Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Bad, vivid dreams please help (19F)I am 19F with a ton of medical issues. Meds are vilazodone, duloxetine, montelukast, levocetirizine, propranolol, norethindrone/ethinyl estradiol, and dexmethylphenidate. Conditions are kind of a mess right now because we are still trying to figure out a lot of them but I have allergic rhinitis, either major depressive disorder or potentially bipolar 2 disorder, excessive daytime sleepiness diagnosed as idiopathic hypersomnia but potentially narcolepsy, POTS, ADHD, and most likely Sjgrens (awaiting rheumatology appointment).I have had what I describe as vivid, disturbing dreams for as long as I can remember. I say dreams because I never wake up during them. They are very unsettling and I feel awful when I do wake up in the morning.Last night I fell asleep without taking my medications (I take the majority of my medications at night aside from the stimulant of course). The dreams I had were awful to say the least. Im not even comfortable sharing the details but there was a lot of killing, fear, sexual aspects which I absolutely hated (these aspects were not in any way a good or wanted thing), and the feeling of being trapped. As I mentioned, my dreams are always very vivid and they feel 100% real but I am not in control as one might be with a lucid dream. And for clarification, I hate violence and, if anything, I am sex repulsed. I made a throwaway for this post specifically because I feel so disturbed and ashamed about these dreams.I woke up this morning disoriented, confused, distressed, and with thoughts of wanting to self harm (which I have not done in a long time). I have these dreams often, but not always to this extent.I know medications, especially some of the ones that I take, can cause nightmares. But why would the dreams be worse if I missed my medications? And what in the world can I do to prevent these? Because I felt so terrible when I woke up (and still feel bad now), I want to rinse out my brain so I can remove the dreams from my memory. I would avoid sleep if it were possible but the fatigue and excessive daytime sleepiness make that impossible.Please help because I cant keep dealing with this when I sleep and I dont know what I can do.. ### Response: Vilazodone and duloxetine are SNRIs that increase serotonin and norepinephrine levels in the brain. Abruptly stopping or missing your doses can cause low serotonin levels during REM sleep. That'll cause more intense nightmares.Might be helpful to talk to your doctor about adjusting the timing or dosages of your meds to minimize their impact on your sleep/dreams.Have you thought about therapy to address any underlying psychological issues? Someone can work with you to develop coping strategies and explore any unresolved emotional issues..