How do I know if my symptoms are due to a physical cause or a mental cause?

Question:

Good afternoon
Sorry for the inconvenience, it is for a query related to the following:

I am 58 years old and I worked for 35 years in administrative tasks with function. For a long time, I didn’t eat properly because I dedicated a lot to my work. At the end of 2017 I had vertiginous syndrome for which I was diagnosed with long-term accumulated stress, anxiety disorders, depression, and panic attacks.

For this reason, I have prescribed sertraline 50 mg and diazepam 10 mg. For almost a year and a half I took sertraline 1 tablet in the morning and another at night; plidan diazepam 1 tablet at night. Then they cut it down to half of each for another year and a half or so.

Later, as I felt better, I continued with half sertraline and half diazepam whenever I needed it, between 10 and 15 days. I then discontinued the sertraline entirely and continued the diazepam.

I started to feel withdrawal symptoms. I went back to my doctor on Dec/21 and she prescribed me half of the sertraline every day and told me for 6 months. Which seemed like a lot to me because I wanted to get off the medication as soon as possible.

I continued like this with sertraline as the doctor told me, from Dec/21 to mid-March/22, and diazepam irregularly, sometimes 1/2 other days 1/4. But since I continued to have good days, days not so good, I decided to change my doctor in mid-March, who prescribed 1/4 of sertraline for 2 months and 1/4 of a diazepam pill for 1 month.

I did as instructed but now almost every day I feel like I’m going on a boat, sometimes with a little dizziness and headache, but the head is dull or swollen all the time and it’s very annoying. I’m even afraid that I’ll catch seizures or pass out because the only thing I’m left with is that feeling in my head.

I don’t know if it really is a consequence of the suspension of sertraline or diazepam. I took the antidepressant on my own, sometimes 1/4, other times 1/2, and the same with diazepam, but I really don’t know how to continue because it seems that this way irregularly doesn’t solve the issue of feeling dull or sore and dizzy. Please, I would greatly appreciate the Dr if she could advise me on what I can do or how to follow the treatment.

I tell you that a long time ago, simultaneously with medical treatment, mindfulness, and meditation helped me with the cause of my anxiety, depression, and panic attacks. And I also take magnesium chloride and B complex, sometimes omega 3 and vitamin D (I don’t know if I’m doing well with these supplements).

From now, thank you for your attention. I’m waiting for an answer, please.

Answer:

First of all, thank you for sharing your story, I am very sorry that you have gone through all this situation. From what you say, the best thing to do would be to carry out a complete psychiatric evaluation, with a detailed clinical and vital history to better understand all your symptoms, and how have been developed and thus be able to better guide management.

On the other hand, it is also important to know if, in the time that you mention having made these pharmacological adjustments, other doctors have evaluated you, for example, an otolaryngologist or an internist, and if analytical tests, brain scans, and/or electroencephalograms have been carried out. . All this because it is always better to rule out an organic cause for the symptoms and if nothing is found, to be able to carry out a therapeutic intervention with the certainty that nothing serious escapes in between.

With this, I explain the importance of making consultation and being able to help you in the best way.

A cordial greeting.