Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

184 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What causes severe anxiety while suffering from insomnia?

Answered by
Dr. Olsi Taka


Practicing since :2004

Answered : 3422 Questions

Posted on Mon, 3 Apr 2017 in Brain and Spine
Question: Approximately 3 months ago I suffered a concussion. I have had post concussion symptoms like insomnia and anxiety, but in the last couple of days i have noticed a sweet floral cleaning smell. I have nothing around like this and someone said I should get this checked out. Do you know what this could be and should i be concerned.
Answered by Dr. Olsi Taka 1 hour later
Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern.

Changes in the sense of smell can at times represent medical issues. However usually they are in the form of bad odors, it is very very uncommon to manifest with a pleasant smell as you describe.
Most common cause of alteration of smell is a case of upper airway infection such as rhinitis or sinusitis. Infections of the oral cavity may also lead to smell changes. So in case you have symptoms like congested nose or teeth and gum issues those may be considered first.
When it comes to neurological causes brain trauma may at time cause damage to olfactory nerve and cause smell changes. That should occur earlier than 3 months after the trauma though. Some rare tumors affecting the olfactory (smelling) nerve may be a cause as well. So If persistent a MRI may be scheduled. However I wouldn't really be too concerned, as I said usually in the form of bad smells, most probably MRI would turn out alright.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 25 minutes later
Hello! Thank you for your reply. I just thought of some other information that came to mind after reading your answer. When I first had the concussion, I had lost all sense of taste and smell and over the last while I have been able to taste more foods and liquids as well as start to smell more foods, liquids, soaps etc, but initially all I could smell was like a cardboard smell. The other thing was that yesterday I went to massage (it was suggested I go once a week as I had also gotten a bit of whip lash) and the massage therapist massage my neck, scalp, and a bit around my forehead down onto may face and around my nose and cheeks. I noticed the smell the most last night and this morning. Could the massage add to this or could it be that my smell may be coming back a bit more. I don't know what to think, but the smell is not bad it just seems very perfumey, but annoying at the same time. This smell change when I really think about it has really only been obvious yesterday and today, otherwise my smell and taste have been coming back gradually. I did have a bit of a minor cold last week, but it has otherwise been good, but I do cry a lot and blow my nose a lot. I have found the post concussive symptoms very hard and have not been sleeping that well in conjunction with anxiety and now to top it off I smell perfume. Also for the anxiety I have tried amitriptyline (which made me feel extremely weird) and Effexor (which made me seem very drunk from a 37.5 mg dose). At the present time I am not taking anything and just trying to rest, do breathing and exercises. Is there anything else you could recommend as I want to make sure that I will heal my brain to the best of my ability, but sometimes it is hard to shut off the anxiety.
Thank you for your time. Also for the anxiety I have tried amitriptyline (which made me feel extremely weird) and Effexor (which made me seem very drunk from a 37.5 mg dose). At the present time I am not taking anything and just trying to rest, do breathing and exercises. Is there anything else you could recommend as I want to make sure that I will heal my brain to the best of my ability, but sometimes it is hard to shut off the anxiety.
Thank you for your time. Also, will this smell go away. It is quite strong.As mentioned earlier, will the smell go away and it is quite strong. Could this be a result of the massage to the face and neck and did damage occur (is this why I have this smell).
Answered by Dr. Olsi Taka 4 hours later
Brief Answer:
Read below

Detailed Answer:
Thank you for the additional information.

The fact that you had lost your sense of smell after the trauma may have something to do with it. In that case the trauma may have damaged the olfactory nerve fibers and now as the nerve is regenerating itself as new connections are created to substitute for the disrupted ones some changes in smell may appear.

On the other hand the anxiety issue makes it a little difficult to be absolutely sure that is the case as anxiety at times may mimic such symptoms as well. Regarding anxiety treatment I feel the doctors have tried the correct options in terms of medications, both amitriptyline and venlafaxine (Effexor) are good choices. If one is to try another option a SSRI like escitalopram may be tried. For the rest you are doing the right things, rest, breathing relaxation maneuvers and moderate exercise are the correct approach. Psychotherapy sessions if not already done are advised. Activities like yoga may also be of help.

Whether the smell can go can't say that with certainty, but hopefully if the trauma is the cause as the nerve regeneration process completes itself in the next three months the issue will improve.

As for the massage question, the answer is no, massage doesn't affect smelling function, I believe it is a coincidence.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 33 hours later
Just wanted to let you know that the smell has stronger and stronger and it is now all encompassing. When I breathe through my mouth or nose I can smell it and taste it. What do you suggest at this point. Should I be concerned and what should I follow up with.Sorry the smell has gotten stronger and stronger. I am concerned. I don't know what to do at this point. The smell also wakes me up when I'm sleeping as I sleep with a cpap machine and the smell fills the mask and I have to remove it.
Answered by Dr. Olsi Taka 7 hours later
Brief Answer:
Read below

Detailed Answer:
Hello again.

In terms of it being a manifestation of something worrying in the absence of any other symptoms I do not see any cause for panic, at least in the sense that the hypotheses remain the same. If anything I would call the possibility of a tumor even less likely now as does not change this quickly, it would be more indicative of anxiety.
Perhaps a medication like Gabapentin might be considered as it would be indicated both for the possibility of the damage to the olfactory nerve from the trauma as well as might help with anxiety.
If not improving I would schedule a MRI, but I would be optimistic nothing major will turn out, as I said lesions like tumors affecting olfactory nerve usually manifest with bad odor sensation and wouldn't change this quickly.

I hope you'll feel better soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  
Drug/Medication ,  
Lab Tests
Medical Topics

Recent questions on  MRI

doctor1 MD

Hello, I am from Canada and suffer chronic pain and fibromyalgia for 25 years. I am on methadone as one treatment and it has been recently altered here. Methadose solution for pain 10mg/ml Methadone HCI 10 mg/ml. Dose, drink 1.5ml four times daily. I can not take this as I said it has been changed. Now the government has made it sugar based cherry flavored, gag reflux crap. I have tried to wean my self off but have experienced anger, smashing plates, cried out for doctor assisted suicide as the pain and withdrawal of this drug is making me crazy. I am on subcutaneous lidocaine infusions weekly, nerve blocks in neck and shoulders, cortisone injections in both hips for bursitis and nerve blocks in lower back, L4,L5. I suffer with herniated, degenerative discs, c5,c6 too. I have osteoporosis, parathesia, IBS, awaiting surgery for bladder prolapse, endometriosis which required hysterectomy and oophorectomy and numerous laporoscopies leaving me with adhesions which are a constant cause of further pain. I am a chronic pain disease sufferer and to the world I look great...haha! I initially started to write to you only for advise on taking myself off methadone but here I went on and on. The list is long and I see many doctors and pain specialists however my quality of life is nil and I am only 55 years young. I can not seem to find answers, help or hope other than being prescribed opiates, methadone which has been changed to suit the government not the patients needs and numerous medications that make me worse. I am on a roller coaster of hell and pain and now I am withdrawing off this horrible new recipe of methadone as I throw up trying to take it. Why change something that was easy to take to this horrible sugar based cherry cough medicine taste that burns to the pit of my stomach whereby I need gravol settle? I am frustrated, in pain and have talked to nurse on line tonight...she told me to go to the hospital...LOL! Right! I can not live in this doctor retired, great I have a woman who has nine kids and never can catch up or give a you know what about her patients. I give up! This is only the tip of the ice have now idea many health issues I have! I have to leave my city to go for help to Vancouver, thank God for HOPE AIR! They took me to the last appointment with my Neurosurgeon and he has ordered another MRI, will be seeing me after or before if I can not take the pain! I am a mess...What happened to good doctors??? How did we get FIBROMYALGIA??? I have a clue...DDT spraying all over the playground I grew up in...playground was a gas line and electric power field...what do you think of that? Five out of six women who played there as children were not able to conceive!!! Gee, I wonder! I am on a quest to find answers and thought perhaps I would start here...I doubt I will get an answer though...Great! Off to cyber space this goes...I am from Canada and You are in the States! Nice! I was on a Canadian all of a sudden does it go here and now I need to pay! Well, thanks for nothing....I will proceed elsewhere because I will find an answer and from you...obviously not!

doctor1 MD

patient was admmitted with above complaints. all necessary investigations were done and managed conservatively.MRI brain showed acute infract in right corona radiata.chronic lacunar infarcts in pons,right thalmus,right lentiform nucleus and right corona radiata.USG abdomen showed solitary GB calculus.UGI endoscopy showed chronic active DU with duodenal stensosis pan gastriti with small pyloric ulcer.Grade B Erosive oesophagitis..bloodreports showed increased total bilirubin level.Gastroenterology consultation was taken for increasing total bilrubin ans was advised barium meal which was showed mild fold thickening stomach S/o gastritis.short segment stricture in post bulbar duodenum.patient was treated with LMWH,antihypertensives,antidiabetics,neurotropic agents and other supportive measures

my dad was advised to take the following medicines at the time of discharge can please help me by telling which medicine is advised by for what purpose

1. tab . Pan 40mg 1-0-0 . strocit 500mg 1-0-1
3. tab A to Z 1-0-0
4. tab LOSAR 25mg 1-0-0
5. tab clodrel 75mg 1-0-0 Ulcikit 000-000 * 5days Amaryl 2mg 0-1(before lunch)-0
8.TAB strovas 10mg 0-0-1
9.syrp SUCRALFATE 10ML thrice daily 1 month.
please tell me detail why each medicine is used and when the dosage should be taken is it before meal or after..
IS Pan40mg and pantodoc 40mg are the same medcines..

doctor1 MD

My shin is burning from the inside,my skin is burning from inside out was all over me.From waist down.See over 50 dr s.Everyone is boggled.Allergists,derm,medicine,rhematology.etc...I have been on remicade,sulu cortef.I am on 3 vials ev/6wks.Recently been off a month.To see if it was that.Came back.Had a biopsy,mri,all cultures.It is hives that start on my bum always then spread down one leg then the other starts,turns purplish/bruised/goes away.My skin peels and I feel literally crazy,fevers,dizzy,itchy,forgetful my speech was off.Now I am limping with it mostly contained in my lower left leg now.It was as red as red.I have crohns.Also on depo provera and sulucortef.All I can do is ice it and take morphine and advil.Nothing is helping.Can t walk.Need some advice.

doctor1 MD

I have very high TSH (68), free T4 is 1.16, which is in the normal range. I have persistent weight loss, lack of appetite. Today I vomited twice. I have a extramedullary plasmacytoma in my gum. Biopsy said CD 79A and Lambda were strongly positive, CD 138, Cd 3 and Kappa were focally positive in a small number of cells, CD 20 was negative. Radiation therapy scheduled for tomorrow was put off so I could get another biopsy. MRI, PET, CT scans bone marrow test show no cancer cells anywhere. The growth in my gum was painful and swollen when I got my first biopsy, but how it only looks different , is not swollen and without pain. I am taking Keppra to prevent seizures, have started prilosec 6 days ago to reduce GERD. I am a 78 year old male. I am trying to make an appointment with an endocronologist. Heart and many other tests are normal Should I be doing anything else? T3 and other blood test results have not arrived yet. Protein electrophoresis shows polyclonal gammopathy. I am slightly anemic and have some osteoporosis according to bone density scan.

doctor1 MD

For past 12+ hours, I’ve had left side pain from left pectoral up through left shoulder and down my left arm to my hand. Sharpest pain is in shoulder, elbow and dorsal side of forearm. Some twitching in wrist and hand.

doctor1 MD

I had a discectomy and I woke up in excruciating pain. A week later a laminectomy to stop the pain. Epidural injection,Morhine, Dilaudid , nothing helps. Something does not seem right. My Dr. has released me and says it will take a year to get...

doctor1 MD

I have been diagnosed with spondylothesis of the L5 and S1 region. I have had an mri and x-rays for my back. I had an epidural injection(2) in Nov in my back which seemed to help the pain going down my legs for a couple of weeks. Unfortunately I...