Struggling with Insomnia and Anxiety: Finding Hope in Mental Health

Q: Struggling with Insomnia and Anxiety: Finding Hope in Mental Health

Hello, Xiao Guang： Thank you for your hard work! It seems that you are trying very hard to improve your situation, but you may feel a sense of helplessness. <br>Given your current circumstances, the lack of someone to express your feelings to in daily life can lead to a buildup o

Insomnia with tendencies of depression?

Since my twenties, I have experienced panic and anxiety, especially in crowded places with unfamiliar people, which causes dizziness, headaches, and shortness of breath.
Sometimes, I get so nervous while shopping that I can't speak.
In June, during a holiday, I had persistent headaches and dizziness, leading to vomiting.
An emergency examination showed no significant issues, but I was advised to see a neurologist if the pain continued.
The neurologist also found no major problems and prescribed me medications: Daan Yuan, Fu Nao Jing, and Tofu Nao.
I took these for about a month and a half.
Later, I felt the hospital was too far, so a friend recommended a nearby psychiatric clinic.
Currently, I am taking Yongkang Xu and Youle Ding, but I still struggle with insomnia.
The current doctor is nice but places a strong emphasis on faith, which aligns with my beliefs, yet our conversations tend to focus heavily on faith.
I feel uncomfortable discussing my struggles under this context.
Since college, I have had difficulties interacting with others and an inexplicable excessive fear and anxiety, which led me to only be able to work in jobs with minimal social contact after graduation.
Following issues with domestic violence, I left home and have since struggled with insomnia, making it impossible to work as an operator, so I had to take a cleaning job.
However, I find it hard to accept this situation.

Since my sophomore year, I have experienced inexplicable anxiety, despite performing well academically.
When people around me ask why someone my age is doing this kind of work, I feel hopeless about the future.
Cleaning is physically demanding, and although I need to work for financial reasons, each day feels exhausting.
I often think that working one more day just means surviving another day, and that tomorrow won’t necessarily be better.
Sometimes, I can't take it anymore and write long letters to friends, but this often burdens them.
I fear losing friends because of my constant writing, and given my unique family situation, I don't have many relatives.
I have only one younger brother who has gone through similar experiences, and I don’t want to pass my difficulties onto him.
I often feel like there is nothing in the world to rely on or connect with.
At night, I frequently feel inexplicably sad and want to cry, but if I do, it gets late, and I can't work the next day.
During the day, I am plagued by negative thoughts that replay like a broken record, making it hard to concentrate at work.
It feels like there is no outlet for my life.
While commuting, I sometimes have thoughts of ending everything when I see trains passing by, but I never reach the point of actually doing anything.
In front of friends and those who share my faith, I still present a positive facade just to maintain good relationships, but inside, I feel very tired and don’t know how to find an outlet or improve my situation.

Xiao Guang, 30~39 year old female. Ask Date: 2020/12/28

Dr. Lin Mianzhang reply Psychiatry

Hello, Xiao Guang: Thank you for your hard work! It seems that you are trying very hard to improve your situation, but you may feel a sense of helplessness.
Given your current circumstances, the lack of someone to express your feelings to in daily life can lead to a buildup of stress.
I suggest that you ask your doctor about the possibility of a referral for psychological therapy.
Your anxiety and fear in social interactions, past experiences of domestic violence, panic, and anxiety can all be gradually improved through therapy.
However, this process takes time, potentially several months or even years.
But as long as there is a beginning, I believe it will lead to better outcomes.
Additionally, since your symptoms of depression, negative thoughts, feelings of hopelessness, sleep disturbances, and decreased concentration are affecting your work, your psychiatric medication may need adjustment.
Yongkangxu can only assist in alleviating mild anxiety and insomnia, while Youleding is effective only for improving sleep.
You may need to consider taking an antidepressant, but this should be evaluated further by your doctor.
Wishing you a speedy recovery!

Reply Date: 2020/12/28

More Info

Struggling with insomnia and anxiety can be an incredibly challenging experience, especially when it feels like there is no way out. Your story reflects a deep sense of despair and isolation, which is not uncommon among those dealing with mental health issues. It's important to recognize that you are not alone in this struggle, and there are ways to find hope and healing.

Firstly, it’s essential to understand that anxiety and insomnia often go hand in hand. Anxiety can lead to racing thoughts and heightened arousal, making it difficult to relax and fall asleep. Conversely, lack of sleep can exacerbate anxiety, creating a vicious cycle. Your experiences of panic attacks in crowded places and difficulty speaking in social situations suggest that you may be dealing with social anxiety, which can significantly impact your quality of life.

The medications you have been prescribed, such as 永康緒 (Yongkangxu) and 悠樂丁 (Youleding), are commonly used to help manage anxiety and sleep disturbances. However, it seems that they have not fully addressed your insomnia. It might be beneficial to discuss this with your psychiatrist, as they may consider adjusting your medication or adding an antidepressant, which can also help with anxiety and improve sleep quality.

You mentioned feeling uncomfortable discussing your mental health struggles with your doctor due to the focus on faith in your conversations. While faith can be a source of strength and comfort, it’s crucial to have a safe space where you can openly express your feelings and concerns without fear of judgment. If you feel that your current therapeutic relationship is not meeting your needs, it may be worth seeking a second opinion or finding a therapist who specializes in anxiety and insomnia.

In addition to medication, therapy can be a powerful tool for managing anxiety and insomnia. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders and can help you develop coping strategies to manage your symptoms. It can also address negative thought patterns that contribute to your feelings of hopelessness and despair. If possible, consider asking your psychiatrist for a referral to a therapist who can work with you on these issues.

Lifestyle changes can also play a significant role in managing anxiety and improving sleep. Regular physical activity, a balanced diet, and good sleep hygiene practices can all contribute to better mental health. For instance, establishing a calming bedtime routine, limiting screen time before bed, and creating a comfortable sleep environment can help signal to your body that it’s time to wind down.

Moreover, finding healthy outlets for your emotions is crucial. Writing letters to friends, as you have done, can be a way to express your feelings, but it’s also important to ensure that you are not overwhelming them. Consider journaling as a private way to process your thoughts and emotions. Engaging in creative activities, such as art or music, can also provide a therapeutic outlet.

Lastly, it’s vital to reach out for support. While you may feel isolated, connecting with others who understand your struggles can be incredibly beneficial. Support groups, whether in-person or online, can provide a sense of community and understanding. Sharing your experiences with others who have faced similar challenges can help you feel less alone and more empowered to seek help.

In conclusion, while the path to recovery may feel daunting, there are steps you can take to find hope and healing. Open communication with your healthcare providers, exploring therapy options, making lifestyle changes, and seeking support from others can all contribute to improving your mental health. Remember, it’s okay to ask for help, and taking small steps can lead to significant changes over time. You deserve to feel better and to find joy in life again.

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