Diurnal Variation in G.A.D

[Devonchap]

Hi all

My reading continues in an attempt to beat this horrible anxiety of mine.

I have GAD with 'Diurnal Variation' - which means that I am very nervy, edgy, worrisome on the mornings, and by lunchtime / mid afternoon I am almost ALWAYS completely free of anxiety.

I am like 2 completely different people I really am.

This has lead me to ponder....will any amount or type of AD or meds 'cure' this - or is this just me and my nature body cycle. Am I on meds for nothing.

Does anyone else have this trait.

I have read that this could be increased cortisol and the body's natural rythum...its just so odd how different I am in the mornings compared with the afternoons.

I currently take 10mg of cit and 7.5mg of Mirtazapine before bed each night. I have tried changing the cit to the morning, but nothing changes.

I am determined to beat this!

[martin222]

i think you should try 20mg of cit, 10 is pretty low,

[keithwms]

My experience is that cit actually increases the morning anxiety- certainly during the startup phase. it is well known that cit can screw around with REM sleep and such, which may well lead into morning anxiety. This seems to be fairly consistent with a lot of people on here. So if anything I wonder if the cit is exacerbating your diurnal cycle issues.

The mirt should be quite active for more than 12 hours, since the half life is 30+ hours. So if it is the right adjunct med, that should be enough to tamp down this problem in the morning. If it isn't accomplishing that, then perhaps you should consider increasing the mirt dose you have plenty of latitude there, and do bear in mind that mirt can peter out with some people. So then if more mirt doesn't work, then you can try a different adjunct med.

Another solution would be to switch to a faster acting med like propanolol that you could take upon waking. But I am biased against that strategy; I prefer the idea of shifting to longer-acting things and aiming to have smooth mood transitions.... and avoiding the shorter-acting beta blockers if you can.

Anyway, you have plenty of latitude with the mirt so that would be where I'd start, not with more cit at this moment. But whatever you do, please only diddle with one variable at a time!! Try something for ~2 weeks and give it time to see if it works before making any further changes. Patience is key.

A more 'natural' solution you may try is to try to get up out of bed and go straight into exercise... a long, brisk walk even. That might help with the cortisol. Exercise can be a great way to set up good rhythms- your body can reward you with endorphins and so if you time it right, it can be quite a mood lifter. Exercise, music, comedy, tea, a lot of things can help with reducing cortisol effects...

http://en.wikipedia.org/wiki/Cortisol

[diurnalmalaise]

im like that too

[Mojo61]

I could have written this post myself. However my morning anxiety was very bad before I started the citalopram so I can't really blame it on that.

My anxiety doesn't wear off until the evening either, and in the summer it wears off later and later as the days get longer so it has to be something to do with the light because I don't get any relief until it starts getting dark. In the winter it was wearing off at about 4pm, now it is 9.30 - 10pm before I get a reprieve.


I have just upped my dose from 10 to 20 (been on 10 for 3 months today) and I'm REALLY hoping that I get a break from the morning anxiety - a lot of people have said that once the Cit kicks in the morning anxiety eases off, so I'm keeping everything crossed for that.

[Gretagetwell]

I have this.. it is ruining my life. Does anyone out there have the answer to fix this?

[sidiam]

Hi Mojo,
First time I've seen this on a forum...
My anxiety doesn't wear off until the evening either, and in the summer it wears off later and later as the days get longer so it has to be something to do with the light because I don't get any relief until it starts getting dark. In the winter it was wearing off at about 4pm, now it is 9.30 - 10pm before I get a reprieve.

I seem to be the same, thanks for posting...
I've just upped to 20mg citalopram and still hoping..
Keith's post was interesting....cortisol mentioned again.
take care
Sxx

[Gretagetwell]

I too suffer from diurnal anxiety. Mine is from 9:00 am until. 5:00 pm. I noticed that it has become more pronounce with the daylight savings time change which occurred in March.

I care barely make it through the day. I cry constantly. Can't think straight, afraid to leave the house. Has anyone figured out what causes this? I am usually fine by 6:00 pm, although exhausted from fighting the anxiety all day.

Has anyone figured this out and how to fix it?????
Need help badly.

[pollynewsome]

How bizarre. I am fine all day.. almost anxiety free, yet get to approx 6pm and it through the roof. Tends to wear off about 9.. I've upped to 40mg stating today. Yikes!! Good luck all.

[beatroon]

I get the morning thing. Less so, the higher dose of Citalopram I take. Still, mornings are a pain. When I can, I tend to get up and go out for a run or a brisk walk, and that makes me feel calmer earlier in the day. I'm usually OK by about 4pm, and then better and better as the evening goes on. By bedtime I feel pretty much like I've got this thing beat - and then it all starts again the next day. It's weird, but liveable with, and I have good months and bad months. There are a few tricky life decisions and events in the mix - I'm finishing up a PhD project which is stressful - so I hope once things settle down, I will too! But resigned at this point to taking the pills pretty much long term. Whatever helps you get through, eh?!