Hi, I am suffering from stress, depression, panic attacks, chronic fatigue for the last 10 years, I have consulted 3-5psychiatrists and homeopaths too. When I take allopathic medicine I get dullness, sleepy thru out the day and when stop medicines. I get panic attacks like chills, feverish, breathing out with big sigh, I do yoga, meditation,yoga nidra etc feel better for 2- 3 hours, the symptoms are severe in the morning till afternoon at 4 o'clock, in the evening I am near normal, half tab of clonazepam .25 gives me instant relief, I am on escitalopram 20 mg in the night, and bupiprone sr at 8 am, for 4 months but no relief till 4 pm, after 3 hours deep sleep in the noon things are normal in the evening, Please guide me I am 58 years now.

Dr. Saul PereiraPsychologist48yrs exp

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I suspect that you are not seeking any help from counselling. You cannot manage with medication alone. Also if you are not mentally and physically occupied, you could easily fall prey to disturbances. Ideally, afternoon sleep is a nap or of forty winks. You are sleeping 3 hours is not at all healthy. What is recommended is 20 minutes to 40 minutes max. This much of sleep will disturb your biorhythm. You must continue with the counseling to develop coping mechanisms to face the daily challenges of life. Because you are not handling fear well, you tend to over-react to normal fear with abnormal panic attacks. About the issue itself: do you know if this is a family trait, or is the family by anyways less to socialize, or have you had any problem with fear because of some family or childhood experience? Have you ever been embarrassed in public by someone that it has left an indelible mark in your personality? You can take the answers to these questions to a counselor and resolve the same. Any way you must deal with your fear of people and it will be the best solution to your problem. You need to change your perception of the fearful stimulus then you can change your response to the fear. The first one is the best and will preempt the need for the second. If you are already far gone into the reaction mode, then you need both responses to counter the attack. The way we see things in life (like half empty or half full glass) is very dependent on our attitude. Attitude may have developed over many years but fortunately can change in a matter of sustained choices made and acted up on now. Accordingly you choose to see things as either threatening or as an opportunity. The opportunist will be positive and work with the situation to make good out of it. The individual who sees it as threatening, will, out of fear, try to avoid/run away from the situation or react with anxiety. Yes, self-belief does impact it too, but you can see that prior to that, perception will tarnish the belief system too. Here, you can see that all the resolution lies in just changing your perception/attitude, even if it is against odds. Changing your response, despite the perception, is building up of your reserves and resources to handle any contingency that life throws up at you. And life throws up situations quite regularly and heavily. In the meantime do some confidence building exercises by attending a personality development course, public speaking skills course (i suggest you join the toastmasters club), work out at a gym to build good self-image, and join social events to practice your skills. Surprisingly many people are often in the same boat as you, and so you are not alone. The very people you are intimidated by may be afraid of you too, though not to this extent! there are three important developments to have to make an autonomous personality: awareness, intimacy and spontaneity. If you are super aware or too conscious of yourself, it will affect the intimacy and spontaneity. Although your problem is now directly to do with intimacy, you can see that they are all connected. Go and work on these matters with a counselor for this level of panic reaction to disappear from your life for good.  

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