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How to manage depression and anxiety?

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Published At April 24, 2024
Reviewed AtApril 24, 2024

Patient's Query

Hello doctor,

I am a 23-year-old female, diagnosed with borderline personality, depression, and anxiety., I also have insomnia. I am currently taking Venlafaxine 375 mg, Depakine 1000 mg, and Quetiapine (extended-release) 150 mg/day. The last time I went to the doctor, I was suggested to change Quetiapine to Aripiprazole because Quetiapine makes me gain a lot of weight (I also had gastric sleeve surgery not long ago) and I would not want to gain weight again. Aripiprazole gave me terrible anxiety and I could not take it anymore, for insomnia, he gave me Levomepromazine, but it does not help me sleep at all. What changes could I suggest? I go to therapy but I feel terrible almost every day.

Thank you.

Hello,

Welcome to icliniq.com.

I can understand your problem and situation but you have not mentioned the dosage and duration of Aripiprazole and Levomepromazine. You must gradually taper off your tablet Quetiapine. Quetiapine is potent and if you stop suddenly, you will surely have withdrawal-like anxiety and sleep disturbance. You have not mentioned the dose of Aripiprazole. You can take up to 45 mg for full effect. You can take the tablet Clonazepam 0.5 mg for sleep disturbance and anxiety issues. Follow the lifestyle below for your problem, it will help you.

  1. Do exercises daily for 30 - 45 minutes like at least going for a walk.
  2. Do meditation for 20 minutes daily, just sit in one place in a comfortable position and try to concentrate on your normal breathing, don't stop or force yourself to stop your thoughts, just let it be.
  3. You should eat healthy home-cooked foods, and avoid junk foods.
  4. You must drink enough water.
  5. You should spend quality time with friends and family daily or do video calls if you are living away from your family.
  6. You should spend time on creative hobbies like reading good books, writing journals, painting, drawing, and learning new skills, languages, or musical instruments.
  7. You should get enough seven to eight hours of sleep daily (sleep hygiene).
  8. You need to fix your time for sleep, which means you must fix the time to sleep and awake.
  9. You must not do any other activities in bed.
  10. You must not just lie down on the bed without any reason, the bed is just meant for sleep.
  11. Wear loose and comfortable clothes for sleep.
  12. Take light food at night or dinner at least three hours before sleep.
  13. You can take a maximum of 20 minutes of nap a day.
  14. Do not use a mobile television or laptop for at least half an hour before sleep.
  15. Try to maintain an adequate temperature in your room, which means not so cold not so hot.
  16. Have a proper bed and pillow.
  17. Make sure there is no noise or disturbance at night.
  18. You can drink warm milk with turmeric before sleep.
  19. You must avoid tobacco alcohol or any substance abuse.

Live your life, do not just spend it. Be bold and confident.

Please, let me know if you want some help.

I hope this helps you.

Thank you.

Regards.

Investigations to be done

CBC (complete blood count), thyroid profile, vitamin B12, vitamin D3.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vishal Anilkumar Gandhi
Dr. Vishal Anilkumar Gandhi

Psychiatry

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