Q: I am 69 years old. I am suffering from journey sickness for the last 20-30 years. I feel very tensed when I am about to take a journey and feel that I have to go to the toilet. This problem arises especially when I am about to take a train or bus journey. While travelling by train, I do not use the lavatory, but the tension prevails. Physically I am normal, except high blood pressure, which is under control. I had some other allied problems also, which I overcame by treatment under a psychiatrist. I want to get rid of this, please advise.

A:Anxiety can be precipitated by many factors. What you have described can be better understood as precipitation of anxiety of an impending travel. Anxiety states can present as sudden onset of palpitations associated with tremors, sweating, shaking, problems in breathing, drying of mouth, urge to go to the toilet, and most importantly feeling anxious or thoughts of impending doom etc. These can be precipitated by specific cues like in your case or may just occur out of the blue. Based on various factors like type of onset and offset, specific symptoms they can be differentiated into different disorders. This specific anxiety can be present all by itself, as a part of a larger anxiety disorder, and may be associated at times with depressive symptoms. Although you have not mentioned about your previous psychiatric problems for which you visited a psychiatrist, there is a possibility of interrelation. I would suggest you to revisit your psychiatrist and discuss options like anti anxiety drugs and behaviour therapy depending on your specific case, which I reckon would be the most beneficial to you.