Q: I am a 27 years old man feeling anxiety, excitement and fear in all situations. I have been using clonazepam after consulting the doctor for the last 3 years. I tried meditation and yoga but nothing helped me. I used to go to the gym for the last ten years. Sometimes my testes get hard due to anxiety and tension. Is hypnotherapy advisable to get rid of anxiety? Is there any permanent solution to get rid of anxiety?

A:You have mentioned anxiety symptoms, more so in the last 3 years. Anxiety can present itself in different forms. It can present as bodily symptoms like odd/funny sensations, stretch sensations, restlessness, butterfly sensation in the tummy, dryness of mouth, palpitations / fast pulse rate, fast breathing / breathlessness, excessive sweating, cold palms, tremors, body aches etc and also as cognitive symptoms (more to do with our thinking processes) like feeling of losing control, negative view of self, lowered confidence, wrongly thinking as if suffering from a major illness, undermining one's ability to cope and making the situation appear too difficult to cope in one's thoughts. As a result mere anticipation of negative event in one's thoughts triggers a significant stress response. At times small issues get pent up and lead to states of significant stress and anxiety.

Yes, anxiety disorders are treatable. One needs to carefully assess the symptoms in the light of underlying factors and situations. I suggest that get your Blood thyroid (T4 / TSH) evaluated. It is a simple test, preferably done empty stomach in the morning. To allay your fears re: hardness in your testes, I suggest a consultation with a Urologist. A detailed psychiatric consultation shall be useful, with attempt to understand your underlying temperament, situational factors, your coping abilities, your thinking processes and perceptions.

Anxiety disorders are managed with a range of medications. Short acting benzodiazepines are avoided in the long run, because of risk of dependence. If you have been regularly taking clonazepam for quite some time now, one need to gradually withdraw it by shifting to a longer acting benzodiazepine with a careful taper over several weeks / months. Low dose antidepressant medications, beta blockers are also found to be useful in managing anxiety symptoms. Careful and judicious use of medication coupled with techniques like Cognitive behaviour therapy, hypnotherapy / relaxation sessions can be helpful. Balanced lifestyle, with time for self development and enjoyment / relaxation also helps. Situational stress also needs to be dealt with.