Mental Health: Addressing Sleep Issues and Medication Concerns

Questions in the heart?

Recently, my sleep quality has been very poor.
The doctor prescribed me one tablet of Yinianan and one tablet of Subit, along with half a tablet of Meishuyu to take before bed.
However, it often takes me nearly an hour to fall asleep, and I experience pre-sleep fantasies and even nightmares.
I also toss and turn during the night.
I have the following questions:
1.
How can I arrange to have follow-up appointments once a month? I prefer not to have them every two weeks or every three weeks; I would like to double it to once a month.

2.
Is there an error in the dispensing of psychiatric medications? Why did I have to spend nearly ten minutes with the pharmacist during my follow-up appointment, and why did they say that even if I wanted to commit suicide, I could use the medication to do so? Is this something a pharmacist should say? When I heard that, I felt like throwing the medication at them or tearing it all apart and taking it all at once.
Now, thinking about having to get medication from the pharmacist again during my next appointment makes me reluctant to return.
3.
What are the risks if I stop taking the medication on my own?
4.
How long is the treatment period for bipolar disorder with borderline personality disorder? I have been receiving treatment for over a year now.
What level of improvement is considered recovery? I know that after taking medication, I can better control my self-harming behaviors, interact more with others, and feel more confident going out to handle things for myself.
So, I want to know how much longer I need to take the medication.
Currently, I am less likely to self-harm, but I still have thoughts about it.
5.
Recently, I engaged in self-harm due to being misunderstood for no reason.
Should I inform my doctor about my self-harming behavior? I got injured at work, and although the wound was initially shallow, I ended up cutting it deeper after looking at it.
I am also afraid to go to the clinic across the street to have the doctor treat it; I just left the wound alone and let it hurt.
During my follow-up appointment, I was too scared to let the doctor know, so I kept my hands behind my back.
I apologize for having so many questions.
Thank you for your help, and I wish you all the best.

MK, 40~49 year old female. Ask Date: 2013/03/21

Dr. Lin Junyuan reply Psychiatry

Hello, since you are a regular patient in our department, we recommend that you follow the previous advice and return for a consultation.
The internet provides general health education information, but for individualized conditions and medications, if you have any urgent issues, you may come in for an earlier appointment.

Reply Date: 2013/03/21

More Info

It sounds like you are experiencing a challenging time with your sleep quality and mental health. Sleep issues, especially when compounded by anxiety and other mental health concerns, can significantly affect your daily life. Let's address your questions and provide some insights into managing your situation.

1. Frequency of Follow-Up Appointments: It's understandable that you want to have a consistent follow-up schedule. Communicating your preference for monthly appointments to your healthcare provider is essential. They can help accommodate your needs while ensuring you receive the necessary support. Regular follow-ups are crucial for monitoring your medication and mental health status, so be open about your preferences and any concerns you have.

2. Concerns About Pharmacy Interactions: It’s unfortunate that you had a negative experience with the pharmacist. Pharmacists are trained to provide medication information and support, but they should also be sensitive to your feelings and concerns. If you feel uncomfortable or misunderstood, consider discussing this with your healthcare provider. They can advocate for you or help clarify any misunderstandings regarding your medications. Remember, your safety and comfort are paramount, and you have the right to express your concerns.

3. Risks of Stopping Medication: Stopping medication abruptly can lead to withdrawal symptoms and a potential relapse of your mental health condition. It’s crucial to consult your healthcare provider before making any changes to your medication regimen. They can guide you on how to taper off safely if that’s the route you wish to take. Your mental health is a journey, and it’s essential to have professional support along the way.

4. Duration of Treatment for Bipolar Disorder and Borderline Personality Disorder: The duration of treatment can vary significantly from person to person. It often depends on the severity of the symptoms, the effectiveness of the treatment, and your overall progress. Many individuals with bipolar disorder and borderline personality disorder may require long-term treatment, sometimes for years, to manage their symptoms effectively. It’s great to hear that you’ve noticed improvements in your self-harm behaviors and social interactions. Continue to communicate your progress with your healthcare provider, as they can help adjust your treatment plan as needed.

5. Self-Harm and Communication with Your Doctor: It’s vital to be honest with your healthcare provider about any self-harming behaviors, even if they seem minor. They are there to help you, and withholding information can hinder your treatment. Self-harm is a serious issue, and discussing it openly can lead to better support and strategies to cope with these feelings. Your doctor can provide resources and coping mechanisms to help you manage these urges more effectively.

In addition to addressing your specific questions, here are some general tips for improving sleep quality and managing anxiety:
- Sleep Hygiene: Establish a consistent sleep schedule by going to bed and waking up at the same time every day. Create a relaxing bedtime routine to signal your body that it’s time to wind down. Limit screen time before bed, as the blue light emitted by devices can interfere with melatonin production.

- Relaxation Techniques: Incorporate relaxation techniques such as deep breathing, meditation, or gentle yoga into your daily routine. These practices can help reduce anxiety and promote better sleep.

- Environment: Ensure your sleeping environment is conducive to rest. This includes a comfortable mattress, a dark and quiet room, and a cool temperature.

- Avoid Stimulants: Limit caffeine and nicotine intake, especially in the hours leading up to bedtime. These substances can disrupt sleep patterns and exacerbate anxiety.

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

- Seek Support: Don’t hesitate to reach out to friends, family, or support groups. Sharing your experiences can provide emotional relief and help you feel less isolated.

Remember, you are not alone in this journey. Seeking help and being proactive about your mental health is a significant step toward recovery. Continue to communicate openly with your healthcare provider, and don’t hesitate to ask for the support you need. Wishing you strength and peace as you navigate this challenging time.

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