nowadays too. CBT has higher efficacy and lower relapse rates.

2) Relaxation training and biofeedback.

3) Hypnosis

4) Acupuncture and acupressure

5) Yoga

6) Meditation

7) Group sporting activities

8) St. John's wort

9) Melatonin
10) Valerian root

11) Deep breathing exercises.

A major component of therapy involves understanding and assuring yourself that the symptoms are neither from a serious medical condition nor from a mental deficiency but rather from a chemical imbalance in the fight or flight response. Alprazolam (Xanax) has been widely used for anxiety disorder, but it is currently discouraged because of its higher dependence potential.

CBT helps to understand how automatic thoughts and false beliefs/distortions lead to exaggerated emotional responses, such as anxiety, and how they can lead to secondary behavioral consequences. Cognitive restructuring involves substituting positive thoughts and getting rid of negative thoughts. Some studies have suggested that high importance to religion and religious practices also improve anxiety symptoms and prevent recurrences.

Please feel free for your follow-up questions.

I would be happy to assist you further if you need any more information.

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