I'm anxious but not depressed – so why is GP offering antidepressants?

DR ELLIE CANNON: I’m anxious but not depressed – so why is my GP offering antidepressants?

I keep getting bouts of extreme anxiety – a panicked feeling that washes over me every few months, each time lasting just a couple of days. The GP suggested I take antidepressants, but that seems a bit unnecessary given that my symptoms aren’t constant and I don’t feel sad or low. What should I do?

Antidepressants are often prescribed for anxiety, as well as depression, alongside therapy.

There is sound scientific evidence that the tablets can help ease the symptoms of many anxiety disorders, including the most common: generalised anxiety disorder. That said, if symptoms crop up only sporadically, it is right to question whether taking daily medication is the right option.

All medications come with side effects and these have to be weighed up against the benefits, which may be limited with an occasional problem.

If episodes are short-lived – usually lasting only a couple of days – treating it will depend on how much the problem impacts a patient’s life.

Antidepressants are often prescribed for anxiety, as well as depression, alongside therapy

Medications to treat for occasional anxiety include a beta blocker called propranolol reduces the heart rate and blood pressure, stopping the panicked feeling

Therapy for anxiety or panic is often cognitive behavioural therapy (CBT), which teaches patients how to recognise thoughts and change behaviours associated with difficult emotions. It arms patients with cognitive tools they can use to manage panic when it strikes.

There are medications to use for occasional anxiety. A beta blocker called propranolol reduces the heart rate and blood pressure, stopping the panicked feeling. You can use this as and when you feel anxious, and take it up to three times a day.

If the episodes cause very severe symptoms, a doctor may consider using a benzodiazepine drug like lorazepam or diazepam – to be taken occasionally.

We try not to use these as they cause addiction and side effects, but they can offer temporary relief from extreme symptoms.

My husband, who is 84, has been diagnosed with cardiac amyloidosis. His doctors have suggested he go on a drug trial, but we are not sure what to do as information on this condition is limited. Can you help?

Amyloidosis is what happens when a protein called amyloid builds up in parts of the body where it shouldn’t. When it builds up in the heart, it is known as cardiac amyloidosis and affects how the heart functions.

It is considered a rare condition but can be very serious, leading to organ failure. The build-up of amyloid can cause the heart to stiffen and thicken.

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If this happens, it doesn’t pump well, causing tiredness, breathlessness and swollen ankles.

We know that treating amyloidosis early, before too much damage is done, is crucial.

Patients may be offered trial treatments, where genetic material or antibodies are used to prevent the build-up of the troublesome protein.

The sooner patients get access to this treatment, the less damage is done.

Doctors offer chemotherapy for some types of amyloidosis.

If you are being offered a trial, you need to be given as much information as possible about the treatments – the chance of them working and the risks.

No treatment is guaranteed to help someone, but doctors usually only offer something they feel is worthwhile.

Over the past year or so, I have had a sore hip. It’s been more uncomfortable than painful. I’m 65, so presumed it was arthritis. About a month ago the pain became so severe that I was incapacitated. I could hardly walk and couldn’t sleep for pain. An X-ray showed it to be moderate osteoarthritis. My GP has suggested exercise and painkillers, and I am mobile again. Why did it flare up and should I expect it to do so again?

Lots of things can cause hip pain – arthritis is one of them. Osteoarthritis of the hip can cause low-level discomfort and flares up where the pain feels particularly bad.

Flare-ups can be triggered by certain movements, a long walk or for seemingly no reason. Like other chronic joint problems, these episodes are common and it is not always clear why they happen. But over time, a clear trigger might become obvious, and you will know what to avoid.

Even if someone does have arthritis, an acute episode may not just be arthritis, but something else.

Do you have a question for Dr Ellie?

Email [email protected] or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

Dr Ellie can only answer in a general context and cannot respond to individual cases, or give personal replies. If you have a health concern, always consult your own GP.

X-rays give us a good picture of the bones, and what might be wrong with them. But the hip is a complicated joint with lots of other parts, including ligaments and fluid sacs.

If there is an issue with one of these components, it won’t always be clear from an X-ray.

Acute pain may be from a sprain within the hip. This is possible in someone who is very active – especially if they engage in repeated, intensive exercises.

Another potential culprit is bursitis – inflammation of the fluid sacs that cushion the joint. This can happen in people who are very active as the hip is over-used and irritated, or from a fall or injury.

Pain is usually triggered by walking and it gets worse when you lie down.

Doctors would recommend painkillers and rest. If the pain continues, other scans such as an MRI could be useful, as well as an assessment by a physiotherapist.

Is your memory failing? Don’t forget to tell me!

While deciding what to write about this week, I thought about mentioning the fact I’d recently been hit by dreadful memory problems.

There are just total blanks. Names of people I’ve known for ages, films I’ve seen, or even words for things – all gone.

Oddly, my husband, friends and a fair few patients are complaining of exactly the same thing.

While deciding what to write about this week, I thought about mentioning the fact I’d recently been hit by dreadful memory problems

And then, horror of horrors, it dawned on me that I’d written about this bizarre brain fog just a few weeks back, but I’d forgotten about it.

Is it Covid? Stress? Age-related cognitive decline (it shouldn’t be, as I’m in my 40s). I really have no idea.

Have you been struck by inexplicable, uncharacteristic memory difficulties?

I’d like to hear your stories – and theories about the causes. Write to me at [email protected]

Help is still at hand tomorrow

Most people will be glad of tomorrow’s bank holiday in honour of the late Queen, but I know there’s concern at the number of patients who will see NHS appointments cancelled.

Many will no doubt have been waiting for months.

Even if we wanted to open our doors tomorrow, it would be tricky when other resources we rely on are shut. But if you need medical help, don’t panic.

And of course, if you’re really stuck, there is always A&E

Check your surgery’s website for out-of-hours phone numbers and local urgent care clinics and, of course, don’t hesitate to call 111 in an emergency.

It is also worth checking whether any local pharmacies are open. As I’ve often said, pharmacists are more knowledgeable than GPs about many things.

And of course, if you’re really stuck, there is always A&E.

Whatever you do, don’t put an urgent health concern on hold.

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