Q. I feel fearful and anxious all the time. Is it due to patulous eustachian tube condition?

Hello doctor,

I am 26 years old. I remain very fearful and anxious 24 hours a day and always feel that something very bad is going on. I have a habit of try listening to even very faint sounds and when outside the house. On-road, I always fear every approaching vehicle, no matter how far it is. Focusing on anything like studying or doing any task feels very hard to do, and I always feel frustration, fear, and doom. When sitting, I cannot stop shaking my legs. I am facing these problems for the past five years. And I am not under any medications.

Thank you doctor,

I do not feel depressive. I feel frustrated when I cannot do anything I want to do, like studying or talking to others. I suffer from a patulous eustachian tube condition in my right ear for the last two years, and I also had the same condition in my left ear for four years when I was from 16 to 20 and from 20 to 24. I had a heaviness in my ear, for which I had surgery. Currently, symptoms occur intermittently throughout the day or some days symptomless.

When I am not facing the ear symptoms, I feel happy and feel like doing things and feel excited, but when I actually start to do those things, I feel fear and anxiety coming back, and then I feel frustrated. But when I have ear condition symptoms, I do not feel like doing anything and feel very fearful and anxious even if I am not doing anything and just lying in bed.

I do not feel hungry, but I always feel like eating something. Concentrating on studies feels very hard. If I keep reading the same text repeatedly, I still won't remember what I read just after it. The understanding of simple text feels very hard. I do not have a thyroid disorder. I feel very fearful and anxious when interacting with others.

I feel to stay aloof when I feel symptoms of my ear problem. Otherwise, I feel like getting involved in social activities. Social events feel very scary when I am part of them. I do not have any suspicious thoughts. I do not have any close friends, only acquaintances. I struggle to fall asleep at night and wake up late in the morning.

Thank you doctor,

I have attached the details of my surgery. Shall I take Paroxetine 12.5 mg in the first week, then after that Paroxetine 25 mg and Clonazepam 0.25 together for the second and third week? Or Paroxetine 25 mg for the second week and followed by Clonazepam 0.25 for the third and fourth week?