A Lump in My Throat, Now I’m Obsessed and Depressed

Reader’s Question

I’m a 25-year-old female. In October 2008 I began experiencing a tightening feeling in my throat and feeling of tingling in my mouth/tonsils. I had been under some stress at work, and at first the feeling would come and pass — but after awhile I couldn’t stop obsessing over it. I researched on the internet and became scared it could be caused by anxiety and might never go away — I worried I would never stop thinking about it and it would be there all my life. In the past I have had some anxiety and a history of irritable bowel syndrome, and my doctor said my throat was anxiety and would go away.

At the same time, I began to worry I was becoming depressed. I am normally a very happy, optimistic person, but I started to feel like I would never be happy again. I started sleepy more, crying often, feeling fatigued and lost interest in things. I began researching depression and anxiety and now have read so much that I feel my mind is just permanently stuck thinking about them. It seems I can’t stop reading on the internet and have read so much on the subject that I feel I can’t get the thoughts of being depressed and anxious out of my head. No matter what I do, my mind just goes in circles — I feel I am constantly ruminating.

Now, as time has progressed I’ve had trouble sleeping because my mind won’t shut off, poor appetite, difficulty focusing, and have lost about 5 pounds. To try and improve, I’ve been running on the treadmill, journaling, doing yoga, and trying not to research on the internet. I have started taking vitamins and recently starting taking the supplement 5-htp (as I have read this can help increase serotonin levels).

So far, I have a decently good day here and there, but overall still feel like I will never improve. I should mentioned I was on hormonal birth control for 7 years and stopped in November because I read birth control can contribute to depression. I also had a significant amount of stress in the past year — I got married, bought a house, and my mother had surgery. I am hesitant to seek medical help, and for some reason am afraid medications won’t help me. I am just scared that I will never stop thinking these thoughts and will always feel this way. I can remember instances in the past where I was obsessed with something or was a hypochondriac, but those thoughts went away after a few weeks. This has been going on for months and has significantly impacted my life. Any advice you have would be greatly appreciated.

Psychologist’s Reply

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You are likely experiencing a clinical depression. When we think about stress, we often forget that ALL significant events in our lives are stressful, including wonderful events such as marriage (a very stressful event), buying a house (a major stressor!), job stresses, health of family members, etc. As stress continues in our life, it lowers the availability of the neurotransmitter Serotonin. As Serotonin levels decrease in the brain, we begin to experience emotional and physical symptoms such as excessive mind speed (rumination), sleep disturbance (mind won’t stop thinking is the most common complaint), appetite problems, loss of motivation and sexual interest, crying spells, and preoccupation with gloom and doom. Serotonin is also a major body regulator so we experience temperature fluctuations, eye muscle twitches, increased problems with bowels, chest pain, and leg cramps. Certain areas and systems of the body are more sensitive to neurochemical changes and are more likely to be affected by stress and depression such as bowels, heart, scalp blood vessels, and yes — the throat. You’ll never hear of anyone having a “nervous” liver or elbow. Body mechanics are pretty weird.

Low Serotonin is also linked to obsessive-compulsive disorder (OCD). Many depressed individuals develop the obsessive thoughts you describe as well as the preoccupation with disease, symptoms, etc. When this happens, it’s as though our eyeballs turn backward and we become preoccupied with our internal functions, symptoms, etc. All of these symptoms are common in depression. Some guidelines:

• Learn about your depression and that rumination, obsessions, etc. are common. These symptoms are actually prompted by chemical changes in the brain. Review information on this website and read my articles on Chemical Imbalance and Understanding Depression.
• The most effective treatment is the use of an antidepressant medication — by prescription. The use of herbal 5-HTP will be totally ineffective. Your family physician or OB/GYN can provide an effective antidepressant that has minimal side effects and one that has been researched to be effective. While you are fearful of medications, you are currently taking something with no research behind it. Keep in mind that you are fearful of everything right now — not just medications. Trust people who have a professional license on the line each time they provide a treatment. We have medications that deal with both anxiety and depression.
• Review other ‘Ask the Psychologist’ questions about depression and OCD by clicking on those terms from the list of tags in the sidebar of the page. Your situation is very common. Using effective treatment, your symptoms will decrease in a matter of weeks. I would also recommend seeking counseling to learn ways to lower and manage your stress.
• In the future, long after this has been brought under control, you may find that your throat sensations will act as a type of stress-level indicator. A person who has never been clinically depressed (a depression related to neurochemical changes) may not know what symptoms will surface should they become depressed. You now know what our red flags for depression and stress will be.
• If the use of a prescribed antidepressant doesn’t provide a relief of symptoms, you should consider consultation with a Psychiatrist. A Psychiatrist is better trained to select and/or combine medications for maximum effectiveness.
• After reviewing the information on depression — stop reading about it for four weeks. Reading during the time when the obsessive thinking is activated will only produce more symptoms.

Your symptoms are very treatable. I’d begin arranging treatment as soon as possible.