instruction: hello doctor I am a 19 year old college student I have been diagnosed with depression two years ago and I have been taking sertraline ever since my mental health is a mess right now I think I have restless leg syndrome and I always have the urge to move my feet and legs especially when I am lying down also I have been dissociating every once in a while real life feels like a dream and I sometimes cannot recognize my own face in the mirror but here is what really bothers me the intrusive thought of death that cannot leave me at all I close my eyes and see horrible images and think about death and visualize my loved ones dying I have also been having recurring nightmares almost daily really disturbing and often death I also tend to worry a lot about my loved ones and always feel the need to check up on them it became like an obsession and I fear losing control and losing stuff I have a lot of doubt about my spiritual and religious life in total I am really anxious and distressed I now have heavy heartache feeling and I tend to clench my jaws and fists I also suffer from a restless sleep please help
output: hi I have gone through your concern and it seems that you have an obsession and your restless leg can be due to iron deficiency or it may be due to sertraline so check out your hemoglobin and complete blood count to rule out iron deficiency anemia restless leg can be managed by adding pramipexole or gabapentin tablet you did not mention about the doses of sertraline if required its dose can be up or downed to manage depression avoid coffee or tea maintain a diary of your symptoms do regular exercise take a healthy diet I hope this helps