Hi. I just started taking pexep cr yesterday. And have read real bad things about getting off these pills. I have just started having anxiety but not that bad. I have it only at nights and difficulty sleeping. But daytime I am perfectly okay. Can I stop taking it and try natural method for anxiety control. My doctor will not reply. Please help.

Dr. Sajeev KumarGeneral Physician32yrs exp

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Natural methods can be tried and do meditaion and yoga. Anxiety is a very normal emotion, which gives rise to feelings of nervousness every now and then. An anxiety disorder is a serious medical condition in which people experience a high degree of distress and mental trauma, which causes difficulties in leading a normal life. People suffering from this medical condition experience high levels of anxiety and nervousness almost all the time. Here are the symptoms that indicate you're suffering from anxiety disorder. 1. Excessive worry - This condition persists if you worry about the day to day activities a bit too much on a regular basis. It is identified when you start taking too much stress about very petty things, which tends to affect you in an adverse manner. A noticeable sign of excessive worry can be too much fatigue. 2. Sleep problems - Problems falling asleep at the right time and problems in maintaining a sound sleep are two signs that indicate you have an anxiety disorder. 3. Irrational fears - This symptom is not generalized; instead, it is specific and subjective in relation to a particular thing or situation. The fears that are experienced under this category are sudden and unexpected in nature and there is no fixed rationale behind these fears. 4. Muscle tension - Muscle discomfort and pain is one of the leading physiological causes of an anxiety disorder. The pain felt is chronic and pervasive, and is very common among people facing situations of anxiety. If you are exposed to constant periods of anxiety, you will experience fatigue, muscle pains and unwillingness to work. 5. Chronic indigestion - Problems related to the digestive system are also a sign of anxiety disorder. In this case, you may face constant digestive problems accompanied by a common disorder called IBS (Irritable Bowel Syndrome). IBS refers to an anxiety situation in the digestive tract, which is characterized by stomach aches, cramping, bloating, gas, constipation, and/or diarrhea. Apart from the above-mentioned symptoms, other symptoms of an anxiety disorder include stage fright, self- consciousness, panic attacks, memory flashbacks, perfectionism, compulsive behaviors, self- doubt, and such others. Symptoms vary depending on the type of anxiety disorder, but general symptoms include: ?Feelings of panic, fear, and uneasiness. ?Problems sleeping. ?Cold or sweaty hands and/or feet. ?Shortness of breath. ?Heart palpitations. ?An inability to be still and calm. ?Dry mouth. ?Numbness or tingling in the hands or feet. ?Anxiety is a normal, predictable part of life. However, ?people with an anxiety disorder are essentially phobic about the feeling state of anxiety.? And they?ll go to great lengths to avoid it. Some people experience generalized anxiety disorder (GAD), excessive anxiety about real-life concerns, such as money, relationships, health and academics, Others struggle with society anxiety, and worry about being evaluated or embarrassing themselves, he said. People with obsessive-compulsive disorder (OCD) might become preoccupied with symmetry or potential contamination. ?The bottom line is that people can experience anxiety, and anxiety disorders, related to just about anything. Most of these steps contribute to a healthy and fulfilling life, overall. For instance, ?making some basic lifestyle changes can do wonders for someone coping with elevated anxiety,? Take these steps from today. 1. Take a deep breath. ?Deep diaphragmatic breathing triggers our relaxation response, switching from our fight-or-flight response of the sympathetic nervous system, to the relaxed, balanced response of our parasympathetic nervous system,? according to, clinical psychologists. Who have suggested the following exercise, which you can repeat several times: Inhale slowly to a count of four, starting at your belly and then moving into your chest. Gently hold your breath for four counts. Then slowly exhale to four counts. 2. Get active. ?One of the most important things one can do [to cope with anxiety] is to get regular cardiovascular exercise,? For instance, a brisk 30- to 60-minute walk ?releases endorphins that lead to a reduction in anxiety.? You can start today by taking a walk. Or create a list of physical activities that you enjoy, and put them on your schedule for the week. Other options include: running, rowing, rollerblading, hiking, biking, dancing, swimming, surfing, step aerobics, kickboxing and sports such as soccer, tennis and basketball. 3. Sleep well. Not getting enough sleep can trigger anxiety. If you?re having trouble sleeping, tonight, engage in a relaxing activity before bedtime, such as taking a warm bath, listening to soothing music or taking several deep breaths. And, if you?re like many people with anxiety whose brains start buzzing right before bed, jot down your worries earlier in the day for 10 to 15 minutes, or try a mental exercise like thinking of fruits with the same letter. 4. Challenge an anxious thought. ?We all have moments wherein we unintentionally increase or maintain our own worry by thinking unhelpful thoughts. These thoughts are often unrealistic, inaccurate, or, to some extent, unreasonable,? Thankfully, we can change these thoughts. The first step is to identify them. Consider how a specific thought affects your feelings and behaviours. Is it helpful or unhelpful? These are the types of thoughts you want to challenge. Therefore it is suggested asking yourself: ?Is this worry realistic?? ?Is this really likely to happen?? ?If the worst possible outcome happens, what would be so bad about that?? ?Could I handle that?? ?What might I do?? ?If something bad happens, what might that mean about me?? ?Is this really true or does it just seem that wa Then, ?reframe or correct that thought to make it more accurate, realistic and more adaptive.? Here?s one example: ?I would feel embarrassed if I tripped on the stage, but that?s just a feeling; it wouldn?t last forever, and I would get through it.? 5. Say an encouraging statement. Positive, accurate statements can help to put things into perspective. See these examples: ?Anxiety is just a feeling, like any other feeling.? and ?This feels bad, but I can use some strategies to [cope with] it.? 6. Stay connected to others. ?Social support is vital to managing stress,? Today, call a loved one, schedule a Skype date or go to lunch with a close friend. ?Talking with others can do a world of good.? Another option is to get together and engage in an activity that improves your anxiety, such as taking a walk, sitting on the beach or going to a yoga class. 7. Avoid caffeine. Managing anxiety is as much about what you do as what you don?t do. And there are some substances that exacerbate anxiety. Caffeine is one of those substances. As said, ?The last thing people with anxiety need is a substance that makes them feel more amped up, which is exactly what caffeine does.? 8. Avoid mind-altering substances. ?While drugs and alcohol might help to reduce anxiety in the short term, they often do just the opposite in the long term,? Even the short-term effect can be harmful. Experts have treated countless clients whose first panic attack occurred while they were taking drugs such as marijuana, ecstasy or LSD. ?Panic attacks are bad enough if you are straight and sober, so imagine how bad they are if you are high, and can?t get un-high until the drug wears off.? 9. Do something you enjoy. Engaging in enjoyable activities helps to soothe your anxiety. For instance, today, you might take a walk, listen to music or read a book, 10. Take a break. It?s also helpful to build breaks into your day. As it is said, this might be a ?simple change of pace or scenery, enjoying a hobby, or switching ?to-do? tasks.? ?Breaking from concerted effort can be refreshing.? 11. Problem-solve. It is suggested considering how you can address the stressors that are causing your anxiety. Today, make a list of these stressors and next to each one, jot down one or two solutions. 12. Pick up a book. There are many valuable resources on anxiety, which teach you effective coping skills. Some recommended are Dying of Embarrassment for people with social anxiety; The BDD Workbook for body dysmorphic disorder; The Imp of the Mind and The OCD Workbook for obsessive-compulsive disorder. It is suggested Stop Obsessing for adults with OCD (and Up and Down the Worry Hill for kids with OCD). For people with panic attacks, it is suggested Don?t Panic: Taking Control of Anxiety Attacks. For a general overview of cognitive-behavioural therapy for anxiety, 13. Engage in calming practices. ?Meditation, yoga, or other calming practices can help minimize anxiety in both the short and long term.? Sign up for a yoga class or watch a yoga video online. (Curvy Yoga is a wonderful and sizes.) Meditate right now for just three minutes resource for yoga for all shapes 14. Contact a therapist. ?Sometimes anxiety can be difficult to manage without professional help,? Many organizations include databases of providers who specialize in anxiety (along with helpful information). 15. Accept your anxiety. ?If you really want to effectively manage your anxiety, the key is to accept it,? This might sound counterintuitive. But anxiety, ?in and of itself,? isn?t the real problem. Instead, it?s our attempts at controlling and eliminating it, he said. ?Not accepting these unwanted inner experiences is the actual source of so much of our self-induced suffering.? Accepting anxiety doesn?t mean ?resign[ing] ourselves to a life of anxious misery. It simply means that we are better off recognizing and fully accepting the existence of anxiety and other uncomfortable emotional states that are inevitable, but transitory,? So if you experience anxiety today, simply observe it. ?Think of it like a wave of the ocean; allow it to come in, experience it, and ride it out.? Anxiety can feel overwhelming. It can feel like chains around your feet, weighing you down. But by taking small steps ? like the ones above ? you can minimize your anxiety and cope effectively. 

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Dr. Saranya DevanathanPsychiatrist46yrs exp

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Dear lybrate-user, Of course it is your decision to take whatever treatment you wish to take. If you consult psychiatrists, they will prescribe according to their expertise based on evidences of many research work. You can take decision to go to psychiatrist or not. You can even take a decision whether to take her/his treatment or not. You can even take a decision of stopping treatment also. You are old enough and have the sanity to use your discretion. You can stop Pexep and try natural methods. If it does not work, please remember that psychiatrists and their treatment will always come for your help. The same doctor also will accept you, since most doctors know that some persons don't comply with treatment. 

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