HELP! early awakening & anxiety... insomnia

[daleuk]

HELP! early awakening & anxiety... so my insomnia is initial sleep onset is fine, I wake after approx 3.5hrs sleep, when I wake my heart feels like it is beating hard (not so much fast) and its that wakes me, relaxation techniques hardly help and I struggle to return to sleep. I have had sleep issues for 3yrs. I know if I sleep >5.5hrs I can feel good. I have realised that some emotional time probably triggered my insomnia, then the insomnia-anxiety circle commenced. I believe that I must have some underlying anxiety that awakens me at night, by day I think I am not particularly depressed or anxious (except with sleep health, but I can do my best to control that once I have a set path to follow). At the start of the yr, I tried Sleep Restriction therapy for 6 weeks, weekly average I got my sleep duration from 3.5 to 5hrs, albeit was very up and down. It was tough I got tinnitus and started to get some chest aching. I am confident that my body and heart are physically fine (all tests confirm too), so this is all learned mental protection response but destructive. I then had to stop and relax everything. I have been on 1mg melatonin which gives me 5hrs sleep, enough to feel semi ok. I can see that I made some gains and im ready to give it another go, and I see that I must give it much more time probably 3 months+ before I would be happy with the sleep I achieve. So I have two options I can foresee:

1) attempt CBTi / Sleep Restriction again for a longer duration, maybe introduce some relaxing herbs to keep calm by day, and I mean legal ones. In the future I am due to do the CBT for anxiety, and possibly I can pay for weekly therapy sessions.

OR

2) take 15mg mirtazapine for 2-3mths, im sure ill sleep like a baby, with the hope that this breaks the anxious habit of awakening, then 1-2mths slow withdrawal whilst putting into place strict set sleep hours. I also have option of Celexa, but I think this may add to sleep difficulties. + anxiety cbt + therapy.

I can see positives and negatives of both, the medicine route could be a role of the dice if sleep well when on them, but everything returns when I stop, plus I get other unwanted side effects, could give me new problems. The CBT for Insomnia / Sleep restriction route could work to exacerbate this night time anxiety, I did see some slow but steady gain, overtime the night anxiety may calm as sleep increases and I see the light! Opinions please?

[ChicagoGirl1961]

What is sleep restriction therapy? Also, if the mirtazepine helps you sleep, why stop and likely go back to having sleep issues? I also have no problem falling asleep but also wake up a few hours later, at which time I take a sleep aid to get me a few more hours of sleep.

[hypercat54]

Hi I am prescribed 15 mgs of mirtazapine to help me sleep but only take half otherwise I feel really spaced out in the mornings. I find this helps but still do wake up once or twice in the night. Usually though I go back to sleep quickly. x

[Hidden in reply to hypercat54]

Do you take anything else but mitrazapine ?

[hypercat54 in reply to Hidden]

I am on 150 mgs of sertraline during the day. x

[Hidden in reply to hypercat54]

Thanks..I am trying celexa. Wish it would help with the suicidal thoughts.

[hypercat54 in reply to Hidden]

Well mine does a bit. I have lived with suicide ideation for many years and my answer is everyday I wake up I make a decision whether or not this will be the day I do it. I answer no I won't. This then leaves me free to see what the day brings instead of my mind being occupied with suicidal thoughts. In other words I look outwards rather than inwards. x

[Hidden in reply to hypercat54]

Sounds like what I am living with. Thanks for the encouragement ...

[Hidden in reply to hypercat54]

I kind of want to die but don’t .. does that make sense?

[hypercat54 in reply to Hidden]

Yes absolutely. I am the same but have managed to put it off for many years now. I am mainly glad and very proud of myself for not 'giving in'.

Another thing which helps me is when I am feeling very bad I trawl the suicide sites. Now this may see strange but when I read that there are very few painless methods, and read a few horror stories it puts me right off the idea.

Many years ago now I faced a stark choice - I decided there was no point in continuing my life feeling so awful, so I either ended it or did everything in my power to find some meaning and change my life. I took the latter obviously.

To this end I started counselling which helped a lot then looked at things in my life I could change. Ok there are some things you can't ie I always had to work full time like most of us but I picked jobs which gave me some autonomy and were quite easy like admin work.

In the couple of years following my decision I decided what I needed (or it's often easier to decide what you don't want), so concentrated on learning how to make friends which I had somehow never learned. I watched and studied others for a long time and slowly started to make some friends.

I bought my own flat, went to Uni, got 2 kittens (I love cats), went abroad for the first time, learnt to drive, and found a passion which I still do today. This is changed my life and made me happier and my self esteem rose.

Although I always struggle with depression and it sometimes gets quite bad I still force myself to do the things I love and eventually I come out of it again.

For me it was (and still is) a journey of discovery but I am mainly content now with some flashes of happiness.

The key for me was learning to look outward more rather than inward which is what we naturally do when feeling depressed. I remember the promise I made to myself and I am not going to let myself down.

Sorry this is mainly about me but I hope it helps you a bit. x

[Hidden in reply to hypercat54]

It does help me. I was a very ‘normal’ person until I suffered a few trauma in 2017. I have a wonderful husband, wonderful children, money, etc. I look perfect to the outside world. Yet I hate myself..I have hurt people I love and who have been good to me, all this as a result of the traumas. My husband does not know the extent of how I feel. I am 61, retired and should be having the time of my life, instead I go to therapists, psychiatrists, etc. then I basically sit around reading this website. I have tried multiple medications which make me feel worse so I quit them. I feel shame and guilt everyday. If someone had told me that this would be my life at this point I would have told them that they were insane. I have struggled with my weight and my looks my entire life. Now I have been diagnosed with a disfiguring autoimmune disease that only adds to my troubles. I also trawl the suicide websites. Realistically, I am too afraid to hurt myself yet I don’t want to live like this forever...not sure what to do. I have ocd which causes horrible rumination. I am a mess. Thank you for reading my ramble. It sounds like you have come a long way...congratulations!

[hypercat54 in reply to Hidden]

No one looks or is perfect as we all have unfulfilled needs and wants, so don't aim for that. Therapy should help you get to the bottom of the shame you feel and the hatred of yourself. I can't understand why it isn't helping you.

We all hurt those we love and if your loved ones didn't want to be with you, they would just walk away. Isn't that telling you something? There must many good things about you that people love but you can't see them.

Depression will do this to you. Can you think of any positives about yourself? Hating yourself will get you nowhere except on the road to hell. Don't you do things for others out of love? Do you care for your loved ones? If you do then there are two positives right away. x

[Hidden in reply to hypercat54]

Thanks for listening. My story is so complex...I couldn’t begin to describe all of it to you. All I know is that sleeping 3 hours a night is killing me emotionally and physically. Funny part is that I am not all that tired which is probably due to the anxiety. I will struggle to fake it through yet another day. Used to believe in a God who was good to those who served him, which I have, but now even that is gone.

How long have you taken the mitrazapine? My doctor only wants me to take it for two weeks along with the celexa, which I have yet to start out of fear and perhaps denial.

Thank you

[hypercat54 in reply to Hidden]

Mirtazapine is not a sleeping pill but is for depression and anxiety so I can't understand your doctor only prescribing it for 2 weeks! it takes longer than that to get into your system. I have been taking the lowest dose for years now and it really helps me relax.

As for your daytime med you need to start taking it as it could well make you feel a bit better. I had to try 2 others before I found sertraline which works well for me. It's got to be worth a try hasn't it? Can it be any worse than what you are feeling now? x

[Hidden in reply to hypercat54]

I think my dr is reluctant to combine 2 anti depressants for any length of time. She feels that mitrazapine has lots of side effects.

You are right abort the other med. My real hesitation comes from having tried others which did in fact make me feel worse even after taking them for 3 months. Beginning to feel like a hopeless case.

Thanks for taking the time. May I ask how old you are and how long you have suffered from anxiety and depression?

[hypercat54 in reply to Hidden]

I am of pension age and have suffered from depression with some anxiety since around 7/8. x

[Hidden in reply to hypercat54]

Oh my..you have suffered a long time. Bless you for being a survivor.

[Autumnsa in reply to Hidden]

Hello. I came across this scrolling through my feed. I can definitley relate to the both of you. One morning (when i was 18) i woke up in a complete panic, and could NEVER SHAKE THE FEELING since then (im about to be 25). So I finally seeked help when i was 20. Started Effxor(which took a month to work) finally gave me all the relief i needed. Ive had my meds adjusted twice. After a year or so on just effexor, started feeling like the med was loosing its juice. So i went back to the doctor and she added Wellbutrin XR. That was great for about 3 years.. Welllppp about a week ago i noticed my anxiety beginning to creep back in. I went to the dr on Tuesday and she prescribed Buspar 5mg/twice a day. I'm battling inner tremors and staying severely anxious.. I'm so worried I won't have relief.

[Hidden in reply to Autumnsa]

The medicine game is such a battle. You are so young. Keep working with your doctor..eventually something will work. Sending you a hug!