Insomnia, loss of appetite, and decreased motivation for two days—how can I determine if I can manage this on my own, or should I schedule an appointment with a psychiatrist?
I have tendencies towards depression, and for the past two days, I've been experiencing sleep disturbances, staying awake all night and only sleeping during the day.
Yesterday, I cried for a long time over a minor issue (problems with renting a place), and I've also lost my appetite.
For breakfast yesterday, I only had a sandwich and then wandered around a cemetery in the mountains until dinner.
Today, I'm still not eating; I've been lying in bed all day without going out or drinking water.
I initially didn't want to eat, thinking fasting might be good since I'm not hungry, but by 9 PM, I finally felt hungry and ordered takeout.
I didn't cry today and my mood is flat.
Recently, I've occasionally stuttered when speaking to store clerks.
I have previously undergone counseling for several years; I never mentioned depression but did mention having some PTSD, which I believe was addressed during counseling (due to childhood domestic violence).
My question is: I have never seen a psychiatrist or taken medication.
Given my current situation (two days of insomnia, loss of appetite, and lack of motivation), do I need to see a psychiatrist, or should I just wait for myself to recover? If I do see a doctor, should I mentally prepare myself to be on medication for one to two years? This has happened before; I feel like it occasionally flares up, but I should be fine in a few days.
Today, I do not have passive suicidal ideation, but I occasionally experience it.
Ting Ting, 20~29 year old female. Ask Date: 2023/10/10
Dr. Lin Mianzhang reply Psychiatry
Hello Ting Ting: It seems that you have occasionally experienced insomnia and loss of appetite in the past.
I would like to know how frequently these issues occur.
If they happen quite often, such as every few days or even once a week, I recommend seeking evaluation from a psychiatrist.
If your current situation has persisted for more than a week, it would also be advisable to consult a psychiatrist for assessment.
Additionally, you mentioned having tendencies toward depression.
Do you find that you feel depressed most of the time? If you notice that you feel down frequently, have lost interest in many activities, or occasionally have thoughts of self-harm, I also recommend seeing a psychiatrist.
There are no strict criteria for whether or not to seek psychiatric care.
Besides obvious emotional, cognitive, or behavioral disturbances, if you have concerns about your condition and wish to seek a doctor's opinion, it is appropriate to visit a psychiatrist.
If privacy or personal insurance considerations are a concern, you can also opt for out-of-pocket payment for treatment.
The decision to use medication will depend on the physician's assessment.
Typically, mild cases can be managed with psychotherapy, but more severe cases may require medication as an adjunct.
The duration of medication use will also depend on the specific condition and does not have a fixed timeline.
Wishing you peace and good health!
Reply Date: 2023/10/10
More Info
It sounds like you're going through a challenging time, and I want to acknowledge the difficulties you're facing. Your symptoms, including sleep disturbances, appetite loss, low energy, and emotional fluctuations, are concerning and may indicate that you could benefit from psychiatric help.
Firstly, it's important to understand that sleep issues, such as insomnia or disrupted sleep patterns, can be both a symptom and a contributing factor to mental health conditions like depression and anxiety. When you mention that you've been staying up all night and only sleeping during the day, this can disrupt your circadian rhythm, leading to further sleep issues and exacerbating feelings of fatigue and low energy. Sleep is crucial for emotional regulation and cognitive functioning, and chronic sleep deprivation can lead to a cycle of worsening mental health.
Your experience of crying for an extended period over a seemingly small issue, along with feelings of low appetite and lack of motivation, are also significant. These symptoms can be indicative of depression, especially when they persist over a few days. The fact that you mentioned feeling "平平" (neutral) today, rather than experiencing extreme highs or lows, suggests that your emotional state is fluctuating, which is common in mood disorders.
It's also worth noting that your history of PTSD could be playing a role in your current emotional state. Even if you feel that you've processed those traumatic events, they can still have lingering effects on your mental health, manifesting as anxiety, depression, or emotional dysregulation.
Regarding your question about whether you should seek psychiatric help, I would strongly encourage you to consider it. While you may feel that you can wait it out, mental health conditions often require intervention, especially when symptoms begin to interfere with your daily functioning, such as your ability to eat, sleep, and engage in activities. Waiting for symptoms to resolve on their own can sometimes lead to a worsening of the condition.
If you do decide to see a psychiatrist, it's understandable to have concerns about medication. However, not all patients require long-term medication, and many find that therapy, lifestyle changes, and coping strategies can be effective. A psychiatrist can work with you to develop a treatment plan that suits your needs, which may include therapy, medication, or a combination of both. It's also important to communicate your concerns about medication with your psychiatrist; they can provide you with information about what to expect and help you make informed decisions about your treatment.
In the meantime, there are some self-care strategies you can implement to support your mental health. These include:
1. Establishing a Routine: Try to maintain a consistent sleep schedule, even if it feels difficult. Going to bed and waking up at the same time each day can help regulate your sleep cycle.
2. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, or yoga can help reduce anxiety and improve your emotional state.
3. Physical Activity: Engaging in regular physical activity, even if it's just a short walk, can boost your mood and energy levels.
4. Nutrition: Aim to eat balanced meals, even if your appetite is low. Proper nutrition can have a significant impact on your mood and energy.
5. Social Support: Reach out to friends or family members for support. Talking about your feelings can help alleviate some of the emotional burden.
6. Limit Alcohol and Caffeine: Both substances can negatively impact your sleep and mood, so it may be beneficial to reduce or eliminate them.
In conclusion, your symptoms warrant attention, and seeking help from a mental health professional could provide you with the support and strategies you need to navigate this challenging time. Remember, reaching out for help is a sign of strength, and you deserve to feel better.
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