Figure 1
The figure contains a dashed text box titled “Question:”. The text in the box is “Question: I had a consultation last November for insomnia and anxiety. At that time, I took Deanxit as prescribed by the doctor, which worked very well and quickly, but my insomnia didn't improve. This April, I stopped taking Deanxit and tried stopping Estazolam. For more than ten days I slept relatively well. Later, due to a stressful event, I resumed taking Estazolam, increasing from one tablet every two days to one tablet daily. I also took Deanxit again for some time. During this period, I consulted several TCM doctors but saw no effect. The last two doctors said I had depression due to liver qi stagnation. After taking their medicine, not only did I not improve, but I felt uncomfortable - poor appetite, low mood, and poor sleep. One TCM doctor even prescribed Sertraline and Lorazepam. I took Sertraline for about twenty days and Lorazepam for seven days before switching back to Estazolam. Now the result is that one tablet of Estazolam can't even get me 3-4 hours of sleep, and one tablet of Alprazolam doesn't work either. I don't know what to do now. what medication should I take and how? I have both anxiety and depression. Sometimes my arms and legs feel a strange sensation - not exactly numb but not shaking either. Sometimes I suddenly feel hot and sweaty. Please help treat me! It's so difficult! Also, when I stopped Deanxit before, I tapered off slowly and had no withdrawal reactions. I'm thinking of taking Deanxit again, I feel Sertraline doesn't seem as effective as it was. I'm not sure if it's working for depression at all? Would taking both be too much? As for insomnia, should I switch to another medication or increase the dosage?” The three sentences in red are: “I don't know what to do now.”, “It's so difficult!”, and “I'm thinking of taking Deanxit again, I feel Sertraline doesn't seem as effective as it was.” The sentences in blue include: “what medication should I take and how?”, “Please help treat me!” “I'm not sure if it's working for depression at all? Would taking both be too much? As for insomnia, should I switch to another medication or increase the dosage?”A representative example of a user-submitted mental health question in an online consultation context. Red-highlighted segments reflect expressed emotional support needs, whereas blue-highlighted segments capture the user’s informational inquiries regarding medical treatment. Note: Original text translated from Chinese into English for clarity. Source: Authors’ own work