Tuesday, 18 July 2017

Disorientation & Confusion

For background: I have been diagnosed with chronic severe treatment resistant Major Depressive Disorder, PTSD, PMDD, GAD, and mild agoraphobia. All those combined equals lots of sleep disturbance, including a lot of nightmares and frequent sleep paralysis.

I have tried way too many meds to count, but currently I’m on Effexor, Zoloft, Xanax PRN, Vistiril for sleep, birth control, and Prazosin as a PRN for sleep/nightmares.

Anyways, the past week or so I have noticed myself having momentary disorientation, like one morning listening to the radio they were talking about the president, and I honestly thought they meant Barack Obama. And not like I was confused, I literally thought it was 2012. I’ve been having other moments like that where I’m confused as to what day of the week it is, like I have to ask someone, and it’s not just like when you casually ask “what day is it?” because you’re tired. I LITERALLY do NOT know what day it is or think it’s a different day of the week. Same thing with what year it is, what house I live in – like I wake up and don’t know where I am because I remember living in a different apartment or house from a previous time in my life.

I will also admit that I have had a very calm feeling of suicidal ideation lately, contemplating what it would be like to take a few too many pills and just drift off (but it’s just ideation, I would never harm myself like that).

My psychiatrist believes I may have obsessive compulsive disorder, primarily because of excoriation – skin picking, not sure if that’s important.

Could this confusion and disorientation be attributed to my depression or PTSD? Of course I have flashbacks, but that feels more like, I feel like the situation I’m in is being transformed into a prior terrifying situation. These moments of disorientation are not like that, I mean, sometimes there is fear, but when I have a flashback, I still know where I am, I just feel my mind playing a trick on me.

Do you think this is a normal symptom of depression or PTSD or one of my other diagnoses?

Thank you!

A. It’s possible that your disorientation and confusion are caused by a number of factors including your mental health symptoms, medications, and sleep disturbances. Each one of these individually could be causing the problem or it may be a combination of all them.

You are in treatment with a psychiatrist, but what about a therapist? Most psychiatrists don’t provide talk therapy. You mentioned being “treatment-resistant” and I am taking that to mean that you’ve been to counseling before. If so, try again. Some people prefer a medication-only approach to treatment, but I think that would be too limiting for you. Counseling is an effective treatment for all of the symptoms you have described.

Report these problems to your psychiatrist and ask about adjusting your medications. Also, consider counseling. Even if you’ve tried it and didn’t find it useful, try it again. Therapists vary in their abilities.

Overcoming mental health problems is often a function of finding the right help. I recommend that you contact at least five therapists and interview them over the phone. Choose the one with whom you feel the strongest connection and then meet with them in person. The right treatment could make all the difference. Please take care.

Dr. Kristina Randle



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