Q: I had been suffering from panic disorder from the last 10 months. I was feeling very uneasy, with shortness of breath, weakness, chest pain, dryness in mouth, etc. However after taking medicine(Paroxetine CR) and practicing yoga for more than 7 months, now I am feeling better. At present I am not feeing those symptoms but that fear/phobia (heart attack) has not yet gone away. Some time I also feel the sporadic pain in my chest. Can you please suggest what I should do for that? I am still under medication of Paxidep (Paroxitine CR). How many days I have continue this medication? I have reduced 9kg of weight during a span of 10 months. My height is 165cm and there is no clinical abnormality except the above. When I consulted a doctor, he said that there is no reason for weight loss and I should maintain this weight. Can you please tell what may be the reason behind this weight loss?

A:Sudden attacks of anxiety characterised by palpitations, shortness of breath, dryness in mouth dizziness and pounding heart can not only be distressing and exhausting but also makes a person feel totally incapacitated. The unexpected nature of these attacks and the possibility of their occurring at any time of the day or night, creates a fear within the individual which not only centres around the distressing nature of these attacks but also regarding the future occurrence of such attacks. From what you report, it seems that you have benefited from medication and yoga. My advise to you would be to continue the medication as advised by your doctor and combine this with some relaxation exercise like pranayam. It would be beneficial if you could consult a professional psychotherapist in your area for the same. Loss of body weight can be due to several reasons like stress, prolonged physical illness, depression etc. As you have mentioned that you have got yourself examined by the doctor and there have been no alarming findings physically, my advise to you would be to analyse if you have undergone any mental stress or tension in the past 10 months or if there have been any significant changes in your lifestyle. Regarding this you can consult a professional psychologist is your city with whom you can reflect upon the probable reasons for this continued weight loss. Apart from this you need to take a healthy balanced diet and include some amount of exercise in your daily schedule.