What symptoms does a person with stress develop? How can you tell if those symptoms are due to stress or something else?
Everyone experiences stress in their lives, but some people cope with it far better than others, and some experience far more due to their individual circumstances.
Stress can cause a very wide range of physical illnesses. Chronic headaches and peptic ulcers are probably the best known diseases due to stress, but depression, heart disease, migraines, diarrhoea, shortness of breath, sweating, passing excess urine, rashes, vomiting and a host of other symptoms may be an outward manifestation of inward emotional turmoil.
There is often no easy way to tell if the symptoms are due to stress or some other underlying disease, and doctors may perform numerous blood and other tests to exclude any other possible diagnosis.

I am a very timid person, and do not like any change in my life. I have been prescribed antidepressant medications by my doctor, and they seem to help, but I don’t think I am depressed. Could there be some other cause?
A I think you may be suffering from social anxiety disorder. This is a common form of neurosis in which the patient realises that they have an irrational level of anxiety or fear. It may be due to an unfortunate experience earlier in life, depression, trauma or stress, but often no cause can be identified.
Patients have a prolonged (greater than six months) marked and persistent abnormal fear about one or more social activities such that fear of embarrassment causes avoidance of others, avoidance of activities that draw attention, and a fear of looking stupid in the eyes of others. The patient does everything possible to avoid these situations, or they are endowed with intense anxiety. If exposed to feared situation, the patient may develop a tremor, stuttering, sweating, rapid heart rate and collapse.
Treatment involves counselling, abreaction (gradual exposure under supervision to situations that provoke fear), and some types of antidepressant medications. Some patients may become totally housebound and unable to function in society.
Fortunately, there is usually a good response to appropriate treatment.

My wife’s general practitioner and psychiatrist believe that she is manic depressive, but her sister has talked her out of taking any medications as she does not believe in doctors or medication. She now refuses to see her doctors and I am having great difficulty in coping with her wild mood swings and neglect of our children.
Manic depression, or a bipolar personality, can affect anyone in the community. It causes patients to have episodes of severe depression when they may feel suicidal, and at another time they may be excessively happy and do things they may later regret. These swings in mood may occur every hour or two, or may be weeks apart. In a depressed mood the patient will be withdrawn, sleep poorly, loose interest in work and friends, and appear generally gloomy. When manic they may spend excessive amounts of money, take outrageous risks, become sexually promiscuous or party till dawn.
Women are far more likely to be affected than men.
Medication can be used to reduce the highs and lows so that the patient has normal mood swings, without stopping them from being the person that you know and love. A bipolar personality is no different to any other chronic disease that requires long-term medication. In the same way that people with high blood pressure, diabetes or asthma must take medication on a regular basis to control their condition, so must people with a bipolar personality.
These people cannot pull themselves together without medical help, and unless they do take medication, in one of their extreme mood swings, they may harm themselves permanently. Doctors cannot force patients to take medication, so it is a matter of convincing your wife (and her sister) that she may be better off receiving appropriate medication than taking risks with her life and damaging the lives of her family.

A friend of mine has an overwhelming fear of contamination and spends hours a day washing his hands and taking showers to the point where he cannot work. What can be done to help him?
I am very concerned that your friend suffers from an obsessional neurosis. This is a psychiatric condition that requires treatment by a supportive specialist psychiatrist as soon as possible. The longer it is left before appropriate treatment is commenced, the harder successful treatment will become.
The first step is to take your friend to his family doctor, using a pretext if necessary to get him to attend. It is often worthwhile warning the doctor beforehand about your concerns. Hopefully the GP will be able to convince him to accept referral on to the psychiatrist. Further treatment will involve the use of medications, psychotherapy (analysis to find out why he has these fears) and behavioural therapy (training him to avoid the compulsive behaviour) to rid him of his unreasonable fears and his compulsion to wash himself.
It will take several months, and possibly years, to control the problem adequately. Some patients tequire continuing management by doctors for the rest of their lives.