Q: I am 43 years old, married for over 12 years with no issues. Over the past few months I have been facing severe stress in my job and have been very sensitive to any adverse remark or rating. A month back I was extremely uncomfortable and had extreme restlessness. When I was taken to the hospital they gave me a tranquiliser and discharged me. The next day I consulted a physician and the doctor diagnosed my problem as extreme anxiety and saw symptoms of depression too. She suggested me to take Fludac 10 mg and Janumet for my diabetes. My fasting blood sugar level is 111 mg/dl and PP blood sugar is 171 mg/dl. There is some numbness, which the doctor said was due to anxiety. I have traces of jaundice also with total bilirubin at 2.5 and direct bilirubin at 1.0. Now I am still physically weak and sometimes get drawn into negative thoughts, which make me even more anxious. My appetite had become nil but is now gradually picking up. I have a strong need and desire to get back to work and my normal life. The doctors referred me to a psychiatrist, who suggested Sterta but I am not taking it. I only take vitamin B complex and Liv 52 and at night 1 tab of 0.5 mg of Restyl. I am overall having a sense of hopelessness, low confidence and lack of interest, which is very unlike me. If someone talks to me positively I feel better but soon I get drawn into negative thoughts again. The frequency was higher a month back and now it’s once a day mostly during afternoons or evenings and the intensity is less. I started listening to spiritual mantras, which is definitely giving me some calmness. What should I do on a long-term basis and for better health?

A:Executive stress is a very much known entity and can present with symptoms suggestive of anxiety and depression. It can lead to burn out and can also happen because of burn out. The profile is usually of an executive who is working under high pressures of time, achieving targets, does not have time to relax, comes home late, is not able to spend time with the family, is working against time and working even on weekends. Now, what really happens is that in the bid to achieve more - one pushes himself against limits and that leads to concentration lapses, short fuses which in fact consequently lead to errors and issues with maintaining the targets. This leads to increasing frustration, and one pushes oneself more leading to more mistakes which start becoming obvious leading to critical comments and further poor performance. This in fact starts a vicious cycle - a cycle, which leads to problems. The solution can be pretty simple if one is happy to adhere to it. The solution is to take it easy. The best way to take it easy is to take care of the immediate acute problem - in your case it is the anxiety and the depression which would best be treated by short term medications like serta (or whatever the doctor prescribes), and cutting the vicious cycle at some point. This can be achieved by prioritising the day and schedule, and setting limits to what can be done in a day - not over doing it, and spending time with the family, having adequate breaks and engaging in other activities, which one likes, for example music, exercise, etc. It is easy - we just need to do it.