Brief Answer: Need to treat anxiety/depression first. Detailed Answer: Hi, Welcome to Healthcare Magic! It is usual for people with anxiety and depression to have sleep problems as well. Since these sleep issues are secondary to anxiety or depression, these do not improve much with sleep aids, but respond to improvement in anxiety or depression. So, rather than focusing on the treatment of sleep problems separately, you need to do your best to control the anxiety and depression. You mention that you have been started on Prozac recently. That should help in both anxiety/depression and sleep problems but it takes around four to six weeks to show its full response. After that, it will also need to be assessed if a dose hike is needed or not. If you let me know when the Prozac was started and what dose you are on, I shall be able to help you better. You must also take Prozac in the morning and not at night. I would also like to suggest that you try relaxation exercises like progressive muscular relaxation exercises or even simple ones like taking slow and deep breaths. You can find detailed instructions online for progressive muscular relaxation exercises and these make a big difference in anxiety, depression and sleep. You will also notice an improvement in the functioning of your eyes. Best wishes. Dr Preeti Parakh MD Psychiatry

---

Brief Answer: Explained below. Detailed Answer: Hi, Welcome back! Vision problems are very common in anxiety and stress. Anxiety affects both the pupil size and the contraction of the muscles in and around the eye. Blurred vision and tunnel vision are likely to improve when anxiety reduces. Lack of sleep adds to the problem by causing fatigue of the muscles in and around the eye which makes it difficult to focus. When you worry about vision problems, you become more anxious which further increases your visual difficulties. While it is true that causes other than anxiety may also be implicated, like vitamin A deficiency, the most likely cause in your case would still be anxiety. In my opinion, you can test this by doing some relaxation exercises as I had mentioned earlier and assessing if that leads to an improvement in your vision. If it does, you can rest assured that your vision problems are due to anxiety only and will improve in a few days when Prozac starts working. You have been on Prozac for only two weeks and I expect it will take around four more weeks for a good response in your anxiety. The dose of 20 mg is just the starting dose and may need to be hiked further. Trazodone is a good choice as it will improve your sleep and also augment the action of Prozac. As I mentioned earlier, Prozac should be taken in the morning only. Please do not worry. I expect a major improvement in your anxiety, sleep and vision problems within the next month. You can hasten the process by doing some relaxation exercises which will provide immediate benefit. Best wishes. Dr Preeti Parakh MD Psychiatry

---