Insomnia and Trust Issues in Psychiatric Care

Insomnia and consultation issues?

There are some uncertainties regarding whether I am experiencing insomnia.
For about five years now, whenever I close my eyes, I feel like there is an eye in the darkness in front of me.
Just one eye, looking to the right from the side.
I always feel like it is about to turn towards me, which frightens me, so I never dare to keep my eyes closed for too long.
This happens all the time, regardless of whether I am happy or sad that day.
When I turn off the lights at night, I cannot close my eyes to sleep; I must keep the lights on.
Otherwise, I can only hide and stare at my phone until dawn, when I am too exhausted to stay awake and fall asleep unconsciously.
Once I do fall asleep, I do not experience symptoms like waking up suddenly or early awakening, which are typical of insomnia.
I mentioned this situation to a doctor during a visit, but they did not prescribe any sleep aids.
What exactly is going on?
Additionally, I have some questions about my first consultation.
Recently, I went to see a doctor alone for the first time.
Before, during, and after the appointment, I completely could not trust the doctor.
The background is that I feel I have a tendency to lie, almost about everything.
Some lies are deliberate, while others are reflexive and unthinking, including about my own condition.
So, a month before the appointment, I kept some records, trying to express my true feelings in writing.
During the consultation, I showed the doctor a rough outline of my notes, but regardless of what happened before or after, I always felt that the doctor was mocking me and viewing me as a neurotic (in a derogatory sense), still believing I was being insincere.
Logically, I know I should trust the doctor, that they are just conducting a normal examination, that they are gentle and kind...
I understand all of this.
Yet, I still feel like they are laughing at me, that the doctor looks down on me as a childish person with delusions, that they do not want to waste time on me, and that they are lecturing me!
During the consultation, I frequently felt restless and confused.
I wanted to lie and leave but forced myself to stay until the doctor finished asking questions.
As a result, I answered vaguely and later could not even recall what I had said.
In the end, the doctor only mentioned that my panic was stronger than that of most people, without clarifying what it was, and prescribed a week's worth of medication for me to take before my next appointment.
Now, looking at the medication I received, I cannot determine whether I should take it.
One voice tells me to trust the doctor and take the medication, but another voice keeps telling me that this is just a form of superficial reassurance, that it is essentially useless, and I do not want to go to the next appointment; I just want to destroy that package of medication! Is this feeling of distrust normal for a first consultation, or is there something wrong with me...?

nà ge, 20~29 year old female. Ask Date: 2018/04/04

Dr. Zhang Fangrong reply Psychiatry

Dear Sir/Madam,
Based on the process you described, I can sense the discomfort and sleep disturbances you have experienced over the past few years.
We are also concerned about how such sleep issues may affect your daytime academics, work, and daily life.
You mentioned that providing a written explanation before the consultation was a great approach, and I agree, especially since your situation is quite unique.
I still recommend that you continue with outpatient follow-up treatment and discuss your condition with your physician.
If possible, arranging an evaluation with a psychologist could provide a more comprehensive understanding of your psychological and mental state, which may lead to more proactive solutions for your discomfort.
Wishing you mental and physical well-being.
Sincerely,
Dr.
Fang-Rong Chang
Department of Psychiatry

Reply Date: 2018/04/04

More Info

Your experience with insomnia and trust issues in psychiatric care is quite complex and multifaceted. It’s important to understand that what you are going through is not uncommon, especially for individuals who have faced significant mental health challenges. Let’s break down your concerns into two main areas: the insomnia-like symptoms you are experiencing and the trust issues you have with psychiatric care.

Understanding Your Insomnia-Like Symptoms
From your description, it seems that you are experiencing a form of anxiety that manifests as an inability to close your eyes without feeling fear. This sensation of perceiving a threatening presence when you close your eyes can be linked to anxiety disorders, particularly those involving intrusive thoughts or hypervigilance. The fact that you feel compelled to keep the lights on or to distract yourself with your phone until exhaustion sets in suggests a significant level of anxiety that interferes with your ability to relax and sleep.

This phenomenon can be associated with various conditions, including:
1. Generalized Anxiety Disorder (GAD): This condition often involves excessive worry about various aspects of life, which can lead to sleep disturbances.

2. Post-Traumatic Stress Disorder (PTSD): If you have experienced trauma, it can lead to hyperarousal symptoms, making it difficult to feel safe enough to sleep.

3. Obsessive-Compulsive Disorder (OCD): Intrusive thoughts and compulsions can also disrupt sleep patterns.

It’s crucial to address these symptoms with a mental health professional who can provide a comprehensive evaluation and appropriate treatment options. Cognitive Behavioral Therapy (CBT) is often effective for anxiety-related sleep disturbances, as it helps individuals reframe their thoughts and develop healthier coping mechanisms.

Trust Issues in Psychiatric Care
Your feelings of distrust towards the psychiatrist are also significant and can stem from various factors, including past experiences, personal beliefs, or even the nature of mental health stigma. It’s not unusual for individuals to feel apprehensive about sharing their thoughts and feelings with a healthcare provider, especially if they have a history of feeling misunderstood or judged.

Here are some points to consider regarding your trust issues:
1. Initial Anxiety: It’s common for patients to feel anxious during their first few appointments. This anxiety can be exacerbated by the fear of being judged or not taken seriously.

2. Communication Barriers: If you feel that your psychiatrist is not fully understanding your concerns, it can lead to feelings of frustration and distrust. It’s important to communicate openly about your feelings, even if it feels uncomfortable.

3. Self-Perception: Your self-described tendency to lie or misrepresent your feelings can complicate the therapeutic relationship. It may be beneficial to discuss this behavior with your psychiatrist, as it can provide insight into your trust issues and help them understand your perspective better.

Moving Forward
1. Open Communication: Consider being honest with your psychiatrist about your feelings of distrust and anxiety. This can help them tailor their approach to better meet your needs.

2. Therapeutic Alliance: Building a strong therapeutic relationship takes time. It’s okay to feel uncertain initially, but try to give the process a chance. If you continue to feel uncomfortable, it may be worth seeking a second opinion or finding a different provider.

3. Medication Concerns: Regarding the medication you received, it’s normal to feel hesitant about starting new medications, especially if you have doubts about their efficacy. Discuss these concerns with your psychiatrist, as they can provide clarity on the purpose of the medication and its expected effects.

In conclusion, your experiences with insomnia and trust issues are valid and deserve attention. Seeking support from a mental health professional who can provide a safe space for you to express your concerns is essential. Remember, you are not alone in this journey, and there are effective treatments available to help you navigate these challenges.

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