Question

I've been prescribed to take the medicines ativan, stalopam plus and serenace .25. I'm having trouble sleeping, with nightmares, along with anxiety, weakness, severe aggression, lack of confidence, etc. Should I start taking these medications asap or should I consider psychotherapy first?

Dr.Saul Pereira · Accepted Answer

You should do both. If you are averse to taking medication, you can try therapy first and then if the therapy requires support via medication, then you can do both at that time too. I don’t know if you are fully aware: you have mentioned that you are suffering from anxiety, which in itself can disturb your sleep. Instead of worrying too much about causes, why don’t you implement some of my suggestions, because they work effectively. The lack of sleep, i.e. Sleep for less than 6 hours per night, is directly linked to about 86 diseases! so let us first focus on that. In your case particularly, do not sleep during the day; don’t even lie down. Go for regular exercise (breathing through your nostrils only) at a fixed time (at about 6 am) every day, whether you sleep or not. You must develop this habit of sleeping by 10 pm latest every night and wake up at a uniform time by 6 am every morning, even if you do not get sleep. If you do not get sleep, just lie down and if you have a bed lamp (or you could get one) lie down and read something light but not exciting. Your eyes will tire and you will fall asleep. If you like you may also put on light and soft music with the sleep function on. Depending on whether you are a visual or auditory person, you may watch tv in a lying down position until you feel sleepy. Have a warm bath before going to bed (for some people a cold bath at night seems to induce sleep! if you are one of them, please do so). Place the head side of your bed in a north-south position. The room must be as dark as possible and there should be no electronic items that give off even a light led glow. There must be ample ventilation in the room. Avoid strong odors, except lavender, on your body or in the room, or on your sheets and clothes. There should not be any live plants in your bedroom. Sleep with the lightest of clothes or without any clothing. When lying down to sleep, lie down on your left ear as much as possible. Do not sleep directly under an overhead fan. You must eat a good breakfast, a fairly light lunch, and an early dinner, which should be a very light meal. Whatever you eat in the other meals, have only a pure carbohydrate meal at night with any vegetables, and preferably before 8 pm. Do not drink much liquids after or near about dinner time. If you know emotional freedom technique or eft (check this out either on youtube or google), then please practice this too for sleep induction. Self-hypnosis and slow relaxation techniques, at night will be tremendously useful. Acupuncture or acupressure will both be very useful too. You can also try the 4-7-8 breathing pattern, which is to breathe in for four counts, hold your breath for 7 counts and exhale with a whoosh sound for 8 counts. This is to be four times at a time first thing in the morning and last thing at night, and any number of times during the day. While doing this exercise place the tip of your tongue on the roof of your mouth. The effects will be seen after a few days. Pray last thing at night before you sleep.

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I've been prescribed to take the medicines ativan, stalopam plus and serenace .25. I'm having trouble sleeping, with nightmares, along with anxiety, weakness, severe aggression, lack of confidence, etc. Should I start taking these medications asap or should I consider psychotherapy first?