Anxiety and Sleep Disturbances: When to Seek Help - Psychiatry

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Frequent dreaming. Anxiety?


For over a month, I have been feeling unwell and have undergone multiple examinations, including consultations with cardiology, infectious disease, and obstetrics and gynecology specialists, all of whom have told me that there is nothing wrong.
This has made me feel even more frustrated; I wish the doctors could find something wrong so that I could receive treatment.
Perhaps addressing those various discomforts would alleviate my symptoms.
I have mitral valve prolapse and occasionally experience palpitations, but they resolve after taking medication.
Since I have run out of my medication, I plan to see a cardiologist again.
Additionally, I have back pain, specifically near my left upper scapula, which is painful when pressed.
Although I have only been applying topical medication for two days, I am worried that if it doesn't improve after a week, it could indicate a more serious condition.
I am also concerned about developing a severe illness, so I frequently check my temperature.
I measure it in my ears, usually taking readings from both the left and right ear, averaging about 4 to 5 times a day, with temperatures ranging from 37.2 to 37.8 degrees Celsius.
I wonder if this is related to my anxiety.
I also worry about potential lung issues, often pressing on my legs to check for swelling.
I have been coughing intermittently this month, just a cough or two at a time.
I feel like I am constantly dreaming, napping two to three times a day (including during lunch), but I usually only remember one dream, and I feel exhausted before noon, wanting to sleep.
When I first fall asleep at night, I occasionally dream, but I definitely wake up at least twice during the night.
Although I can fall back asleep quickly, I always dream again.
During my afternoon naps, I also dream, and the dreams I remember most clearly are mostly negative or involve my mother, who passed away several years ago.
In these dreams, I often find myself in situations where I am running away, arguing with family, or feeling emotionally distressed.
I am unsure if I need to see a psychiatrist because my family is aware of my situation and advises me not to overthink, but I just can't seem to control it.

A Zhu, 10~19 year old female. Ask Date: 2022/02/05

Dr. Wu Enliang reply Psychiatry


Hello, if you have seen many doctors without reaching a conclusion or finding results, it is indeed possible that it could be psychosomatic disorders (such as anxiety or depression) caused by recent high levels of stress in your life.
It is advisable to consult a psychiatrist.
Hang in there, you will get better! Dr.
Wu Enliang

Reply Date: 2022/02/05

More Info


It sounds like you are experiencing a complex interplay of anxiety and sleep disturbances, which can significantly affect your overall well-being. Given the symptoms you've described—persistent physical discomfort, frequent temperature checks, recurrent dreams, and feelings of anxiety—it's essential to consider a comprehensive approach to your health.

Firstly, it's important to recognize that anxiety can manifest in various physical symptoms, including heart palpitations, muscle tension (which could explain your back pain), and even gastrointestinal issues. Your history of mitral valve prolapse and the associated palpitations can understandably heighten your anxiety, especially when you are already feeling unwell. The fact that multiple specialists have not found any significant medical issues can sometimes exacerbate feelings of frustration and helplessness, leading to increased anxiety.

Regarding your sleep disturbances, it's not uncommon for individuals with anxiety to experience disrupted sleep patterns. The dreams you describe, particularly those involving negative emotions or themes of conflict, can be a reflection of your subconscious processing stress and anxiety. The fact that you wake up multiple times during the night, even if you can fall back asleep quickly, suggests that your sleep quality is compromised. This can lead to feelings of fatigue and irritability during the day, further perpetuating a cycle of anxiety and sleep issues.

Here are some strategies you might consider to help manage your anxiety and improve your sleep:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for anxiety and sleep disorders. CBT can help you identify and challenge negative thought patterns that contribute to your anxiety and sleep disturbances. A therapist can guide you through techniques to manage your worries and improve your sleep hygiene.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, or progressive muscle relaxation can help reduce anxiety levels and promote better sleep. These techniques can help you stay grounded in the present moment and reduce the tendency to ruminate on worries.

3. Sleep Hygiene: Establishing a consistent sleep routine can be beneficial. Aim to go to bed and wake up at the same time every day, create a calming bedtime ritual, and ensure your sleep environment is conducive to rest (dark, quiet, and cool). Avoid stimulants like caffeine in the afternoon and limit screen time before bed.

4. Physical Activity: Regular exercise can help reduce anxiety and improve sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week, but try to avoid vigorous workouts close to bedtime.

5. Limit Temperature Checks: Constantly checking your temperature can reinforce anxiety. Consider setting specific times to check your temperature rather than doing it multiple times a day. This can help reduce the compulsive behavior associated with anxiety.

6. Seek Professional Help: Given the persistence of your symptoms and the impact they have on your daily life, it may be beneficial to consult with a mental health professional. They can provide a thorough assessment and recommend appropriate treatments, which may include therapy or medication if necessary.

In summary, your symptoms suggest a significant level of anxiety that is impacting both your physical health and sleep quality. By addressing these issues holistically—through therapy, lifestyle changes, and possibly medication—you can work towards alleviating your anxiety and improving your overall quality of life. Remember, seeking help is a sign of strength, and you don't have to navigate this alone.

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