How can one manage headaches, irritation, and mood swings?

Question

Hello doctor,

I have not been able to sleep or eat for one and a half months. I can fall asleep for a few days, but I usually sleep for four or five hours now. There are times when I get irritated. I started taking sleeping pills to fall asleep, and when I do, I do not go to sleep.

I used to eat a lot, two to three meals, with constant snacking. Now I usually eat only one or two small meals a day. Sometimes I start eating but lose my appetite quickly, so I throw the rest of the food away.

I have constant headaches, and I get irritated at things very easily. I am usually sad, and sometimes I cry for no reason. I have been having bad dreams, and it feels like everyone is taking advantage of me and lying to me, and I am sick of it. I feel weak and empty like my whole world died, and there is nothing. I can do something about it, but I sit back and watch. I do not know what I am doing wrong.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

This looks very much like depression. But to be sure, we want to get a few blood tests done, such as hemogram, thyroid profile, liver and kidney function tests, to rule out any other medical problems. I presume that you have not had similar problems in the past. I also assume that you did not have any other psychiatric problems in the past, such as a history of bipolar disorder.

Do you have any family history of bipolar disorder?
Are you on any other medicines for any medical condition?

If not, your problem can be easily treated with antidepressant medications. An antidepressant such as Mirtazapine, which has sedative properties but is non-addictive (unlike the regular sleeping pills), will be very suitable for you.

Mirtazapine can also normalize your food intake by stimulating a healthy appetite. Typically, it is started at 7.5 mg; you may need up to 30 to 45 mg of Mirtazapine. However, it must be started after a proper psychiatric consultation and under supervision.

However, if you do not want to take medicines, cognitive behavior therapy (CBT) may be a good option. But considering your symptoms, I would prefer medicines over CBT as of now.

The general measures to improve your mood include making more time for hobbies, sharing your burden with a trusted friend or relative, and going out and meeting friends (even though you may not feel like doing so). Eat small, frequent meals and get this consultation as soon as possible.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.