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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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My son has had Night Terrors, not nightmares, since he was

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My son has had Night Terrors, not nightmares, since he was 13. He is 31 now and still has them. He graduated from college but decided to be a policeman and loves it. His is married with an 8mo. old son. Are there any new Medical findings about treating Night Terrors. He has always refused to take medicine.I have read everything so please just tell if there is something new.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 2 years ago.

Hi! I believe I can be of help with this issue.

First, let me say I can imagine how worrisome and difficult this situation is for you. Your son has lived with this for so long that he seems more scared of the cures than he is of the night terrors. And so this is going to take some effort to get him to be willing to try the cures.

There are no new medical findings to report to you. I'm sorry. The same diagnoses and the same treatments as before are present today. They're a little better than a decade ago, but not different. The treatments are: medications, hypnotherapy, environmental changes, and psychotherapy (in no particular order).

You've done a lot of research, but let me give you the link to the Mayo Clinic's entry for night terrors. I like their "lifestyle and home remedies" page. It might have some tips for you about environmental changes:

http://www.mayoclinic.com/health/night-terrors/DS01016

This is really his wife's domain to try to implement as he's resistant to making efforts.

Also, at the end of the answer, I'm going to paste in instructions for a technique to help when he's awake with the anxiety that remains. This technique will offer some immediate relief whenever he may need it and that's why I'm offering it to you. So see if he'll read my answer or at least that part of it.

Hypnotherapy may be something he can relate to as it's more brief than traditional psychotherapy. Now here's the important statement about hypnotherapy: hypnotherapy can help with a specific problem and that's why I'm thinking of it. HOWEVER, there are good and honest hypnotherapists and there are other types. Your only way of assessing is two ways: first, make sure he or she is a licensed psychologist. Don't let anyone tell you they are a licensed hypnotherapist. There is no licensure in most states that I know of. It's all a "self-licensing" which is not good enough. So you want to know his or her license number as a psychologist and call the state licensing board to make sure there have been no complaints filed. So please don't skip this step.


I'm going to make two herbal recommendations. This is because I know there is SOME research evidence for these two herbs. However, it is not that conclusive or even impressive. But it is some and they have the following going for them: in the cultures they come from, they are traditionally used for anxiety. That's encouraging. The first is Black Cohosh, the root of which was used by Indians in our country. The second is Kava, sometimes called Kava Kava, which is from the Pacific Islands.

Not directly for anxiety but useful for moods is Omega 3 fatty acids, either in fish oil or capsules. Buy good quality. The clinical dosage is 2-3,000 mg daily. All these things you should get at the biggest and most frequented health food store and ask them for the best brands they trust in terms of quality. Because these are all unregulated supplements.

He may consider these to be placebos. But I want him to not underestimate the power of placebos. He can look them up on the net. And Omegas are not placebos, though the herbs may indeed be.

Which brings us to psychotherapy. He will need to find a psychologist or psychotherapist to help manage the anxiety and panic. EMDR can be very useful for long term behaviors such as night terrors he has. It is a type of therapy specifically for PTSD originally. Here is the International Society's website:

http://www.emdria.org/

On the web you will find many opinions on EMDR both for and against. I am trained in it and have found it useful. However, I have found that you need to combine these types of therapy with a more introspective, psychodynamic approach.

Fortunately, anxiety and panic are among the most researched disorders in terms of effective treatments. And the therapies today are very effective. The preferred form of treatment today is Cognitive Behavioral Therapy to learn skills. Here is the Amazon web page address for the classic workbook for phobias by Edmund Bourne:

http://www.amazon.com/Anxiety-Phobia-Workbook-Fourth/dp/1572244135/ref=sr_1_1?s=books&ie=UTF8&qid=1286170992&sr=1-1

If his 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 CBT therapy in their orientations and anxiety disorders as one of the areas they work with.

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

If he would want someone who isn't as structured as a pure CBT therapist, consider seeing if the therapist also lists psychodynamic therapy in their orientation. 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 him and will help him look at the sources of your emotions and social phobia.


Okay. Now for the technique: 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, 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:

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5095
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 2 years ago.
You have given me many good web sites and I thank you but Mark is not anxious during the day. A Night Terror is where his eyes are open and he usually is running away from something and yelling "no,"no".....and it is a matter of life and death for him but he is not awake. Before he married I would usually get up and tell him, "Mark your haveing a bad dream" and he would wake up. His sister used to lock her doors so he wouldn't disturb her, but one night he was trying to get away so badly she thought he was going to knock her door down. From then on she kept her door unlocked. His eyes are open he even talks and runs but he is not awake. My last example is: We were all asleep. Mark was 18 and 6'2". I heard him coming down the hall and at the end of our bed he put his arms up like he was diving and then dove into the bed between my husband and me. He is not anxious during the day! and he is not anxious if you wake him up, but this has continued up to and even after he married.
Expert:  Dr. Mark replied 2 years ago.
First, I'm sorry that my PMR document implied I wanted him to use it for day anxiety. I meant it as a tool for him to use once he's awakened in that recovery period.

You know, now that you describe it more and I put it together with him starting as a young teen, I wonder if he's had neurological testing?

It's theorized that some night terrors are caused by chemical triggers in the brain. Well electro-chemical "events" are what seizures are. I'm not talking about the kind in movies. But, has he had any neurological testing?

Dr. Mark
Customer: replied 2 years ago.
No, he has not had testing and if I can talk him into it I am going to try or have his Father talk to him about that possibility. Thank you very much for your answer and for explaining to me what you meant about the exercises. That is quiet helpful. Thank you.
Expert:  Dr. Mark replied 2 years ago.
I don't want to put too much on the neurological testing. But child night terrors that continue into adulthood like this is not so common. And so please ask him to rule out what might be an important way to get relief.

All the best, XXXXX XXXXX
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5095
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and other Mental Health Specialists are ready to help you

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