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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5154
Experience:  Dr. Mark is a PhD in psychology in private practice
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I have Restlessness eaxh day. take clozapam,but does not help

Customer Question

I have Restlessness eaxh day. take clozapam,but does not help anything else i could take
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 3 years ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.


The medications you are taking and have been taking are rather specific. What is the diagnosis that they were and are prescribed for?

What do you mean by restlessness? Do you mean anxiety? Do you mean inability to sleep? What are the symptoms you are experiencing?

You have mentioned only medications. Have you had no psychotherapy? Would you be interested in psychotherapy?

You mention a nurse. Have you not been treated by a psychiatrist at all and only a nurse? If so, why?

Any extra information that will help, feel free to share.

Let's go forward from the answers to these questions.

Dr. Mark

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5154
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
lCan not sit still no interest in anything. Never know which way to go. My aprn is both kinds of doctors,but says nothing can settle me down. I go crazy,as I just can not concentrate,sit have hard time doing what needs to be done. she tried anax and did not work either. l must be able to take something to help me even hard time sleeping. trying to stay in bed.
Expert:  Dr. Mark replied 3 years ago.
This truly sounds like a very serious situation.

Again, I am concerned: have you no access to a psychiatrist? Your symptoms are severe enough that I think a nurse is not qualified enough to deal with your case. Is there any way you can get a referral to a psychiatrist?

What is the diagnosis? Because is this a problem of racing thoughts? Is it anxiety? Is it a neurological problem?

Your symptoms are extremely severe and without a proper diagnosis, there is no way to proceed in treatment.

Have you had any history of thought disorders or schizophrenia or bipolar disorder?

Was there trauma in your life that caused this? Or how did this start?

Dr. Mark
Customer: replied 3 years ago.
I had kidney cancer a year ago this month. within 2 months all the other stuff started. not sure it"s back or i am just having trouble dealing with it. i also lost my mother this past jan.. we were very close. been on many meds that don"t seem to work. just came off seroaquelxr as it made me very tired. feel little better,but now nausea. was on 50mg.not sure if it"s withdrawels or cancer back.. all started 2 months after my surgery. dr said it was a small piece,so i have part of my kidney. just can"t seem to find anyone who cares enough to help sort it out. one dr sends me to another. think sucicide alot,but not there to do it yet. thanks for listening!!
Expert:  Dr. Mark replied 3 years ago.

Thank you for the added information. It helps a lot.

First, let me say I can imagine how overwhelming this situation must be for you. I am very concerned. I believe you have gone through some serious trauma with your kidney and cancer problems and are also in the midst of grief that is not able to fully express itself because of the medical problems. All this has now become emotional problems that are expressing themselves as this restlessness.

And this is actually the key to my answer to you that you need to consider and think about. The restlessness is consistent with traumatic stress compounded by unexpressed grief. And by the way, the nausea is a common side effect of withdrawal from Seroquel. It should ease up after a while.

Your symptoms are too severe to treat on your own. You need to deal with this in psychotherapy. You don't have to keep feeling this way. Psychotherapy with a competent psychologist or psychotherapist can help with the trauma and the grief. If your doctor isn't able to refer to anyone, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list trauma and grief in the areas they work with.


http://therapists.psychologytoday.com/rms/

Consider seeing if the therapist also lists humanistic and/or psychodynamic therapy in their orientation because you are clearly a sensitive person and I think you will benefit from this type of treatment. The idea here isn't that these types of therapy are magic. It's that you may want to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions and restlessness.

Okay, that should help you get working on these symptoms and get some relief. I wish you the very best!

Now, I want to give you a tool to use for when the restlessness is overwhelming. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety that underlies restlessness, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety states is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

 

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Dr. Mark
Dr. Mark
Mental Health Professional
5154 Satisfied Customers
Dr. Mark is a PhD in psychology in private practice