Tag:

Insomnia

Emotional Instability

by Dr. Marie Hartwell-Walker March 1, 2011

written by Dr. Marie Hartwell-Walker

I was a strong, athletic, patient, confident, intelligent 20 year old with the potential to achieve greatness. I had the ability to talk to anyone, confront any adversity, I was optimistic and more importantly, I was a fearless alpha male type.

5 years later & I hate myself. I’m now 25. I have lost all my patience, I am almost always nervous. I get panic attacks on a regular basis. I am severely overweight, suffer from insomnia and sleep deprivation, get chest pains, stomach and headaches daily. I don’t like my friends or family and rarely spend any real time with anyone.

I have gone from being a highly focussed and decisive individual to something of a frightened grasshopper. I cower from decisions and hop haphazardly even in the simplest of tasks like for eg, organising the garage or tidying my office. I cannot visualise the solution anymore, my mind has a fuzzy idea of all things involved and it jumps between them starting all of them and completing none.

I feel like I have become agoraphobic, constantly afraid that people around me are dangerous and may hurt me at any moment. I take every incident so harshly that I cannot accomplish anything sometimes; just the other day I had a credit card application rejected and I began to cry believing that it had to have been personal. I can no longer handle simple situations in the workplace or at home, I lose control and begin to sweat. I feel my heart beat speed up and my head starts pounding. I become mute, so fearful that at any moment I will start to hyperventilate or cry, as is often the outcome.

Overall I am exhausted. I cannot take criticism, I am often suspicious and paranoid. I have issues communicating with everyone and I constantly attribute blame to the other party. I snap and yell at my wife and parents. I feel so afraid speaking to people in the wrong way that I take my leave regularly just to avoid it.

I saw a psychiatrist a couple of years ago for these issues, he diagnosed me with depression and anxiety and proscribed two different meds. Medication and therapy did not help me at all and after 9 months I quit them both.

I had bad reactions to the drugs and my Doctor, whom I believe to be very well qualified and experienced and was easy to talk to, did not help. I was an active patient and having also spoken to two other therapists, I don’t know who I can consult to feel better. Am I doomed to spiral further out of control? I just want to be healthy, to deal and express with my emotions in a positive way, to not be terrified of strangers and criticism and decision making.

I don’t allow myself to wallow in self pity for too long but I have noone that I can talk to and nothing that I feel I can do. Please give me some real practical advice.

What an honest and heartfelt letter. Please go back to the doctor you trust. Take your letter with you and show it to him. You wrote an articulate description of your feelings. There are a number of mental illnesses that show up between the ages of 20 – 25. Without talking to you personally, I can’t hazard a guess. But your doctor certainly can.

You probably need a combination of medication and some talk therapy to help you get back into balance. Please don’t write off taking medicine because you had a bad reaction to some. We are very fortunate these days to have quite a few to choose from. While you may have negative side effects to some, you may well respond favorably to others. In addition, you need to take charge of yourself and start eating right and getting some physical exercise each day, even if it is only a long walk. A healthy body can help you have a healthy mind.

You took an important first step toward better health by writing to us. Now take the next one. Call your doctor for an appointment.

I wish you well.
Dr. Marie

March 1, 2011 0 comments

Very Anxious About Social Interaction

by Kristina Randle, Ph.D., LCSW February 21, 2011

written by Kristina Randle, Ph.D., LCSW

I am very anxious when I talk to people, and tend to blank out, or just go mute. I want this to stop, please help! When I talk to somebody I get very anxious, my palms sweat, and I never can think of anything to say. I used to be a very outgoing person, now I seem to be unable to talk to anybody I do not know. I have tried many things, for example going out of my way to talk to people I don’t know, but either nobody responds, or I just go blank. I really want this to stop, I want to have friends like I used to have!

P.S: I also have major sleep problems and insomnia (if this might affect it in some away.)

I would have to know much more about you to know with certainty what is causing your problems but it seems as if you may have social anxiety. If I were able to interview you in person I would want to explore the change process that took you from being a very outgoing person to presently struggling with social interaction. Was there a negative event or series of events that may have led to your current anxiety? Something is responsible for your loss of confidence. You had it once and now it’s gone. In addition to anxiety you may also be experiencing depression. It is very common for anxiety and depression to co-occur.

Generally speaking, when interacting with others try to be yourself. Try not to worry about what others think about you because you cannot control what they will ultimately perceive. In every social interaction you should strive to be authentic, down-to-earth, and attempt to communicate with others in a sincere way. In other words, simply try to be yourself. Nervousness often occurs when an individual attempts to be someone that they are not or simply are guilty of “trying too hard.” If you focus on trying to be yourself, then the nervousness should diminish.

If this is an issue that you continue to struggle with then you may want to consider counseling. Counseling is a great way to improve social interaction skills.

Even if it is uncomfortable at this time, you should continue interacting with others. The more you interact with others, the more practice you will get and the more likely it is you will improve. A therapist can teach you valuable new skills in addition to their giving you objective feedback about your present interaction skills. If counseling is not an option, ask your parents if they may be able to assist you. They may be able to assess your interaction skills and give you tips about how to relax in social situations.

Your sleep problems should not be overlooked. I would recommend a therapeutic evaluation of your total situation: sleep problems, social anxiety and any other changes that you may have failed to include in your letter.

Good luck.

Dr. Kristina Randle

February 21, 2011 0 comments

Suffering From Depression and Scared I Need a Therapist

by Kristina Randle, Ph.D., LCSW February 12, 2011

written by Kristina Randle, Ph.D., LCSW

I dont know how to tell my parents that its serious. I have a very low self-esteem and low confidence. I’m not sure if that is a result of, or perhaps the cause of my depression. But, I have been suffering from depression for a year and a half. For almost two years I have had insomnia issues I barely get any sleep, in fifth and fourth grade almost every other day I would have a sort of panic attacks normally surrounding the things I hadn’t done that day or the things I had done wrong. This last six months my depression has gotten progressively worse.

I no longer want to hang out w/ my friends or family I spend most of my time locked up in my room. I said something that scared my mom and made her think that I’m intending self-harm. It scared me that I meant what I said. My best friend thinks that I need to gain for confidence and get out of my room. She thinks I need a therapist. My parents don’t understand the scope of my problem they joke about me staying in my room. How could I approach that? How can I tell them that I no longer feel any motivation to do anything at all anymore. I don’t think I would ever commit suicide but I feel like by shutting myself off from everyone it’s almost worse.

When your parents make jokes about your isolation they are likely indicating that they do not know how to help you or that they are attempting to minimize the seriousness of your problem. There are several ways to approach this situation. One would be to plan a meeting with your parents. Inform them that you have something important to discuss and request their undivided attention.

If you are uncomfortable with a face-to-face meeting, my second suggestion involves writing them a letter describing your feelings. The contents of the letter should contain much of the information you have provided to us at Psych Central. It should also include details about:

how serious you believe the problem has become;
how depression has affected your behavior in practical ways (i.e. insomnia, loss of motivation, not wanting to hang out with friends, increased isolation, etc.)
how you are struggling to deal with the feelings of depression;
your fear about them not taking you seriously;
the fact that you have had thoughts of suicide;
how your friends have noticed your depression symptoms; and
your strong belief that you need and want help.

Other important information to include should be the fact that you have written to us at Psych Central. The purpose for relaying this information is to underscore the severity of your depression.

If none of the aforementioned options are feasible, a third option would be to speak to your school guidance counselor. Report your symptoms of depression. Ask for his or her guidance and advice about how to approach your parents. Guidance counselors are trained to deal with these types of situations. The guidance counselor may be able to intervene and contact your parents. Other ideas include speaking to a trusted family member, a family friend, or a member of the clergy, each of whom may be willing to speak to your parents on your behalf.

I hope my suggestions will be useful. Generally speaking, the best approach is to be honest and sincere. Don’t assume anything. Also, don’t let fear prevent you from getting the help that you need and deserve. In order to receive help you must first communicate your feelings to your parents. It may not be an easy task but they can’t help you if they are unaware that a problem exists. I wish you the best. Please take care.

Dr. Kristina Randle

February 12, 2011 0 comments

No Support But Need Help

by Kristina Randle, Ph.D., LCSW January 4, 2011

written by Kristina Randle, Ph.D., LCSW

I am a 28 year old single mother of two who lives with her parents. I graduated from college in 2008 but have not been able to find a job at all. I don’t have anybody at all. I had to move in with my parents because my ex was abusive. I have been suffering from depression for about three years. I can’t go and talk to someone because I have no money or insurance. I have insomnia and have been hallucinating. I find myself being irritable and lashing out in anger. I haven’t bathed in about a month. I’m afraid to go outside and I stay in my room in bed all day. I have constantly thought about death everyday, I like to cut myself. My parents get mad at me because they do not want to hear what is going on with me.My dad attacked me one day and my mother called the cops on me. I am so lonely. I just cut all my hair off today. I feel so lost and incapable of doing anything at all. I hate myself and my life. I want to always kill myself. I can’t get a job because I don’t have enough work experience. I don’t know what to do or where to turn. Help me! I feel like I’m drowning. I feel guilty and like a failure in life. I feel out of control. My brother tells anybody who will listen that I don’t do anything and am lazy. I can’t get over the only man I have ever loved and he dumped me 3 years ago and is married. I’m just a wreck. I feel like I’m crazy.

You should strongly consider going to the hospital immediately. You currently are having suicidal thoughts. You are also unable to care for yourself at this time. This is evidenced by the fact that you have not showered in a month and cannot leave your bedroom. Other very concerning symptoms include: hallucinations, insomnia, extreme anger and irritability, cutting, hopelessness and the lack of a support system. It seems as though your home environment may be significantly contributing to the problem. The hospital could provide a much needed reprieve from an unstable and unsupportive home environment.

You should go to the emergency room and report all the symptoms that you wrote about in this letter. Even if you do not have health insurance, given your symptoms, you are likely to be admitted. The hospital has an obligation to admit individuals who pose an imminent danger to themselves or to others. Once in the hospital, you can work with a doctor who can prescribe medication that will help to decrease your symptoms. You will also have the opportunity to work with a therapist and a social worker. The social worker can assist you with a comprehensive aftercare plan including follow-up care, the acquisition of health coverage, housing assistance, as well as any other practical and immediate needs that you may have.

If you do not wish to go to the hospital, then call your local community mental health center (CMHC) and ask for their assistance. They can provide similar services to that of a hospital social worker. CMHCs also have therapists on staff who can provide counseling. You can also call the local health department and ask what type of services may be available to individuals who do not have health insurance.

The CMHC or the local health department may be of assistance with regard to locating mental health services but I would recommend more immediate assistance. It is important to recognize when immediate help is appropriate. Given your symptoms, I would advise that you go to a hospital for an evaluation. Call 911 if you feel that you cannot get yourself to the emergency room. You need and deserve help. I hope you’re able to get the help that you need. Please take care.

Dr. Kristina Randle

January 4, 2011 0 comments

What Happens When Therapy Isn’t An Option?

by Kristina Randle, Ph.D., LCSW November 29, 2010

written by Kristina Randle, Ph.D., LCSW

I have been in therapy since I was seven. Starting with bipolar, anxiety, insomnia and now including borderline pd, avoidant pd, and PTSD. I work very hard to provide myself with an environment that is healthy and from the outside I live the ideal life.

Unfortunately, I continue to live with a lot of demons and anger that I literally can’t express without screaming, crying, and cursing. I work excruciatingly hard to keep it inside of me because I am so afraid of what will happen when people find out what a monster I am.

My question begins here. I had been with one therapist for eight years without me ever being able to touch the topic seriously. One day, I completely lost it on them. I let everything out. I was my absolute worst, but in reality no one had ever witnessed a truer me. They told me though that that was the last time we would ever speak. I then tried to kill myself. This happened this year.

I can’t believe that even someone I was paying to help me couldn’t handle my monster. The consequence has been my hatred for psychologists, psychiatrists, and basically anything associated. I know its kind of ironic that I’m asking for your advice but I thought it would be easier because you can’t see my face. I don’t know what to do. What does an extremely troubled girl do when everyone becomes the enemy? I want to note that I have been drifting from therapist from therapist in search of a “fit” and it only makes me sadder and angrier. I’m in between a bullet and a target and that bullet is looking very good.

You may be misinterpreting what happened in the therapy session. As you stated, you were in counseling for eight years but were not sincere with your therapist. Perhaps, when you “lost it,” the therapist realized that you had been withholding important personal information and no longer believed that he or she could help you. It’s not uncommon for a therapist to refer his or her patients to other mental health professionals when they feel as though they can no longer be of assistance. Please don’t misunderstand. I’m not defending the therapist. I’m suggesting that you may have misinterpreted the event. It is a realistic possibility.

It’s understandable that you would lose confidence in your therapist but your opinion about one mental health professional should not extend to all mental health professionals. Therapists do not limit their patient clientele. Most therapists are willing to work with virtually anyone, no matter what the nature of their problems. Therapists work with sex offenders, rapists, murderers, etc.

You need to recognize the fact that everyone is not the enemy. Therapists have chosen to enter a helping profession. Someone who is willing and sincere in their efforts to help you is by definition your friend and not your enemy.

It is not acceptable to believe that suicide is a solution to your problems. It is instead a sign of depression. Viewed from a purely logical perspective, the consideration of suicide doesn’t make sense. Your perception of the situation is that you have tried therapy for many years and it has not been effective. You are in essence saying “why bother? I’ve tried it and nothing works” but your perception of the situation is inaccurate. The reality is that you withheld your true self, your deeper problems, your real issues from your therapist. That’s OK, because it does take some people a long time to trust a therapist with their deepest thoughts, the most vulnerable parts of their being. You can’t blame the therapy process for the fact that you withheld parts of you, important parts, from the therapist. Don’t blame yourself either. Blame the nature of your psychological problem. In actuality, I believe you had a breakthrough when you “completely lost it on them.” I have had similar moments, sessions, with my own clients. It was an important part of their therapy and the pathway to their healing.

I would strongly urge you to reconsider therapy. By your own admission you were not sincere with the therapist. It is very difficult to effectively help a client when he or she withholds information. I understand that you may be weary of therapists but this is not necessarily a bad thing. One should be choosy about his or her therapist. You should only work with a therapist who is competent and who has a successful track record of helping individuals with similar problems. Not just any therapist will do; it has to be the right therapist.

Please understand that suicide is never the answer. If you’re considering suicide you should go to the emergency room immediately or call 911. You should also have your possession the phone number to the national suicide hotline: 800-237-8255. Please take care. I wish you well.

Dr. Kristina Randle

November 29, 2010 0 comments

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