I am suffering from sleep, sexual, and mental issues and I feel tired and weak throughout the day. Please help.

Q. How to overcome sleep, sexual, and mental issues?

Answered by
Arooj Maqsood Ahmed Warraieh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 08, 2013 and last reviewed on: Aug 28, 2023

Hi doctor,

I am suffering from the below-mentioned problems:

  1. I am not able to sleep properly at night and by that, I mean I am not getting sound sleep.
  2. When I wake up in the morning, I feel weak and tired. This weakness and tiredness continue throughout the day.
  3. When I walk for a long distance, I get swelling in my thighs just below the testicle.
  4. I feel sexually unhealthy, and the size of my penis and testicles are very small. My sexual performance is also very low.
  5. I am also mentally unstable, and I am unable to concentrate on anything. Various thoughts come into my mind, and I feel depressed and lonely.

I have consulted various physicians. Kindly suggest proper treatment for my above-mentioned issues.



Welcome to icliniq.com.

We are elated to have you on board at icliniq.

You have mentioned your problems precisely which is good but still I require more details as mentioned below:

  1. You mentioned that you had visited various physicians. I would like to know about their recommendations and solutions so that it will help me understand your problem.
  2. Please add details about yourself, your schedule, age, etc.

Apparently, it seems more to be a psychological problem than a physiological issue (based on the symptoms that you had mentioned). Your sleep problems need to be organized and scheduled and for that appropriate sleep management strategies should be used. Tiredness and weakness are also because of sleep disturbances at night. Furthermore, your description of being mentally unstable, depressed, and lonely needs to be evaluated in detail. What do you know about them and how do you feel about them? Also, quote with an example.

I wish you good health.

Thank you.

Hello doctor,

My answers are as follows:

  1. Last year, I visited a psychiatrist and he gave me medicines that helped me to sleep but I could not take them for a long time. The doctor prescribed general medicines that had an effect during the time of taking the medicines but after that, there seemed to be no effect.
  2. I am an engineer working in a telecom company and mine is field work. There is no office culture in my job. There are four engineers in our team working in different locations and we meet rarely. We only talk over the phone and do our work. I am 27 years old. From the time I started to work and wherever I work, I do not have any close friends and I feel very alone. Even if I have to go shopping, I do it alone. Till now, I do not have any girlfriend in my life (not even a single female friend). By looking at other people I think that I should also have a girlfriend but there are no such friends to befriend at the office or at another place.

I communicate less with my family members, and it is only formal. I call them once in a week or once in 15 days. I do not feel like talking with them. I want to share lots of things with them but I am unable to do it and I do not know the reason for this.

Regarding my social life, I think I do not have any social life. I talk with very less relatives in my family. I do not attend any family functions due to my job and even if I did, I feel very awkward because I know only a few people. Regarding my sex life, as I had described above, I do not have any female friends till now. I think a lot about sex, but I am unable to do anything. I do masturbate but I do not feel any pleasure as everyone says because there is no tightness in my penis, and I ejaculate within one minute. Whenever I masturbate at night, I feel very weak, especially in my legs.

I have had sex with a commercial sex worker once, but I did not feel any pleasure after having sex. I do not feel sexually healthy enough to satisfy any woman in sex. Now, I am 27 years old, and my family is asking me to get married, but I am not confident about marriage. And about being mentally unstable, I am working in a telecom company and whenever I have heavy work or if the workload increases, I cannot handle it. If anybody tells me anything that hurts me, it stays in my mind for a long time. Nowadays, I have started shouting at people over the phone regarding any work-related matters.

Whenever I go to sleep, thoughts come to my mind. I cannot get sound and peaceful sleep. My sleep goes off early in the morning and thoughts start to come and I feel weak and my headache also kicks in. I suffer from this pain and tiredness the whole day. Also, I feel vibration and joint pain in my legs and arms. Whenever my legs and hands are not straight, it starts vibrating. Sound comes from my joints as if they are breaking.

Due to all these, my digestive system has also been affected. I go to the toilet twice or thrice in the morning and gas and acidity persist all day long.

I take less spicy food daily and try to avoid spicy foods.

I take fruits, green salad, green vegetables, and juices. I am very conscious about my eating habits, and I take dry fruits. I take a morning walk four to five days a week. I have done a few tests and I have attached the reports. Please check and provide a proper solution for my issue. If it is a psychological problem, kindly suggest steps to recover from it. I am totally done and fed up with this problem. Sometimes, I have suicidal thoughts, but I try hoping that one day I will be able to recover from this and lead a healthy and peaceful life. Please help.



Welcome back to icliniq.com.

Glad to have you back.

It is really good to hear from you again. I appreciate your concern about your problems and thanks for confiding in me and sharing your issues.

Initially, I will reply briefly to some of the problems that you have mentioned.

  1. Regarding sleep patterns and medications that you have taken, I will not recommend that again because sleeping pills are generally not prescribed for sleep issues, because of their various side effects including mood problems. It would be much better if you try to adapt to sleep hygiene (as advised). Again, sleeplessness can be linked to your daily life problems especially due to lack of stress management and general anxiousness.
  2. Anxiety: You have indigestion and acidic problems in the morning, which could usually happen when you have a bad sleep and also when you suffer from anxiousness and stress (as apparently there is no issue with your diet).
  3. Sexual problems that you experience like lack of stiffness and immediate ejaculation are not the criteria to conclude that you are not capable of having healthy sexual relations with your partner.

By looking into the details of your answer I have formulated that you have been facing the following problems for some time (varied according to

the course of the problems):

1. Disturbed sleep patterns

2. Communication problems with family members.

3. Social relationship problems (lack of friends).

4. Self-esteem issues and feelings of loneliness (regarding lack of friendship with the opposite sex, sexual problems).

5. Stress and anxiousness (may be due to excessive workload).

Let me explain to you the mode and duration of your treatment. With online counseling sessions, usually, it would take a series of sessions to deal with your problems. We will deal with the issues in detail and shall try to achieve the goals (need to be identified first) of treatment. As you have sent the details to me, I assume that you are having severe problems, and you are very keen on receiving the necessary treatment (which is a very positive aspect of you, that you are willing to move out from the problems on your own). I humbly appreciate that.

But we will have to make a treatment plan, and for that, your support and willingness is my priority. You will have to do a few homework assignments (some of which I will be giving you right now). I would like you to

  1. Rate the problems from 0 % (very low) - 100 % (very high) in terms of intensity.
  2. Keep a diary or paper or mobile pad (whatever is convenient for you) and write down your thoughts (like those you mentioned in your answers) every day or whenever you feel more disturbed. Send these back to me. We will discuss them later (probably in an online session rather than through a query).
  3. List down at least ten of your achievements or even more that you have made in your life. Also, mention what you expect from this therapy from my side.

Have a good day and keep up the healthy spirits within you. I hope to hear back from you soon.

Thank you.

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