Managing Anxiety and Depression: Insights on Medication and Sleep Issues - Psychiatry

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Managing anxiety and depression, especially when it involves medication and sleep issues, can be quite complex. Your mother’s situation, as you described, involves a combination of long-term medication use and ongoing symptoms that are affecting her quality of life. Here’s a detailed response to your questions, along with some insights into managing these conditions.


1. Medication Adjustments for Sleep Issues
Your mother has been prescribed multiple medications, including 當眠多膠囊 (Duanmian Duo) and 艾斯樂錠 (Aisle), to help with sleep. It’s understandable that after 30 years of taking 牟靜錠 (Mujing) and 當眠多膠囊, she might still struggle with severe insomnia. Increasing the dosage of 當眠多膠囊 to four capsules may provide temporary relief, but it’s crucial to consult her prescribing physician before making any changes to her medication regimen.
In general, while some medications can be adjusted for short-term relief, they should be done under medical supervision to avoid potential side effects or dependency. If the hospital does not provide a higher dosage, purchasing the medication out-of-pocket may be an option, but again, this should be discussed with her healthcare provider.
Additionally, exploring non-pharmacological approaches to improve sleep quality, such as cognitive behavioral therapy for insomnia (CBT-I), relaxation techniques, and sleep hygiene practices, could be beneficial. These methods can help address the underlying issues contributing to her insomnia without solely relying on medication.


2. Combining Medications
Regarding the combination of 牟靜錠 and 離優膜衣錠 (Liyou) in the morning, it’s essential to follow the prescribing physician’s instructions. If both medications are intended to be taken at different times, combining them without consulting the doctor could lead to unintended interactions or side effects. Always check with her healthcare provider before making any changes to her medication schedule.


3. Throat Pain and Depression
Your mother’s persistent throat pain, despite normal ENT evaluations, raises the possibility of a psychosomatic response, which can occur in individuals with anxiety or depression. This condition, sometimes referred to as 喉球症 (Globus sensation), can manifest as a feeling of a lump in the throat or discomfort without any physical cause.
To address this, it may be helpful for her to engage in stress-reduction techniques, such as mindfulness, meditation, or therapy, which can alleviate some of the psychological stress contributing to her symptoms. Additionally, ensuring she stays hydrated and avoiding irritants (like smoking or strong odors) may help reduce throat discomfort.


4. Frequent Urination and Depression
Frequent urination can be a challenging symptom to manage, especially when it’s not accompanied by significant output. While it’s less common for depression to directly cause frequent urination, anxiety can lead to increased awareness of bodily sensations, which might make her more sensitive to the urge to urinate.
Encouraging her to maintain a regular hydration schedule and to avoid caffeine and alcohol, which can irritate the bladder, may help. If the problem persists, it would be wise to consult a urologist to rule out any underlying medical conditions that could be contributing to her symptoms.


Conclusion
In summary, managing your mother’s anxiety and depression, particularly concerning her medication and sleep issues, requires a careful and collaborative approach with her healthcare providers. Adjustments to her medication should always be made under medical supervision, and exploring additional therapeutic options may provide her with the relief she needs. Encouraging her to engage in holistic practices, such as therapy and lifestyle modifications, can also significantly improve her overall well-being.
If her symptoms persist or worsen, it’s crucial to seek further evaluation from her healthcare team to ensure she receives comprehensive care tailored to her needs.