Tuesday 29 August 2017

Do I Have a Mental Illness?

From Spain: I’ve been having anxiety since I was 16 (normally lasts less than a month). I’ve gone without anxiety for about a year, but now that I’m on summer vacation it has come again.

My greatest fear and obsession is to have mental illness like schizophrenia, so every time I see something in the corner of my eyes I get incredibly nervous fearing I might be hallucinating, same when I faintly hear something and I’m not able to rapidly identify where it’s coming from.

Lately this fear’s got a hold of me, so much that I’m having very troubled sleep. Not only I experience a fair bit of anxiety every night when I go to bed but I wake up at 3am ~ shaking. The first time this happened (this year) it had been so long since my last anxiety attack that I didn’t know what was going on. I though the bed was shaking and that there was an earthquake or something going on haha. But the shaking I can live with (regular panic attack), what really frightens me is the times in which I wake up in the middle of the night and keep ‘sort of’ dreaming even though I’m awake.

Like, maybe I’m dreaming that there’s a some kind of bug on my sheets and when I wake up I try to shake it off… or sometimes I wake up thinking I’m chocking on some food and run to the kitchen to quickly drink some water.

I use these examples for the sake of convenience but normally I wake up to such irrational and weird ideas I cannot begin to explain… And until a few seconds/minutes pass I’am fully convinced those things/ideas are real.

I’ve read up on it and it seems to be what’s called ‘hypnagogia’.

So, what has me worried is how much these ‘things’ happen to me lately:

– I wake up in an hypnagogic state (about 3 times last week, not much but worrying considering it almost never happened to me before)
– Sometimes I confuse objects with another/see things in the
corner of my eye and I’m incredibly nervous about it
– I forget things that happened recently
– Trouble sleeping a full night
– I’m often in a very bad mood lately though I force myself to socialize and get out of the house.

A: You are correct. The symptoms you report are consistent with hypnagogia, not a mental illness. The feelings you experience are very real. The hallucinations (both physical feelings and visual) are not. What will help is dealing with the sleep disorder directly. You need a sleep hygiene program. I can give you a brief outline here but you do need to see a therapist who specializes in sleep disorders to individualize a treatment plan.

Generally a sleep hygiene program includes the following:

  • Do not drink caffeine after your morning cup.
  • Eliminate other substances that interfere with sleep (alcohol or nicotine or drugs).
  • Do not take naps.
  • Do get some exercise every day but not after mid-afternoon.
  • Set a reasonable bedtime and go to bed at the same time every night.
  • Set up a safe and comfortable bedroom.
  • Establish a “going to bed” routine. Something like bath, pajamas, brush teeth, meditation. Do the same thing every night.
  • An hour before bedtime, get off all screens. No TV or reading in bed either. Put your phone in another room.
  • If you wake during the night, don’t stay in bed longer than 10 minutes. Move to a chair and sit in the dark for awhile to settle down. You want your bed to be associated with sleep, not with tossing and turning.

It will take time to re-regulate your sleep. Establish the routine and stick with it for at least a month. I repeat: You do need to talk to a local therapist to individualize the routine for maximum help. You probably need some coaching for dealing with the anxiety disorder as well.

I wish you well.
Dr. Marie



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