Brief Answer:
These symptoms need further evaluation

Detailed Answer:
Hello, Welcome to Health Care Magic

I can understand your concern. You are 21 years old and have symptoms like feeling detachment from reality, feeling dazed, scrambled thoughts etc.

You are facing these symptoms for over a year and symptoms are becoming progressively worse.

Though these symptoms suggest some chronic stress or anxiety or depression but need evaluation. It's not possible to make diagnosis of depression based upon these symptoms. I'd like to know if you have-

- Any pervasive persistent sadness of mood?

- Any lack of energy in doing things or persistent tiredness?

- Any lack of concentration or poor focus?

- Any bad thoughts or suicidal ideation?

- Any complaints of poor sleep or changed eating habits?

- Any complaints like episodic racing heart rate, sweating, tremors, chocking sensation of thoughts, chest tightness etc.

- Are the thoughts you are having are your thoughts? Are these thoughts are purposeless?

- Any other positive symptom you are having?

- Any history of drug abuse or trauma?

Please provide these symptoms as per your convenience so that I can reach to a provisional diagnosis and can help you.

Thanks, I hope this helps you. Take care

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Brief Answer:
These symptoms suggest depressive disorder.

Detailed Answer:
Hello thanks for asking a follow up question.

The symptoms like remaining persistently sad and depressed, tiredness and fatigue, lack of motivation, poor concentration, negative thoughts related to future or hopelessness, feeling life as complicated etc are classical depressive symptoms only. Also as these symptoms are causing affects in your professional life so there is need for urgent treatment.

Along with these symptoms you have racing heart, chest tightness, dryness of mouth, racing thoughts, feeling dazed and confused, feelings of detachment etc point towards some co-morbid anxiety.

You are just 21 and please don't ignore these symptoms. Try to take appointment from a psychiatrist and get yourself evaluated. In Depression and Anxiety medicines like SSRIs are mainstay of treatment. These medicines when taken regularly result in improvement in symptoms in about 4 weeks of starting the treatment. Sertraline, Escitalopram, Fluoxetine etc are commonly used medicines. These medicines are also good anti-anxiety drugs so would help in your anxiety also. It is safe to take these medicines and no serious risks are associated with these medicines so you can go for drug therapy without worries.

Along with medicines give some time for relaxation exercises like Progressive Muscle Relaxation Exercises, Yoga or Breathing Exercises. These relaxation exercises will help to keep anxiety away. For details of these relaxation exercises you can take help of youtube.

Take diet rich in proteins and complex carbs and low in fats and refined carbs. This would help to lift the mood. Omega-3-Fatty Acid supplements and vitamin B12 supplements are also found to be very useful in some patients with these symptoms. These are available with common chemists and you can start these supplements immediately till you see the psychiatrist.

Please dont be stressed due to these symptoms. These symptoms will reduce in some days and you will definitely become fine after taking medicines.

Thanks, Please dont hesitate to ask again for more doubts. Take care

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Brief Answer:
De-realisation like feelings are not hallucinations so no need to worry

Detailed Answer:
Hello again and thanks for asking a follow up question

Feelings of completely disconnected from reality and feelings as if you are on drugs can occur in severe underlying anxiety and stress. These feelings are not hallucinations but to some extent are related to derealisation. In this individuals feel disconnected from reality and they cant work normally. The history of trauma due to accidents have caused not much effects on your current psychological problems but still to some extent they may affect the psychopathology of anxiety.

The psychological evaluation can be done and I can help in making a provisional diagnosis but as this is an online forum I can't write a prescription of medicines or definite treatment here because of legal issues.

Try to follow the life style changes as I have mentioned in my last answer and you will see improvement. Relaxation exercises, diet, supplements with good sleep will help in quick recovery. Also remember one thing that these symptoms are not very serious and you will come out of these symptoms easily.

Thanks, Still have more doubts please ask again. Take care

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Brief Answer:
Don't remain stressed due to these symptoms

Detailed Answer:
Hello again and thanks for asking a follow up question

Yes it is normal to forget what you are in real life. But that loss of memory doesn't occur completely. Even in severe stress individuals develop symptoms that they are not real.

You have mentioned that you forget that what you are doing or where you are. You even forget what you really are.

Are these symptoms occur commonly or in some situations only?

Do you have any awareness that you assume a new identity during the states of feelings of detachment?

Severe confusion, stress and anxiety may cause individuals to feel like you are feeling. Some dissociative symptoms have neurotic origin.

You have sense of who you are. But there are no symptoms that you have mentioned
that show that you assume a new identity. You are losing awareness to reality but not assuming a new identity so we can rule out dissociative disorder easily.

The sense of unreality to external world is derealisation and alteration of sense to self is depersonalisation. Both are seen in perceptual disturbances but considering your age, history you have mentioned the reason behind these symptoms is severe anxiety and depression.

In my first two answers I have asked you few details and those were asked to make provisional diagnosis of depressive disorder and anxiety disorder.

Be assured there is nothing serious in these symptoms, please remain relaxed and you will come out of these symptoms.

Thanks, Hope this helps you, if you have more doubts you can ask again.

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Brief Answer:
Psychological evaluation In detail

Detailed Answer:
Hello again and thanks for asking a follow up

Psychiatric evaluation consists of two main parts-

- Detailed clinical history
- Mental Status Examination (in MSE patient should be with interviewer in real)

Some times a third part in which some interview scales are applied based upon the provisional diagnosis.

Coming to details, please provide me in detail-

- Your personal particulars like relationship status, educational and occupational status. Details of family with number of family members, their attitude towards your symptoms. Type of job like day time or shift type, any stressors at job?

- If we consider five most distressing symptoms that are bothering you, then what are they? Since how much time they are present. Any significant event or stressor that preceded the onset of symptoms? How your symptoms progressed if they increased in severity progressively? Any effects of these symptoms on your job, on your social life, on your personal life etc.?

Any symptoms like wishing to die, any attempts to harm yourself, any ideas about hopelessness, helplessness or worthlessness? Any history of hearing voices which other can't hear? Suspiciousness if any?

Also provide if any past history of similar complaints? Any history of chronic medical treatment?

History of any chronic illness in family. No of family members? Attitude of every member towards you and your illness? Your relationship with them? No of your friends and any close friends?

Any history of substance abuse in you? Any problems in personal relationships?

Do you have interest in work? Any hobbies that are pleasurable? Any persistent tiredness, fatigue?
Sexual relations and any complaints regarding sexual activities?

Your attitude towards life, towards world, about your symptoms?

Do you think if you have any mental problem? Do you think that your symptoms will reduce with treatment or have no hopes of improvement?

Please provide me details so that I can make a provisional diagnosis again with more confidence.

Thanks and take care

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Brief Answer:
Telephonic consultation option is available

Detailed Answer:
Hello again

Yes option of phone consultation is there but you have to contact customer care again for telephonic consultation. On Skype it's not there.

But if you can provide details by writing even this can help me in reaching the diagnosis.

If you wish phone consultation the ask them for "Dr Seikhoo Bishnoi, Psychiatrist " and they will fix a schedule with me.

Thanks

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