I would appreciate some advice

A

AllDay

New member
Joined
Jan 22, 2019
Messages
2
Location
Minneapolis, MN
#1
Hello everyone. Thank you for taking the time to read this. I anticipate this being long, so pleases bear with me.

I am a 24 year old male who has suffered from a few different mental health conditions since high school. It all started with anxiety during my junior year. I was embarrassed by it, confused of what was going on and therefore tried to ignore it and didn't talk to anyone or see a physician. When I started to understand it, I began seeing my primary doctor, who started me on Zoloft and Xanax PRN. This didn't help the anxiety long term, as I would only find relief with PRN meds.

After switching between a few psychiatrists to find one I was comfortable with, I finally landed with one who I felt would benefit me the best. I have been seeing him for about four years now.

Conditions he has diagnosed me with include:

  • Panic Disorder without agoraphobia
  • Mixed obsessional thoughts and acts
  • Bipolar Disorder (manic depression)
  • Sleep Disorder (delayed sleep syndrome)
I have an appt coming up, and I want to cover some more topics with him and would like to get advice or recommendations from others who may suffer from the same conditions.

My main struggles right now involve anxiety and sleep. Anxiety has been getting worse, as it had gotten much better for about 2 or 3 years. I have not discussed with him, but I know CBD oil does help. My only concern with that is the small chance for testing positive for THC if an employer does a drug screen. I have never and will never touch an illegal substance.

Sleep is what is really affecting my life right now. I fall asleep very easy and stay asleep without problems. My issue is waking up. I can sleep for 12 hours or more and still feel exhausted. It is affecting my work, as I am showing up later and later (today was 2 hours later than normal). When my alarm goes off, I will set it for 10 more minutes many many times. I did go through a time when I was constantly exhausted, and would fall asleep right after getting home from work.

The other things that are difficult for me are my legs and hands. I'm always having to move my hands and feet. I almost describe it as hurting if I don't constantly move them. I am very particular about my night time clothing, and after I shower I MUST be completely dry before putting clothes on. I am embarrassed for this next one, but I am always feeling like I am sweating between my buttocks. It is very frustrating as I am always needing to place a paper towel between my buttocks throughout the day and while I sleep.

Does anyone else have similar experiences? Is there any advice as to what I can speak with my psychiatrist about? The appts are only 20 min, I always try to go in prepared with reading materials to discuss with him.
 
A

Aurelius

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Joined
Aug 14, 2018
Messages
308
#2
Some thoughts in response to your questions.....

Do discuss your anxiety and medication concerns with your psychiatrist.

Waking up exhausted despite length of sleep could be 'lassitude' (a more severe form of fatigue) which is sometimes treated by a wakefulness-promoting agent such as Armodafinil . This is worth following up with your psychiatrist or with your primary care physician/GP..

The excessive perspiration sounds like a condition known as 'hyperhidrosis' - there is some basic information on it here - Excessive sweating (hyperhidrosis) - This is not a psychiatric condition, so you should initially follow it up with your primary care physician/GP.

There are quite a lot of conditions that can cause your 'need to constantly move' issues, such as sensory/nervous system/motor disorders, ADHD (which in my case is responsible for the same symptoms as you describe), or the symptoms can sometimes be caused as a side-effect of particular medications. This is worth following up with your psychiatrist.

Your night time behaviour sounds to be somewhat 'ritualistic' or 'obsessive-compulsive', but if it does the trick where your anxiety is concerned and does not distress you, I would not worry. This kind of behaviour is common in people whose lives are quite normal.
 
A

AllDay

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Joined
Jan 22, 2019
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Location
Minneapolis, MN
#3
Thank you for the reply.

I will discuss a wakefulness promoting agent at my next visit.

It was my understanding with DSPS, summer time was difficult as it stayed light outside longer and really disrupted sleep cycles. This makes sense as we are in winter and I am not as tired during the day. Waking up is still the issue. After I get out of bed, I wake up well and don't have a current issue of staying awake.

Do you have any knowledge of Chronotherapy? I would like to discuss with my psychiatrist that as an option.

My main goal is to be on as few of medications as possible. I currently take Depakote and Gabapentin, and use Klonopin and Hydroxyzine as needed for anxiety.

I do want to talk to my psych about the CBD oil as well, but I am nervous to bring it up because I don't want a perception of someone looking to use drugs. I do think it really helped, and did a lot of research and reading lab testing results for each manufacture. But it is a supplement that is not federally tested, so there is that risk of other stuff being in it.

What is your view on telling my psych about the oil? My worry is that he will stop prescribing Klonopin as needed. I use them sparingly, and only ask for 15 per month and that usually lasts me longer than a month. They are just nice to have if I'm having a severe panic attack that Hydroxyzine does not help.
 
A

Aurelius

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Joined
Aug 14, 2018
Messages
308
#4
Chronotherapy - Mainly in the context of depressive disorders involving circadian sleep disordes/syndromes. There are issues around its potential for developing more severe sleep disorders, so it is used far less frequently these days. You might have a look at these for a brief overview of treatments - Treatments - Circadian Sleep Disorders Network
https://www.sleep.org.au/documents/item/2683

Do not mention the CBD oil if you have no intention of using it. As it is not regulated, one or more of the contents, even if not harmful in themselves, may react adversely to something else that you may take.

Limiting your medications to only those that are necessary is a very wise move, as is taking the lowest dosage that is effective.
 
Bizzarebitrary

Bizzarebitrary

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Joined
Dec 17, 2018
Messages
410
Location
California, US
#5
Hi. I didn't see any mention of therapy is there a counselor or therapist you talk to. If so, do you feel comfortable talking openly?
 

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