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Ryan LCSW
Ryan LCSW, Mental Health
Category: Mental Health
Satisfied Customers: 872
Experience:  Individual and Family Therapist
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please help! About two months ago I had a lingering sinus

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please help! About two months ago I had a lingering sinus cold and began worrying about it. The worry kept snowballing to the point of having panic attacks. During one of those panic episodes I had a weird intrusive thought that i was going to kill myself and my wife. This terrified and traumatized me (because I would never do anything like that) and I went to a shrink who said that I was having high levels of anxiety. After the shrink assured me I wasn't going insane, i got better before christmas but since January my nightmare began... feel like I don't know where I am, confused, can't concentrate on anything without some terrifying thought. My perspective feels off, I'm numb. Having these thoughts that everything I'm looking at can only be seen by me. I'll be in a room with my wife and feel as though i'm 3000 miles away from her, having some messed up existential thoughts that consume me to the point where I believe them. These thoughts spiral me in to panic, and panic makes me think about the thoughts. Then I have an inner dialogue to try and rationalize whatever im thinking to try and calm me down. this plays out into an inner conversation that doesnt stop. As insane as I feel inside, I appear normal to everyone else and I even managed go through a series of job interviews and get a new job which I will start in March, but I felt like I could barely converse. I am so aware of the experiences, so I tell myself that I couldnt be insane. I am hyper aware, i guess..obsessed with finding a diagnosis for what is going on. My memory is non-existent, I can't sleep without taking 1mg of clonazepam. All experiences feel foreign, as if I all my memories and experiences never happened. I am sitting down in at a country club I've been to a million times in a neighborhood I spent 6 years in and say to myself "I cant believe this is the same place where i had so much fun" I am incredulous that two months ago I was completely normal and loved all aspects of life and now i live in absolute terror all day everyday. I need to get some relief. I have no comforts, nothing I once enjoyed I can even focus on. I desperately want my old self back... does this sound like depersonilization/derealization?, ptsd? What course of action do you recommend? Have you ever heard of these symptoms/thoughts? My shrink prescribed me effexor about a month ago, but I have not taken it because I thought I could think my way better. I hate the idea of being on meds and I'm afraid they won't work or side effects will outweigh the benefits. Is there any alternative to medications that you can recommend to me?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Ryan LCSW replied 1 year ago.
Thanks for your question. My name is XXXXX XXXXX X'd like to help you out.

I'm terribly sorry to hear about what you've been going through and I can certainly understand how you would be concerned and frightened by your experiences in the past couple months. I can also understand your hesitation to take medication, and generally that would only be recommended if it was absolutely necessary.

All of the symptoms that you've described can be attributed to Anxiety. Anxiety can certainly cause symptoms of depersonalization and derealization, and if all of these other problems started to occur at the same time as the panic attacks, that would be the most logical explanation for what you are experiencing. Anxiety can have a crippling effect on a person's life, can produce all of the problems that you have mentioned, so it doesn't seem necessary to continue to search for a different solution or diagnosis at this point.

It appears that your shrink was able to diagnose this properly and the medication that was prescribed is often very beneficial for these types of problems. While I completely understand your hesitancy to take the medication, studies have shown that the combination of medication and therapy is the most effective way to treat this type of problem. Since you have only had these problems for two months now, the medication would only be used until you have more control over your anxiety and are able to stop using the medication. This is why the therapy component is so important, because while medication is not a permanent answer, it can make this problem much more manageable while you are working on one. Since these problems you're experiencing are potentially harmful to your future employment and your relationships with people, that would be the point where it is appropriate to consider taking the medicaiton.

Overall it does sound like this has been treated appropriately so far. If you are not currently receiving counseling that would be the next most logical step. You may also find that if you were to start taking the medication as prescribed that there would be a significant difference in your ability to manage all of this. I definitely wish you the best, XXXXX XXXXX there is anything else I can do to help please let me know.

Ryan
Customer: replied 1 year ago.

I feel like if I could sleep, I could turn the corner. I can sleep on the clonazepam, but does that suppress true restorative sleep (rem sleep)? is there a better medication for sleep that allows for more "natural" sleep

Expert:  Ryan LCSW replied 1 year ago.

I agree that a lack of sleep does make everything more complicated. The clonazepam should actually help you to achieve rem sleep and is prescribed for people who have difficulties with rem sleep, so that doesn't seem to be a bad option even though your sleep isn't as good as you'd like. There are other prescription sleep aids such as Ambien, Lunesta and many others that people have good results with, however if you have been having success with the clonazepam and are taking it as directed, it does seem appropriate for your situation.


Most likely it is this underlying anxiety problem that is causing you to have problems shutting down your mind at night. You are correct that being well rested will make this a lot more manageable. If you aren't satisfied with the clonazepam it may be worth considering a switch to a different medication, but sometimes it does take a few attempts to find something that works well for you. In the meantime I suspect that by treating the anxiety and managing that more effectively during the day, you should find it easier and easier to get the rest you need at night. Hang in there and good luck with everything,
Ryan
Ryan LCSW, Mental Health
Category: Mental Health
Satisfied Customers: 872
Experience: Individual and Family Therapist
Ryan LCSW and 2 other Mental Health Specialists are ready to help you
Expert:  Ryan LCSW replied 1 year ago.
Hey there, I never heard back from you so I hope that I was able to help you out. If there's anything else I can do to help just let me know, otherwise if you wouldn't mind leaving me a positive review for my time I'd really appreciate it. Thanks.

Ryan

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