I am 28 years old and I having been going through stress quite a long time. It is periodical sometimes I am very confident to do things and sometimes I feel very low. My body keeps on shaking whole day when I am feeling low. Also I get panic attack when I have to deal with public and body starts shaking. It has affected my performance and day to day activities. I don't feel like going in public. Can someone please suggest the possible solution for this.

Dr. Sajeev KumarGeneral Physician32yrs exp

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Psychiatric treatment is the best option. We generally use the word 'stress' when we feel that everything becomes too much to handle - we are overloaded and wonder whether we can cope with the pressures placed upon us. Nowadays stress is a normal part of life. Almost everyone has some sort of stress. Constantly reacting to stressful situations without making adjustments to counter the effects, threatens our health and well-being. There are steps you can help you managing day to day stressful conditions and take to feel better. 1.Be realistic: If you feel overwhelmed by some activities (yours and/or your family's), learn to say NO! Eliminate an activity that is not absolutely necessary. You may be taking on more responsibility than you can or should handle. If you meet resistance, give reasons why you're making the changes. Be willing to listen to other's suggestions and be ready to compromise. 2.Shed the 'superman/superwoman' urge: No one is perfect, so don't expect perfection from yourself or others. Ask yourself, 'What really needs to be done? How much can I do? Is the deadline realistic? What adjustments can I make? Don't hesitate to ask for help if you need it. 3.Take one thing at a time: For people under tension or stress, their day-to-day workload can sometimes seem unbearable. The best way to cope with this feeling of being overwhelmed is to take one task at a time. Make a list of things you need to get done and start with one task. Once you accomplish that task, choose the next one. The positive feeling of 'checking off' tasks is very satisfying. It will motivate you to keep going. 4.Share your feelings: A conversation with a friend lets you know that you are not the only one having a bad day. Stay in touch with friends and family. Ask them how they have dealt with a similar situation that may be 'stressing you out. Let them provide love, support and guidance. Don't try to cope alone. 5.Be flexible: If you find you're meeting constant opposition in either your personal or professional life, rethink your position or strategy. Arguing only intensifies stressful feelings. Make allowances for other's opinions and be prepared to compromise. If you are willing to be accommodating, others may meet you halfway. Not only will you reduce your stress, you may find better solutions to your problems. Go easy with criticism. You may expect too much of yourself and others. Try not to feel frustrated, disappointed or even 'trapped' when another person criticises you. 6.Hobbies: Take a break from your worries by doing something you enjoy. Whether it's gardening or painting, schedule time to indulge your interest. Exercise: Regular exercise is a popular way to relieve stress. Twenty to thirty minutes of physical activity benefits both the body and the mind. Meditate: Just ten to twenty minutes of quiet reflection may bring relief from chronic stress as well as increase your tolerance to it. 7.Take Herbal Supplement: Herbs like Brahmi, Ashwagandha, Mandukparni, Shankhpuspi, Kaunch are very helpful in managing stress. These herbs work on the brain and help relax you which ultimately empowers you to manage your stressful conditions easily. There are many herbal supplements available in the market that can help you. 8.Consult the Doctor: If your stress level doesn't seem to improve with above tips, it may require more attention and consultation with an Expert. Or consult me on Lybrate privately Physical symptoms of stress include: ?Low energy. ?Headaches. ?Upset stomach, including diarrhoea, constipation and nausea. ?Aches, pains, and tense muscles. ?Chest pain and rapid heartbeat. ?Insomnia. ?Frequent colds and infections. ?Loss of sexual desire and/or ability. STRESS CONTROL There are many ways to tame your stress and keep it at bay. Here are 20 tips to tame your stress today, and keep the stress monsters at bay. 1.Perform diaphragmatic or deep breathing exercises. 2.Lie face down on the floor and begin breathing deeply and slowly, with your hands resting under your face. Do this for five minutes. 3.Sit in a reclining chair. Put a hand on your abdomen and a hand on your chest. As you breathe, make sure the hand on your abdomen is moving up and down rather than one on your chest. If the hand on your abdomen is moving you are breathing deeply and slowly. 4.Try progressive muscle relaxation or ?deep muscle? relaxation. Progressively tense and relax each muscle group in your body. Learn the difference between muscle tension and relaxation. 5.Meditate. Use visualization or imagery to help you learn to be one with your thoughts. Sit quietly with your eyes closed, imagining the sights, sounds and smells of your favorite place, such as a beach or mountain retreat. 6.Exercise regularly or take up yoga. 7.Consult a psychologist about the use of biofeedback 8.Make time for music, art or other hobbies that help relax and distract you. 9.Learn to identify and monitor stressors. Come up with an organized plan for handling stressful situations. Be careful not to overgeneralize negative reactions to things. 10.Make a list of the important things you need to handle each day. Try to follow the list so you feel organized and on top of things. Put together a coping plan step by step so you have a sense of mastery. 11.Keep an eye on things that might suggest you?re not coping well. For example, are you smoking or drinking more, or sleeping less? 12.Keep a list of the large and little hassles in your day versus the major stressful events in your life. This helps you focus on the fact that you?re keeping track of and managing those as well as you can. 13.Set aside a time every day to work on relaxation. 14.Avoid using caffeine, alcohol, nicotine, junk food, binge eating and other drugs as your primary means for coping with stress. While they can be helpful once in awhile, using them as your only or usual method will result in longer-term problems, such as weight problems or alcoholism. 15.Learn to just say, ?No? occasionally. It won?t hurt other people?s feelings as much as you think and is simply a method to be more assertive in your own life, to better help you meet your own needs. 16.Get the right amount of sleep. For most people, this is seven to nine hours a night. 17.Cultivate a sense of humor; laugh. 18.Research has shown that having a close, confiding relationship protects you from many stresses. 19.Don?t run from your problems! This only makes them worse. 20.Talk to your family and friends. See if they can help. If these tips don?t help, or you?ve tried a lot of them with little luck in better taming the stress in your life, it may be time to consider taking it up a notch. A mental health professional ? such as a psychologist ? can help teach you more effective methods for handling stress in a healthy way in your life. Such psychotherapy is short-term and time-limited, with a focus on helping you better deal with stress. Remember ? we do have control over the stress and choices we make in our lives. It sometimes takes a little practice and effort to put some of these techniques into play in your life. But once you do so, you may be pleasantly surprised at the positive benefits you?ll receive If you need any prescription please consult me as we cannot prescribe in questions session. Regards. 

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