Overcoming Insomnia: Managing Anxiety and Emotional Turmoil - Psychiatry

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Insomnia?


Thank you, Dr.
Chen, for answering all my questions.
However, right now, I can't sleep without sleeping pills.
The doctor explained to me that this is just a transitional phase and it will get better naturally.
With the school year starting, I know that once the pressure comes back, I will definitely experience insomnia again.
I'm worried about my insomnia, which is causing me to actually become insomniac.
I've also heard that taking sleeping pills can make you feel dull or impair your memory, and I can't stand this inherent tendency of mine.
Sometimes, I really hate myself for being so anxious or for feeling lost in these emotions.
I want to quickly get out of this emotional rollercoaster; I can be very happy one moment and then feel extremely anxious or depressed just a few minutes later.
I care deeply about every word others say to me, and this makes it hard for me to let go! During therapy, my psychologist keeps telling me not to take what others say too seriously and just to listen, but I still can't manage to do that...
This really frustrates me.
I feel like my stress resilience and emotional control (EQ) are not as good as others.
I took the Wechsler Intelligence Scale and scored better than 95 out of 100 people.
Is that considered good?

mimi, 10~19 year old female. Ask Date: 2004/08/28

Dr. Chen Wenke reply Psychiatry


Mimi: As you described, these emotional issues are indeed difficult to improve quickly.
You find yourself constantly ruminating on your problems, feeling indecisive, and unable to tolerate excessive stress.
No one enjoys living this way.
The reality is that you are already in this situation, and it can't get much worse; the only way left is up, right? If you can outperform 95 out of 100 people, does that make you feel good? Try to remind yourself of that.
After all, sometimes you need to feel things for yourself without relying on others' validation.
Occasionally, you can give yourself some affirmation and applause.
As mentioned earlier, you are still young and have many opportunities to learn about emotional management.
Your maturity may bring more worries than those of your peers, and accepting this can bring some comfort.
Regarding your insomnia, it might be worth exploring if there are other contributing factors, such as having too much homework that forces you to stay up late or other stressors that make it hard to sleep well.
Long-term use of sleeping pills can indeed have side effects, but it's important to recognize that medication has both benefits and drawbacks.
Don't let the fear of side effects overshadow the potential therapeutic effects.
Wishing you all the best.

Reply Date: 2004/08/28

More Info


Overcoming insomnia, especially when intertwined with anxiety and emotional turmoil, can be a complex and challenging journey. Your concerns about dependence on sleep medications, the fear of cognitive decline, and the emotional fluctuations you experience are valid and shared by many individuals facing similar struggles. Let's delve into these issues and explore potential strategies for managing your situation.


Understanding Insomnia and Its Triggers
Insomnia can often be exacerbated by anxiety, particularly when the fear of not sleeping becomes a self-fulfilling prophecy. This cycle can create a heightened state of alertness, making it even more difficult to fall asleep. The pressure of upcoming events, such as the start of a new school term, can amplify these feelings, leading to increased anxiety and, consequently, insomnia.


The Role of Medication
While medications like Zolpidem (Stilnox) can provide temporary relief from insomnia, they are not a long-term solution. Concerns about cognitive impairment and dependency are legitimate, especially with prolonged use. It’s important to have an open dialogue with your healthcare provider about these fears. They can help you weigh the benefits and risks of continuing medication versus exploring alternative treatments.


Cognitive Behavioral Therapy for Insomnia (CBT-I)
One of the most effective non-pharmacological treatments for insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). This therapy focuses on changing the thoughts and behaviors that contribute to sleep problems. It can help you develop healthier sleep habits, manage anxiety, and reduce the fear associated with insomnia. Techniques may include:
1. Sleep Restriction: Limiting the time spent in bed to increase sleep efficiency.

2. Stimulus Control: Associating the bed with sleep rather than wakefulness or anxiety.

3. Cognitive Restructuring: Challenging and changing negative thoughts about sleep.


Mindfulness and Relaxation Techniques
Incorporating mindfulness practices and relaxation techniques into your daily routine can also be beneficial. Techniques such as deep breathing, progressive muscle relaxation, and meditation can help reduce anxiety and promote a sense of calm. These practices can be particularly useful before bedtime to signal to your body that it’s time to wind down.


Emotional Regulation and Self-Compassion
Your feelings of frustration and self-criticism regarding your emotional responses are common among individuals dealing with anxiety and depression. It’s important to practice self-compassion and recognize that it’s okay to feel overwhelmed at times. Engaging in activities that promote emotional regulation, such as journaling or talking to a trusted friend or therapist, can help you process these feelings.


Seeking Professional Support
Given the complexity of your situation, continuing to work with a mental health professional is crucial. They can provide tailored strategies to help you cope with anxiety and emotional fluctuations. If you feel that your current therapist’s approach isn’t resonating with you, it may be worth discussing alternative therapeutic modalities or even seeking a second opinion.


Conclusion
Your intelligence and awareness of your emotional state are strengths that can aid you in this journey. Remember, overcoming insomnia and managing anxiety is often a gradual process that requires patience and persistence. By combining medication management with therapeutic interventions, mindfulness practices, and self-compassion, you can work towards a more restful night’s sleep and a more balanced emotional state. Don’t hesitate to reach out for support when you need it, and remember that you are not alone in this journey.

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