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Summary
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A reader describes weeks of severe insomnia, hearing things, panic, and fear of losing touch with reality. They have a therapy appointment soon but are unsure whether they can wait.
The response prioritizes emergency assessment because of the reader’s fear and current symptoms, rather than treating a future appointment as sufficient by itself.
It explains that hallucinations can have several psychiatric, substance-related, or physical explanations and recommends a medical evaluation while explicitly declining to diagnose online.
Question
Reader · Identity withheldI've been struggling with severe insomnia for the past few weeks. I can't sleep at night, I sometimes go days without any rest and none of the medications I've tried have helped. Lately I've started hearing things and even though I’ve previously tested negative for schizophrenia, I’m also experiencing mild hallucinations so I’m afraid they might get worse.
\nIt feels like I’m slowly losing touch with reality.
\nOn the rare occasions I do manage to sleep, I wake up drenched in sweat, my mind racing with panic until I can reassure myself it was only a dream. Just the other day, I found myself pacing for over an hour, unable to calm down.
\nI’m constantly on edge. I am shaky, anxious and jumping at the slightest sound or shadow.
\nI have a therapist appointment scheduled in two days but honestly I don’t know if I can wait that long. I feel dangerously close to snapping and I’m scared.
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Answer
Allan Schwartz, Ph.D.Given the fact that you are feeling frightened about losing your grip on reality it would be a good idea to either go to the emergency of the nearest hospital or call 911 so that they can send help. They could take you to the emergency room.
\nOf course, there is no way that I could possibly offer any kind of diagnosis over the Internet. In addition, you have offered very little information. However, I can suggest some possible problems that may be causing your problems.
\nYou could be suffering from Post Traumatic Stress Disorder. If you are a recent war veteran or have been through something extremely life threatening, it could explain the onset of symptoms.
\nIt is always a good idea to have a complete physical examination. It is always possible that a physical condition contributes to what seem like psychiatric problems. High blood pressure, stroke, diabetes and other problems have been implicated in contributing to changes in the brain. Get a physical check up.
\nSchizophrenia is not the only psychiatric condition that can lead to hallucinations. For example, this can happen with anything from Major Depression to Bipolar Disorder and the abuse of certain illicit drugs. I am not in anyway implying that you are using drugs. I do not know you. Therefore, just be aware of this.
\nThere are always other possibilities.
\nGo to the hospital emergency room and get yourself checked out. You are feeling an enormous amount of panic and this could relieve that for you. Also, get that physical exam with your physician.
\nBest of luck.
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