Depression

Question
Posted by: Ella | 2018/05/25

Q.

Is it anxiety?

Good Day Doc I am not sure if I should see someone about possibly suffering of anxiety, I hope you can give me direction. My issue is that I suffer of a bunch of symptoms that could be stress / anxiety related, yet I don't feel that I'm not coping. In my head I feel a little overwhelmed at times, but who doesn't? I am plagued by insomnia, nightmares, colds and flue, muscle tension, I even developed shingles and now it started shaking - like an internal vibration (for lack of a better description) and the other day I think I might have had a panic attack! I had serious chest tightness and difficulty breathing. The GP gave me a muscle relaxer and Zopax. I do have some stress factors; i have two busy school going children, my husband is in a wheelchair but will be in hospital 120km from home for the next 4 weeks - so I am travelling a lot. We live on a farm so you are always alert I guess. I run two home-based businesses and have a lot of responsibility at home and in the community. I am an introvert who needs down-time which I'm not getting much of now, I'm off anti-depressants for about 2 years now after being on them for 9 and I also have Rheumatoid Arthritis (which is causing me some discomfort but I can cope right now) The point is I don't spend time worrying about things I am positive and even cheer my husband up. I stay away from confrontations and I do have a pretty good support system. My question really is; is this what anxiety feels like or could something else be to blame? Why would I have physical manifestations when I'm not tearful or sad or constantly thinking about the things that stress me? Could it be a reaction to my RA meds? I take 10 Methotrexate tablets a week and try to avoid the cortisone etc unless I am in real pain.

Expert's Reply

A.

Depression expert
- 2018/05/28

Hello  Ella,
Most of us experience symptoms of anxiety, sometimes for extended periods of time, yet we usually cope with this.  The criteria we generally use for deciding when a bunch of symptoms have become a disorder, is whether they form a recognized cluster, and whether they significantly interfere with your work or personal life.
Certainly some of what you describe could be part of an anxiety disorder.  Such disorders are common even among people leading a relatively peaceful life, and it's clear you are coping distinctly well with a complex life and set of stressors.  With a previous history of depression, apparently effectively treated, it's possible that a form of the depression may have returned, even if a depressed mood as such isn't prominent right now.   Antideprssants are also effective in treating anxiety and it's symptoms. Counseling of the CBT form can also be very effective in both conditions.
Nowadays, even more than previously, we recognize that sedative tranquilizers like Zopax ( a trade name for Alprazolam,  a relative of Valium ) and whatever the muscle relaxant is (often also a member of that family ) may provide some rapid relief ( like a stiff whiskey ) but there are real concerns about their long-term use, as they can become habit-forming, and expert guidelines suggest they be used for less than 2 months ).  They also are not useful for depression.
Also be aware that all of this family of drugs impair your reaction times and affect driving & operating machines : even taken at night, thy may affect your driving reaction the next morning as much as a stiff drink of alcohol.
So please be cautious about this. 
Cortisone can be associated with mood disorders, but it's not clear to me from your comments, how much of this you take.  Methotrexate isn't usually associated with anxiety symptoms, but can include aches and pains, and flu-like symptoms.

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