Depression/dysautonomia?

The excellent description of your symptoms makes sound a lot like you are suffering from a combination of diagnoses. First, you are experiencing somatic symptoms. The particular types of somatic symptoms sound a lot like panic. Panic attacks are common for many people and can begin for no apparent reason. Some individuals may have a chronic type of General Anxiety Disorder that, life become difficult, suddenly switch into a full blown panic attack. Anxiety and panic are often accompanied by depression. Depression can also bring with it somatic or physical symptoms. Due to the severity of your symptoms I doubt that psychodynamic psychotherapy or counseling would do much good.

You need a three pronged approach to your difficulties:

First, the correct medications would help reduce or eliminate many of the types of emotional and physical responses you are having. These medications would also help you concentrate on your Master’s Degree. You need to be seen by a psychiatrist to be evaluated and prescribed the correct medication regiment. Thereafter, you would need to see him to make any necessary adjustment in dosages. There are many good medications that can help with both anxiety and depression at the same time. If the panic attacks occur often, the psychiatrist may prescribe an additional anti anxiety medication on a PRN basis, and that means on an as needed basis.

Second, medication is not the entire answer to your difficulties. You will need to see and be treated by a psychotherapist who can teach you to use Cognitive Behavioral techniques to help you identify the automatic thoughts you have that give rise to your emotional reactions. He will then help you learn to alter and correct your thoughts in order that you come to more realistic and, therefore, less dire conclusions. On the theory that automatic or distorted thoughts affect how we feel, CBT can help you reduce your depression and your tendency towards panic and anxiety. Part of this process is learning to identify the stimuli that cause you to go into panic. Once you can identify those stimuli or cues you can either avoid the panic, use your CBT techniques or do a number of exercises to prevent the panic. This brings us to the third prong of the approaches to help you control your symptoms.

The third prong to your difficulties has to do with using meditation on a daily basis, deep muscle relaxation and deep and relaxing breathing. Your CBT therapist can teach you these techniques and you can purchase a number of self help books that are available in most book stores. I would also urge you to sign up for classes in Yoga, which is a wonderful way to reduce tension and anxiety. There are also meditation classes that will include teaching and using muscle relaxation and deep breathing.

Once your symptoms are under control it might be possible for you to stop using anti depressant medications. For people your age it is usually recommended that use be continued for six months to one year. However, it will always be important for you to use your CBT types of thinking and to continue with meditation, yoga, deep breathing and, in addition, getting lots of exercise.