Anxiety and Depression

Do antidepressants cause weight gain?

DEAR DOCTOR K: My doctor thinks I could benefit from an antidepressant. But I've heard that antidepressants cause weight gain and I'm already overweight. Do any antidepressants cause less weight gain than others?

DEAR READER: Many of my patients have asked me that question. Like you, they were hesitating to take antidepressants because of the possibility they would gain weight. And they're right: Many antidepressants do cause weight gain in some people. The question has been how much weight gain they cause.

Does “mindfulness meditation” really help relieve stress and anxiety?

DEAR DOCTOR K: I've heard a lot about "mindfulness meditation." Does it really help relieve stress and anxiety?

DEAR READER: Mindfulness meditation has become quite popular in recent years. The practice involves bringing your mind's attention to the present without drifting into concerns about the past or future. Many people practice it hoping to stave off stress and stress-related health problems.

Why does my stomach clench up in knots when I’m stressed?

DEAR DOCTOR K: Whenever I'm stressed out my stomach clenches up in knots. Why does it do that?

DEAR READER: A particularly sad experience is described as "gut-wrenching." Hearing about a gruesome crime makes you "feel nauseated." An upcoming presentation gives you "butterflies in your stomach." We use these expressions because anger, anxiety, sadness, elation and other emotions can trigger symptoms in our gastrointestinal tract.

I worry a lot, my psychologist she said I didn’t have anxiety disorder — I can’t believe there’s nothing to do. Can you help?

DEAR DOCTOR K: I've always worried a lot. I saw a psychologist, but she said I didn't have anxiety disorder, so she couldn't help. I can't believe there's nothing to do. Can you help?

DEAR READER: I don't agree with your doctor. I've talked before in this space about how doctors typically define diseases by how they appear in their most extreme form. I call it the "tip of the iceberg" phenomenon. Doctors have certain criteria for what constitutes an anxiety disorder.

I’ve been feeling sad and tired but my doctor doesn’t think I’m depressed. What else could it be?

DEAR DOCTOR K: Recently I've been feeling sad and tired. My doctor doesn't think I'm depressed, but I know something's not right. What could it be?

DEAR READER: Doctors typically define diseases by how they appear in their most extreme form. I call it the "tip of the iceberg" phenomenon. For example, you don't have diabetes until your blood sugar reaches a certain level. You don't have lupus until you have a certain combination of symptoms, physical examination and laboratory abnormalities. The same with multiple sclerosis.

What is agoraphobia?

DEAR DOCTOR K: My daughter's new roommate is afraid to leave a 10-block area around their apartment in New York City. She has something called "agoraphobia." What is that?

DEAR READER: Agoraphobia is the fear of certain situations in which an individual feels threatened and trapped and unable to escape. Most often, the fear is of being in open or public places. In the most severe cases, people with agoraphobia become afraid to leave home at all.

How can I get over my fear of going to the dentist?

DEAR DOCTOR K: I'm a rational person, but I have a deep fear of the dentist that I just can't overcome. Any suggestions?

DEAR READER: I don't know too many people who enjoy a trip to the dentist. But the health of our teeth and gums are an important part of maintaining our dental and overall wellness. So we do it.

How does lithium treat bipolar disorder?

DEAR DOCTOR K: I have bipolar disorder. I've experienced the highest highs and the lowest lows. How can one medication -- lithium -- treat both extremes?

DEAR READER: Bipolar disorder is certainly a condition of extremes -- extreme opposites. On the one hand are episodes of mania. During these episodes people with bipolar disorder feel like they're "on a high." Then there's the other side of bipolar disorder: the sadness and hopeless feelings of depression.