Frank - This definitely sounds like a medical issue. It will be a little difficult to find a physician who can sort it out, but I can probably find you someone in your area. You may have to pay outside your insurance to see someone who really knows how to deal with you properly.
As a start, there are a few things you need to ask your current physician to check:
- a full thyroid panel (not just TSH, but also FREE T4, FREE T3 and thyroid antibodies). Low OR high thyroid can cause anxiety. My niece was treated for a year for an anxiety disorder before they finally discovered her over-active thyroid. Thyroid problems also affect your ability to concentrate, can mimick ADD.
- a morning cortisol level. Low adrenal function can also cause anxiety and is a cause of hypoglycemia and afternoon "slumps". Unfortunately, a morning cortisol will only pick up the worst cases of adrenal failure. Milder dysfunction may show up on a salivary cortisol test where you measure four different times a day, but mainstream doctors usually don't do these tests. You can order it yourself, though, through Vitamin Research Products website, I believe. Also read Wilson's book Adrenal Fatigue. I really like Wilson's Adrenal Rebuilders, they're great for adrenal support in milder cases.
- testosterone level. I personally NEVER experienced anxiety in my whole life until I was perimenopausal. Then, every month when my hormones would drop, I would wake up at night with crushing anxiety. I knew it was hormones because it was very regular, one night every 28 days! Dropping testosterone levels in men can trigger similar symptoms.
- blood sugar and maybe a 3-hour glucose tolerance test. There are some medical conditions that cause blood sugar to drop too low after eating (dumping syndrome, insulinoma); and diabetes can cause difficulty concentrating when blood sugars are too high.
Be aware, too, that Concerta can cause depression. Check B12 and folate levels.
This doesn't sound like an "emotional" issue to me. This sounds hormonal or nutritional.
