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Q1: I am a carer for my mother who is 91 and has heart problems, arthritis and has recently had a wisdom tooth removed because it was embedded in her sinus. My father died last year and I am finding it very hard to cope. I suffer from depression but find antidepressants difficult to take because of the side effects. At the moment I do not have a good relationship with my GP and I do not know who to ask or how I can ease the stress I am feeling.

My sleep is poor as I have to keep getting up to go to the loo, I am told I have to live with it, and I also find it impossible to relax. I had a hysterectomy for cancer three years ago and a part disc removed nine years ago. All these still cause me problems.

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The stress of wondering what I am going to do in the future, as I am single and do not have a home of my own, is more than I can cope with so any suggestions would be gratefully received. Name and address withheld

A1: People who are depressed, even if the depression is mainly the consequence of troubles that are readily identifiable, haven't usually the temperament that enables them to bear with ease the psychological and physical problems of others. They have enough of their own to cope with and are always beset by gloomy thoughts.

An additional difficulty for those whose personality is thrown off course by adverse events of one sort or another, and you seem to have a great many, is that they are not always the type of person who will respond readily to antidepressants. Most antidepressants have side effects. These symptoms although not medically serious may be hard to bear by those who are not very phlegmatic. As a result the sometimes small advantage derived from the antidepressants is outweighed by the inconvenience of the side effects.

Have you discussed the nocturnal urinary frequency with its sleep destroying trips to the lavatory with your doctor? Quite frequently hysterectomies leave someone with waterworks problems of one sort or another. These can range from simple infections to alterations to the nerve supply of the bladder neck that have resulted from the essential, but sometimes disruptive, exploration of the lymphatic glands above the uterus. There are various treatments, but the choice depends on the cause of the trouble that has beset the patient.

Help the Aged would be the organisation to consult about your mother. It is possible that a visit to some temporary residential accommodation to give you a respite might be helpful. You don't tell us how old you are but I have no doubt that their advice will always be extended to cover your own current and future problems, or if these problems were outside their remit they could tell you who to contact.

It is a pity that your relationship has broken down with your current GP but perhaps there is another doctor in the practice with whom you could establish a better rapport. Even good doctors can't always establish an easy friendship with everyone. Most experienced doctors realise this and also appreciate that it is sometimes not possible to work out why doctor and patient just simply don't click.

Q2: Can stress cause nightmares that spill over into waking delusions? My mum, an anxious person who is under stress as she tries to sell her house, says that she is unable to sleep at night because of vivid waking dreams that she is in acute physical discomfort. And if this is stress or anxiety-related, what should she do to combat it? Name and address withheld

A2: Are the nightmares that your mother suffers hypnagogic dreams? These are the very lifelike vivid dreams that do have an almost hallucinatory quality about them. They tend to occur between sleep and wakefulness and so strike just when a patient is either about to wake up or to fall asleep. Hypnagogic dreams are more common when there are other disturbances of sleep pattern. Your mother should see her own doctor about it. For as her troubles are caused by a transitory problem - selling her house - it would be justifiable to consider prescribing an appropriate tranquilliser to tide her over a few weeks. You don't tell us your mother's age. When your mother talks to your doctor remind her to go into detail about her dreams and sleep troubles as some neurological conditions have sleep disturbances as one of the initial symptoms. In these cases the choice of the tranquilliser is all important.