Overcoming Anxiety and Insomnia: Seeking Help for Mental Health Struggles

I've been feeling very anxious every day lately?

I have recently been experiencing insomnia, often overthinking before bed.
I have been contemplating leaving a job that everyone praises, and I worry about my friends and family’s opinions regarding my unstable employment situation.
After finally falling asleep, I wake up after one or two hours, feeling my heart racing in the middle of the night, accompanied by feelings of unease, fear, and anxiety.
This has been ongoing for one to two months, and my menstrual cycle has also become irregular.
A gynecologist mentioned that I show symptoms of hormonal imbalance.
After taking progesterone, I’m unsure if it’s a placebo effect, but I feel my insomnia has worsened.
I often lie awake for two to three hours, which is very distressing, and I feel like screaming in the middle of the night.
A friend had me take an online depression assessment, and I scored 37.
I’m not sure if that’s high or moderate, but they suggested I seek professional help.
Dr.
Ding, how can I improve this situation? I understand that finding a job might alleviate some symptoms, but my anxiety has made it difficult for me to interview and search for work effectively.
I’m also concerned about becoming dependent on medication, yet I feel unable to overcome my mental struggles, which is very painful.

Xiao K, 20~29 year old female. Ask Date: 2016/03/08

Dr. Ding Shuyan reply Psychiatry

Hello, anxiety and insomnia are very common issues and are quite manageable.
If they are short-term and transitional, you can handle them on your own without significant impact on your life, and it may not be necessary to see a doctor.
Psychological therapy or self-adjustment is certainly beneficial and important; however, medication can provide rapid relief of symptoms, giving you confidence that this issue can be improved, which makes subsequent self-adjustment easier.

The issue of medication dependence is related to the dosage and duration of the treatment.
In my experience, treatment for anxiety disorders is usually quick, especially when following a doctor's guidance.
Additionally, personality and attitudes toward medication play a role.
Some individuals may psychologically depend on medication; they do not mind whether they become reliant on it as long as it resolves their insomnia or anxiety, and they lack motivation to reduce or discontinue the medication.
This mindset is more likely to lead to dependence.
I see that you do not have this situation, so you should not worry about medication dependence.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2016/03/08

More Info

It sounds like you are experiencing a challenging time with anxiety and insomnia, which can be incredibly distressing. Your symptoms, including racing thoughts at night, difficulty falling asleep, and feelings of panic, are common manifestations of anxiety disorders. It's important to understand that you are not alone in this struggle, and there are effective ways to seek help and improve your situation.

Firstly, the connection between anxiety and sleep disturbances is well-documented. Anxiety can lead to hyperarousal, which makes it difficult to relax and fall asleep. The racing thoughts you mentioned, especially about your job situation and the opinions of friends and family, can create a cycle of worry that exacerbates insomnia. This cycle can be particularly difficult to break, especially when compounded by hormonal changes that can affect your mood and sleep patterns.

You mentioned that you have been experiencing these symptoms for one to two months, and it’s good that you are aware of the impact they are having on your life. The fact that your menstrual cycle has also been disrupted suggests that there may be a hormonal component to your anxiety, which can be influenced by stress. The use of progesterone (黄体素) prescribed by your gynecologist may help regulate your cycle, but it’s essential to monitor how it affects your mental health as well.

Your score of 37 on the depression scale indicates a significant level of distress, and it’s wise to take this seriously. Seeking professional help is a crucial step. A mental health professional can provide you with a comprehensive evaluation and help you understand the underlying causes of your anxiety and insomnia. They can also guide you through various treatment options, which may include therapy, medication, or a combination of both.

Cognitive-behavioral therapy (CBT) is particularly effective for anxiety and insomnia. CBT helps you identify and challenge negative thought patterns and develop healthier coping strategies. It can also teach you relaxation techniques and sleep hygiene practices that can improve your sleep quality. Additionally, mindfulness and meditation practices can help calm your mind and reduce anxiety, making it easier to fall asleep.

Regarding your concerns about medication dependency, it’s important to have an open discussion with your healthcare provider about your fears. Many people worry about becoming reliant on medications, but when used appropriately, they can be a valuable tool in managing anxiety. Your doctor can help you find a medication that works for you while minimizing the risk of dependency. Moreover, medication is often most effective when combined with therapy, which can help you develop long-term coping strategies.

In the meantime, consider implementing some self-care strategies to help manage your anxiety and improve your sleep. Establish a calming bedtime routine that includes activities such as reading, gentle stretching, or listening to soothing music. Avoid stimulants like caffeine and electronic screens before bed, as they can interfere with your ability to fall asleep. Regular physical activity can also help reduce anxiety and improve sleep quality.

Lastly, while finding a job may alleviate some of your stress, it’s essential to prioritize your mental health first. Focus on small, manageable steps to improve your well-being, and remember that seeking help is a sign of strength. You deserve support and guidance as you navigate this challenging time. With the right resources and strategies, you can work towards overcoming your anxiety and insomnia, leading to a healthier and more fulfilling life.

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