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Nightmares Attacks. Taking Xanax, Nardil. Is This Subsyndromal Temporal Lobe Epilepsy?
Question: I sometimes wake in the night with a weird nightmare feeling, like the feeling I felt when having a nightmare as a child. My brain feels scrambled. Something is wrong but I don't know what. Is part of my brain still asleep? If I drink only a little in the evening, then I sleep straight through. But if I wake in the night to go to the toilet, that's when I get one of these attacks. 1mg Xanax helps, or a chat with my son if he's awake. My sister has the same complaint and so did my late Mother. I've sometimes thought it was subsyndromal take Nardil (phenelzine) 90mg/day. My 18 yr old son is staying with me and I'm very worried that he can't seem to get started in life, but I'll miss him so much when he leaves, even though he's obnoxious a lot of the time. Perhaps this is the major worry that gives me a strange feeling if I wake during the night. I hope I've given you enough information. Perhaps it's not a medical problem at all. Many thanks
Hi XXXXXXX,
Thanks for writing in.
I am a medical specialist with an additional degree in cardiology.
I read your mail with diligence. Honestly, I am impressed by the insight you have about the anxiety disorder which you are having. That gives me tremendous hope that you can be cured completely. And, to top that 70% of cure will be because of self help. Lack of insight on part of patient is when any doctor or for that matter both, start at stupendous disadvantage.
Coming straight to self help:
Self-help for anxiety attacks and anxiety disorders: Take care of yourself
Practice relaxation techniques. When practiced regularly, relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and XXXXXXX breathing can reduce anxiety symptoms and increase feelings of relaxation and emotional well-being.
Adopt healthy eating habits. Start the day right with breakfast, and continue with frequent small meals throughout the day. Going too long without eating leads to low blood sugar, which can make you feel more anxious.
Reduce alcohol and nicotine (if you smoke). They lead to more anxiety, not less.
Exercise regularly. Exercise is a natural stress buster and anxiety reliever. To achieve the maximum benefit, aim for at least 30 minutes of aerobic exercise on most days.
Get enough sleep. A lack of sleep can exacerbate anxious thoughts and feelings, so try to get 7 to 9 hours of quality sleep a night.
Yogic Exercises:
I believe, and you will also start believing after trying for 15 days Please do progressive muscular relaxation exercises, a yogic exercise, has been found extremely useful in such situation ( also called "Shawasanam" as per instruction below).Instructions 1. Lying on your back, let the arms and legs drop open, with the arms about 45 degrees from the side of your body. Make sure you are warm and comfortable, if you need to place blankets under or over your body. 2. Close the eyes, and take slow XXXXXXX breaths through the nose. Allow your whole body to become soft and heavy, letting it relax into the floor. As the body relaxes, feel the whole body rising and falling with each breath. 3. Scan the body from the toes to the fingers to the crown of the head, looking for tension, tightness and contracted muscles. Consciously release and relax any areas that you find. If you need to, rock or wiggl part sof your body from side to side to encourage further release. 4. Release all control of the breath, the mind, and the body. Let your body move deeper and deeper into a state of total relaxation. 5. Stay in Shavasana for 5 to 15 minutes.6. To release: slowly deepen the breath, wiggle the fingers and toes, reach the arms over your head and stretch the whole body, exhale bend the knees into the chest and roll over to one side coming into a fetal position. When you are ready, slowly inhale up to a seated position.Benefits Benefits: Corpse pose is essential to practice at the end of every yoga practice. This posture rejuvenates the body, mind and spirit while reducing stress and tension. Modifications + Variations/Modifications: Place a bolster or blankets under the low back and/or knees.
When to seek professional help for anxiety disorders
While self-help coping strategies for anxiety can be very effective, if your worries, fears, or anxiety attacks have become so great that they’re causing extreme distress or disrupting your daily routine, it is important to seek professional help.
If you’re experiencing a lot of physical anxiety symptoms, consider getting a medical checkup. Your doctor can check to make sure that your anxiety isn’t caused by a medical condition, such as a thyroid problem, hypoglycemia, or asthma. Since certain drugs and supplements can cause anxiety, your doctor will also want to know about any prescriptions, over-the-counter medications, herbal remedies, and recreational drugs you’re taking. Your doctor will be the best person to adjust the dosage and frequency of anxiolytics you are currently taking (Alprazolam is the salt in Xanax, and maximum dose one can take in a day is 3 mg before developing toxicity).Medication for anxiety disorders
Is anxiety medication right for you?
Anxiety medications can be habit forming and cause unwanted side effects, so be sure to research your options. It’s important to weigh the benefits and risks so you can make an informed decision about whether anxiety medication is the right treatment for you.
A variety of medications, including benzodiazepines -anxiolytics (which you are taking at present) antidepressants, are used in the treatment of anxiety disorders. But medication is most effective when combined with behavioral therapy and anxiety self-help strategies. Medication may sometimes be used in the short-term to relieve severe anxiety symptoms so that other forms of therapy can be pursued.
If your physician rules out a medical cause, the next step is to consult with a therapist who has experience treating anxiety attacks and anxiety disorders. The therapist will work with you to determine the cause and type of your anxiety disorder and devise a course of treatment.
Treatment options for anxiety disorders
Anxiety disorders respond very well to treatment—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with behavioral therapy, medication, or some combination of the two. Sometimes complementary or alternative treatments may also be helpful.
Behavioral therapy for anxiety disorders
Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. Behavioral therapy for anxiety usually takes between 5 and 20 weekly sessions.
Cognitive-behavior therapy focuses on thoughts—or cognitions—in addition to behaviors. In anxiety disorder treatment, cognitive-behavioral therapy helps you identify and challenge the negative thinking patterns and irrational beliefs that fuel your anxiety.
Exposure therapy for anxiety disorder treatment encourages you to confront your fears in a safe, controlled environment. Through repeated exposures to the feared object or situation, either in your imagination or in reality, you gain a greater sense of control. As you face your fear without being harmed, your anxiety gradually diminishes.
I hope you found the above discussion useful. If you have further query please do write, I will be more than happy to answer.
With Best Wishes.
Dr Anil Grover
MBBS, MD(Internal Medicine) DM(Cardiology)
WWW.WWWW.WW
Thanks for writing in.
I am a medical specialist with an additional degree in cardiology.
I read your mail with diligence. Honestly, I am impressed by the insight you have about the anxiety disorder which you are having. That gives me tremendous hope that you can be cured completely. And, to top that 70% of cure will be because of self help. Lack of insight on part of patient is when any doctor or for that matter both, start at stupendous disadvantage.
Coming straight to self help:
Self-help for anxiety attacks and anxiety disorders: Take care of yourself
Practice relaxation techniques. When practiced regularly, relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and XXXXXXX breathing can reduce anxiety symptoms and increase feelings of relaxation and emotional well-being.
Adopt healthy eating habits. Start the day right with breakfast, and continue with frequent small meals throughout the day. Going too long without eating leads to low blood sugar, which can make you feel more anxious.
Reduce alcohol and nicotine (if you smoke). They lead to more anxiety, not less.
Exercise regularly. Exercise is a natural stress buster and anxiety reliever. To achieve the maximum benefit, aim for at least 30 minutes of aerobic exercise on most days.
Get enough sleep. A lack of sleep can exacerbate anxious thoughts and feelings, so try to get 7 to 9 hours of quality sleep a night.
Yogic Exercises:
I believe, and you will also start believing after trying for 15 days Please do progressive muscular relaxation exercises, a yogic exercise, has been found extremely useful in such situation ( also called "Shawasanam" as per instruction below).Instructions 1. Lying on your back, let the arms and legs drop open, with the arms about 45 degrees from the side of your body. Make sure you are warm and comfortable, if you need to place blankets under or over your body. 2. Close the eyes, and take slow XXXXXXX breaths through the nose. Allow your whole body to become soft and heavy, letting it relax into the floor. As the body relaxes, feel the whole body rising and falling with each breath. 3. Scan the body from the toes to the fingers to the crown of the head, looking for tension, tightness and contracted muscles. Consciously release and relax any areas that you find. If you need to, rock or wiggl part sof your body from side to side to encourage further release. 4. Release all control of the breath, the mind, and the body. Let your body move deeper and deeper into a state of total relaxation. 5. Stay in Shavasana for 5 to 15 minutes.6. To release: slowly deepen the breath, wiggle the fingers and toes, reach the arms over your head and stretch the whole body, exhale bend the knees into the chest and roll over to one side coming into a fetal position. When you are ready, slowly inhale up to a seated position.Benefits Benefits: Corpse pose is essential to practice at the end of every yoga practice. This posture rejuvenates the body, mind and spirit while reducing stress and tension. Modifications + Variations/Modifications: Place a bolster or blankets under the low back and/or knees.
When to seek professional help for anxiety disorders
While self-help coping strategies for anxiety can be very effective, if your worries, fears, or anxiety attacks have become so great that they’re causing extreme distress or disrupting your daily routine, it is important to seek professional help.
If you’re experiencing a lot of physical anxiety symptoms, consider getting a medical checkup. Your doctor can check to make sure that your anxiety isn’t caused by a medical condition, such as a thyroid problem, hypoglycemia, or asthma. Since certain drugs and supplements can cause anxiety, your doctor will also want to know about any prescriptions, over-the-counter medications, herbal remedies, and recreational drugs you’re taking. Your doctor will be the best person to adjust the dosage and frequency of anxiolytics you are currently taking (Alprazolam is the salt in Xanax, and maximum dose one can take in a day is 3 mg before developing toxicity).Medication for anxiety disorders
Is anxiety medication right for you?
Anxiety medications can be habit forming and cause unwanted side effects, so be sure to research your options. It’s important to weigh the benefits and risks so you can make an informed decision about whether anxiety medication is the right treatment for you.
A variety of medications, including benzodiazepines -anxiolytics (which you are taking at present) antidepressants, are used in the treatment of anxiety disorders. But medication is most effective when combined with behavioral therapy and anxiety self-help strategies. Medication may sometimes be used in the short-term to relieve severe anxiety symptoms so that other forms of therapy can be pursued.
If your physician rules out a medical cause, the next step is to consult with a therapist who has experience treating anxiety attacks and anxiety disorders. The therapist will work with you to determine the cause and type of your anxiety disorder and devise a course of treatment.
Treatment options for anxiety disorders
Anxiety disorders respond very well to treatment—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with behavioral therapy, medication, or some combination of the two. Sometimes complementary or alternative treatments may also be helpful.
Behavioral therapy for anxiety disorders
Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. Behavioral therapy for anxiety usually takes between 5 and 20 weekly sessions.
Cognitive-behavior therapy focuses on thoughts—or cognitions—in addition to behaviors. In anxiety disorder treatment, cognitive-behavioral therapy helps you identify and challenge the negative thinking patterns and irrational beliefs that fuel your anxiety.
Exposure therapy for anxiety disorder treatment encourages you to confront your fears in a safe, controlled environment. Through repeated exposures to the feared object or situation, either in your imagination or in reality, you gain a greater sense of control. As you face your fear without being harmed, your anxiety gradually diminishes.
I hope you found the above discussion useful. If you have further query please do write, I will be more than happy to answer.
With Best Wishes.
Dr Anil Grover
MBBS, MD(Internal Medicine) DM(Cardiology)
WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr for such a thoughtful reply. Years ago I had a course of autogenic training which didn't help. But I see there's more to your version. Likewise cognitive behavioural sessions have never helped. Anxiety and panic disorder have characterised periods in my life when there's been a problem, particularly one of isolation, which the childish part of me translates as abandonment, desertion and neglect. I don't remember being abandoned however, but as the past recedes I can see life situations in perspective. The nightmare feeling is different in flavour from daytime anxiety and doesn't seem to involve body tension. It seems more like a harbinger of hell or somewhere, but I doubt that. No thoughts seem to provoke it. However my dreams, which are not generally anxious, give symbolic or literal information of what's wrong I believe. There's no need for complex interpretation or Jungian archetypes; when I tell the dreams or write them out, it's perfectly clear that I'm very concerned that my 18 year old son should spread his wings and leave the nest, but I'll miss him! Also that I very strongly desire a nice woman in my life. Sorry to ramble on. I seem to have entered a sweet spot in my life, and "the feeling" hasn't visited me for a week.
Once again, thank you for helping me XXXXXXX
Once again, thank you for helping me XXXXXXX
Hello there,
At the cost of repeating myself I will reiterate that you have remarkable insight in your thought process, emotions you feel and actions you take. That is your greatest strength, I have rarely seen that in someone to quote your words "harbinger of hell". This insight will give you power to come out of the condition which you have helped me in analyzing,
With Best wishes. If you have a question to ask I will be happy to answer. If none then please close the query with comments. Thank You.
Dr Anil Grover, Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
At the cost of repeating myself I will reiterate that you have remarkable insight in your thought process, emotions you feel and actions you take. That is your greatest strength, I have rarely seen that in someone to quote your words "harbinger of hell". This insight will give you power to come out of the condition which you have helped me in analyzing,
With Best wishes. If you have a question to ask I will be happy to answer. If none then please close the query with comments. Thank You.
Dr Anil Grover, Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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