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Suggest Treatment For Nightmares During Sleep And Sleeplessness
Question: I have severe nightmares. As a teen my brother. Passed awaay very young, I watched him take his last breath. Now however I have an only child whom has made hisself indispensable. To the milatary and his contractor. He deploys alot, and I have nightmares even when is stateside. I take alot of melatotin and Ambein. I need a change from Ambien, but am afraid to talk to my Doctor about it. I sleep approx. 2-4hrs and alot of all nighters. Should I just call the Vet. And have him put me down? Also I'm a hard person to put under for surgery, I awaken anywhere from 10mins to 20mins. Also sleep with my eyes open alot. So what say you, please.
Brief Answer:
need to consider adjustment problems, anxiety, depression, etc
Detailed Answer:
welcome to HCM
I can understand the distress that you must be through.
As i can understand that your major complaint is of
Nightmares during sleep
Inadequate sleep
stressors in life.
There could be anxiety, depression related problems or adjustment related issues that appears to present. Additionally we need to consider presence of co occurring medical conditions such as chronic infectious conditions, etc.
I would need to know
1. How long have you had problems with nightmares?
Acute nightmares should make one think of the possibility of infectious disease, acute situational maladjustment (adjustment disorder) or a head injury. Chronic nightmares may be associated with drug or alcohol use, epilepsy, anxiety, depression, post-traumatic stress disorder, schizophrenia and bipolar disorder.
2.How often do you get nightmares?
3. Is there memory of the dream-associated unpleasant episode?
4. What is the content of the nightmares?
5. details of medcations you are currently taking.
Kindly revert back with information
Regards.
need to consider adjustment problems, anxiety, depression, etc
Detailed Answer:
welcome to HCM
I can understand the distress that you must be through.
As i can understand that your major complaint is of
Nightmares during sleep
Inadequate sleep
stressors in life.
There could be anxiety, depression related problems or adjustment related issues that appears to present. Additionally we need to consider presence of co occurring medical conditions such as chronic infectious conditions, etc.
I would need to know
1. How long have you had problems with nightmares?
Acute nightmares should make one think of the possibility of infectious disease, acute situational maladjustment (adjustment disorder) or a head injury. Chronic nightmares may be associated with drug or alcohol use, epilepsy, anxiety, depression, post-traumatic stress disorder, schizophrenia and bipolar disorder.
2.How often do you get nightmares?
3. Is there memory of the dream-associated unpleasant episode?
4. What is the content of the nightmares?
5. details of medcations you are currently taking.
Kindly revert back with information
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Breifly, IAm a re-covering alcoholic. Sober since 2004 Had a bad car crash in 1970 of which I. Take a small amout of Tizisdine as a muscle relaxant. I have cirrhosis with LFTs very much undercontrol. I take Xixfican, spriolactone, zinc, potassium, omeprazole, nadol, and lyrica for neuropathy, and fibromyglia. I want you to know I sobered-up all on my own. Once the peroitintis with liver failure, and pneumonia, came all at once I looked live bigbird! I left Sonora with a 75/30 chance. Stanford gave me no hope either, after 12liters later off me I was 199lbs & now 110lbs.
My chilhood stunk left at 12.5yrs. Living on the streets everywhere I met my 1st husband. He promptly put a 45 up to my head, I was 7months pregnant. After my son left for the Navy the bad dreams from my young childhood, then the physical.and mental abuse from his Dad. Well I thought my son whould be on a ship, but oh no he was in county 8times once in Afghanistan. The nightmares of him the past all increased. When he was finally stateside he got work with a contractor. He made himself indispensable. And it all started over again. I've stated before I use Anbien and 50units of melatonin. I do not feel comfortable asking my doctor an increase on Ambien nor asking for a stronger drug. Oh I do have a low dosege of Lorezapam , and Diludid. I rarely use pain meds they are low dosage also 2mg! Im not some addirive kind of person, im strong & bullheaded!.
My chilhood stunk left at 12.5yrs. Living on the streets everywhere I met my 1st husband. He promptly put a 45 up to my head, I was 7months pregnant. After my son left for the Navy the bad dreams from my young childhood, then the physical.and mental abuse from his Dad. Well I thought my son whould be on a ship, but oh no he was in county 8times once in Afghanistan. The nightmares of him the past all increased. When he was finally stateside he got work with a contractor. He made himself indispensable. And it all started over again. I've stated before I use Anbien and 50units of melatonin. I do not feel comfortable asking my doctor an increase on Ambien nor asking for a stronger drug. Oh I do have a low dosege of Lorezapam , and Diludid. I rarely use pain meds they are low dosage also 2mg! Im not some addirive kind of person, im strong & bullheaded!.
Brief Answer:
A psychiatric consultation and revision of treatment
Detailed Answer:
Thanks for the reply.
The given information is suggestive sleep problem secondary to a probable underlying mood disorder, possibly of chronic depression or bipolar cyclic condition.
The history and life stresses during your childhood and later, strongly support the psychological distress.
The problem that you currently suffer of nightmares are secondary to the stressors in your life.
Here our approach should be to look out for a primary psychiatric condition that has resulted in sleep related issues.
One will need to evaluate in detail regarding mood, energy levels, motivation levels, kinds and content of thoughts and ideas.
Additionally, one will need to asses your current social, familial issues, and their support and care levels,etc.
We may need to address the co occurring and possible medical complications.
Considering all these, my suggestions to you are
Consult a local psychiatrist and discuss with him regarding-
to Re consider or establishment of primary diagnosis,
to Consider addition of anti depressant of mood stabiliser if needed
Revise treatment plan
“z” drugs can be considered for sleep and nightmare problem(prescription drugs)
to Consider psycho-social management option.
2. An opinion of physician is advisable as there are issues concerning liver.
I suggest a more detailed mental status examination and history is essential. And as it can be done only on in person interview, consultation to a local psychiatrist is very much advisable.
Welcome for further queries and suggestion.
Regards,
Dr Pankaj
A psychiatric consultation and revision of treatment
Detailed Answer:
Thanks for the reply.
The given information is suggestive sleep problem secondary to a probable underlying mood disorder, possibly of chronic depression or bipolar cyclic condition.
The history and life stresses during your childhood and later, strongly support the psychological distress.
The problem that you currently suffer of nightmares are secondary to the stressors in your life.
Here our approach should be to look out for a primary psychiatric condition that has resulted in sleep related issues.
One will need to evaluate in detail regarding mood, energy levels, motivation levels, kinds and content of thoughts and ideas.
Additionally, one will need to asses your current social, familial issues, and their support and care levels,etc.
We may need to address the co occurring and possible medical complications.
Considering all these, my suggestions to you are
Consult a local psychiatrist and discuss with him regarding-
to Re consider or establishment of primary diagnosis,
to Consider addition of anti depressant of mood stabiliser if needed
Revise treatment plan
“z” drugs can be considered for sleep and nightmare problem(prescription drugs)
to Consider psycho-social management option.
2. An opinion of physician is advisable as there are issues concerning liver.
I suggest a more detailed mental status examination and history is essential. And as it can be done only on in person interview, consultation to a local psychiatrist is very much advisable.
Welcome for further queries and suggestion.
Regards,
Dr Pankaj
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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