Nightmares, Self-Harm, and Hallucinations: A Teen's Struggle - Psychiatry

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Nightmares, self-harm, auditory hallucinations, and tinnitus?


Hello doctor, I am currently a high school sophomore.
I have been having this nightmare since the third grade when I first learned that my brother left this world.
The dream involves me watching two strangers kill my brother right in front of me.
I experience this nightmare almost every day, which often leads me to sleep only 1 to 2 hours.
This has made me more irritable and prone to emotional distress, even to the point of self-harm.
I have stood on the rooftop of my apartment building (13th floor), but I have not gone through with it because I don't want to cause pain to those around me.
I am also unsure if my tinnitus and auditory hallucinations are due to lack of sleep.
I really hope you can provide some answers, as I have seen doctors before but it hasn't been helpful, so I would like to hear your thoughts.
Thank you.

Hu Rou, 10~19 year old female. Ask Date: 2023/11/14

Dr. Yan Congyou reply Psychiatry


Hello Hu Rou: I am very sorry to hear about your situation.
Such a significant event must have seriously impacted your life and mood.
Based on your description, it is essential for you to seek medical attention at a hospital as soon as possible.
If your previous consultations have not been helpful, I encourage you to seek assistance from other physicians.
Many matters require face-to-face discussions and confirmations in order to provide you with a comprehensive response.
If you have trusted family members or friends, do not hesitate to ask for their help, and please have them accompany you to your medical appointments.

Reply Date: 2023/11/14

More Info


I'm truly sorry to hear about the struggles you're facing. It sounds like you're dealing with a lot of pain and distress, and it's important to acknowledge that these feelings are valid and deserve attention. The experiences you've described—nightmares, self-harm, and hallucinations—are serious and indicate that you may be dealing with significant mental health challenges.

Firstly, it's crucial to understand that the loss of a loved one, especially a sibling, can have profound effects on a person's emotional and psychological well-being. The nightmares you are experiencing, particularly those related to the traumatic event of your brother's death, are a common symptom of complicated grief or post-traumatic stress disorder (PTSD). These nightmares can lead to sleep disturbances, which you've noted, resulting in only getting 1-2 hours of sleep. Sleep deprivation can exacerbate feelings of irritability, anxiety, and depression, creating a vicious cycle that can be hard to break.

Your mention of self-harm and thoughts of suicide is particularly concerning. Self-harm is often a way for individuals to cope with overwhelming emotions or to express feelings that they cannot articulate. It’s a signal that you are in distress and need support. The fact that you have considered jumping from a height indicates that you are experiencing thoughts of escaping your pain, which is a serious matter. It's commendable that you have chosen not to act on these thoughts because of your concern for others, but it’s essential to seek help to address the underlying issues that are causing you to feel this way.

Hallucinations, such as tinnitus (ear ringing) and possibly auditory hallucinations, can occur due to severe stress, anxiety, or sleep deprivation. However, they can also be symptoms of more serious mental health conditions. It’s important to discuss these experiences with a mental health professional who can help determine their cause and provide appropriate treatment.

You mentioned that you have seen doctors in the past but did not find their help effective. It’s not uncommon for individuals to feel that way after a few visits, especially if they didn’t connect with the therapist or if the treatment plan didn’t resonate with them. Mental health treatment can be a process of trial and error, and it’s vital to find a healthcare provider with whom you feel comfortable and understood. If your current provider isn’t meeting your needs, don’t hesitate to seek a second opinion or find a different therapist. Sometimes, a fresh perspective can make a significant difference.

In addition to professional help, consider reaching out to trusted friends or family members about what you’re going through. Sharing your feelings can alleviate some of the burdens you carry and provide you with additional support. You might also explore support groups for teens dealing with grief or mental health issues, as connecting with others who have similar experiences can be incredibly validating and comforting.

Lastly, I encourage you to engage in self-care practices that promote emotional well-being. This could include journaling, art, physical activity, or mindfulness exercises. These activities can serve as healthy outlets for your emotions and help you cope with stress.

In summary, your experiences are serious and deserve immediate attention. Please reach out to a mental health professional who can provide you with the support and treatment you need. You are not alone in this, and there are people who want to help you navigate through these challenging times.

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