Hey everyone. I'm a bit new here. This is going to be a bit of a long one but I guess I'll start by stating the obvious: I've been suffering from some pretty nasty anxiety since January. I've always been an anxious person to some extent but it never really interfered with my day to day life, or they were short bouts I was able to overcome. Unfortunately, the last few months have been some of the mentally hardest for me.
I've always been a bit of a hypochondriac and worried excessively over my health even though I'm a healthy, 21 year old (BP is good, blood-work was fine last year, heart rate is a little elevated at times - it usually stays in the 80s or 90s, sometimes a little over 100 when I'm feeling panicked or on edge). However, I find myself obsessing over little things all the time. It's really anything. Before it was my breathing and heart health, earlier this year it was the consistency of my stools and number of daily bowel movements, and now it's my sleep that's bothering me. Previously I've battled with short bouts of somniphobia, or the fear of sleeping, but they would usually pass. It seems irrational but I used to worry that I might die in my sleep or I would have terrible nightmares/sleep paralysis. It's been on and off for a while but lately it's manifested into something terrible. I was having some trouble sleeping back in January on a couple of days and lied down to take a nap (as was typical for me) and woke up to what I now assume was a hypnic/hypnagogic jerk that felt like a pop or tear in my lower right abdominal region. My mind ran wild with the possibilities: was it appendicitis? If that was the case, I had very limited time and had to seek out a doctor as soon as possible. They told me everything seemed fine after they checked the area where I experienced the sudden pain, but said to go to the ER if I experienced worsening symptoms. Well for the rest of that day I felt fine, albeit slightly disconcerted. I had a hard time falling asleep for fear that something might happen, and my abdomen/body would twitch a bit and keep me awake, but eventually I slept and got plenty of sleep. In the morning however I felt a little nauseous, and reading up on appendicitis, learned this was one of the symptoms, and went through the rest of the day on edge. I had lost my appetite and was filled with worry. That night I forced myself to eat basically and experienced cold sweats, nausea, etc. that made me think something was seriously wrong with myself. I tried to sleep but my body would force me awake and I ended up pulling an all-nighter (to compound this, I had a test in the morning). The next day I was able to sleep around midnight and got a whopping ten hours and had a follow up appointment the next day, to which another doctor confirmed I was normal and healthy. My current working hypothesis for why that might have happened was my consumption of a few antacid tablets directly following my meal that night. I assume the high levels of calcium carbonate might have triggered nausea. That and the anxiety. I am still uncertain.
However, ever since then, random nights I would get a feeling in my lower chest/abdomen that was either a twitching or burning sensation that would arise right before I drift into sleep and keep me awake, or just hypnic jerks that jolt me awake. Come to think of it, I experienced those feelings earlier in that month even before the imagined appendicitis episode, but thought nothing of them and ignored them enough to fall asleep. They were also at a lesser frequency. Eventually they became frequent enough that I started noticing them more and more, and understanding how my mind operates, became fixated on why I was experiencing these random sleep starts. Was it alcohol, caffeine, anxiety, or some unknown disease slowly ravaging my body and stealing me of sleep? I had no answers, and that intense feeling of panic I had experienced during the imagined appendicitis episode spawned a somewhat mild fear of eating, since I was afraid I would experience the same thing again. I never truly did, but I would get random bouts of nausea, especially after continued antacid consumption.
Up until April/May I had been good at coping with the sleep starts/sleep drift sensations until one night I simply could not fall asleep because of an intense burning sensation in my lower chest/upper abdomen. Earlier that day I drank some alcohol on an empty stomach with a friend so I assume that might have had something to do with the sensation. This one I could not ignore. It would simply not go away. Every time I would begin to drift, a burning, rising feeling would radiate from my chest. I panicked, wondered what was wrong with me. What was worse was that I had to move out of a house in Orlando the next day with the assistance of some family members, so I pulled yet another all-nighter and was exhausted moving stuff in and out of the house. I tried to sleep on the car ride but was unable to. Eventually I decided I had finally had enough and called my doctor's office and was placed into contact with my PA. I described my symptoms to her and she assumed that I had anxiety and insomnia, and prescribed 50mg trazodone for sleep and 20mg prozac. It took me a while to fall asleep that night but after two trazodone tablets I finally passed out around 2-3am. I felt rested and relieved in the morning. The next couple of weeks I experienced the sleep starts occassionally, but they were usually resolved by me taking the 50mg trazodone. Then around the two week mark something awful happened. My brother got strep throat and wasn't getting better for days, and he developed a severe allergic reaction to the antibiotic they prescribed him (zithromax) which led him to experience severe anxiety and insomnia. A lot of the symptoms he experienced sounded eerily similar to mine, which scared me at the time. He went to the hospital three times and had to be given two large shots of ativan the third time for him to begin to feel remotely normal again/sleepy. Eventually he returned to normal and started seeing a psych who prescribed him trazodone as well. But that event made me fearful of losing my brother and also fearful of my own predicament as well.
Another two weeks passed and I seemed to be doing fine. The sleep starts had mostly died down and I was feeling better/more positive. I had no difficulty falling asleep but sometimes I would awake early in the night and have a difficult time falling back asleep, but I was getting around a decent 6-7 hours of sleep. I attributed this to the prozac since it had been roughly four weeks and the PA assured me that I would begin to notice its full effects around the 3-4 week mark, and I sincerely thought I did. Acknowledging this elevated mood, I assumed I no longer needed the trazodone and did not take a tablet one night, as I had been advised by my PA it was not habit forming and I would not experience withdrawals. Well I woke up extremely sweaty that night earlier than I normally would have (after about 2-3 hours), wide awake, and although I was able to fall back asleep again, the remaining sleep I received was not restful and I felt anxious, lethargic and nauseated throughout the rest of the day. I was unsure of why this happened and went another day of sleep without the trazodone. Same thing happened. The next day I finally took a trazodone tablet and woke up feeling much better. This only furthered my suspicions about possible withdrawal symptoms, but I thought it might also be the prozac. Even when I was taking the trazodone, I was having somewhat strange sleep where I would wake up around 4-5 hours after passing out and be wide awake, and having a hard time falling back asleep. I've also been experiencing vivid, strange dreams on a fairly consistent basis. I was confused by all of this but coped with it fairly well until my brother absolutely destroyed my sense of security by informing me about a rare, neuro-degenerative disease called "fatal familial insomnia" that causes progressively worse insomnia until coma and death. Though he told me it was extremely rare, genetic and there had not been many sporadic cases identified across the world, my mind went into full panic mode. I freaked out. It's rare, but what if I had it? The early stage symptoms sounded oddly similar to mine: anxiety, paranoia, difficulty sleeping, etc. etc. The later stages are apparently fraught with hallucinations and dementia (none of which I am currently experiencing) so I felt somewhat assured until I began to think: "what if I'm just in an early stage?" I was absolutely terrified and panicked. That night I slept six hours but woke up in the middle and had a panic attack, and was on edge for the rest of the day. I called my PA and she said symptoms of anxiety might be breaking through my medication, and suggested I increase the prozac dosage to 40mg. I did so for two days. Those two days I experienced four hours of sleep each and was woken up in a state of panic in the middle of each night. I was scared. The next day I lowered the dosage of prozac back to 20mg and although I had interrupted sleep, I was able to sleep a total of eight hours and felt relatively well rested. This allayed my fears and turned my attention to the prozac: would it be causing these bouts of insomnia? And why are my symptoms of anxiety still so pronounced even on anti-anxiety medication? I told my PA about how I thought my insomnia might have been caused by the prozac and she suggested it shouldn't be, but just to be safe she suggested I go off the prozac Monday and try Lexapro starting Wednesday or Thursday. I've been on prozac for almost seven weeks and my mood is variable. I'm still plagued by some level of fear that I am experiencing early onset of fatal insomnia, as ridiculous and unlikely as that sounds.
Sorry for the long rant, I haven't talked to a therapist yet (I have an appointment Monday) and really need some support in the meantime so I don't go crazy. I guess my main questions are: has anybody had similar difficulties sleeping on prozac? Could the trazodone have caused withdrawals? And is it a wise decision moving forward to switch medications?
I was hoping things would return to normal on the prozac, and for a time it seemed they did (with still some mild sleep disturbances) but now the cracks are really showing and I don't really want to stick it out longer than I need to if there is a better solution available.
Thanks for reading. Any comments are appreciated.