anxiety...nightmares...hyperactivity.

I am an 18-year-old girl, with a history of depression and an eating disorder - which has recently been brought under control.

In the past month I have suddenly become excessively anxious about many things, especially being on my own, being attacked etc. Sometimes my fears border on the ridiculous... for example, a few days ago, I noticed an ambulance and a police car rushing to a house on my street - I concluded that there had been a murder in that house and the murderer might be coming to get me next. Now I realise that that was irrational, but at the time, I was terrified.

I have nightmares most nights, and usually wake up sweaty and very scared. I often then have trouble going back to sleep. I have woken up in the middle of the night every night in about 3 weeks. I don't always remember what my dreams were about, but I remember being very scared.

In the day time, I am not as anxious, but I do get hyperactive. I talk a lot, usually about rubbish. I feel like I should be saying something, even if it doesn't make sense. I sometimes even feel that it isn't me saying the things that come out of my mouth, like I have to concentrate hard to say the right things, as if I'm not controlling it.

From this, I easily slip into frustration - even anger, at the slightest thing. And then back, in seconds.

I see things - flashes of light, or shadows, or shapes, and when I've looked back, they're gone.

I obssess about things, and blow very minor things out of proportion.

I sometimes get strange rituals into my head - for example, if I'm feeling ill, I sometimes believe that if i press a certain part of my arm, I will feel better. Or i think that a certain piece of jewellery I'm wearing is bad and making me feel ill, so if i take it off, I'll feel better. I read somewhere that it is bad luck to sleep with your feet facing a door, and I now think that if I sleep with my feet facing the door - bad things will happen.

I get very worried that people close to me are going to leave me. I feel they see me as a pest, a burden. Like they are putting up with me.

Please help me.

[HFHS MD - RG]

Dear Katherine,

It appears that you are suffering from multiple symptoms - feeling paranoid,irritable, anxious, nightmares, talking excessively, feeling that you are not "saying that comes out of your mouth", seeing things that appear not to be there, and "rituals in my head".

I do not have sufficient data to diagnose your problem. The two main diagnosis to consider are borderline personality disorder and bipolar disorder.

Borderline Personality Disorder Borderline is a pervasive pattern of instability of interpersonal relationships, self-image and affects and marked impulsivity beginning by early adulthood and presents in a variety of contexts including feelings of abandonment, suffer from poor self-image, impulsivity in at least two areas (eg. spending, substance abuse, binge eating, sex), affective instability due to marked reactivity of mood (eg. anxiety or irritabilty thaqt lasts for a few hours), inappropriate anger and transient stress-related paranoia or severe dissociation.

Bipolar disorder is a type of mood disorder in which one manic episode must be present irrespective of the number of
depressive episodes. Bipolar disorder can have psychotic symptoms which include delusions (false fixed beliefs) hallucinations(abnormal perceptions) which can be either auditory or visual. Patients with bipolar disorder may have co-morbid disorders too.

Other illnesses that may include some symptoms you describe are Obsessive Compulsive Disorder and Major Depression with psychotic features. All of these illnesses are treatable with therapy and/ or medications.

I would recommend an evaluation with a mental health professional.

Sincerely,

HFHS MD - RG

*KEYWORD:  MULTIPLE SYMPTOMS