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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10547
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hi, So I am a little concerned because upon waking up today,

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Hi, So I am a little concerned because upon waking up today, I started crying. The thing is there was nothing particularly upsetting enough to trigger the visceral response. All the things plaguing me emotionally are the same things I have been dealing with (in therapy btw) for months. But for some reason this morning, seemingly out of nowhere (I wasn't even thinking about those things at the time) I began crying and not only could I not stop it became worse, I would say it's the closest to hysterical I have ever gotten. I tried to suppress it and take deep breathes just so I could start going about my day. Looking back on it it would have been a comical view for anyone who walked in: me blow drying my hair and sobbing uncontrollably at the same time.

I seem to be composed at the moment, but I am fearful about going out and starting my day. What if I lose my composure in public? Is there anything I can do (in a reasonable amount of time) to make sure that once I leave I can at least have a few hours of normalcy while I try to get through my errands? The thought of leaving the apartment right now, even though I have managed to stop crying after two hours of sobbing uncontrollably , is actually making me quite nervous

My room mate is staying at her boyfriends' for the day she has no idea what just happened. I am alone right now. There's no one who lives near by that can come help me with these errands.

Also in case it is helpful: For the last few months I have been taking 300 mg Effexor and 150 mg Wellbutrin every day. Up until today I haven't had any ill effects (though I don't know if it's an effect of meds at all). I take 1 mg Ativan as needed for anxiety, but this morning did not feel like an anxiety attack so I did not take it. I worried that taking a "downer" while I was sobbing would only make things worse. Alcohol is not an issue I haven't had a drink for several days (when I do drink its 1 or 2 glasses of wine). Any ideas what's going on?! I have never felt so out of control before.

Dr. Z :

Hello I believe I can help you with your concern

Dr. Z :

I am so sorry that you experienced this symptom of crying spells, I can imagine how distressing that must be for you

Dr. Z :

I would like to ask you a few questions to get some more information, so that I can give you the best answer possible.

Dr. Z :

You mentioned that this started when you woke up today, how long after you woke up did you start crying?

Dr. Z :

And was this the first time you dealt with this type of crying spells?

Customer: Hi, thank you for your response.
Dr. Z :

No problem, I am here to help :)

Customer: I would say roughly 20 minutes. I got up, went to the bathroom, and started bawling as I was washing my hands.
Customer: Yes first time the spell occurred without provaction. Sometimes it happens if I am upset over something specific but that wasn't the case here
Dr. Z :

Okay, so you have had crying spells before, but this time you found no cause for it. Has life been particularly stressful for you lately?

Customer: Yes. Last week I had to have a colposcopy due to an abnormal pap. But I have received the results a few days ago and they were fine.
Dr. Z :

Okay, I am glad the results came back normal for you, that is definitely a relief. May I ask how did you sleep last night?

Customer: I also discussed the colposcopy with my psychiatrist (who I see weekly for therapy as well)
Customer: i slept more hours than usual but the sleeping was fine quality wise. No bizarre dreams or even sleep paralysis which I sometimes get
Dr. Z :

Well because this was a one time event so far, I would not relate it to your medication use, although crying spells are a rare side effect of Effexor use. I think you might have had a subconscious reaction to certain stress or thoughts while you were sleeping. We usually go through on average 5-6 REM cycles during a full 8 hours of sleep and this allows for 5-6 different dreams, so it is possible that one of your dreams may be very intense and caused this subconscious reaction which spilled over when you woke up, hence the crying.

Dr. Z :

This is not uncommon as are subconscious processes a lot of issues, thoughts, and feelings while we dream because our mind is still active

Dr. Z :

If it continues to occur then this could be a chronic issue concerning your medication or possibly a defense mechanism of repression that cannot handle the intensity of your subconscious mind while you sleep

Customer: That makes sense.
Customer: Also I just want to make sure and perhaps I should have mentioned it before
Customer: But when I went to the bathroom I did happen to bang my head on the sink (I was leaning down to pick something up and hit the ledge on the way up)
Customer: it was bizarre because it did seem like this could have been a trigger. It did not hurt any more than a typical bump on the head. But it was a little strange that as I was rubbing the spot I hit (partly checking for blood on my scalp. There was none I was fine) that it was a few minutes after that that I started crying
Customer: Could there be some physical mechanism at work? Seems like overkill for a minor bump on the head. I am inclined to say that's just coincidence
Dr. Z :

Well now with the combination of Effexor and Wellbutrin, you are more prone to seizures, which can be triggered by head trauma, but that does not appear to be the case here at all because you did not lose consciousness, and I do not believe that when you hurt your head it was that severe to provoke a seizure. So it seems like it is just a coincidence, or because of the stress of your colonoscopy last week, you have been thinking about your physical being and mortality and this incident just triggered all that stress again from your subconscious because you were really focused on your physical pain, which may have caused your crying spell today

Dr. Z :

So it could be a coincidence or a tragedy of simultaneous events (e.g. last weeks colonoscopy, subconscious thinking about mortality, bump on head).

Customer: That makes perfect sense because my immediate thought after hitting my head was "could that be serious? What if I have some internal brain bleeding" which I shook off at the time as me being a worry wort. It does make sense though that after a few minutes many suppressed issues came together that I can't really pinpoint.
Dr. Z :

And that is what I think it was, so you actually could have taken your Ativan and it may have helped because the crying spell was caused by mental stress, which does happen

Dr. Z :

Also, this is a link for something called Progressive Muscle Relaxation that can help you create a long term calm by using muscle tension and release techniques; it can help manage that mental stress and is very similar to a style of meditation.

Customer: Understood. Thank I so much for all your help!
Dr. Z :

Anytime, I am always happy to help. One more question, did you post another question that was very similar to this with another username?

Customer: Yes, that is my account that supposed to have unlimited q&a but I have been having a lot of technical issues with it. I am actually in the process of trying to figure out how to close it
Dr. Z :

No problem, would you like me to close that question for you to help you out

Customer: I don't think that will be needed but thanks. I sent an email to tech support so they should be taking care of it. Thank you!
Dr. Z :

I am just happy to help, is there anything else I can assist you with today?

Customer: no thank you, XXXXX XXXXX thanks again!
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