Mirt Diary

[anxiousjomo]

Hi,

As these sort of things help me, I thought I would do one. Any comments, support, advice etc gratefully received.

Brief background: 38 year old male - struggled with GAD/Social anxiety and depression all my life. Never as extreme as some of you on here, and I have never been hospitalised or anything for it, but it has been very tough at times. I was on Prozac twice - once for 5 years and once, after a couple of year's break, for 6 years. Never had much in the way of issues coming off and on - some mild side effects, but nothing unbearable. Came off Prozac in August 2016 as felt I was doing ok (classic mistake). In Feb 2017 I accepted the fact that I was not coping well (particularly with anxiety) and decided to go back on Prozac. Unfortunately my body decided not to allow that and went nuts - massively increased anxiety, uncontrollable shaking, insomnia etc etc. So got switched to Citalopram, and that was just as horrible. After about 6 months of all this, I decided to come off everything as the side effects were just getting worse. Used exercise and meditation etc and managed eventually to get myself to the point where I was operating at about 6 out of 10 on a daily basis.

But I also found that this daily struggle to maintain that not-that-great state was starting to increase the depression...And I started to get increased insomnia etc - probably slept an average of 4-5 hours for the past year, and in April and May this year it was probably about 2-3.

So in the end I decided to try something else. My mum is on Mirtazapine and it seems to work ok for her, so I thought I would give it a try. If it works for me, I plan on staying on it long term at as low a dose as possible. I am aware of the weight gain potential, but I am in decent shape and am hopeful that regular exercise and keeping an eye on my intake will help keep it down.

Day 1

15mg taken at 9.30pm. It did not seem to knock me out like it did for some. I was still awake at 11am and, when I finally slept my sleep was very broken (thought I partly blame my 6 year old son who came in because he had a bad dream!).

Day 2

Woke at about 8-9am and dozed a bit. Felt very groggy and fuzzy - very sleepy and out of it/detached. No real anxiety or anything though. Feels like I have taken a Nytol or Night Nurse during the day and am trying to stay awake. Almost like being a little stoned too. Strange sensation when I had to run at one point like little rushes of electricity up from my feet through my legs from the impact when they hit the ground. Very odd. Not particularly unpleasant, just odd.
I went for a decent walk to get out of the house. A bit low in the evening, but not too bad.
15mg taken at 9.15pm.
A bit of restless legs when trying to get to sleep (which was something I also had on the prozac) - again did not pass out or anything, but probably fell asleep around 11pm and seemed to sleep through with only some minor wake-ups. Seem to remember by dreams more than usual (I rarely remember them at all usually).

Day 3

Woke around 8-9 again - felt ok. Still a bit groggy/fuzzy, but less than yesterday. Very mild headache and slight ringing in ears, but otherwise fine. No real anxiety or depression. I tried thinking about things that normally make me anxious, and it was almost as though they were further away somehow - somewhere lower down - and could not get the traction they needed to ramp up and get going.
I was almost a little hyper at certain points - though that may be more to do with having had some sleep at last and being cautiously optimistic about these meds.
I had a party in the evening for my mother-in-law's birthday - though I did not drink - I was able to engage and talk to people etc
Pill taken at 9.45 while still at the party - I started to feel a little odd by around 10.30 so went home (felt like I was slightly slurring my words etc).
Some mild restless legs in bed, but seemed to fall asleep relatively quickly.

Day 4

Bad nights sleep due to son waking up multiple times, but I managed to fall back asleep each time (which I would not have been able to do previously). Felt quite low and depressed - negative thoughts (but not as bad as many times in the past) - sluggish and foggy and groggy. However, again, the fog was not quite as bad as the day before.
Pill taken at 9pm.
Restless legs from around 10-11pm when trying to sleep, but eventually I fell asleep and slept through. Again, I could remember my dreams and they seemed more vivid.

Day 5

Woke around 7am by my alarm as I am back at work today and had to take my son to school. Felt ok - no anxiety and no real depression - still a bit groggy and still have that strange feeling in my head - almost like my centre of balance is slightly off. If I move my head quickly from side to side it makes me dizzy and it almost feels like I can actually feel my brain sliding around in my skull.
However - while this is all weird, it is not that unpleasant. And compared to anxiety it is a walk in the park.
I know that it is very early days and things could go rapidly downhill, but I am hopefully that if the grogginess etc keeps fading, this could work.
I am at work right now so keeping my finger's crossed all goes fine. I am a lawyer so attention to detail is important, which means I will just have to triple check everything today as I am sure I am not totally with it!
Slightly upset stomach.
Also some slight anxiety/fear rising a little this morning. Almost like I felt it, and then got frightened that I was feeling it which meant these drugs were not going to work and I would be back to square 1 etc...silly I know, particularly as it is early days. But certainly feeling a little fearful.

Anxiety increased by mid-morning - not feeling good at all - it may be in part because I am at work, and things are a little slow today so I don't have much to do but sit at my desk and fester. But I am feeling pretty anxious and the addition of the dizzy/grogginess and strange head sensations from the Mirt is making it worse as I am anxious about those too.

Felt a bit better as day went on - less groggy and less anxious

[anxiousjomo]

Carrying on day 5:

Got upset stomach around 4pm, but was ok emotionally and physically in the evening.
Pill taken at 9pm - took until about midnight to fall asleep and had some heartburn

Day 6

Woke around 7am
Less groggy but emotionally low - however I felt a lot better as the day went on (particularly after going to the gym) - no anxiety and mood much better in the afternoon and evening. Slight headache and a little dizzy when standing up at times
Pill at 9pm
no restless legs, but took a while to fall asleep

Day 7
Slept until 7am with a few wakes in the night - bit groggy, but less so than previous. Still a little light headed. Mood fine. Slightly upset stomach, but I had IBS in the morning prior to taking pill.
Seem to have put on about 2lbs already - I can see why, as it is very easy to snack and overeat. I don't seem to feel full/satisfied quite as quickly. However, this is easy to manage it I keep an eye on it.
Am at work now writing this and feel about relatively Ok with it. Still feel like if I close my eyes I could easily fall asleep though

Felt better as day went on - positive and good mood in afternoon with no anxiety. Maybe a little groggy, but nothing important. Still a little concerned about the weight gain point, but will try and keep regularly exercising and keeping control of the snacking. At the end of the day I would rather be a couple of pounds overweight and happy, instead of skinny, anxious and depressed! (but that is easier for me to say as a guy (and one who is already happily married with kids etc so not having to date and all the rest!) )

[Belleblue]

Hi Jomo,
I am following your diary and wish you the best with this medication. I took it for approximately a year about five years ago. I seem to be very sensitive to medications, but I got on quite well with this one. The only problem I had, (apart from the start up groggy feelings) was that at the 9 month mark I started to experience flu like symptoms. I tapered down and they disappeared, then tried reintroducing the mirt a couple of times and got the same issues. I eventually came off it altogether, but at that time I was ready to do so. I think I got a rare side effect called agranulocytosis which means that your white blood cells are affected which can affect your immune system. I must stress that's a very rare side effect.

I've looked up some of your previous posts and like you I've been rocking in the boat about starting a antidepressant again. Some days I feel fine and feel I can hack it without them, but I feel I'm going through too many days when my anxiety hits the roof, I end up not being able to sleep, take half a zopiclone and feel depressed and ten times worse the next day. It's a vicious cycle.

If I start on a med I feel I will need to start on it long term. I would like to try mirtazapine again but am fearful that eventually after several months I will get that same side effect again and then what? I cannot tolerate the SSRIs as they are too stimulating. Anyway that's my problem.

Wishing you the very best.

Belle

[anxiousjomo]

Thanks Belle - yeah, I am similar to you I think re SSRIs. If this works for me I plan on being on it long term. But it is a little scary to think that I could be doing fine on something and then, after 9 months or so, have something crop up like you did. But I have to try and not worry about it! I am hoping I can stay on 15mg rather than go up. If that is the case then hopefully the taper off will not be too bad if I have to come off it. Were you on 30mg in the end? How long did you taper for, and was it ok?

Re being on meds in general. It is a really hard decision to make. And you have no idea what the outcome will be of your decision. But I guess it reaches a point when the feeling of not being on them is worse than the potential risk of the side-effects of trying something new....

[Belleblue]

Hi Jomo,
I was on 15mg. I tried 30mg for a very short while, but it proved too stimulating causing restless legs and affecting my sleep. For me 15 was my therapeutic dose.

I tapered for approximately two weeks and had hardly any problems, the odd sleepless night which I expected, but that was all.

Yes, I agree you have to reach a point where you almost have no alternative but to take medication or go on feeling grim for days at a time and taking the risk the toll that would take on your physical and mental health. So it's always a risk either way. I sometimes think I just want to be like other people who don't have to take anything and just get on with it, but some of us need the medication to just reach that level playing field that every one else functions on.

Take care now and have a nice evening :)
p.s There used to be a very nice member here who went by the name of Ingenious. He's not around any longer, but his posts are still here if want to look them up. He was on Mirtazapine and I always found his posts very helpful and positive.

Belle

[anxiousjomo]

Thanks Belle - and completely agree.

Day 8

Pill at around 9pm, asleep by around 11. Woke at 3am but went back to sleep fine.
A little tired this morning, but not that groggy.

Finding I was getting a little obsessed about the possible weight gain etc, so need to just get better at not catastrophising. Still the odd headache etc, but nothing that bad.
Mood fine

Ok until the evening when had a little panic/anxiety/guilt/obsessive thinking episode. Not that bad, and did not escalate into anything really unpleasant. But was a reminded that it is still early days and I still need to keep working on all this stuff with CBT etc

Pill at 9pm

Took a while to fall asleep again - maybe about midnight


Day 9

Got woken by my son at 4am as he could not sleep and took an hour or so to get him back sleeping, by which time it was light outside and I could not fall asleep again. Up at 7am for work. So feeling very tired today, but that is not the pill's fault. Slight headache and upset stomach etc, but again that may be more due to lack of sleep. Mood ok so far.

[anxiousjomo]

I am not going to keep doing this day by day, in part because one of my anxiety issues is constantly obsessing about symptoms etc.

But is all still going well - not really groggy any more in the mornings, no real side effects noticeable at present. Certainly feel an uplift to my mood - much less anxious and much less depressed. Also seems to be having a positive effect on my IBS, as I no longer suffer from morning diarrhoea etc

[Maca44]

My first thoughts on Mirt was I'm not sure I can handle the groggy feeling it gave me next day but that went in a week and a year and a half on I find it very helpful and my anxiety and H/A is so much better, not gone but better.

I hope you find it as helpful as I have but stick with the CBT as that helped me also. I do have abit of trouble with eating about an hour after taking Mirt and have put on some weight but that is the last of my worries at least I know I can get rid of the fat it's the anxiety that causes me to get depressed and life isn't so bad since I have been on the Mirt.

Stick with it

[anxiousjomo]

On day 13 now - having a strange spike in anxiety today. Not sure of the reason or source, but certainly feeling all the old anxious symptoms - jittery, hear pounding, hard to swallow, shaky etc. Hoping this is just a temporary blip - I am not even two weeks in so must be patient.

Still feeling a bit dizzy/groggy from time to time, and still getting restless legs at night about an hour after taking it, though they are gone after about an hour.

Finding my body takes longer to recover after the gym - my legs are still sore from exercise i did a couple of days ago that usually would not cause me much problem.

Other than that, in general mood is still good. Sleep is ok - better than it was off the meds anyway - still takes an hour or two to fall asleep, but I seem to be able to get back to sleep much easier if I wake in the night.

Oh, and I also seem to be getting heartburn more than usual, which may be mirt related?

[anxiousjomo]

Day 15 - feeling very good today. Slept well (apparently at one point my wife says I was smiling in my sleep - which compared to my previous insomnia/nightmares when sleeping issues, is a pretty good sign!)

Interestingly about 45min-1hr after I take the pill in the evening I get restless legs for about an hour, then they go. For this reason I have started taking it a little earlier (about 8.30) so the legs will calm down by the time I need to sleep.

In general, after being on it for 2 weeks, things are much much better. I have gone from getting only a couple of hours sleep a night and having anxiety, shakes, obsessive thinking, depression and all the rest (managed through exercise and meditation to mean I was averaging about 5-6 out of 10 a day) to falling asleep within about 30min-1hr and sleeping through until about 6.30-7am (or falling back asleep easily when I wake up), and having minimal anxiety and depression. Some days are worse than others (yesterday and the day before were a bit all over the place).

I have put on a bit of weight, and I still feel a little foggy/groggy/dizzy at times. I also get mild headaches from time to time, which feel like they are mirt related. Other than that, the side effects seem to have calmed down.

Finger's crossed I don't get blindsided by something crazy. Hopefully this drug looks like it might be working.

[anxiousjomo]

Day 18 - still going well. Tried taking it at 8.30pm last night, and did not have the same restless leg issue and fell asleep pretty quickly at 10.30. Slept through and was woken up by my son at 7am. Groggy when woke up, but it is normal for anyone not on drugs to be groggy when first woken up!

Still some slight dizziness/faint grogginess during the day, and the odd faint headache. Anxiety is much lower than it was, and no real depression issues. Certainly feeling a lot better in general than I was.

I had been having 5am wake-ups and diarrhoea every morning (I have posted about that on here previously), and have not had either since I have been on this med. My IBS in general seems to be a little better.

The impact of this med is relatively mild I think (at this dose) - I am not sure how much help it would be to someone with debilitating anxiety, for example. But for someone with moderate GAD and moderate depression like me (particularly when exacerbated by insomnia), it does seem to be helping.

Of course, regular exercise, meditation and CBT are all playing an important part in that too

[anxiousjomo]

Day 21 - still a bit up and down. Had a bad night on day 20 - could not sleep/kept waking up - ended up taking 1/4 of a zopiclone just to try and get me out.

No major anxiety - just jittery.

Still a little dizzy from time to time and a little groggy occasionally. But in general/on average doing better than I was off the meds.

No real weight gain the last couple of weeks, though I am watching what I eat and exercising regularly.

[anxiousjomo]

So - 3 weeks in - in general things are still going well. I would say my base line has just been nudged up a few notches, which makes everything a bit easier to deal with. Obviously this is not some magic pill that will have me skipping down the road filled with joy every second, but it does seem to be helping with sleep and it does seem to be dialling back the anxiety and lifting my mood a little.

Still some odd dizziness and sometimes if I suddenly move my head from side to side I almost feel slightly sea-sick. No real weight gain (maybe a couple of lbs) but I exercise regularly and keep an eye on what I eat, so that may be helping.

But, in general, so far, so good.

Hopefully I will not suddenly start having new side effects, as some have had, later on. Also know about the "poop-out" phenomenon, so we shall see if this keeps working over the next few months.

[anxiousjomo]

Day 25 - re weight and some of the horror stories - I have put on maybe 1 or 2lbs, but no more than that so far, and that may well have happened anyway as there have been multiple kids birthday parties in the last few weeks with far too much cake! It certainly seems that the issues relate to feeling a bit hungrier than usual, so I think regular exercising and keeping control of your intake may well help. But I think everyone is different, so I guess it is just a matter of keeping an eye on it and deciding how much you think it matters. How the med effects me is not indicative of how it will affect you.

The morning grogginess is much less now, hardly there at all really. Sleep is still way better than it was before I took the pills, though I took a couple of hours to fall asleep last night and woke up a bunch of times, so feel tried today. However, this was due to the fact that we got some stressful news just before bed, which would make even someone without any mental health issue pretty anxious and not sleep well! I am a bit jittery and anxious today due to that.

Still have the occasional restless legs at night when trying to sleep, but this is manageable.

I am trying to remain positive, and not let myself fall back into any of my old negative thought patterns. One of my big problems was/is obsessive and anxious worrying about how I feel (the old anxiety about anxiety), so I am trying to keep out of that pattern. I am still exercising 3 or 4 times a week, and try to meditate using Headspace most mornings. I also did some CBT so try and keep those techniques in play.

Other than that, things seem to be going ok, and I am going to keep on 15mg and see where I am in the next few weeks. I just have to stop caring so much about silly and entirely unimportant bodily sensations and thoughts!

Hope anyone reading this is feeling well.

[anxiousjomo]

Day 32

Had a couple of days of feeling very good - happy - all day. Slept well, no restless legs etc

Not feeling so great today, though that is because things are very stressful at work, so I can't really blame the meds. Had vivid dreams about wife and son and I being held in a prison camp, and trying to escape with them both while wife had gunshot wound in leg and river we had to dive into to reach the boat was polluted, so I was worried about infection...my brain is not very subtle...

Muscles feel a little sore and tired, though that may well be just from the gym. Also feel like I am slightly fighting something - throat feels a bit odd (like the start of sore throat, or like my sinuses have been dripping overnight or something).

Still seem to be very slowly putting on weight - have maybe gained 3lbs since I started. It is hard to tell though as I am going the gym 4 times a week and doing weights etc, so some of that may be muscle. I have no idea.

Of course, my brain is trying to get me worried about all this - that the sore throat is because the meds are lowering my immune system, that the weight gain is going to continue and I will get fat and unhealthy etc and then I will have to come off the meds and have horrible withdrawal and struggle for the rest of my life etc etc etc

Gotta love catastrophizing. Such a helpful pattern ;-)

So am just telling such thoughts to bugger off and trying to get on with my day.

[anxiousjomo]

Day 33

Feeling more sick today - feels like a head cold - sinuses/back of throat feel a little bunged up etc - head feels hot and fuzzy - feel very tired - certainly feels like I am fighting something. Hard to know if this is the meds or if this is just a summer cold/flu I have caught.

Also slightly increased anxiety/obsessing over how I feel etc. Finding myself worrying a bit about these meds, about having to come off if they have bad side effects or dont work etc. How do I know what is the med and what is me?

Sleep is still a lot better - so nice to fall asleep relatively quickly and wake up at the proper time in the morning. Scared if I do have to go off these meds I will lose that.

But also have to remember the good days I had a few days ago. Hopefully all this is just me feeling a bit rubbish from a cold/flu.

[anxiousjomo]

Day 34

Still feeling sick. Sneezing and blocked nose. Head feels bunged up/fuzzy. Hoping this is just a coincidence and not anything to do with the meds. I guess I will give it a week or so and see if I feel any better. If not, maybe it is the meds and I will go to the doc to discuss.

Oh and re the side effects in general - the morning dizziness/grogginess has gone, but I do get very tired around 9pm which is when I usually take the med, so no crazy late nights for me!

[anxiousjomo]

Day 35

Still sick. Yuck.
Had very stressful work ending with a midnight finish and promise of a 6am start the next morning, and was too wired and worked up to fall asleep. Took 1/4 of a tab of zopiclone and fell asleep pretty quickly for 4-5hours and then woke up. I hate taking those things, and very rarely do, but it is good to know that I can take such a small amount for emergencies and get a bit of sleep.

Tired and stressed with work today, and still hoping this is just a summer cold and nothing to do with the meds.

[Belleblue]

Hope you feel better soon Jomo. Try not to worry that it might be mirtazapine related. I know a couple of people who are not the best at the moment. I think this unrelenting humid weather can cause just as many bugs as cold weather. We need a good shower to clear and clean the atmosphere and the streets! Hang on in there .. this too shall pass.

All the best.

Belle x

[anxiousjomo]

Thanks Belle - I feel very mean partly hoping my wife or son come down with it, but that will help put my fears to rest! I am pretty confident it is just a summer cold, as I hear and see lots of other people suffering. Travelling on the Tube to work every morning means exposure to pretty much every germ out there!

[anxiousjomo]

almost 6 weeks now.

There are a few issues:

1. Sweating in the mornings - I had this in Prozac too - I get super sweaty for about an hour maybe an hour or so after waking up. It is worse when it is hot, obviously (like now), but also does not seem to matter much what the temp is. I also seem to sweat more when I work out.

2. Strange peeling skin on my fingers. I think I may have had this very mildly before, but it is getting worse.

3. Irritability. This is my current big concern. I snapped at my wife yesterday, which is very unusual for me. When I spoke to her about it, she said she had notice I was more irritable for the last 5 or so days. I know this can be an issue with Mirt, and it is something I really don't like the idea of. Particularly with a young son, and having suffered from an irritable and aggressive father myself. I have asked her to keep an eye on it for me, and if it gets worse, or continues for another week or so, then I may have to consider coming off the meds. Of course, it may also be that I am stressed with work at present, it is hot, I am still fighting some sort of cold (which may also be the meds...)...I don't know.

4. Sometimes have dry mouth.

5. Sometimes a bit dizzy/weird in the mornings. And an odd slight tension/headache/tightness in my head from time to time

6. Vivid dreams - but this is not really an issue

7. Upset stomach/diarrhoea - this is a difficult one, as I have had IBS for years, and was actually having really bad issues (waking at 5am every day and going to the loo about 4 or 5 times every morning) prior to going on the med. In general it is better - I don't wake at 5am etc - but I still often have upset stomach, particularly in the morning. Again, as I had this before I started Mirt, it is likely nothing to do with it - but it will be interesting to see if it makes the situation worse or better.

Other than that, the big thing this med is doing for me is the sleep. I am getting a good 7-8 hours every night, which makes a big difference. I don't know if it is actually doing that much for my anxiety and depression, it is just that sleeping better makes it all much easier to deal with. Hard to tell. I certainly am feeling jittery and anxious today, but that may be just a little blip. I am a bit trembly too, but used to have that with anxiety, so think it is that rather than the meds.

No more weight gain, for those of you worried about that - I maybe put on a 1lb or 2 right at the beginning, but no more than that.

I guess I keep going and see how I feel this time next week. The scary thing about this med, after I have stupidly read too much online and here about it, is it seems like people are fine for a while and then suddenly things get unpleasant. But by that stage the withdrawal is bad as you have been on so long...This makes me (when I am feeling more anxious) get a bit panicked about whether or not to cut my losses and get out now....Alternatively I could be fine and stay on this for the rest of my life with no issues...Oh well. Guess there is nothing I can do but wait and see....

[Betula]

Anxiousjomo,

I'm new here and because Im in the same boat like you, I decided to write, also I was reading your diary. It 24 days since im on Mirt 15mg...And I have the same concerns about it. What if it doesnt work and the fear about withdrawal.
I was pretty much ok last days, today I felt terrible. Hope this will pass. I cant say if its working, because my anxious and depressed feelings and fears were before meds also coming and going (few days alright, then 2 days or week horrible).

Take care and sorry for my english.

B

[anxiousjomo]

Betula,

Thank you - and welcome!

I think the important thing to remember is that our minds can create all sorts of the problems that we fear - and with meds like this it can mean we overreact to "normal" ups and downs, or obsess over things (as I was doing yesterday).

Those of us who struggle with anxiety/depression have a habit of "catastrophising" (meaning, we always go straight to imagining the worst possible outcome..).

I think we both have to give these meds chance to work - it is still early days for both of us. The worst thing that can happen is we have to come off, and so long as we do that slowly and carefully, there should be no problem.

Best of luck to you - and try to just relax and let it be (I need to take my own advice too!)

[Betula]

Thank you! I think you're right. Im just wondering if 15mg is enough...but of course its to early to say. :)

[Betula]

Its me again cause im worried. Today I feel really depressed and this crying spells are hard to take..could Mitr cause that, after 25 days on 15 mg?

[anxiousjomo]

I am not sure if it could cause it - certainly I think that in the early days there can be ups and downs like this, and it will take a while to settle.

I am not having a great day today myself - woke very jittery and anxious, bad diarrhoea, finding it hard not to sink into the bad habit of obsessively worrying about how i feel, about the meds etc. Also a bit dizzy/groggy etc and slight headache. But I have to remember that I felt relatively fine yesterday. This too shall pass.

I would say you need to try and give it a few more weeks before making any decisions. It may be you need to go up to 30, or it maybe that the med does not work for you, but I think it is still too early to tell.

Take care of yourself, try to keep yourself busy so that the days pass as quickly as possible.

[Betula]

Hey, thank you..like I would read myself..Its so strange, I was also feeling well past days, good sleep, normal appetite but constipated..then 2 days ago, suddenly bad feelings, also obssesing about the meds and how I feel, bad sleep and today diarrhoea and all is resulting in fear ..

And becasue of that im wondering is this realy my mental state or meds (I know that's my obssession, cause Im affraid of meds etc,,and would like to be off, but who wouldn't..)

Hope that will pass, for you too!

[anxiousjomo]

Nearly 7 weeks now.

Just to update - the skin peeling is fungal, and nothing to do with the meds. I am using hydro cortisone cream and is going away.

Irritability has not been much of an issue the last week. May have been more to do with the hot weather and stressful work.

One thing I forgot to mention, and is definitely the meds, is restless legs at night. These start about an hour or so after taking the pill and last for an hour or two. I was counting it last night and almost exactly every 20 seconds I get a rising up of that really unpleasant sensation (usually only in one leg) that makes me want to move it, then it fades away. Then 20 second pause, then again. Super annoying. I am going to try taking the pill later tonight (i usually take it just before 9pm and go to bed about 10pm) to see if I can fall asleep before the restless legs start. If that does not work, maybe take it earlier to get them out of the way. I had the same problem on Prozac (even though I took that in the morning) and it went away completely when I was off the drugs, so know it is a side effect.

Other than that - still slight tightness/headache and slight groggy feeling in head, but nothing major.

[anxiousjomo]

8 weeks: All good. Restless legs happens maybe once or twice a week. Some odd head sensations from time to time, but I am sure that is perfectly normal and it is just that I am more attuned to it.

I still get anxious and I still get depressed, but this has been taken down a few notches to a more manageable level. I made a mistake on Friday at work, which was very stressful to deal with, and I was anxious and down for a couple of days about it, but it never spiralled out into a panic attack or anything like that.

Sleep is still not perfect, but better than it was. My IBS is still pretty much what it was. I have noticed that a lot of my anxious sensations actually start from by gut, and seem to be triggered by my stomach feeling upset/potential diarrhoea, so I am going to try and work on my diet a bit more to see if I can find a way to help the IBS.

Speaking of diets - I have lost most of the weight I put on (I think I put on maybe 4lbs and have lost 2-3lb of that). Seems like keeping an eye on my intake, and exercising regularly helps to stop weight gain. Plus the exercise helps my mental health too, so it is a win/win.

So, at present, no desire to change dose or come off. I would say the 15mg knocks my issues down by about 20% which, luckily for me, is to a level I can cope with.

[anxiousjomo]

10 weeks

Have been struggling a bit the last couple of days. I am on holiday at my in-laws house, so am out of my routine and have lots of days of just hanging around.

Felt depressed and anxious for a couple of days now - withdrawn and hard to pull myself out of myself. Anxiety is not that bad, but I do seem to be trembling all the time. Also found myself obsessing over things (including the classic of scaring myself by thinking of suicide and then obsessing over how bad it was I had thought that, and how messed up I must be etc etc...all very silly I know). I am also doing classic catastrophising about the meds and my mental health etc.

I also find it hard to be in the present, and keep thinking about the end of the holiday next week and going back to work etc, and all that comes along with that...whereas I know I should be enjoying each day as it is.

Hopefully this is just all part of the process, and reflective of the change in circumstances while I am here. I suppose I am still only 2 1/2 months in as well, so should expect a few ups and downs, and for the meds to take time to work.

Other than that, regarding side effects - no real change. Still sleeping better, still have occasional restless legs, still feel like it is very easy to put on weight if I let myself go.

It may be that going up to 30mg would have a better effect on the depression and anxiety, but I am very reluctant to do that, both because I am sensitive to meds and can feel that the restless legs/stimulation etc would kick in more, and the sleep help would probably go. Also want to be on as low a dose as possible to make any eventual withdrawal easier. So will stay where I am for now.

[kynkari1]

I was worried about going up to 30 mg because I'm a terrible insomniac and didn't want to mess with what little sleep I was getting. I tried it, though, because 15 mg wasn't touching the depression (and usually won't at that dose), and I was pleasantly surprised. My sleep is even better on the 30 mg. It seems that dose has regulated my sleep to a more normal pattern. My anxiety also lessened but unfortunately it hasn't completely gone. Still bad in the mornings especially.

I do think, after nearly 3 weeks @ 30 mg, my mood is much improved. I was really hesitant to try the 30 mg but I'm glad I did.

[anxiousjomo]

Glad to hear that! I am doing ok - still ups and downs, and also struggling with bad jet lag (8 hours time difference flying east), which is not helping.

At present I have no plans to increase, purely because I know I have a tendency to get obsessive and anxious about taking meds, so don't want to increase the problems.

I tend to experience sensations that I am sure are totally normal, or caused by all sorts of things, and immediately assume they are related to the meds and a sign something terrible is going to happen....

very silly.

Just have to keep telling myself not to worry.

[anxiousjomo]

12 Weeks

All good - lost the couple of pounds I gained, so back to the weight I was when I started. No real side effect issues - I am tired, but would be anyway with a busy job, a small child and all the rest! Anxiety and depression are still there - just muted enough to mean that my other techniques (meditation, exercise etc) keep them manageable and much less intrusive.

Still have the odd bad day (or few days), but these have not yet ever got as bad as they did off the meds.

I still worry a bit from time to time about having the drug in my system - what the long term effects are, whether it will stop working, whether my brain is not functioning as well on it etc etc....But I have committed to this route, and I guess I keep going down this road until something happens that is dramatic enough to mean I have to change paths.

To anyone else considering this drug - I would say certainly give it a go, give it time (and expect a few days at the start feeling like you are half asleep all day).

[anxiousjomo]

Interestingly had a rough night last night - did not feel that bad but just could not fall asleep at all...was awake for pretty much the whole night. First time that has happened since I started on Mirt. Hope it is not a sign that things are stopping working....To be fair to myself, and the meds, I am in the midst of an incredibly stressful period at work - with a pile of pretty impossible deadlines - so it may be understandable that I am having trouble sleeping...

[anxiousjomo]

Had a good night yesterday, and then another bad night last night of about 1hr sleep or so. Partly can blame noisy neighbours having a party, as well as work stress, but am getting a little concerned that the mirt is stopping helping my sleep.

I would be reluctant to go up to 30, not least because when the 15mg is at its highest in my system about an hour after I take the pill, I get restless legs, which suggests to me that if I go up a level, those sort of issues are going to increase.

Anyway. Hopefully this is just a temporary blip. I am not feeling that anxious - though my chest is tight and I am obviously a little stressed, on edge and very very tired....

[anxiousjomo]

Well - had magnesium and turmeric before bed, wore and eye mask and ear plugs and slept for a straight 7.5hrs without waking once...So hopefully all is ok

[anxiousjomo]

So I had another brutal night last night. I think I maybe got 1hr sleep in total, but maybe not even that. I think the mirt has stopped having its sedative effect. Maybe what is happening is my body is used to that histamine like effect, and now it has worn off, it is like withdrawal? I dont know. But I just could not fall asleep at all.

I took a Valium at about 2.30am to see if that would help, but as usually happens with that med, it just made me depressed and full of suicidal thinking. I need to remember never to take it again...

I don't know what to do. I dont feel that anxious, so don't know if the mirt is still helping with that, but this week I have had brutal insomnia one night, then being so exhausted I pass out the next, then insomnia again. And the insomnia is from 10pm to 7am.

I don't think going up on the dosage is the right idea. It is apparently more activating at the higher dose. Plus, what if it just gives me another 3 months of sleeping ok, then cuts out again, but this time it is even worse because I was on a higher dose?

And I don't think I want to stop taking the med - it does feel like it is helping a bit with the anxiety.

I don't know. I just have to find a way to sleep again. Everything is manageable when I have slept.

[anxiousjomo]

More potential issues emerging, which I will ask about in a separate thread. But about a month ago I had severe abdominal pain for about 10hrs, but I put it down to having gone for a run on an empty stomach. Then last night I had really brutal pain, all around my abdomen - very sharp stabbing pain - lasted all night and was getting worse, so went to the hospital at about 6am. They did blood tests and urine tests that came back fine, and the Dr said he could not feel anything wrong etc. They gave me codine but even though only dulled the pain. It is now 12pm and the pain is still there, but dulled a lot, which may be the codine or it may be going away.

My concern is that abdominal pain is one listed side effect of Mirt...
What with this and it no longer helping with sleep (or doing that much for my anxiety and depression), I am starting to think it may not be working for me...

[anxiousjomo]

14 weeks

Still struggling with insomnia. Managing a couple of hours sleep a night, which is really taking its toll. I am exhausted and full of anxiety that I know comes primarily from the lack of sleep. Chest tight, body jittery, hard not to obsessively think about how I am feeling and what I am going to do. Hard too not to feel down about the future, and how this is all going to progress.

I think we can safely say that any sleep impact from the Mirt has now gone. It has been about 2 weeks now of insomnia - difficulty falling asleep then, if I do, waking up quite soon afterwards and rinse an repeat. Ranging from no sleep at all, to about 4-5hrs if I am lucky.

With the anxiety, it is hard to tell whether I would be worse if it was not for the mirt, or if it has just stopped working. I am reluctant to come off in case it is the latter, or in case this is just a blip. But if the former, and I have already determined that going up a dose is not a good idea for me, then the sooner I start to withdrawal the better.

I have an appointment with the Dr next week, so will discuss with her then. However she, like most GPs, has no real idea about these medications. I suspect she will recommend going up a dose.

It is so frustrating to have had a month or so of feeling really good, and sleeping well, only to have it all taken away from me.

[Maca44]

It goes like that for me but im glad I didn't rush in and come off the Mirt thinking it had stopped working because I pick up again.

Rotten when we feel well then back it comes again, cruel almost.

[anxiousjomo]

Been feeling a lot better the last couple of days. Have slept relatively well the last two nights with no pills or powders or eye masks or anything else. Am finding the CBT/ACT approach very helpful. As this is all in my mind, I just had to tell my mind to stop being a silly sausage.

[anxiousjomo]

and then, of course, the inevitable blip again - had a few days of insomnia again. I find the lack of sleep a real killer, as it exacerbates the anxiety, depression and IBS and makes them much harder to deal with.

I don't think I am having any other issues with the Mirt at present, just that it no longer seems to help with sleep. I do think it is helping a bit with the anxiety, as I suspect I would be feeling much worse without it.

No issues with weight gain etc, though I have been craving chocolate biscuits in the afternoon!

[anxiousjomo]

So the insomnia has continued. Has been going on now for well over a month, with only occasional breaks of ok (but never good, and only for a night or two) sleep. I got about 1hr last night. Am not overly anxious, just cannot seem to get to sleep. All the CBT stuff keeps me relatively relaxed, but it just seems impossible for me to fall asleep. If I were withdrawing, or starting a new drug I would blame it on that, but as I am still on the same 15mg, it seems impossible that it could be what is causing the insomnia...

My anxiety and depression and obsessive thinking etc are all pretty much what they were when I was not on the meds.

So I think it is safe to say that Mirtazapine has stopped working for me. To say I am gutted would be an understatement. I had a good 2 months in there somewhere, but that was it.

I certainly dont want to go up to 30mg - I have the side effects just after taking it (restless legs etc), and can already tell that it will be too activating for me (plus even if it does work, it could well just stop working after a few months and leave me with an even worse withdrawal)

So I think my only option is to try reducing to 7.5mg. Maybe will start by just cutting a little off the edge of the pill and first and see what happens, then reduce down to half over the next week or two. Then see what happens at that level. Maybe it will help me sleep.

I don't know.

Feel really crappy, and really upset about the fact it seems to have pooped out on me.

Any help/thoughts/suggestions from anyone on here would be gratefully received.

---------- Post added at 09:36 ---------- Previous post was at 07:41 ----------

I don't know. Maybe I should not mess around with the meds. Maybe I should just stay where I am - it may be the insomnia is just something else (work stress or whatever) and I would feel worse with the anxiety and depression off the meds. I don't think I am having any side effects, and the restless legs have pretty much gone now that I take magnesium before bed.

It is so hard when I feel like this. Hard because I am so exhausted and that makes me down and anxious and I find it really difficult not to obsess over how I am feeling and what I should do. The nights are so long. And the days I feel so groggy and tired.

I just dont know.

[anxiousjomo]

Got an appointment with by GP on the 17th Oct, so will just keep on with the Mirt at the same level until then. Unfortunately, like most GP's I am not sure what real help she will be. Suspect I will just be advised to go up to 30mg (sidebar: why don't they make smaller increments? Seems nuts to me to double my dosage straight away). I suppose the worst thing that can happen is I try that, and it does not work. Maybe this insomnia is just related to my anxiety because the Mirt is too low a dosage to deal with it. Perhaps if I go up to 30mg it will help...

Anyway. Guess I just have to keep on going until next week and then see where I am.

---------- Post added at 14:57 ---------- Previous post was at 14:24 ----------

And another possibility might be to cross taper with Prozac. That worked so well for me for about 10 years, and I only really gave it 3 weeks this time (as the side effects were so brutal). Maybe the Mirt would help me get over the initial problems with Prozac and I could get back to where I was 2 years ago (happily on 20mg of Prozac with no issues and thinking I could stop taking meds as was so content. Silly old me...)

[SmilingAlbert]

Hi Anxious,

Sorry to hear this - insomnia is horrible and I've been there. As I've suggested before, 7.5mg taken around 1-2 hours before bedtime might be worth a shot - for me it's better for sleep than 15mg - but I obviously may be different from you. I doubt 22.5mg or 30mg would be better in this area. If it doesn't work, well you tried.

If that doesn't help, I suggest you talk to your doctor about Pregabalin, which I'm also on. Mirt + Preg is a very successful combination for many on these boards. 7.5mg of Mirt + 75mg of Preg an hour or two before bed is a very relaxing combination. Preg also has very limited side effects at start-up for most people - you will probably feel a bit woozy at first, and hungry, but you'll get none of that head-exploding nonsense that you get from SSRIs etc.

It's licensed for GAD in England & Wales, but not Scotland, I think - it can be expensive so some areas don't like giving it out so you may need to work at it a bit, or even get a private psych to recommend it, and then get a NHS prescription off the back of that, which is what happened to me.

Tons of positive stories on the Pregabalin board here. Like Mirt, it's not a sleeping pill per se, but creates the right mental environment to help sleep happen.

For some, it's known as the benzo you can 'take all the time', as for most its effect lasts, and as such its medically respectable to be on it for a long time. No doctor will give you a Benzo for anything more than a month or so - and neither will they give you sleeping pills long term either, for the same reason.

The solution is out there, and you will get there, sooner or later I assure you! And keep in touch here.

Best wishes,

Albert

[anxiousjomo]

Thanks Albert - and thanks for taking the time to respond.

I tried taking some melatonin last night that an american friend had with him, and slept but am today feeling a little groggy with increased depression/anxiety, so not sure if that is an answer.

I think that, as 20mg of Prozac used to work well for me, I do need to be on something that increases serotonin etc, so it may be I try going up to 22.5mg of Mirt and see what happens. If that is unpleasant, I can try going down to 7.5. I think that, as I have not really had much in the way of side effects, I should hopefully be ok. If the insomnia is coming from the anxiety, maybe if I increase the Mirt dose, and then helps with the anxiety/depression, then I will sleep better.

My pharmacist friend has suggested I try taking 5-HTP supplements, as that can help boost both serotonin and melatonin levels and that way help with both sleep and mood. So I might try a low dose of that.

It is hard because I think I am, in many ways, suffering much less than many of you on here. It is just this constant low level anxiety and obsessing over my mental health, and depression that comes partly from that....and then the not sleeping...

I guess I will just keep fighting on until next week and then see what the dr suggests.

[anxiousjomo]

I was observing myself last night (another night of maybe 3hrs sleep in total). About 45min to 1hr after taking the pill I get restless jittery legs, a wired feeling and a kind of tightness in my chest. Then pretty much all night I feel just wired. Not particularly anxious or depressed, just overly alert.

I wonder if what is happening is that, now the histamine effect has worn off, and this is the Norepinephrine effect. Certainly feels like adrenaline.

If depression was more my issue, I can see how this could be useful to get you up and moving, but I don't think it is good for my anxiety!

This also makes me think going up on the med is not the way forward.

[anxiousjomo]

So I went to see the GP today, after another night of maybe 2hrs sleep, and he is insistent that I go up to 30mg. He said that that was the usual dose, and that he thinks my sleep issue is the anxiety and depression and that I need to up the med. He said he has many patients on it, and most are on 30mg and most doing fine. As I have not been having other side effects (no grogginess, no weight gain etc) he thinks it will work.

I tried to explain my concerns, and that as I understood the way the med operated, it was more stimulating at higher doses.

He said no.

I guess I can try 30mg and see what happens. The worst thing that can happen is I feel horrible and then at least I will know for sure and can drop back down to 15 and reevaluate.

This GP is very arrogant, and I am inclined not to trust him, but feel a bit pressured into trying this.

So tonight I will take 2 pills and see how I do...

It is doubly hard because my brain immediately wants to worry about taking that much of a mind-altering drug (despite having been on 20mg prozac for about 10 years previously - I really am silly) - and about how much harder it may make withdrawal (catastrophising!)

But I feel like I need to try in order to know for sure.

I should also say that my wife thinks in general I am doing better on the med and that I should not come off it - if I can get the sleep under control and maybe a bit more assistance with mood, I think I will be on to a good thing. I suppose I should count my blessings that (as long as this insomnia does not count!) I have had no real side effects so far (and it has been over 3 months), so there is no reason why I should not be fine on an increase.

So wish me luck...

[anxiousjomo]

Day 1 of 30mg

Took 30mg at 9pm last night. By about 9.40 I was feeling quite groggy so went to bed. Had restless legs for about an hour or so while lying in bed, then fell asleep around 11 and slept till about 6.30am I think - then woken by my son at 7am.

Have been up for about an hour - feeling a bit groggy and with slightly increased anxiety. A bit shaky too. But so far nothing too horrific.

[SmilingAlbert]

Sounds like progress - 7 hrs sleep or so. Few doctors have ever been on the AD etc. meds they prescribe, and the lower-dose-sleep thing is so counter-intuitive that I'm not surprised most don't know about it.

But it's not 'fake news' - this UCLA report looks into the issue:

https://proceedings.med.ucla.edu/wp-content/uploads/2016/11/Dose-Dependent-Sedating-and-Stimulating-Effects-of-Mirtazapine.pdf

But if 30mg is working for you, stay with it!

Albert

[Belleblue]

Albert thanks for supplying that very comprehensive explanation of how mirtazapine works. I've been aware that it was most sedating at low doses and when I was on it several years ago I stayed on 15mg as each time I tried to go up any further I got dreadful restless legs and it disrupted my sleep.
Very interesting that trying the higher dose earlier in the day might offset this.

Anxiousmojo - I've been following your diary and am sorry to read that you have been struggling at times. I hope this new dose works out for you and that you will see an improvement in your sleep pattern.
You may remember that I was going to go on mirt again, however several life events have got in the way of that and I needed my wits about me to deal with those and felt I couldn't put up with the initial side effects and those.
While I am waiting for those to settle I am still trying to decide if it's the right med for me. My feeling is that the Pregabalin would suit me better but worry about tolerance and some bleak stories about people who have subsequently tried to get off it.

Take it easy.

[anxiousjomo]

Thanks Belle and Albert.

It is now coming up to 7pm here in the UK and I have a pretty good day, all in all. Felt more energised and positive, with very little in the way of anxiety or negative thinking. Occasionally worrying about the meds, but nothing out of the ordinary. Nothing to report in respect of side effects. I know it will take a good 4 days to a week for the blood plasma levels to stabilise, so am expecting some ups and downs. But at least there has been nothing crazy so far.

It is interesting - I had forgotten the difference between how I usually feel and how I can feel when the meds work. It is like I am usually halfway down a well all day, and to engage with anyone, or be present, involves this extra effort to climb out and hold on to the ledge. When the meds work it is like someone put in a ladder, or puts a shelf under my feet.

Anyway. Second 30mg dose tonight, so will report back tomorrow.

Wish me luck!

Belle - sorry to hear you have been having some struggles, and all that pesky life stuff has been getting in the way. I guess there is nothing you can do but see each day successfully completed as a victory - one more bead on the necklace of life....

I am sure you will find something that works for you. Personally I have accepted that I probably need to be on something forever, so am hopeful Mirt works for me long term, but if not, there are always other options.

Preg seems to work for many people on here. Maybe give it a try?

Sending best wishes

[anxiousjomo]

Day 2 of 30mg.

Hmm. So, fell asleep at around 11am and slept until 6am, but woke up feeling wired and quite jittery. It is now about 9am and my chest is a little tight and I am finding it hard to sit still. Have slight trembles/tremors and mind is racing a little.

I am going to give it more time, but this does seem to be fitting the pattern I expected. I am sleeping from the histamine effect, but when this wears off (which it will do!) I am left with the adrenaline and serotonin and I think the reason I was not sleeping on the 15 was because of the adrenaline. The insomnia felt different from normal insomnia - I was not worrying or anything, and not any of the symptoms of anxiety, i just felt wired and a little hyper, just like I do this morning.

I will see how the day goes, and see how I feel tomorrow. But I am still leaning towards trying 15mg in the morning.

It is fascinating though - Even on 15mg I found I slept better for a couple of months, but was never that groggy in the morning. Some people seem to the same amount and be knocked out. It always amazes me how different our responses to these meds can be! I have had no real weight gain, no real munchies to speak of, no dry mouth etc. Yet the sleep help went quite fast, and now I feel like I have drunk 3 cups of coffee.

Any advice - should I try and keep on 30mg for a week or two and see if the jitters calm down? Or should I go with my gut instinct and maybe give it a couple more days and then try dropping back to 15mg and doing it in the morning?

***

It is now about 5pm - interestingly starting to feel a bit groggy and tired. Head feels a little odd - like tight and a bit tingly. Jitteriness is a bit less too.

head and face feel oddly hot - like that feeling you get in the early stages of the flu. Legs feel a bit weak and wobbly. Mood fine though.

Am very curious to see what tomorrow brings....

[anxiousjomo]

Oh - and restless legs sufferers - I have found taking 400mg magnesium citrate about 1hr before bed seems to completely get rid of them. I had bad restless legs on prozac and had them on the mirt too, but this seems (so far!) to be working well to stop it.

[anxiousjomo]

Day 3 of 30mg

Took meds at usual time of around 9.45 but felt wired about an hour afterwards - very restless legs which the magnesium did not seem to help - did not fall asleep until around 2am. Then woke a bit before 7.

Not quite so wired today as I was yesterday, but still feel like I have drunk too much coffee. Stomach a little upset as well. A bit shaky/trembly/dizzy. Feels like my centre of balance is a little off or something.

My mood is relatively good though - no real anxiety etc.

I know I am just talking to myself here really, but it never ceases to amaze me how different our responses to these meds can be. Some people sleep for 14 hours, I get kept awake!

Also reminds me that I should not worry about the withdrawal if I do end up coming off - just because other people had a rough time, does not mean I necessarily will.

Will see how today and tomorrow goes. Have an appointment with my proper GP (rather than the unpleasant guy I saw on Friday who insisted I go up to 30mg) in a couple of days, so will re-assess then I think.

But, at present, I am still leaning toward trying 15mg in the morning.

***

Update - 11.30am - just had my usual 11am cup of coffee (I always have green tea first thing, then one coffee a day around 11am and no caffeine after that). I now feel very jittery indeed. Legs bouncing and hard to sit still. Head still feels a little odd too - a bit hot/tingly etc

Update - 2pm - eyes feel very odd - when I blink it feels strange/tingly. Also odd sensation in my cheeks and jaw which kind of reminds me a bit of the few times it took Ecstasy as a youth.

No real anxiety and no real depression though. But was not really having that on 15mg either. No upset stomach anymore either. Starting to feel more and more groggy/tired as the day goes on. Feel like I could fall asleep if I closed my eyes.

[anxiousjomo]

Day 4 of 30mg

Pill taken around 9.40pm. Asleep by around 11pm but woke somewhere between 3.30am-4am, wired and wide awake and jittery. Have been awake since then. Again, feels like I have drunk lots of coffee. Not a particularly pleasant sensation.

I think this experiment may be coming to an end. Clearly, as I thought, I am getting very little from the histamine side of things, but a lot from the adrenaline.

Sweating and jittery. Also weirdly sort of heavy eyelids - like part of me wants to fall asleep and the other part wants to run a marathon.

Will maybe drop to 22.5mg tonight and perhaps tomorrow and then try switching to taking 15mg in the morning.


***

11am coffee time...am super jittery and still have diarrhoea. My legs are bouncing up and down like mad as I sit here trying to work. Finding it hard to concentrate and feel like I need to go run around the block a few times. My mood is fine though. Not upset or depressed about it, and not really anxious. Just totally wired...

Actually finding the whole thing mildly amusing (though I may also be a bit hyper from the meds and lack of sleep lol)

Interestingly - in terms of how this med operates and the differences between us, I would note the following:

1. Over the counter sleep aids that work on an anti-histamine basis have never really worked to send me to sleep. Often they actually seem to have the opposite effect and keep me awake.
2. I have had no munchies and no weight gain on this med. Actually weigh a couple of pounds less now than I did when I started (but I do go the gym 3 or 4 times a week).
3. Never really had daytime sleepiness either.
4. No dry mouth

My guess is my brain processes histamine atypically....

***

8.30pm - have been having increased shakes and anxiety this evening. Have not felt like this since before I started the Mirt. Think this must be the final nail in the coffin of the 30mg experiment.

[anxiousjomo]

Day 5

Took 22.5mg last night - slept until about 4.30am. Super wired again today and still have upset stomach. Went to see my usual (lovely) GP and she said it was obvious just by interacting with me that I was very hyper and full of adrenaline. She had never heard of this happening, so I made her google the UCLA article you linked to Albert, and she printed it off to read later, as said it was very interesting! I feel sorry for GPs actually, as there is no way they can possibly keep up to date on all the nuances of all the many medications they prescribe every day.

So she agreed we need to come back down to 15mg. She also said it is fine to try taking 15mg in the morning (but to try on the weekend in case it makes me sleepy!).

She also said, if my mood is ok, but sleep remains an issue there are lots of other options to try. I have Zopiclone, although I never really take it and she said having one of those every week or two is absolutely fine. She also said that, once I have tried the morning 15mg, I can also try taking a low dose of 5-HTP to see if that helps.

Feeling more positive now. The good thing about this failed experiment is it means I don't need to worry/ruminate about the "what if" of going up on the meds anymore. I also don't need to worry so much about potential side-effects, as if anything bad was going to happen (apart from the insomnia and the upset stomach!) it would have kicked off when I doubled the dose...

So....will take maybe 20mg tonight and then back to 15mg tomorrow....

[anxiousjomo]

Day 6 - took about 20mg last night around 9.45. Fell asleep by around 11pm but woke up around 3am feeling a little anxious. Dozed a bit, until woken by my son at 5am as he had an upset tummy. No sleep after that, so feeling pretty rubbish right now.

Reminding myself that it is perfectly normal to feel a bit shaky/down/anxious as (a) have been messing around with med dosage and (2) only got about 4hrs or so of sleep

Will prob go back to 15mg tonight and see what happens.

[anxiousjomo]

Day 7 = took 15mg last night around 10pm. also took a little bit of melatonin. Fell asleep fine, but woke again at 3am - wired and could not sleep. Possibly managed to dose a bit until I had to get up at 7, but I think I was pretty much awake for that whole time.

Feel pretty rough today. My mood is not too bad, but I am exhausted and jittery. Reminding myself that bad thoughts are not real, they are just the natural by-product of being so tired...

Going to try taking a zopiclone tonight, and then not take the 15mg until the morning and see what happens.

[anxiousjomo]

Day 1 of 15mg in the morning...

Took at 3.5mg zopiclone last night, and slept from about 10.30pm to about 6.30am. Then dozed a bit. Took 15mg Mirt at about 7am. Went back to sleep for a bit - maybe slept for an hour or so - then just dozed a bit (my very kind wife took my son this morning to give me a bit of a rest).

It is now 11am - I can certainly feel the Mirt - Am a bit groggy and it feels like I could sleep if I closed my eyes. Will see how it goes. Part of the grogginess could be from the Zop and from sleeping in longer than usual etc (as well as exhaustion from the last month or so of insomnia!), so I am not jumping to any conclusions.

Will try taking nothing at all tonight (except magnesium) and then mirt again tomorrow morning and see what happens.

Mood fine though.

[Yvonne]

Hi Jomo,
Just had a little read of some of your posts here. Why are you taking the Mirtazepine in the mornings? It's widely known that this med has to be taken at night before you go to bed.. No way could I take it in the mornings - When I take it at night within I'd say 20 minutes I begin to feel very dopey. I really don't know how you manage your day taking it in the morning. What am I missing here? Also, I wouldn't have thought you need the sleeper at night with this med. Hope you're feeling okay today :)

[anxiousjomo]

I was trying taking it in the morning (and only lasted one day) to see if it was having anything to do with the insomnia. It has no effect on my sleep, and actually seems quite activating, so I was wondering if the adrenaline side of it was keeping me up.

But yesterday and last night were a disaster. Groggy for most of the day and then at night I fell asleep ok, but got woken up at midnight by my son and then got incredibly anxious and could not sleep. got to that horrible point of insomnia where you feel suicidal at the endlessness of it. Ended up taking my Mirt at about 2am, and then a 1mg Lorazepam at about 3am. I think I finally feel asleep about 4.30am and then was woken by my son at 7am.

Feel awful today.

Anyway. So my experiments in going up a dose have failed, and I think my experiment of trying taking it in the morning have also failed.

So need to try and find another way to deal with this insomnia. I don't know how much more of it I can take.

[Yvonne]

Hi Jomo,

So sorry to hear this - I know I touched on it in the other thread. As I said, the 15mg still makes me drowsy but I only sleep for a few hours and then I start waking at around 3 am and it's really hard to get back to sleep.. and yes the thoughts are demons. I really think you should consider coming off this med completely. It's making you feel activated/anxious at 15mg and this just isn't right... Having said that I've had severe anxiety every since I've been on it .. not particularly blaming the med, just hasn't helped my anxiety. We have both just decreased from 30mg and so maybe that's why you are more anxious and the insomnia is so bad. The Lorazepam is a good med for helping you to relax I used it for a while, but you could ask gp/psych for Clonazepam which if you haven't tried, in my experience makes me very very sleepy. Hope you're feeling better today and look forward to hearing your update.

[anxiousjomo]

Thanks Yvonne.

I slept ok last night actually - fell asleep relatively quickly, woke up about 1.30am but managed to go back to sleep. Woke up a few other times but managed to go back to sleep then too. Trying to just relax and remember that there is nothing I can do about it. Either I sleep or I dont, I can't control it.

If I am able to have a few good nights with just this sort of CBT/ACT stuff, then that proves is it is not the Mirt keeping me awake, just my ordinary insomnia, and that is something I can hopefully combat with mental techniques.

I think the Mirt is helping a bit with the anxiety and depression, so am loathe to come off it, though I am feeling quite jittery and a little anxious today. Very tired too. Falling back into my old patterns of worrying about how I am feeling, and obsessing over what to do re meds. One thing I have possibly noticed about the Mirt, but I cant tell if it is the drug of the tiredness from the insomnia, is I am very shaky all the time - legs and arms feel like they are permanently trembling, and if I hold my hands out they are noticeably shaking.

I might try adding a low dose (50mg) of 5-HTP in the evening to see if that does anything. I think I should stay on 15mg for the next month or so and then see where I am. The good thing is I don't really seem to be having any of the usual side effects with this med, so am reluctant to change unless I really need to. But I don't know, hard to tell really. Certainly the Mirt is neither providing a major help, nor a major hindrance, but probably on balance I am a bit better on than off. I know I need to be on something, but it is hard not to wonder if there is something else out there that would work better.

Hope you managed to get some rest and are feeling a little better today as well.

[Yvonne]

Hi Jomo,

Really pleased to hear you had a better night's sleep, great news. How are you doing with your CBT and what technques are there for sleeping better? I've done loads of CBT but can't really remember anything about sleeping techniques. What is ACT? I should know but have probably forgotten. If you go on You Tube you will find some wonderful meditations for sleep.. Look for Power Thoughts Meditation .. they have some excellent stuff. When you can't sleep it's the subconsciouses way of telling you there is something wrong or stressing you. Same as the thoughts... It's like a little child who keeps tapping his mother saying... mum mum... - and mum takes no notice and tells the child to go and play. This is according to my private psychologist/hypnotherapist. Obsessing about the illness.. well this could be me speaking. My gp who is excellent asked me if I suffered any OCD. My reply was no definitely not. I then spoke to him again when I was having a really bad day, and he said.. You remember I asked you if you suffer any OCD.. I say yes and I don't. He said well I think you do .. you are obsessed with this illness. The man hit the nail directly on the head! I have been completely obsessed with it and think of little else. However, I'm working on it LOL.

Sorry you're feeling jittery today not nice. As for the trembling.. OMG yes, me too, but have always just put it down to my anxiety. Adding 5HTP.. I was told to add nothing to my meds. However, if your gp is agreeable then I say go for it. What about a couple of glasses of red wine before bed?

Yes I quite understand why you don't want to change medication, what with start up side effects etc.. If you feel the Mirtazepine IS helping the anxiety and depression most definitely you should stay on it.

Chat soon... and hope you sleep okay tonight.

[anxiousjomo]

Thanks Yvonne,

The ACT stuff is from The Sleep Book by Dr Guy Meadows. It is the next stage on from CBT, as emphasises the acceptance side of things rather than trying to continually fight with/reframe thinking - plus I agree with him that getting out of bed in the night can be counterproductive.

As for the drinking before bed, red wine does sometimes help, but often I find alcohol actually makes the anxiety worse (if not that night, then the next day), so I don't really drink much any more.

I agree with you re the OCD thing - I think I am certainly obsessive over it. I would guess a good 60% of my mental energy on a daily basis is used up with going over how I am feeling, what I am going to do about it, whether I should change the meds, whether I will sleep tonight, why I am feeling down etc etc etc

Very boring.

We also need to remember that even the most "healthy" people have days where they feel tired and groggy and down, or where stress and anxiety keep them awake. We should not be aiming for "perfection" with these meds, just something to help make life bearable at least.

The hard thing for me is just that I remember how I was on Prozac 3 years ago - I had none of these issues, was happy, slept well etc. If only I could re-wind time and never have come off them!

So I guess I am trying to find something that replicates that. But the problem is the 3 years of dealing with massively increased anxiety due to SSRI side effects and everything else has got me into a lot of bad habits, and has seemingly permanently altered my brain chemistry, so I don't know if that is even possible. Maybe I should just be happy I can function and go to work every day, regardless of how much of a struggle it might be. And when those thoughts come about "what is the point of doing this every day", just remember my wife and my son, and that I will not always feel like this.

Anyway. Enough rambling about this, which is a bad habit in itself.

I hope you are feeling a little better today, and that you sleep better tonight.

J

[Yvonne]

Hi Jomo

I'm liking the sound of the ACT and am going to look into it. Yes acceptance of the illness is most definitely Key as Claire Weekes preached. I get out of bed in the night, early hours, come downstairs, get a glass of water. Sometimes you feel you can't just lie there with the thoughts. I'm not a fan of CBT at all... reframing, challenging thoughts, I did it to death and it didn't help me. However, it does help a lot of people.

God, you are so like me, yes, my thoughts probably 70% of my day my mind is focusing on the illness, meds, everything you mentioned. My god, that thought - why do I feel so down? I get this constantly! My life is not bad by any means in comparison to some poor people who are doing just fine and dandy and so I constantly try to analyse etc.. I get bad headaches from the worry. Thing is, even by being on here we are focusing on the thing we are trying to get away from. I think I'm going to make this my last post... This forum has helped me immensely in the past but I swore years ago that I wouldn't post on these sort of forums again or look up meds blah blah. Have really enjoyed chatting to you and people can be so kind on here but I do feel I must stop. Great you have your job because it must be an excellent distraction and well done you for continuing to work.

Okay yes, agreed... I am not looking for perfection from the meds and any psychiatrist/psychologist/gp will tell you that meds alone will not cure the problem. It has to be a hollistic approach. I can't believe this, something else we have in common; .. You haven't felt right since coming off Prozac. Did you by any chance go back on it and it didn't work? I had same experience when I came off Seroxat which is a close partner to Prozac - generic name is Paroxetine and is also an SSRI. I went into severe withdrawal .. first time in my life had to see a shrink and he put me back on it and raised the dosage up and up and it did nothing. I also feel this damned med changed my brain chemistry in some way. Most definitely keep those thoughts up.... WE WILL NOT ALWAYS FEEL LIKE THIS.

Sorry I've gone on so much... a tip which may help... say a mantra to yourself when you are feeling bad... keep repeating it in your head to keep the negative thoughts out. It helps me. Psychotherapy can be good and something in your past which is still in subconscious could be the cause. It isn't easy reliving past traumas.. conversely this is the opposite to what I've said above because this is about facing the things that we like to try to forget.

Take care Jomo ... Really hope you start to feel better soon... Been great sharing with you. :)

[anxiousjomo]

Another brutal night of no sleep. Feel awful today. Really struggling. Don't know what to do. So tired. Stomach upset, eyes heavy and sore, trembling, very low mood. Feel like I cant keep going on like this.

Maybe try dropping to 7.5mg and see if I sleep better? Or maybe try 5-HTP?

Or maybe Mirt is just not working for me and I need to try a different medication.

[Belleblue]

Jomo, I hate to see you struggling like this. You have given this as good a shot as I think you can. I don't think you can go round and round with this for much longer. Maybe it's time to see your doctor again about trying something else or perhaps being referred to a psychiatrist who may have more understanding and may be able to offer medication tailored to your particular needs.

I know you mentioned about perhaps trying Prozac once more. But there is also a relatively new medication called Agomelatine, have you thought about that? Also of course Pregabalin. Or perhaps some combination.

Don't give up hope, there are always options :hugs:

[anxiousjomo]

Thanks Belle, really kind of you to respond.

Yeah I am starting to think this med might not work for me...I have an appointment with the Dr next Wednesday so will see.

I may try going down to 7.5mg before then, just to see if it helps with sleep.

The hard thing is I am so scared of all these other drugs, and of doing permanent damage to my brain by trying one, then another, then another...

I am feeling really depressed right now. Worse than I have felt in a long time. On the verge of tears at work and just trying to make it through until I can leave this evening.

I am so tired of being broken.

[Belleblue]

Hang in there Jomo, there is a solution for you of that I'm sure.
Do tell the doctor of your fears regarding the meds so that those fears are out of your head and not going round and round, I'm sure he/she will be able to reassure you.

Regarding doing damage, I have known people in my life who have taken all sorts of illicit things shall we say and they have done no permanent damage, so I don't really think you have anything to worry about on that score.

Go easy on yourself.

[anxiousjomo]

Thanks Belle.

Last night I took a 3.75mg Zopiclone at 10pm, but still woke up at 2am very anxious so took a 1mg Ativan. Feel like a bit of a failure for doing so, but I know I am being silly. Just have to make sure I leave a good 3 or 4 day gap between using them. At least I got some sleep, so feel slightly more human today.

Tonight maybe I will take melatonin.

I think I will try going down to 7.5mg on Friday evening and see what happens. Maybe it will help with the sleep at least.

Then I have a DR appointment on Wednesday.

Last time she wanted me to try amitriptyline as apparently that may also help with my IBS. So that is an option.

I also suppose that just because Prozac and Citalopram did not work for me, does not mean none of those other SSRIs or SNRIs will work (though my reaction to the increased norepinephrine in Mirt may mean SNRIs are not a good idea)

I clearly need something to boost my serotonin though as the first day on 30mg Mit, before the adrenaline really kicked in, I actually felt happy for the first time in over 2 years.

Actually, maybe will stay where I am on my meds until I see the Dr on Wed. No sense in rushing things, and I have been up and down a bit with them recently, so should give things time to settle...

[anxiousjomo]

still feeling really anxious and depressed. still on 15mg in the evening. Still not sleeping.

Have to try and make it to Wed when I see the GP so we can discuss what to do.

Going to have to take an Ativan tonight as otherwise I don't think I can cope.

Feeling frightened and broken. I feel worse than I ever did before all this nightmare with different medications started two years ago. Don't know what to do. Don't think I can survive without being on meds anymore, but don't think I can cope with the up and downs of trying different things over and over again.

Also - if Mirt does not help me sleep, doesnt that mean Tradazone and Amnytriptaline wont help either? Isnt it all just the same histamine effect?

---------- Post added at 18:17 ---------- Previous post was at 14:40 ----------

just trying to survive for another few hours until I can take an ativan and sleep. Very anxious and depressed, head tingles and aches, eyes hurt, stomach upset.

I don't know if anyone is reading this anymore - I already annoy myself with all this worrying and obsessing, so cant imagine anyone else is that interested - but if Mirt has not been helping me sleep - in fact it seems to be having minimal effect at all - does that mean I am less likely to have withdrawal? I don't see how I can have insomnia as a withdrawal symptom when I already have insomnia on it! lol

Anyway. Will stay where I am until I talk to the GP next week, but if I do come off I will go down to 7.5 for at least a couple of weeks and see where we go from there (I will have been on 15mg for 4 months, so not a crazy length of time).

Then, if that is what happens, I have to decide whether to roll the dice with another med (and if so, what), or try and survive without anything (which is terrifying too).

Ah well. Such is life I suppose.

[Belleblue]

Hi Jomo,
I was on mirt for just under a year and had no real problems withdrawing and I am very sensitive to medication. It didn't take long, just a couple of weeks reducing with some insomnia for which I took a half to a quarter of a sleeping pill on those difficult nights. You haven't been on it a long time, so I doubt very much that you will experience much discomfort.

I never had any problems sleeping on mirt, but when I tried Amitriptyline it just kept me awake most of the night and even when I slept it was strange restless sleep! So I don't think it's that unusual that for some people certain meds which supposedly should help with sleep have the opposite effect.

Go easy and take care of yourself.

Warmest,

Belle x

[anxiousjomo]

Thanks Belle

I cut the pill down to about 11mg the last couple of nights and have slept a little better - maybe 5-6 hrs, as opposed to 3....Lots of vivid nightmares when I did sleep though...

I am going to hold at each stage for as long as I feel like things are a better there - prob go down to 7.5mg in a week or so and then, if I am sleeping a bit better, and feeling a bit better generally, maybe stay there for as long as I feel it works.

The good thing is this is not like coming of Citalopram, where the side effects were so horrific I was desperate to get off them. This is just that it is not working, and may be making it harder for me to sleep.

We shall see.

Thanks for the kind words, and take care of yourself too

Jx

[anxiousjomo]

Day 4 of 11.5mg. Noticing some sinus pressure and a hot feeling to my face all day, plus some generally grogginess. Also still trembling all the time, upset stomach and nausea. This may, in part, be due to the drop in dose.

Will stay here for a week at least, maybe two depending on how I feel.

Still sleeping slightly better on the lower dose - woke up a lot last night from crazy/vivid dreams but managed to fall back to sleep after a while.

[will351]

Just started yesterday at 15mg. Did it help your anxiety at all. I also started Desvenlafaxine
12 days ago. Using mirtzapam as a bridge from taking benzo’s.

[Maca44]

You say that your not sure if anyone is reading this a few posts back, so just wanted to say I am reading this as I'm sure many other are and I find it really helpful knowing what other are going through and it's a great help for me.

Keep posting

Thanks

[anxiousjomo]

Will - not sure it helped much for me with the anxiety, but it is hard to know. I responded atypically to it, so not sure if you should use me as an example! I found the sedative effects minimal at 15mg (I maybe slept for about 6 hours), and 30mg was too activating. I would suggest giving it a few weeks at least - the good thing about Mirt is that it is quite fast acting, with none of the really unpleasant start up effects you get with SSRIs, so I would stick with it.

Macca - thanks for your kind words. Saw my GP today, and she agrees I should try 7.5mg and, if that does not work, come off it. She has also referred me to a psychiatrist who will be able to consider properly my experiences with Prozac, Citalopram and Mirt, and then decide what we do next.

My plan is to go to 7.5mg on the weekend, and see how that works. If it helps me sleep a bit, I will stay there until it stops doing so! May try 5-HTP at some point too (at a low dose - 50mg).

Last night I fell asleep, but was awake from about 2am, so am very tired today, but my mood is ok. Very busy at work, but managing to keep going. Regular gym time, and meditating using Headspace every morning really does seem to help.

[anxiousjomo]

Day 6 of 11mg.

Still sleeping a bit better, but finding myself feeling quite dizzy/foggy headed during the day. Head feels a little hot. Anxiety ok, though I am quite stressed.

Limbs feel quite weak too.

***

Feel a lot better in the afternoon, after having gone to the gym at lunchtime. Mood fine.
Although I just ate far too many chocolate biscuits at 4pm and am now having a bit of a sugar crash lol

[anxiousjomo]

Day 7 on 11mg,

Slept ok last night - maybe 6-7hrs, which is not bad at all. Struggling a bit with some low mood today, and some shaky/trembling and anxiety/rumination etc.

Just checked my online notes from my GP for our meeting on Tuesday and read the following (which I post because it is interesting to see how these things get recorded and responded to - and because she got the histamine point wrong - it is the adrenaline side that is the issue - and I also did not say sleep deprivation was the "main issue", just that it made everything worse! ):

Problem: Mixed anxiety and depressive disorder
History: came to review meds. Has now dropped down to 12 mg mirtazipine (3/4 pill).
lower doses help with sleep counterintuitively.
will drop now to 7.5 mirtaz. FEels like has a hyper reaction to histamine.
lorazepam is very helpful for sleep- very careful to avoid depenndency- taking only once a week.
Main issue is sleep deprivation- poor sleep drives bad mood. Not suicidal due to protective family factors.
Busy stressful job aas lawyer
Was once happily established on Prozac some yeras ago but no antidepressants have helped since then.
Plan: refer to psych for advice- given his unusual reaction to sedative antidepressants

[anxiousjomo]

Day 9 on 11mg

Still sleeping a bit better, but not as well as I was. Felt pretty decent for much of yesterday, not particularly groggy or anything, but some anxiety in the evening. Woke this morning at 4am feeling wired and unable to go back to sleep. It is now almost 8am and I am feeling a little jittery and anxious, but am trying not to fixate on it.
Still diarrhoea every morning. But that may just be me as I have had it for a long time.
If sleep is worse again tonight, then I may try dropping down to 7.5mg, though I am a little worried that any help I may have been getting with the anxiety will be well and truly gone at that low dose.

[anxiousjomo]

Day 10 on 11mg (or maybe 9 or 10mg)

Very rough night last night - Fell asleep around 11pm then awake from about 1.30am. Quite anxious and unsettled. Tossing and turning a lot. Not sure if it is because I think my cutting of the pill was not very accurate and I took less than usual, or if I should actually cut down to lower. Will try and do a larger (as close as possible to 11) tonight and see if that makes things worse or better. If worse, I will go down to 7.5. If better, I will stay there until next weekend.

Hard to know exactly what is going on. I know people report delays of 1-2 weeks for withdrawal with Mirt when going down doses, so it could be that. Or it could be the old histamine tolerance + build up of adrenaline.

Worst case scenario, it has been 9 days since I took a lorazepam, so I can always take one tonight if I need to.

[anxiousjomo]

Day 11

Took some melatonin last night, and got about 6 hrs sleep I think. But very groggy and dizzy today. Also anxiety is up. Tight chest, trembling etc. My head feels very odd.

I know this it partly because I have a very busy and stressful week at work this week - lots of very tight deadlines - and the fact that my head is groggy and I am feeling so crappy is making me more anxious, as I need to be on good form. I guess I have no choice but to grit my teeth and fight my way through to the weekend. I have still not taken a benzo, so I have that as an option if I get desperate - although i can't take them at work as it affects my performance. Will try and go to the gym at lunchtime and hope that helps a bit.

[anxiousjomo]

Day 12

Slept relatively ok. Dizzy and nauseous today. Arms and legs still feel very weak. Hopefully things will improve as the day goes on. I hate this dizziness in particular, it makes it really hard to focus on anything. Anxiety fine, just still ruminating and obsessing over how I feel.
Still aiming to go down to 7.5mg on the weekend, as will have been 2 weeks on 11mg, so should be ok. I have only been on Mirt for 4 months, so hopefully should not need to go too slowly with the dose decreases.

[anxiousjomo]

Day 1 of 7.5mg

Current pattern seems to be falling asleep ok at around 11, then waking about 1.30am and taking quite a while to fall back asleep. Then waking again about an hour or so later and rinse and repeat for the rest of the night. Then up for good between 6 and 7am.
Very tired. Some trembling, headaches, pain in chest etc. Not so much nausea, but still upset stomach in the morning.
Also getting a lot of heartburn.
Quite dizzy and groggy today but that is probably due to the tiredness.
Also in the midst of a very stressful period at work - was at work from 8.45am to 10pm yesterday for example - so I am sure that is playing into it all.
Mood ok - not really that anxious, nor that depressed.
Have got my appointment date with the NHS psychiatrist, which is a week today. Very surprised it was so soon, but I guess they speed things up when you mention you have been having suicidal thoughts lol...
Wish me luck on 7.5mg...will give it at least 2 weeks before deciding whether to go off or stay on this dose for a while. Finding it quite funny that most people sleep for 14hrs on 7.5mg, but apparently my body decided it wants to be different....

[anxiousjomo]

Day 3 of 7.5mg

Feeling ok. Very groggy today though. Still waking up a lot in the night but managing to fall back asleep eventually. Have that sleepy feeling which I think is what people usually get on this med, as I feel like I could stay in bed all day...

Some increased anxiety at times - had a weird night last night when I ended up taking an ativan as I felt strangely anxious.

Nothing horrific so far though. Just very tired.

Weirdly anxious and off most of the day today (sunday). Interestingly my heart rate (I wear a fitbit) has been about 10bpm higher than usual all day (my resting heart rate is around 62-63bpm and it has not gone below about 70 today. Clearly that is all connected to this feeling of being a bit on edge. Headache all day too, but only a mild one.

Certainly noticing the effect of coming down to 7.5mg. Hopefully things will settle down over the next week or so.

[anxiousjomo]

Day 4 of 7.5mg

Again, woke up roughly every 1 1/2 hours - first wake up at about 1am was very hard to fall back asleep from. Ended up taking some melatonin, but think part of my grogginess today is because of taking that so late.

Nauseous today. Feeling jittery and a little anxious. Some stomach pain as well. Worried about my brain fog and general unwellness. Feel like my brain is not working properly. Feel like I could just curl up into a ball somewhere. Instead I am at work and have to try and focus. Trying hard not to let myself fall into the patterns of worry and depression about how I am feeling. Certainly noticed an increase in the general anxiety since going down to 7.5mg, but guess that is inevitable. Have to wait and give my body time to settle.

Just have to keep going until Friday when I see the psychiatrist, and hopefully then I will get some clarity on what is going on. Just so tired of all this.

[anxiousjomo]

Day 7 of 7.5mg

Had a couple of nights of pretty good sleep - fell asleep quickly and slept through - have been feeling relatively ok during the day - some dizziness and muscle weakness etc, as well as some sinus pressure and other things. Still getting (mild) headaches every day though. No nausea for the last couple of days.

Then last night seemed like the night the "switch" had gone off again with the med and sleep - took quite a while to fall asleep, woke at 2am and took about an hour to fall asleep, then woke a few times after that. Still having very vivid nightmares too.

My mood is ok - not really depressed, and not really that anxious. Hard to know if that is the med or all the CBT/Meditation etc. But I do find the head grogginess hard, particularly as I worry about it affecting my ability to do my work, which then has a tendency to get me worrying about the long term consequences of that, and losing my job etc. Which is silly, I know. But I certainly dont like this constant feeling of being slightly dizzy and with a head full of cotton wool.

I have my appointment with the psychiatrist tomorrow, so we will see what he says. Either way I will be staying on this dose for at least another week.

The good thing is I have not had any horrific issues yet - no nights without any sleep at all, no panic attacks or really bad anxiety, and no suicidal depression (though I only really get to that stage after a couple of weeks of no sleep, so the slightly better nights are likely helping with that).

[anxiousjomo]

Day 8 of 7.5mg

Not much sleep last night, maybe a couple of hours. Anxious and tired. Better in the afternoon.

Saw Psychiatrist. He is taking me off the Mirt - he says, and I agree, that I am the same, if not worse, on it that I was off, so there is no point staying on. Will drop down to 3mg or so next weekend, then prob go off after a week or two on that.

He said there are some other med possibilities for me - Tradazone or Pregablin or starting on lower dose of prozac and going up slowly - but he thinks (and I agree) that part of my problem is the brutal side effects I got from the Prozac and Citaloproam was traumatic, and as a result of that trauma, my mind is obsessively looking out for it to happen again - hence the continual rumination over how I feel and the side effects - so i am likely to have issues with anything I go on. He thinks that supplements (like 5-HTP etc), exercise, CBT and counselling etc, and eating better and all the rest, might be sufficient. At the end one has to look at it from a "balance of harm" perspective - these meds will have side effects, or other issues, and I have to balance them against how I feel without them. At the moment I think I can cope without meds - particularly if I have ativan and zopiclone available for emergencies.

So that is the plan. Will come off Mirt over the next month, and prob start 5-HTP once I drop down to 3mg of Mirt.

Will keep this diary until I am off the med, just in case anyone finds that helpful.

Oh well. Has been an interesting experience trying Mirt - a real rollercoaster! The tough thing is it can feel like it is helping quite quickly, which gets the hopes up, but then poop out just as fast.

But - on the other hand - there are many people (my mum included) for whom it works wonderfully, so I would never suggest not giving it a go.

Hopefully my withdrawal process will not be too bad.

Wish me luck!

[Belleblue]

Hi Jomo,
I'm sure you're relieved you've seen someone who has more expert knowledge with medications etc. than your GP.

I think if you can manage without being on some permanent medication and just using zopiclone or ativan on an as needed basis it would be the best way to go. I wish that zopiclone didn't make me so hung over or depressed and cognitively challenged the following day, I would just go with that. However I'm managing okay at the moment.

People with crippling bouts of anxiety and depression can and do manage their lives without meds. Often for some people the current crop available just add to their distress or do nothing at all.

I was just thinking of a couple of books by people who don't take antidepressants which you've probably read, anyway one is Matt Haig's Reasons to Stay Alive and his other one which I haven't read yet but sounds like it might be interesting and helpful: Notes on A Nervous Planet. The other one is Cheer Up Love by Susan Calman, which is a bit chicky, but still relevant to anyone suffering the twin terrors.

I'm still getting by without ADs, I have no idea if that will change .. watch this space :D

Best of luck with your withdrawal.

Take care now.

Belle x

[SmilingAlbert]

Thanks for your updates Jomo

Best of luck to you

Albert

[anxiousjomo]

Thanks Belle and Albert.

Belle - good luck with being med free, and well done on getting this far! - I think part of the trick is just to take each day at a time, and each moment within that day at a time - it is amazing how different one can feel in the morning, say, to in the evening - everything is always changing.

I am certainly a bit nervous about going med free, and about coming off Mirt, but am trying to be positive.

At least I know that I have some options to help with the short term issues: Melatonin does help me sleep, and zopiclone and lorazepam work for me too in emergencies. Things only tend to get really bad for me when I have gone for a week or so without any sleep, so I know i can turn to those options to help then.

It may also be that I come off Mirt and it turns out that 7.5mg was actually helping, as it is just so hard to tell if I would be feeling much worse on nothing at all, or if the Mirt is not doing anything for me. But if that is the case, i can always just go back on.

Anyway. Took melatonin last night so slept, but accidentally took more than usual (about 5mg) so feel very groggy and a bit rubbish today. But hopefully coffee and some sunshine will help

[anxiousjomo]

Day 11 of 7.5mg

Am going to start slowly shaving a bit off each of the half of the pill now for the next couple of days, before dropping down to 3.5mg.

Took about 4hrs to fall asleep last night, and woke up at least three times from very vivid nightmares.

Mood ok today - a little dizzy and stomach upset, but that is likely more from the lack of sleep than anything. A bit jittery etc, but trying to be positive.

The only negative is that I looked up the person my Psychiatrist recommended (Dr Amen) and discovered he is one of those awful quacks that sell masses of overpriced supplements and endless books... So that does not fill me with confidence. Certainly got the sense I was being rushed out of the door when I saw him - but that is what comes from going on the NHS and not private, and not being in seriously dire straits.

Regardless, I am sure eating better and trying some things like 5-HTP can do me no harm!

[anxiousjomo]

Day 12 - about 6.8-7mg

Slept well last night - took 1.5mg of melatonin and that seemed to help. Also had had a heavy session at the gym during the day, so was exhausted!

Mood ok today - trying a new multivitamin that has Ginseng and L-tyrosine and L-carnitine in along with the usual stuff. Felt very dizzy about 1hr after drinking it and still feel a bit odd now, so am blaming that rather than the Mirt for today's fuzzy head. Prob wont bother to have that again, as why add more chemicals to the mix...

Actually doing relatively ok on around 7.5mg, now I have adjusted to it, so if things go bad when I come off, then I can always try going back to this level.

However, interestingly, it is only now I am down at this level that I seem to be having some of the food cravings people talk about - every day for the last 3 or 4 days I have had really strong cravings for sweet/carb things around 3-4pm. Also noticed a bit of weight gain over the last week as well. Will have to watch that, but hopefully it will drop off as I come down off the med.

Trying to resist the temptation to come down quicker than planned, as am feeling fine and just want it over and done with, but know that it is not worth the risk!

[anxiousjomo]

Day 13 of 7.5mg (but took around 5-6mg)

Brutal night of no sleep last night. A number of variables could be responsible, including that new multivitamin that had insane (1200% RDA) of B vitamins which is (according to some research papers and studies) a possible cause of insomnia. Also, and much more likely of course, it is the old Mirt doing its usual. No anxiety or anything during the night, or really today, just very tired now and dizzy etc.

Going to go down to 3.75mg tonight.

As I have had insomnia on 30mg, 15mg, 22.5mg and 7.5mg, I am obviously not worried about getting insomnia as a withdrawal symptom if I go a bit faster!

Last night felt like the last time I tried taking Night Nurse - and how I have often felt on this drug - so am hoping this insomnia is down to my atypical histamine response and will be easier to deal with once I am off the drug.

May try taking melatonin again tonight, as would rather take that than zopiclone or ativan. If I can make it to the weekend, but am still struggling, then I will take a one of those Friday night. But hopefully I can survive until then....

[anxiousjomo]

Stupidly just googled Mirtazapine withdrawal and have now scared myself with the horror stories...There are people out there creating liquid suspensions so they can go down by 0.1mg and spending months taking what seems to be basically water, in order to avoid what are some pretty horrible sounding withdrawals.

Ugh. That was silly of me.

Oh well. Will go down to 3.75 tonight and, if anything horrific happens, I can always go back up a bit and go down more slowly.

[Belleblue]

I really think those kind of protracted withdrawal symptoms only happen to people who have been on mirtazapine for a long time. I've never read or personally known anyone who has been on it for only a matter of months having that kind of experience.
As I told you before I am super sensitive to medications and I came off it with very few issues, a bit of sleepless, diarhoea (sp?):blush: funny tummy, all very bearable.

I think you're overthinking it all :)

Take care Jomo.

Belle x

[anxiousjomo]

Thanks Belle - I am sure you are right (and I can never remember how to spell diarrhea either). Lack of sleep makes idiots of us all :D

[Belleblue]

Thanks Belle - I am sure you are right (and I can never remember how to spell diarrhea either). Lack of sleep makes idiots of us all :D
Yes indeed, not only can I not spell diarrhea (thank you) apparently I cannot spell sleeplessness either!! :doh:
All the best!

[anxiousjomo]

Day 1 of 3.75mg (ish - it is not easy to cut these pills into quarters!)

So took 3.7mg last night, along with 1mg of Melatonin and slept like a log - to the extent that my wife tried to say something to me about 30min after switching off the lights, and I did not respond and did not wake up...

Slept right through until 7am when my son woke me up to get him ready for school.

Bit tired, groggy and dizzy today, but grateful for the sleep. No real anxiety or depression issues as yet and, apart from a slight headache and some trembling/slight jitteriness, no other issues. Will see how the day goes.

This drug, and my response to it, continues to be very weird. Why - if I have insomnia on it at 30mg, 15mg and 7.5mg, would I suddenly sleep through on 3.75mg? If I had a tolerance to the histamine side of things, or an a-typical response to it, surely this would not happen. Or maybe it is because I was so exhausted, and now there was less impact on the histamine receptors, so my body could sleep by itself (with a little help from the melatonin). Weird.

As for my regimen during this process, in case this is useful to anyone, it is as follows:

1. High strength omega 3-6-9 fish oil pills in the morning
2. Iron +B vits+ Vit C+ Zinc effervescent drink in the morning (Feroglobin)
3. 400mg Magnesium Citrate before bed
4. Occasional (usually a few times a week, and always with at least 1 day off in between) 1mg Melatonin 30min before bed.
5. Very rare (maybe once every 2 or 3 weeks - but if needed then more) - 1mg Lorezepam and 3.75mg Zopiclone. These are for real emergencies only and, unless things are desperate, I try and go as long as possible without one.
6. Green tea every morning, and one coffee before lunch. No caffeine after 1pm.
7. Try to eat as healthy as possible - cut down on sugar and all the rest. Lots of Kale and nuts lol.
8.I go to the gym 3-4 times a week, and get at least 30min exercise every day (I get off the Tube 2 stops early in the morning, and walk the last 20-30min, for example).
9. Headspace app meditation for 15-20min every morning (though I often have to do this on the commute, so it is not ideal!)
10. Lots of hugs from my wife and 7 year old.

I try to focus on each day as its own entity, and try to make sure there is something positive each day - even if it is just reading a bedtime story with my son, or going to the gym and getting exercise so I am healthier and (hopefully) will be around for longer for him.

I try to keep busy (easy when you have a hectic job and a small child!) and am trying to get better at not wasting hours worrying about how I am feeling, and about medication and anxiety and all the rest. This last is the hardest, and I think will take the longest to deal with. But CBT and ACT etc will hopefully help with that.

Am planning to stay on this dose for 10-14 days and then, if there have been no issues, go down in smaller pieces for a few days and then stop. So hopefully by Xmas should be med free.

[anxiousjomo]

Day 2 of 3.75mg

Well, scrap everything I was rambling about yesterday. Last night was back to the insomnia as per usual - maybe 3hrs sleep in total. Feeling pretty rubbish today. For some stupid reason tried taking melatonin at about 1am, but that did nothing. I know you need to take it when you first go to bed or not at all, so no idea why I did that.
Had some anxiety in the night and this morning. Unpleasant but not bad enough to need any benzos or anything. Got some Diazapam in my work bag with me in the office, more as a security blanket than anything else.

Will try taking melatonin and the med together tonight and, if that does not work, either a zopiclone or a lorazepam.

It is hard to know how much of the insomnia is me (I was struggling with it before going on the meds - it was the main reason I tried Mirt!) and how much my response to the med/withdrawal from the med. I guess the only way I will know is by coming off it. But as I have had insomnia the entire time I have been on it (save for about a month at the start when I slept "normally" - i.e. about 6hrs a night).

But it really is the insomnia that kills me - I can cope with the depression and the anxiety when I get sleep, but as soon as I go for a night or two with no sleep, everything just gets infinitely more difficult.

Oh well. Just have to keep working today, and make it to the evening.

[Yvonne]

Hi Jomo

I did say I wasn't going to come on the forum again but since coming off the Mirtazepine just had to check in to see how you're doing and in an effort to see how others have coped with coming off it.

I came off it quickly as you know.. within a month. 45 to 37 in a week, then following week 15mg for two weeks. Took my last dosage two weeks ago. It was hard during the four week period when I was tapering down, high anxiety and worse depression. It was to be expected of course. I am not sleeping at all well at night and keep waking .. sometimes hourly. I am taking clonazepam when I go to bed at night to help me sleep. In general feel very weak and lethargic and very sleepy most of the time and it isn't nice. I did speak to gp last week and he offered to put me back on 15mg but I said I would rather weather the storm as it were. He said I will probably feel like this for three weeks.. eek! I feel so tired but can't sleep when I go to bed.. makes no sense does it.

I'm glad I came off it but as I say it isn't easy. I know I came off it very quickly but that was psychiatrist's advice.

Very interested in all the supplements you're using and going to the gym and walking and meditating is all good stuff. You are very motivated which is fantastic. I am meditating and walking the dog early in the morning.

You seem to be doing well JoMo.. keep up the good work and the positive attitude. You will get there. :)

[anxiousjomo]

Day 4 of 3.75mg

Yvonne - great to hear from you. Sorry you are having a rough time, but glad to see you are keeping such a positive attitude! It is so weird not being able to sleep when you are that tired - such an odd, counter-productive behaviour of our bodies and brains! Hopefully things will improve for you over the next few weeks. Good to hear you are walking the dog - exercise really is key, I think. Glad that both of us will be able to start the new year hopefully in a better, less medicated, space.

I had a rubbish night last night - not much sleep, and feeling a little anxious and tired today. Just trying to remember "this too shall pass" and not fixate on it. But I guess this is now the time when my blood plasma level has got to the lower dose, so it is to be expected that this would be a rough couple of days.

As for the supplements - the only really noticeable thing is the magnesium - if I don't take it I get restless legs, and sleep worse. I have experimented and there is a clear correlation.

Melatonin really does help with the sleep - on the nights I take it I sleep much better, but I dont want to get reliant on it/build up a tolerance so try not to do it too much. I would suggest trying it - you cant get it over here except on prescription if you are over 55. Otherwise you can order from overseas, or get friends to bring it over for you. Lower dose is better - 1mg or so. But I really do find it works, and there are not really any issues using it, as your brain makes it anyway. However, I do find it interesting that melatonin is made from seratonin by our brains, which means if your seratonin is low (which it may well be for many of us with depression/anxiety) it makes sense that you may also be low on melatonin.

I also think the omega 3 helps - but you have to spend more to get ones with a decent quality (Minami Nutrition are the ones I use - I did some research and these have been independently verified to be of good quality).

I am looking forward to being off in the next couple of weeks and starting 2019 med free.

Best of luck to you, and to anyone reading this.

[anxiousjomo]

Day 5 of 3.75mg

Slept ok - took 1mg melatonin before bed. Woke a few times, particularly at about 5am, with some anxiety, but managed to control it with deep breathing etc and go back to sleep. Mood ok. A bit jittery today, but it is Monday and I am at work, so that is to be expected! Upset stomach this morning, but that is pretty usual for me, so think it is not really anything to do with the meds. Still feels like I have a pretty permanent mild headache, and my limbs feel a little weak, but this could just be from tiredness etc.

Trying to keep positive, productive and busy.

[pulisa]

Good for you, jomo. You have a wonderful attitude to what must be a very challenging time for you. Keep going and look after yourself. I'm sure many people will gain inspiration and strength from reading through your thread. Meds aren't for everyone.

[anxiousjomo]

Pulisa - thanks for your kind words. It is harder some days than others to stay positive, but as long as I remember that today does not determine how I feel tomorrow, then on the bad days I just have to get to the evening. If I keep busy, and exercise etc, then getting through one day is not so hard. The fight is to keep away those thoughts that "you are broken forever, every day is going to be a horrible struggle" etc.

It is also much easier for me than many of you on here. My anxiety and depression are nowhere near as severe as they are for many of you, and even on the worst days I can still (just) function and (just) make it through a day at the office etc.

But I am continually amazed at how much exercise helps. I felt pretty rubbish this morning, but just did a high intensity workout class at the gym and feel a million times better now. That and cutting out processed, sugar-filled, unhealthy food, has made the most difference to my mood I think.

[pulisa]

It's such a bonus when you find natural remedies can help you in a way that meds don't and so much better for you in the long run. This must really boost your mood and make you feel that you have some degree of control over your symptoms and condition.

It's no mean feat to continue working throughout the worst of it all. You should give yourself credit for having the courage to go into work despite feeling really vulnerable and fragile.

[Yvonne]

Hi JoMo

Well I think you're doing really well. I may think about getting some melatonin from gp. I used to take Omega 3 regularly and then stopped so I think I should start taking that again. You have done so much to help yourself with this withdrawal and as I said you are doing marvellously. Well done for doing the high impact workout .. this is also great because when you feel a bit sluggish and aren't sleeping well the last thing you want to do is exercise. I must try it ! :)

I see you've been reading Claire Weekes LOL "this too will pass" .. such wise words, so much good advice in her books. She of course suffered herself. The thoughts are little demons and these are what keep us ill in my opinion. Have you read any Eckhardt Tolle? If not, have a look at his books. Or, better still you can get all his wonderful talks on You Tube.. He really knows this illness inside and out and his advice and beliefs are so spot on. He suffered himself many years ago. He talks a lot about living in the moment.. doesn't like the word Mindfullness.

Re: the stomach upset you had, I had some bad stomach upsets when weaning down but they cleared up pretty quickly. I had a lot of muscle aches but they also didn't last too long. It's the sleeping that's the main problem. It will get better I'm sure.

You mentioned that you have cut down on sugar... this is what I intend to do. I am literally addicted to sugar and crave cake and chocolate. I know how bad it is for us in general and I'm going to make a major effort to cut it right down.

Keep up the good work... you will get there :)

[anxiousjomo]

Thanks so much to both of you, very helpful to hear such kind words.

I am certainly trying to keep the mindset "sod this bloomin' anxiety and depression" and not letting it win. I am not a fan of exercise, nor do I enjoy the gym, so I always have a little fight with myself before I go, but feel so much better afterwards.

Omega 3 is a really good idea - I am not a big believer in vitamin supplements generally, but a good quality fish oil supplement does make a difference. After all, we evolved originally on a coastal diet, and dont get anything like enough fish and seafood anymore.

Magnesium is also a really good idea for sleep and anxiety - but you need a decent sized dose - 3-400mg.

I have had IBS for years, so the stomach thing is quite probably that. Either way, I am just letting it do its thing.

And, yes Weekes is my anchor through all of this. That and meditation every morning.

I will check out Eckhardt Tolle - thanks for the recommendation. My brother was ordained as a zen monk a few years ago, so he always has lots of helpful suggestions for me along those lines.

But re food - the more I think about it/read about it, the more it makes sense. Obviously what we are ingesting makes a huge difference to every aspect of our body, and our mental health is a part of that. Cutting down on sugar (I am not a believer in cutting it out totally - a nice cake can do wonders for brain too!) does make a difference, I think. That and trying to eat more healthily in general - more fruit and veg, less processed carbs, more fish and lean meant etc.

Anyway. Yvonne, I think you are doing amazingly too - that is a seriously fast withdrawal from the meds, and it must be very tough. I would recommend talking to your GP about melatonin - it helps a lot of people to sleep and, as it is just a hormone your body makes anyway, there is not really an issue with side-effects or long term use.

Good luck to you, and I hope you get some sleep soon.

Oh and, diary entry for today -
Day 6 of 3.75mg

All fine - slept relatively ok with no melatonin or anything else - was fast asleep when my alarm went off this morning, so a bit groggy but ok. Mood fine. Some slight dizziness etc, but nothing major.

[anxiousjomo]

Day 7 of 3.75mg

Been feeling pretty good the last couple of days. Slept well last night, and feeling in a decent mood today. No noticeable withdrawal issues, save perhaps some itchiness that could be mirt related, and mild headaches (but they could just be tiredness/stress). Also still some oddities with my stomach, but as I have said before I have had IBS for years so it may well be related to that.

No melatonin for 2 nights now, and no issues with sleep.

Maybe a bit of weight gain over the last week or so, but that is not something I am too worried about.

Will probably start slowing walking down to 0mg now over the next 10 days or so. I have been keeping the smaller 1/4s from the last few days separately (as my cutting is not remotely accurate!) so will move on to those from tomorrow.

[anxiousjomo]

Day 8 of 3.75mg

As if to give me a little check on my hubris - last night was not so great. Woke at about 4am feeling quite anxious, chest tight etc. But managed to calm down enough to rest using deep breathing/meditation/CBT. Don't think I slept again but managed to stop it escalating.

So this morning I am feeling a little off - I can feel my mind wants to run down its old, well-trodden, anxious, worrying paths, so am trying to keep busy and mindful etc so that it doesn't.

Am a bit dizzy, tired etc, and stomach has been pretty upset all morning, though seems to be calming down a bit now.

In light of this, and in light of the fact I am not in any real rush, I will hold off on starting to walk down to zero until after the weekend.

Had a work event last night where I had to make small talk with lots of clients and accountants. I hate those sorts of things, and did notice the odd attempted rush of anxiety during it, but managed to take deep breaths and try and focus on the conversation rather than withdrawing into myself. Still not exactly pleasant, but I survived. so am pleased about that.

[anxiousjomo]

Day 9 of 3.75 and day 1 of about 2.5mg or so

Friday was fine - no issues - slept relatively ok with no melatonin or anything else.

Saturday: after going down to my smaller quarters last night - so likely around 2.5-3mg - slept ok but some anxiety and nausea today. All bearable, but not exactly pleasant. Tired all day as well, and headaches from time to time. Will be having these smaller quarters for the next few days, then go smaller and smaller until getting to 0 by next weekend I think, but will play it by ear and slow down if feel I need to. Have to keep reminding myself that these feelings are all due to coming off the meds, and not to worry. Plus it has now been a good 4-5 weeks of being on a lower than 15mg dose, and nothing horrific has happened.

[anxiousjomo]

Day 2 of about 2mg

Rough night - not much sleep and feeling quite anxious today. May take a lorezepam tonight just to help get a good nights sleep, as it has been nearly 4 weeks since I took one.

[anxiousjomo]

Day 3 of about 2mg (or less - am slowly making them smaller and smaller).

Proud of myself because I managed to get a decent 6hrs sleep with just 1mg of Melatonin, and no benzo or sleeping pill. Feeling fine today - still getting weakness sensation in my arms and legs, some dizziness and mild headache, but otherwise ok. Mild anxiety but nothing too bad at present.

[anxiousjomo]

Day 4 of about 2mg

Tired today, and feeling quite down. I took melatonin again last night, so got some sleep, but am having to fight hard not to let my thoughts go down the usual depressed routes. And then, of course, I have some anxiety about the fact that I am feeling depressed etc. The day ahead at work seems very long.

Apart from that, a mild headache/tight feeling in my skull, and some mild anxiety, I am ok.

[pulisa]

It's very tiring fighting these feelings and mornings are daunting when the working day yawns ahead..

I hope the day got better for you. You are ok and coping and that is the main thing. Take things slowly and steadily. You know you are doing really well despite the tiredness-induced doubts.

[anxiousjomo]

Thanks Pulisa - that is very kind of you. The mornings are always the toughest, particularly when they are dark and cold and a long work day beckons!

Feeling a bit better now, and have my book club after work, so am looking forward to that.

Also looking forward to getting to 0mg this weekend! Then, hopefully, if I get to the new year without any horrible withdrawal kicking in, I can start 2019 with the aim of ending that year in a better mental space than I ended this!

[pulisa]

Just take it a day at a time and don't put any additional pressure on yourself though. What matters is overall progress and working towards consistently feeling better mentally. Christmas and New Year can be tough going for anybody. let alone someone withdrawing from powerful meds.

[anxiousjomo]

Thanks Pulisa, you are completely right.

Last night I probably took about 1mg or so of Mirt. Fell asleep fine, but then my son woke me up at 1.33am because he had had a bad dream and could not find his water bottle...after 15min of searching for it upstairs and downstairs, he found it in the bed right next to him! Apparently it was "camouflaged"...sigh..
So of course he fell right back asleep, and I spent the rest of the night unable to do so, with growing anxiety and general unpleasantness. Then up at 6.50am to get him ready for school, and to head to work.

Don't know if the insomnia was from the meds, or from my brain saying "uh oh - now you are not going to get back to sleep you know!" as soon as I lay down. Probably a bit of both.

Either way, I feel pretty awful today. Exhausted, obviously, and a little anxious and depressed. I know I just have to grit my teeth and fight my way to the evening. Will make sure I go to the gym too, to try and burn off some of the adrenaline/cortisol etc.

Then I have planned for tonight: (1) a long, hot, Epsom salts bath; (2) a meditation session; (3) some chamomile tea; (4) melatonin; and (5) bed.

If I can't sleep again, I will take either a zopiclone or 1mg ativan (as it has been about 4 weeks since I took one, so can safely do so). I find zopi does not work so well if the insomnia is anxiety based, so will just try and see how I am feeling.

If my son wakes up again, it is my wife's turn to deal with him!

Going to do some research on 5-htp too, just to see if I do want to start taking it and, if so, whether I should do it for short period with gaps or longer etc. It certainly makes sense to me that (what with serotonin being made from 5-htp, and melatonin being made from serotonin), it could be something that helps.

Am intending to try:

1. 5-htp
2. L-Theanine
3. Insitol

Will wait until I am off the Mirt before trying any of them, and try and do one at a time for a week or two to watch for the effect.

[pulisa]

My guess is that your brain produced those thoughts of not being able to get back to sleep again...and then you tried too hard so a self-fulfilling prophecy? You've had so long of not taking sleep for granted..It's hard to accept that you will be able to sleep naturally again but you will..

I think you will be able to come off the mirt and stay off. By all means research alternative stuff but you could well be stable without anything.

[anxiousjomo]

Thanks Pulisa - you are hopefully right.

Still on 1mg or so of Mirt. Last night was rough. Had relaxing bath, meditation etc, lemon balm, insitol and even some melatonin, but could not sleep. Anxiety grew. ended up taking a 3.75mg zopiclone at about 12.30pm. Still seemed to take an hour to fall asleep - and struggled not to get worked up about all these things not working and the insomnia being brutal and lasting forever etc etc

Then woken about 6.30am by my son.
Feel tired, groggy and anxious today. Not sure if this is withdrawal or just the same underlying problems that have been there throughout. I have had insomnia off Mirt, and on it after all.
Have to try and survive today and tonight (have work xmas party this evening which is the last thing I feel like doing). Then Friday night if I still feel awful I will take a lorezepam.

Trying hard not to catastrophise, but my mood is very low today, and the ongoing issues with my mental health are frightening me. Hard not to think I am permanently broken.

[pulisa]

I think you're trying too hard. You're not permanently broken-just suffering from sleep deprivation and your desire to find a solution is exhausting you and is all-consuming.

Why not take a break from documenting your sleep patterns because this can be counter productive and keeps the focus on insomnia?

[anxiousjomo]

Pulisa,

Thanks - you are right, I know. I seem to spend all of my time thinking and worrying about my mental health. When I have had some sleep and feel ok, it is not such an issue, but days like today when I am exhausted and stressed and anxious, it is hard not to fixate on it, and fixate on the anxious sensations within me.

All this monitoring of how i feel, and worrying about this withdrawal process and all the rest is totally counterproductive. I guess it comes from that idea that somehow, if I just research enough, or think enough about what is going on with me, I will find some magic solution that will make everything alright. But the only real magic solution would be to relax, stop thinking about it, and let it be.

I know too that the work xmas party, and my end of year appraisal tomorrow (with 3 partners!) is not exactly helping with my anxiety/stress levels either! If I get through these two days, we have a Hannukah party at our house on Saturday with about 24 people, all of whom I love very much, so am going to look forward to that. Plus Friday night my son is sleeping at his granny's house, so I will get a lie in!

Must just try and keep positive and keep on truckin on.

[pulisa]

Look forward to your party once you've got tonight and tomorrow over (no mean feat) and try to "let it be"? You will never be able to do enough "research"-the answer lies in acceptance and as quiet a mind as possible, certainly at night. Ditch your night time "regime" at the weekend and see what happens? Hopefully the party will be a truly enjoyable occasion with people you love. No reason why it shouldn't be and a break from all the torment is long overdue!

I think you've done incredibly well to keep going at work. Have you actually told them about what's been going on? Somehow I doubt it. It's a very difficult situation to be in but you should be proud of yourself for carrying on regardless.

[anxiousjomo]

So apparently 2 glasses of red wine + 1mg melatonin = good long sleep and feeling very chipper today...Either that or the Insitol is helping, which is the only other variant.

Only two more days of tiny bits of pill and then I will be med free.

Xmas party last night was fine, and I enjoyed myself, with no anxiety or other issues.

You are totally right that I just need to let it be. Whatever happens, happens. It is such a waste of my life to spend so much of it worrying about this stuff.

I have not told work - though I have told a couple of my closer colleagues. And my secretary has struggled with insomnia for years, so we chat about that sometimes. But I would never tell my bosses - too much chance of it being seen as a "weakness". Even though actually doing a good job at work while dealing with all this rubbish is indicative of strength, as far as I am concerned. I think you guys on here fighting on with way worse mental health issues than me are some of the strongest people I have come across.

Anyway. My review is in a couple of ours, then I will have a nice fun weekend, and start next week med free.

Good luck and best wishes to all of you.

---------- Post added at 11:36 ---------- Previous post was at 11:10 ----------

Oh and Pulisa - I just wanted to say thanks again to you for taking the time to comment. I really appreciate it.

My plan is to post less frequently in this thread now I have pretty much got to 0 on the med. I will do some updates just to detail how things are going, and if anything interesting occurs. My aim with this thread has always been to provide help for people in the future, as I found such diaries very useful. Hopefully, if all goes well coming off the meds, it will be good to have a positive account to show that withdrawal does not always have to be a nightmare!

[pulisa]

I hope the review went well and I just wanted to wish you well for the coming weeks, jomo.

This thread is inspirational and will be a great help to many, I'm sure. You have done so well to keep going and to withdraw completely from the mirt whilst carrying on working as normal despite all the setbacks and symptoms. I look forward to your updates as and when and I wish you a really happy time at your party tomorrow!

All the very best!

[anxiousjomo]

Thanks Pulisa - Review went well - said I was one of the "star" associates, and had had an excellent year! Just goes to show that what we feel like inside, and how much we feel we are struggling, does not necessarily correlate to how we appear to others, and how productive we are actually being. When I was feeling particularly anxious I was worrying that I was not doing my work properly, that I would get a bad review and get fired etc, so this was a good reminder not to listen to such thoughts!

[pulisa]

That's fantastic news and maybe the best news you could have to set you up for the coming weeks?!! Despite everything you are a "star" employee! Remember that if you think you are "broken"? You're anything BUT "broken" to others but just put a lot of pressure on yourself..

Onwards and upwards, Jomo!

[chrismex89]

Hello anxiousjomo I followed your diary and it is admirable, two questions: if I take another antidepressant (escitalopram) and use 7.5mg of mirtazapine to sleep, it will be difficult to leave the mirtazapine when the psychiatrist indicates it? What have you been told is the cause of your insomnia, is it anxiety? One last question, do you do CBT, how did you do with that?Greetings.

[anxiousjomo]

Hi Chris, thanks.

I don't think it will be difficult to come of 7.5mg Mirt when used in conjunction with another med, particularly if that med has had time to come to full effectiveness. I also think it is a good idea to use them both this way - I know a number of other people do similar things. However, I would not recommend just stopping taking it cold turkey, but come down tapering as slowly as you feel able to do. I would expect that you could go to 3.7mg for a couple of weeks and then maybe a week or two on an even smaller dose before stopping. You could be absolutely fine just stopping 7.5mg, but I believe with medication that messes around with the chemical make-up of our brains, it is better to be safe than sorry!

My insomnia is anxiety based I think, though I also reacted badly to the Mirt which made it worse. I never realised it but apparently I have had insomnia since I was a child, as it always took me a few hours to fall asleep - which I always assumed was the same for everyone! Right now I am finding a low dose of melatonin (about 1-1.5mg) helps a lot to get me asleep but last night, for example, (and I think because I took a tiny bit of Mirt (about .5mg) I woke at 3am quite anxious. I had promised myself if this happened I would take 1mg lorezepam to get a good sleep, as I had not taken one for over a month. So I did, and I slept, and I feel ok today.

CBT (and ACT) are excellent, and I do try to do them, but nowhere near as much as I need to. I think you really have to work at it daily to re-train the brain, and I think I have been going at it a bit too half-heartedly.

So my big plan for 2019 is to work properly on my mindfulness, meditation and CBT/ACT practice, as well as continuing to go to the gym 3-4 times a week (which is a HUGE help)., and eating more healthily. I have also joined a book group, and am making more of an effort to see old friends for lunch and other things, rather than allowing myself to remain isolated and withdrawn.

Hopefully all that will help.

[chrismex89]

Thanks anxiousjomo for your advice, my psychiatrist says that the mirtazapine is only to regain confidence in sleep and if at the time I seek to reduce the dose slowly until suspended.
Seeing that you can achieve sleep in a natural way gives me confidence, would you be open to return to the medication if necessary or never again? Thank you

[anxiousjomo]

Day 1 of 0mg

So last night was my first night without any Mirt and, whether due to this, or for psychosomatic reasons, I had a rough night of only a couple of hours sleep. I think I finally fell asleep about 4 something, and then was woken up at 6.50am by the alarm. I had some diarrhea in the night, but my mood was pretty ok (aside from being very very bored! Nights are so long when you can't sleep...) and I was not worrying or getting anxious.

So I am feeling pretty rubbish today because of the lack of sleep - very tired, headache, upset stomach, dizzy etc. Anxiety and general mood are not too bad, but am a little on edge.
This is totally to be expected, and I am not worrying about it. I will probably take a 3.75mg Zopiclone tonight (it has been about 5 days since the last one, so should not be a problem) to try and help my body adjust. My plan remains that I will just keep going until January, taking the odd zopi or lorazepam if needed, and then re-assess how I am doing then.

Chris - I would not go back on Mirt, mainly because it never really did anything for me. It only very briefly helped with sleep, and did not have much impact on either my anxiety or depression. But had it worked for me, I would have happily stayed on it forever.

Oh - and for anyone reading this who is vaguely interested in how the party went this weekend - it was good! But I struggled a bit for the first hour or two as so many people crammed into our flat (and lots of small children) was a bit overwhelming. But once I had warmed up, I had a lovely time (and 2 glasses of red wine, which also helped)....But was great to see lots of friends and have a positive, fun time with them all.

- update at 3pm - increasing nausea as the day went on, as well as some increased anxiety/worry. Impossible to tell what is from the med and what is from the lack of sleep, but I will take a zopiclone tonight and see how tomorrow feels.

[pulisa]

Am very glad that the party was such a success! Getting a brief respite is worth its weight in gold!

Lack of sleep and overwhelming fatigue can play havoc with our wellbeing, both mental and physical. I hope the zopiclone does the trick tonight, jomo. You are still on course-tomorrow is another day.

[chrismex89]

Have you tried meditation and self-hypnosis to sleep, melatonin or is it very soft?

[anxiousjomo]

Day 2 of 0mg

Took 3.75mg zopi at about 9.45pm and slept from about 10.30 to 6.45am...so happy about that! Mood and physical symptoms ok today - a little groggy and anxious but nothing too bad. Mild nausea, but better than yesterday. Though the nausea has got worse as the day went on. Struggling a bit to stop thinking and worrying about how I am feeling today, but was like that before and on the med so know it is just me!

Chris - I do do meditation in the mornings, and use deep breathing and things like that to help stay calm and help sleep. Sometimes it works, but sometimes not. One of the reasons I want to get off the Mirt is so that I know that any insomnia is just me, rather than being related to any medication. Then I can try all those techniques. I do all of the basics - no caffeine after lunch, exercise, no screens for at least an hour before bed, no naps etc - but often it does not seem to make that much difference. I know that it is really just as simple as the fact I get anxious about not sleeping, so my body sees "not sleeping" as a threat I need to be protected from, so tries to help by releasing adrenaline to keep me awake and ready to fight. I am trying to view this behavior of my body with compassion rather than irritation ;-)

Melatonin (a low dose - about 1.5mg) helps often and is a gentle and more "natural" way to help. But as with all such things, I think it is important to try and do without.

update 7pm - been struggling a bit this afternoon evening - quite low/depressed and worrying. Hopefully I will get some rest tonight and feel a bit better tomorrow.

[anxiousjomo]

Day 3 of 0mg,

Last night was scary. I felt increasingly depressed and anxious as the evening went on and then, about 30min after I had got into bed (and therefore about an hour after I would have usually taken the Mirt) I started uncontrollably shaking/convulsing. Cold sweats. Suicidally depressed. Frightened. I have never had anything like that before.
Took 1mg Ativan and then half of a 3.75mg zopiclone and eventually calmed down and fell asleep around midnight. Woke about 5.30am with some anxiety and depression but not too bad.
Worried because I took an ativan on Friday night and now Tuesday night, and a zopi on Monday night and tuesday night, so am not sticking to my rule of keeping them well spaced out. But I also know if that happens again tonight I wont have any choice but to take at least the ativan. But I need to find a way to cope without those drugs as they are a recipe for disaster.

I guess this is part of the withdrawal process - it has now been 4 days since my last bit of Mirtazapine, so I guess it is pretty much all out of my system now.
I just have to try and get through the day and make myself not worry about all this too much. If I have to take another ativan tonight it is not going to make me an addict, nor is it going to mess up my brain.

Just hard not to feel scared. Particularly with the force of the suicidal feeling - that is very unusual for me. But I would myself wondering at what age it would be safe for me to kill myself without it damaging my son too much and things like that. But, of course, the real answer is "never". Even if he was 21 it would still hurt him, and I never ever want to do anything to hurt him.

Anyway. Need to stop thinking about all this. Today is another day and tonight is another night. I will go to the gym and try to be productive and try to stop myself worrying.

Wish me luck.

[pulisa]

These are just thoughts, jomo. However, you should speak to your psychiatrist if you are feeling completely overwhelmed and unable to function. It may be an idea to speak to him/her anyway for advice? This episode could just be a one-off anyway. I know you don't want to go back on meds.

It must be a scary situation but you are doing the right thing by trying to carry on regardless and keeping to your healthy routines. Being frightened is a natural reaction but it makes the feelings more heightened and significant. Just remind yourself that you are safe and that any troubling thoughts you have are just thoughts and you are not going to act on them. You have your family and friends to support you. This is just a horrible episode in your life but you are learning from the experience and as you say, today has to be got through but tomorrow is another day. Hopefully you will soon be able to take a break from work and all the commitments? Remember you are a star employee despite everything!

[anxiousjomo]

Thanks Pulisa - they are, as you say, just thoughts. I am feeling a little better today, but can feel my brain wanting to go down the anxious/depressed route, so am fighting it and trying to stay busy.

Unfortunately the psychiatrist I saw on the NHS was not very good - he barely listened, told me to come off the Mirt, and suggested a very dodgy snake-oil looking website to get supplements (BrainMD). Then he did not update my GP, nor did he make any arrangements for a follow up session.

I think in the New Year I may just have to save up some money and go private.

I know this is all part of the process, and my brain is obviously going to be all over the place (whether actually from withdrawal, or from my anticipation/expectation of withdrawal). It is just hard when you are in the middle of it all. I promised myself I would wait until the New Year before re-assessing where I am, so I have just got to keep fighting on until then, and hopefully things will calm down a bit over the next few weeks. I saw the DR this morning and she thinks I had a panic attack. I don't think I have ever really had one properly before - at least not like that - so she may be right. Uncontrollable shaking, tight chest, cold sweats etc, so all sound like the symptoms of a panic attack. Next time I just have to not let the symptoms scare me and breathe through it.

I may try a low dose (50mg) of 5htp this weekend, as a number of people (including that psychiatrist - little though I trust him!) suggested it is a good idea.

Thanks for your kind words and your support.

[pulisa]

I'm sorry the psychiatrist you saw was pretty poor and disinterested. You would probably get more time with a private psychologist if you wanted to stay meds-free.
I've had 2 hospitalisations so I understand how terrifying all this is.

You have the 5htp as an option-see how you feel when the weekend is here?

Wishing you all the very best for the coming few days. If you have another panic attack it won't be so terrifying. You are safe and these are just intense feelings. It won't always be like this.

[chrismex89]

I agree with Pulisa you must take your follow-up with your psychiatrist and if it can be private it is better, the supplements can be a good option, and do not stop working with the CBT

[anxiousjomo]

Day 4 of 0mg

Thanks both, and I agree.

I managed to get about 5hrs sleep or so last night, and also managed to stay relatively calm and relaxed. No bad anxiety. But I would say it seems like the melatonin is not really working anymore - it took me a good 3hrs or so to fall asleep. Maybe I should take a break from it anyway, particularly if I am going to try 5-htp.

This morning, however, I woke about 6am quite anxious and am feeling low, very very tired and dizzy, and with tight chest, jitters etc. The dizziness/grogginess is particularly noticeable. It is going to be a hard fight today not to let myself slip into depression or obsessive worry and all the rest. Struggling, but know I will get through.

It is so frustrating to be so tired, yet unable to rest. That is one of the hardest things for me about anxiety - I wish I could just lie in a bit and sleep, or have a restful day lazing around the house, but the anxiety just makes me need to keep moving...

[pulisa]

I'm like that and my daughter is too. Meds just make this worse for me.

For what my opinion is worth I think you are doing the right thing by pressing on regardless and trying not to worry about how much you do or don't sleep The physical symptoms are more pronounced when you are low on sleep but they won't harm you. It's "just" a question of being able to rise above them which is a tall order, I know.

I hope things got a bit more tolerable after you got to work.

[anxiousjomo]

Thanks Pulisa

Unfortunately I am really struggling today. Very anxious and depressed. Shaking and all the rest. Really trying hard to fight the negative thinking. My chest is very tight. My legs feel very weak. Trying not to feel frightened.

What is hard, and I think I have said this before, is I never had any of this before I tried to go on Prozac and then Citalopram and had the horrible anxiety side effects. It is like that experience triggered something in me and I can't turn it off.

I wonder too if I might be feeling worse due to the benzo/zopiclone use 30 odd hours ago. Maybe a bit of an after effect from those drugs. I don't know. Or it is withdrawal. Or just me.

Anyway. I have no choice but to keep trying to fight on through today.

[chrismex89]

I think you need a private psychiatrist as soon as possible, I know that several medications have not worked for you but you have to see some yes, one question: if I take escitalopram 10mg and 7.5mg of mirtazapine just to sleep, you think it will be hard for me to leave the mirtazapine if I reduce it gradually?

---------- Post added at 10:26 ---------- Previous post was at 10:25 ----------

I saw that you had already answered my question, sorry and encouragement, there must be medicines that work for you

[anxiousjomo]

Thanks Chris. I have an appointment with a counselor/therapist next thursday at 8.30am before work, so will see how that goes. Also have a private psychiatrist I liked the look of that I can try if things are still rough in January.

I looked back on my diary from when I was on citalopram and coming off it, and I have to remember that in many ways that was worse than this. I was regularly having mild panic attacks, regularly barely sleeping etc. The last few days have been tough, but I have faced worse and dealt with it. I just have to ride it out and help my body and brain get back in a better place. I also need to try not to take the benzos or zopiclone, as they are short term solutions that, I think, make the whole experience worse in the longer term. I am convinced I feel worse a day or so after taking one.

I will keep updating this diary for at least a few more days, as I think this is all part of the Mirtazapine journey, but at a certain point it will just be me and my issues, so does not belong on this thread. I guess I will see where I am next week.

[chrismex89]

And your CBT therapist who thinks what you're going to be without medicine? Have supplements helped you like 5htp? I do not think you can become resistant to melatonin since it is a natural neurotransmitter but it may be very soft

[anxiousjomo]

Day 5 of 0mg

Feeling a little better today. Slept maybe 5-6hrs with no melatonin or anything. Fighting a cold and feeling run down but not too bad otherwise. Still having nausea - and actually threw up a little in my mouth at about 4am for some reason (may have been a dodgy chicken sandwich I had at the theater last night rather than withdrawal) - but it is manageable.

I was thinking last night about ways to re-frame all this. I think the best is as follows:

1. This is not something I need to "cure" or "fix". I am not broken. I do not have cancer or something like that. My body has some sensations, which I then obsess over and worry about and get depressed about. So the issue is not the sensations themselves, but my response to them. “There is nothing either good or bad, but thinking makes it so." - of course, there are limits to this, and there are things in the world that are bad regardless of how one thinks of them, but when it comes to bodily sensations, I think this is a useful mantra to steal from Hamlet.
2. I am learning from all of this to be more compassionate - now, if someone has anxiety or depression issues, I can understand them more due to my experience, and help them more. What if, for example, my son has anxiety or insomnia later in his life? If I had not gone through this experience, I would not be so well placed to help him.
3. Each day is different - I struggled (but again, that is not the right word - "struggling" or "fighting" against all this is precisely the problem) yesterday, but am doing much better today.

So today I may well start to feel anxious or depressed or have other sensations in my body during the day. But that is fine. I do not need to give those sensations energy by worrying and fixating on them. And I need to remember, and believe, all this on bad days.

Hopefully, while I know I will continue to have days that are easier and days that are harder, slowly the former will increase and the latter will decrease.

---------- Post added at 09:58 ---------- Previous post was at 09:53 ----------

Oh and Chris - thanks - I don't see a CBT therapist - I had about 6 sessions on the NHS here but they were not very helpful. I don't see anyone, which is why I have been looking into finding a therapist/counselor. I don't think I need a psychiatrist, as I don't think medication is the way to go for me. I have not tried any supplements yet. I want to see if I can do without as, again, that is taking things to try and "fix" myself, which may be just compounding the problem. I can imagine taking 5-htp then worrying about when I should take a break, then thinking about whether or not it is working or if it will stop working or if I will get side effects etc etc. Best I think to try and just eat better, take some vitamins (I do think a good high dose of magnesium citrate (400mg) at night does help, and then all the B vitamins are key), exercise, meditate and be mindful. Hopefully that will work.
I am lucky in that my condition is nowhere near as bad as it is for many of you, so I think I could hopefully cope with just this. Medication is great, and essential, for many, but I have had such bad luck with it personally, and I think trying different meds has made things worse for me.

[pulisa]

Sometimes you can focus too much on symptoms, feelings, supplements, meds, sleep patterns etc etc etc. Sometimes the simple approach can be the most successful approach. Letting things be and not "struggling" against them, not "fighting" your way through the day, trying not to care so much about how things pan out, anxiety-wise and not feeling obliged to follow a rigid recovery programme..

You might just need to give yourself a break and be compassionate towards yourself, jomo.

[anxiousjomo]

Thanks Pulisa - I agree. What will be will be and there is not really that much I can do about it. I am very tired, and work is boring, so can feel myself slipping a bit emotionally, but know too that that is fine. I am not going to die from feeling a bit anxious and depressed!

I also know that updating this every day is not really the best idea either, but I committed to recording at least the first 7 days off mirt so people can get an idea of how it went, as those kind of things helped me. After that I will try and post less regularly in order to try and spend less time thinking about it all.

[pulisa]

I think keeping a diary on here has its pros and cons but it's probably a good idea to wind things down a bit if you find yourself wanting to document everything and thinking about your situation too much.

I hope your weekend goes well and that you can enjoy some quality time with your young son. He will be better for you than any meds or therapy!

[Belleblue]

Very wise words from Pulisa whose gentle advice to you I am finding a very helpful reminder to myself.

Wishing you the best as you go forward on this journey Jomo. You are an inspiration :)

Take care.

Belle x

[chrismex89]

I totally agree Jomo and it gives me hope to see that it goes well, I will apply the same with me whether it is anxiety or side effects will pass, it is annoying but it is not dangerous, by the way I am a GP Mexican doctor who suffers anxiety, here we do not usually take treatments psychiatric as I see if in the UK, here it is derived more to the psychiatrist

[anxiousjomo]

Day 6 of 0mg

Thanks everyone.

Slept well last night - woke up a bunch of times, but went back to sleep fine. Been feeling ok all day - managed to stay present and engaged and focussed on playing with my son etc. We had a friends xmas party this afternoon with lots of people and quite a few kids. As with the last one I felt a little overwhelmed at first, but warmed up ok as the day went on. I am fighting a rotten cold at present so bunged up and sick, but apart from the odd little bit of nausea I don't think there are any other withdrawal symptoms from the Mirt.

I need to remember days like today as they prove there is nothing medically wrong with me. I just need to let it go...as the song goes.. ;-)

Tomorrow is another day, and I am sure there will be blips along the way, but that is all fine. Feeling more hopeful and positive that I can get back to a more stable emotional state.

Hope all of you have a good weekend, and get the rest and love you need.

J

[pulisa]

Glad today was better, jomo. As you say, just let it go and don't over-analyse. The less you focus on how you feel, the more relaxed and "normal" you will feel. If you have a bad day so be it-we all do but yours may well feel more pronounced at the moment as you recover..It doesn't matter or have any significance though. You are doing very well, just remember that?!

[anxiousjomo]

Day 7 of 0mg

Thanks Pulisa.

Fighting a horrible cold, so feeling very tired and sick, but emotionally ok. A little on edge and blurg but that is probably in part from feeling so rubbish. Some negative thinking and mild anxiety, but am not letting it take over.

Nothing withdrawal related as far as I can tell.

I think I will stop updating this daily now, as I suspect if anything else goes on it will be me rather than the Mirtazapine. However, I am aware of lots of people reporting having withdrawal stuff suddenly kick in 2 weeks or so after stopping, so if anything odd happens in the next couple of weeks, I will note it here.

Thanks to everyone for their support on this Mirtazapine journey! I hope my record of it is helpful to someone in the future. It is still working well for my mum, but sadly did not work for me. I wish all of you the best in your travels with anxiety, and I hope you all find something that helps bring you peace.

[pulisa]

Good luck and let us know how you are getting on periodically if or when you want to?

I'm sure your diary will have helped many people and this thread is a credit to your courage in carrying on and doing your very best to manage your anxiety. Enjoy the holiday period with your little boy and next year will be the start of better times for you.

[chrismex89]

Thanks Jomo your diary has given me confidence, if you start taking supplements let us know how you are doing with them and it shows that you have very worked CBT that is essential, it is a matter of time for you to stabilize

[Magic]

Mirt working for me Jomo. Constipation ugh!!! .....or a toilet attached to my back.
Can't win on that score. I am not being put off yet, sending:hugs:x

[anxiousjomo]

Thanks everyone - your kind words and kind thoughts are much appreciated. 3 good days in a row now, so that gives me hope it is possible for me to get by without meds, but know it is very early days. I am sure I have some insomnia and some tough days coming, but I also am sure I can survive them and not let them beat me.

Magic - I have had IBS and morning diarrhoea for quite a few years now so I was kind of hoping the Mirt would have a positive effect on that, but no such luck! I am sure your digestion system will calm itself down over time - as side effects from antidepressants go, things could be much worse!

:hugs:

[anxiousjomo]

Day 8 of 0mg

Morning!

i was not going to post anything, but thought I would just note this - the last couple of days my heart rate has been weirdly low - my resting BPM is usually about 62 and it has been 57-58 the last couple of days. I also have been feeling a little dizzy and some strange slight pain in my chest.

I am sure it is all perfectly normal - could be related to having a cold, could be something to do with coming off mirt, could just be normal fluctuations, could be I am so bloomin' exhausted after a long and hard year! So I am not particularly worried about it, but just thought I would record it here in case it goes on, or in case it is something to do with the Mirt.

One other withdrawal/mirt related thing to record - For the last 4 nights I have had pretty vivid dreams/nightmares and wake up from them during the night. I manage to go back to sleep after calming myself down, but before I went on Mirt I never used to remember by dreams. Since I have been on it (when I slept anyway!) I seem to remember them more. Interesting, but not something I am concerned about.

Hope you all are well.

[pulisa]

Probably best not to monitor your heart beat. You will just trigger anxiety symptoms.

[anxiousjomo]

:roflmao:

Its ok - you are totally right, but I just really use it for exercise tracking. I have been in a pretty good mood all day, thankfully, and not worried about it at all, just thought it was an interesting possible thing to note - particularly as I think Mirt has been shown to potentially raise heartrate by a couple of bpm on average, so it might make sense for it to drop a bit when you come off.

Anyway...back to work!

[anxiousjomo]

Just a little update - have been doing well, and in a pretty good mood the last few days....Except until last night when i had insomnia and was awake all night. This was likely due to the fact that I was anxious about having my first meeting with a therapist this morning. The actual meeting went well, and I liked him enough to book more sessions in the new year. Interestingly he thinks part of my problem is I have become psychologically addicted to the idea of meds/supplements or whatever as being a way to "fix" me etc. I think he is right in that I find myself thinking "oh, it has been nearly 2 weeks since you had a benzo, that means you can have one again soon etc", which is not healthy. I really should just throw them away, but will give myself a month or so just to get settled into being off the anti-depressants. He also, rightly, pointed out I have a hell of a lot of things in my life that would cause most people stress and anxiety, my issue is just how I process it.

Other than that, not much else to report. Hope all of you are doing ok.

[chrismex89]

Jomo will you look for a private psychiatrist or not anymore? Have you ever had a problem with your job because of anxiety? How did you solve it if yes?

[chrismex89]

Jomo, you should do a thread where you tell us about your med-free experiences, to see what life is like after medication, what other things you use as supplements, relaxation techniques, exercises, etc.

[anxiousjomo]

Day 16 of 0mg

Happy Xmas to you all - hope you are having a lovely holiday season.

All ok (ish!) - I am managing to keep my mood together despite still struggling with insomnia (I had a couple of nights of pretty much no sleep at all over the last week) - but I know these are due to stress and anxiety and worry, rather than anything medical. I know that it will be hard work to try and undo all these bad habits, and the fact that I now get anxious every time I lay down my head, but I have to try. Sleeping pills are a quick fix for these sort of things, but they just paper over the cracks. The only way I can fix my sleep is by CBT/ACT and hard work. I have to retrain my brain to not care about whether or not I fall asleep. I have some chest pain, but also know this is just from stress/anxiety and nothing to worry about, but occasionally that little voice tries to get me to google chest pain, which I am certainly NOT going to do ;-)

I am not taking any supplements yet - partly because I have had enough good days to know that it is possible without them, and I would rather not take anything at all. Currently still just taking fish oil, magnesium and choline/insitol along with a multivitamin. Trying hard not to let myself slip into rumination/worry, and keep positive. I am currently up in the mountains of wales with my son and my parents (my wife stayed in london - she has had bad gastritis and was hospitalised with bleeding etc, which is I am sure one reason for my anxiety/sleep issues - I found my brain running away with "what if she died!!" type thoughts at 2am - silly, but understandable) - last year I found this period difficult (the change of routine, the long days with nothing to do etc) but am doing much better this year by focussing on how joyful my son is about getting to play lego with me for 3hrs....He came into my room at 6.45am yesterday morning, after I had had a rough night, and said "daddy please come and play with me, I love you and want to play with you", which made it hard to keep grumpy/depressed about the morning!

The biggest, most helpful thing to me so far has been this switch in perspective - seeing the unpleasant periods as learning times to make me a better husband/father/person, and remembering (for example) that getting no sleep from time to time because I am stressed/anxious is a million times better/easier than, for example, people kept awake with chronic pain, or those families in Indonesia after the Tsunami etc. I should remember how lucky I am.

Chris - work with anxiety has been tough at times (I am a litigator in a big international law firm, so the job is very high pressure and stressful), but I actually find keeping going and keeping busy during the day helped on the worst days. If I had been hanging around at home, I would not have been able to cope. Some of my colleagues know a bit about my struggles, and it is amazing how many of them have had, or continue to have, similar issues. But I have not told my bosses, as I have a sneaking suspicion it would impact negatively on my career.

As for relaxation techniques - deep breathing, mindfulness/meditation and regular exercise make a noticeable difference.

Anyway, enough computer time, back to the family.

Hope you are all doing well, I know this time of year can be difficult.

Take care
J

[chrismex89]

I'm very happy that Jomo is doing well, have you considered clinical hypnosis for insomnia?

[anxiousjomo]

I have, but not sure if I believe in it, and worry it would be a waste of time and money. I am not sure I think there are any short cuts with all of this. Even if it did work, it could just as easily stop doing so. The only real solution for me is to get to a point when I can genuinely not care about whether or not I sleep.

[pulisa]

You are so right, Jomo.

I do hope your wife is getting better-what a horrible thing to happen at Christmas.

I think you are doing all the right things-taking back control is very empowering and you are not reliant on any therapist or med for progress. It's all your own work so to speak.

Had you heard that "Lego Therapy" is the latest fad? You can understand why!

Wishing you well on Christmas Day and enjoy the rest of your break with your little boy.

[anxiousjomo]

Thanks Pulisa - she is doing a little better now.

Lego Therapy sounds like a great idea! I can completely see the appeal.

Day 17 (or maybe 18, not sure..) of 0mg

Ups and downs today, but nothing I could not manage. A bit shaky this evening, but am just breathing through it and reminding myself it is entirely irrelevant. Don't think anything Mirt related, so hopefully (as it has now been nearly 3 weeks since my last pill) I might be over any withdrawal, but will keep an eye on things for another week or so.

[pulisa]

Don't keep too much of an eye on things though? You're doing just fine.

Enjoy the rest of your break. Any symptoms you get, just accept them for what they are..Irrelevant. Let them happen and don't react to them with fear.

[anxiousjomo]

Day 24 of 0mg

Sadly I had a brutal night of insomnia last night - no sleep at all - and was fighting suicidal ideation from about 3am onwards. Worse than I have ever had it before - just feeling like there is no hope, that I might have the odd few days of feeling ok, but then this awful, endless insomnia and anxiety/depression during the day. That I am never going to get better. Got to the point I was thinking how I would do it etc. Just horrible.

I have had the odd night of decent sleep over the last few weeks (well...much more than that really - I have not slept properly since August), but the majority of nights have been 3-4hrs of sleep if not less. It is really taking its toll. The insomnia is the real thing making my other mental health issues impossible to deal with.

Frightened to try 5-htp. Even if it works, I see all these things saying long term use can decrease dopamine etc and have negative effects on the brain. I have zopiclone, but that is not really a viable option - not only do you not sleep properly on it, but it is not a long term solution. I have Lorezapam but, again, this is not a long term solution, and taking these sorts of things are likely to compound the underlying problem.

I have been really trying not to use any pills, but may take a melatonin tonight just to try and get some sleep. I do all the stuff the books recommend, but nothing seems to work. I just lie there wide awake and going increasingly nuts. It is not uncommon for me to be awake from 10.30 until 4 or 5, if not all the way through the night. I wish just wish I could find some solution for chronic sleep onset insomnia that would mean I could get a more human amount of sleep. I tried Mirt in the first place to deal with this issue, but it did not work.

Going to try and keep going today, and try and keep my mind off the negatives. But so hard not to be frightened of another long night of no sleep. Or if not tonight, then tomorrow....how do I get back to a point where I am not afraid of going to bed? Where I get a decent amount of sleep on a regular basis? I just don't know.

Sorry for the unpleasant ramble on New Year's day, but I just needed to get this out and down somewhere. Not sure if this is related to the Mirt, but it is probably just my underlying issues. I don't know. Just feeling really exhausted and unable to see a way out of this hole.

[Belleblue]

I am so sorry to read that you are in such torment. I am wondering if there is any chance that you could contact your local crisis mental health team? I know that you wont act on your thoughts because of your family, but sometimes that can feel like an added enormous responsibility when we are so down.

I'm no expert but from reading your diary over these last couple of months I am now thinking you may need something to stabilize this rollercoaster of insomnia, anxiety, good mood then back to insomnia and anxiety and worsening depression. Maybe you need to hand this over to a mental health professional who can really help so that you are not constantly trying to figure it all out for yourself, thinking that some supplement can help and then reading that it may cause other things, which only knocks your hope of a non med solution.

Sorry I can't be of more help.

Sending you :bighug1:
All the best.

Belle x

[anxiousjomo]

Thanks Belle. Now I am up and moving, it is not as bad. Managing to keep the bad thoughts at bay, though feeling very shaky. No need for crisis.

It is a rollercoaster, and I would love it to stabilise! As I mentioned somewhere earlier, I saw a psychiatrist on the NHS, but he just told me to come off Mirt and maybe try to supplements. He really did not seem that interested. I wonder if I downplayed things too much to him.

I have also started seeing a counsellor (had my first session about 10 days ago) - only had one session so far, but his view was I did not need a psychiatrist, nor any medication, but needed to work through all the things causing these issues including, as he saw it, a kind of addiction to medication to "fix" things. He said I should not take zopiclone or Lorazepam or any supplements.

My GP just gives me zopiclone and/or Lorazepam and says "dunno".

The books I have read, and the sites I have looked at, tell me either to take XYZ supplements, to not take XYZ supplements, to take medication, to not take medication, to get up if I cant sleep in the night, to stay in bed if I cant sleep in the night etc etc etc.

It is exhausting and I feel completely confused and unable to know what to do.

In an ideal world I would be able to sort myself out and get by without any supplements or medication or anything, but I don't know how realistic that is.

Maybe I say just pay to see a psychiatrist privately. I don't know. But then that would just be another viewpoint likely in contradiction with all the others!

Thanks for your help though, and sending you hugs in return.

Jx

[Belleblue]

Hi Jomo, I realize you are trying everything and yes I remember you writing that you had seen a psychiatrist who told you to come off mirt and maybe try supplements. You may have downplayed things as you said, perhaps because not unreasonably you want whoever is in front of you to know that a large part of who you are is strong, capable and responsible. I know I have done that myself.

I could be wrong, but if you were a friend sitting in front of me I think I would suggest that you see another psychiatrist privately. Yes you will most likely get different advice which will contradict the previous, but there is a chance that he/she could have the insight into your issues which may be more helpful than any given before.

I know you are doing everything you can. Take good care.

Belle x

[pulisa]

Would it be worth considering a Sleep Clinic? Just to assess whether the underlying issue is chronic insomnia or anxiety/depression and which issue is driving which?

---------- Post added at 14:14 ---------- Previous post was at 14:04 ----------

It's so frustrating when every professional has a different opinion and a different suggestion. Mental health is such a grey area and if you saw 5 psychiatrists you would get 5 different outcomes and prescriptions..Knowing what to do for the best would be a lot clearer if you were not so sleep-deprived of course.

[anxiousjomo]

Thanks Belle and Pulisa - feeling a lot better as the day has gone on. We have friends over with their kids for new year lunch, so that is helping. Certainly things feel much more hopeless at 3am on New Year than they do in the light of day...I have to remember that. I am also going to take a melatonin tonight, just because there is nothing wrong in doing so and it will hopefully help.

I have written to the psychiatrist I liked and will make an appointment with him, just to get another opinion, but he may not be able to fit me in until early Feb. I have my second session with the counsellor next tuesday, and an appointment with the GP on Thursday, so will use all of those to help.

I have been thinking about a Sleep Clinic actually, and am going to look into the options and discuss with the GP too. I suspect it is anxiety and that I am fixating all my anxiousness on the insomnia. There are a number of things that I am obviously anxious about, but find that I never seem to think about them, as all my worry is taken up re sleep etc. When I am lying in bed unable to sleep, all I am thinking about is that, rather than work or money or all the other things I am clearly actually also anxious about!

Anyway. I must stop thinking about it and just relax.

Hope you all had a good New Year, and wish you a healthy and happy 2019.

[Belleblue]

I think a sleep clinic is a brilliant idea. So you have three or four options which might help and now you have little rafts to hold on to if things become rough in the wee small hours :) Hold on to hope.

I wish you a happy New Year too and a brighter 2019. Enjoy the rest of your day.

Belle x

[pulisa]

Those little rafts are so important..especially when we think we are losing our oars!

And you're not..

Let us know how you get on at your appointments and all the very best to both you and to Belle.

[anxiousjomo]

Thanks - I got an email from the private psychiatrist, whom I had already given a lot of details of what had been going on with me and, interestingly, he said:
"I think that you might have an excess of glutamate activity in your brain and less GABA (glutamate is excitatory and GABA inhibitory), hence the insomnia, restlessness and anxiety (this is just a theory, which unless we meet and take through I will not be able to confirm or rule out). "

He has also given me a very long questionnaire to fill out. Hopefully can get to see him sooner rather than later.

And thanks to both of you for being rafts as well!

[pulisa]

Will be interesting to see how he assesses you.

I'm also on the agitated end of things and anti depressants have put me in hospital.

He may well offer you an earlier appointment if he's interested in your case.

[chrismex89]

I think it's best that you see a private psychiatrist Jomo and I know you do not believe in it but look online on the effectiveness of clinical hypnosis for insomnia, greetings.

[anxiousjomo]

Thanks both. Slept for 10hrs last night with just 1mg of Melatonin. My body obviously decided it needed to get some bloody rest!

Looks like I may have an appointment on the 16th, so will let you all know what he says.

Best wishes to all
J

[pulisa]

You see...you haven't lost the ability to sleep!! Just let it happen without overthinking too much? Use the melatonin each night if it helps. If it doesn't, so be it.

I hope you get that appointment confirmed as psychologically it will help you to know that you will be able to talk about this at length with a professional.

[anxiousjomo]

Thanks - got it confirmed for 12 Jan, so even sooner, which is good.

No sleep at all last night, but staying positive, and managed not to get worked up into a state again during the night. I have ordered a sleep mask with bluetooth earphones so I can try listening to things (meditation or whatever) when I cant sleep. I think that may help make the long nights a bit more bearable, but will also mean I can stay in bed with my eyes closed resting my body rather than getting up.

Hope you are all well.

Jx

[pulisa]

That's a very good idea. I'm very pleased you have that appointment confirmed. You need some proper help with this and the 12th is certainly better than sometime in Feb.

You did very well to keep calm last night. I hope the day has been manageable.

[chrismex89]

I admire your calm Jomo you are a great example to follow, listening to mindfullness or self hypnosis to sleep is a great idea

[anxiousjomo]

Thanks both. A big help to me with remaining calm has been that I talk to my body when it is getting anxious and say things like: "thank you very much dear for trying to protect me, it is very kind of you, but there is no need. I am perfectly safe" - something about the slightly silly/loving tone seems to help. That and remembering to breathe slowly and to note and re-direct thoughts that are going down the wrong path. It is hard, and I do not always manage it, but I have made it to almost 4 weeks now with no Mirtazapine, Zopiclone or Lorazepam, so am pleased about that.

Re sleep. My new idea is to try operating under the assumption that I am not going to sleep - and to prepare and be ready accordingly - that way I will not be anxious/scared about whether or not I will sleep, because I know I wont. Then if I don't sleep, I am ready for it, and if I do it is a pleasant surprise. We shall see if I am able to do this, and if it works!

[pulisa]

Or just not to be particularly bothered if you sleep or not. Not caring is a great anxiety breaker.

[anxiousjomo]

yeah - that is absolutely the key. Fell asleep about 2.30am last night, so got 5hrs or so, which is not bad. A little on edge today, but ignoring it.

[pulisa]

That's the best thing you can do. It's a minor detail.

[chrismex89]

Jomo Do you use the techniques of Dr. Weekes when you have symptoms?

[anxiousjomo]

yes - I love her work, she has been a real life saver for me! A combination of her and Pema Chodron has helped a lot.

[pulisa]

I do hope your appointment tomorrow is helpful, Jomo. Having a professional opinion will be interesting but he'll probably want to prescribe meds, being a psychiatrist.

[anxiousjomo]

Thanks Pulisa - agreed, and if he does I don't think I will take his advice.

I have been doing fine - still not sleeping great, and still having a few ups and downs, but totally bearable and no panic attacks, serious anxiety issues or depression. No meds at all for nearly 6 weeks now, and no supplements either - just vitamins etc.

It is a full 90 min session, and he has already sent me a bipolar questionnaire and an adult ADHD one too, which I have completed. I certainly do not have the latter, and am highly doubtful I have the former, even in a very mild form. I have never had any "manic" episodes etc for a start.

He may well have his own agenda, and he may well want to prescribe meds, but I think my plan is to keep any such suggestion in my back pocket for emergencies. If I am seriously struggling again, it may be that I consider that option. At the moment I seem to be doing ok, and am hopeful I can stay med free. I think I just want to see it as another data point to take into consideration. Hopefully he wont freak me out with some diagnosis that perpetuates the silly idea I am somehow "broken" and need "fixing"!

Re sleep - the GP is going to look into a sleep clinic or other option for me, but really I know I just have to retrain my brain to sleep, and stop worrying about whether I do or not. The same with my anxiety and depression - I just have to get better at letting it all go and relaxing about it. Then the counselling will help get my self esteem and mind-management techniques better, which will hopefully help with things long term.

Thanks for your continued support and concern - hope all is well with you.

[pulisa]

I completely agree with you.

I think you need to guard against a bipolar/ADHD diagnosis or anything too complex and concentrate on how you are approaching your issues at the moment. Personally I think just letting it all go is the best option if you are able to feel confident about this and I think the more time passes the more you will have faith in your own ability to restore a natural sleep pattern.

You've made fantastic progress. See what the psych "pronounces" and you can make your own mind up about what he has to say?

[anxiousjomo]

Thanks Pulisa.

It went well with the psychiatrist - I liked him - a good 1 1/2 hr session.

The conclusions were that I should keep doing what I am doing and try to get by without meds. I am not bipolar, nor do I have ADHD. However, if I do feel like I need to go back on meds at any point, I should try Pregablin, which accords with what some of you have said on here, and what I was thinking too.

Fundamentally he thinks (again, as did the counsellor) that it all really comes down to very low self esteem and a sense that, because of that, I wont be able to cope with whatever life throws at me etc etc. He also came to the same conclusion that I had been traumatised by the months of crazy side effects from the meds (and had also been traumatised by my physically and emotionally abuse prior relationship). He was very cross with my GP - he said my reaction to the Prozac made very clear I should not be on an SSRI, and making me go through 6 months of trying different doses of Citalopram etc was just an awful and unnecessary thing to put me through....
A lot of it all goes back to my childhood, and all the bullying etc at home and at school, and so hopefully seeing a counsellor to work through that stuff, and working on the meditation and mindfullness etc should help.

So, basically, I have to remember I am doing much better, that I am not fundamentally broken, that I am a decent human being, and good husband and father and can cope with much more than I think I can!

[pulisa]

He sounds great!! So pleased you had such a positive appointment and hopefully this reassurance will help you to carry on with all you are doing so successfully! GPs aren't the experts on prescribing-and they just dole ADs out like sweets..

Thanks so much for updating us. Keep up the really excellent work and well done!

[chrismex89]

Well done Jomo, did the psychiatrist suggest anything to insomnia in particular?

[anxiousjomo]

Thanks both.

Had a rough night of insomnia last night, so am of course now having to fight against my brain wanting to either obsess over whether or not I should start Pregablin, or just generally getting anxious and all the rest of that silliness.

He had no real advice on the insomnia, other than that the Preg would likely help with that. He had had insomnia himself previously, and agreed that the only real long term solution is to get to the point where you don't care if you sleep or not. Which is very very hard to do. Unfortunately there is no magic pill that will fix everything. I certainly feel like if I can solve this sleep problem I will be ok. I just really need some decent rest!

Anyway, enough rambling. Hope you are all well

[anxiousjomo]

Interestingly, by the way, he also told me that GPs follow the NICE guidelines, but that these are put together with issues of cost at the forefront, rather than effectiveness. The reason GP's push CBT and certain medication over others has more to do with the relative cheapness. It is also, apparently, based on a lot of out-of-date information.

He said, in many ways, it is easier when someone clearly has Bipolar disorder or ADHD, as there are proven medicines that can really help. When people have something like GAD mixed with depression, as I do, it is much harder to point at something that will solve it. It is impossible to know without trying things what will work. But he was hopeful I can keep going with my current regime and stay of medication. But, if I can, it is not the end of the world! My plan (if I can do this!) is to keep going and revisit in about 6 months time.

He is doing me a formal report, which he is also sending to my GP, so I will let you know if that says anything that may be of interest to others (e.g. about the operation of Mirtazapine etc). He agreed with me re Mirt that my atypical response to other histamine medication likely explains the unusual effect it had on me.

If anyone in London is interested in seeing him, his name is Jose Belda, and I recommend him wholeheartedly.

[pulisa]

He sounds very competent and refreshingly honest. I will make a note of his contact details-thank you very much for the recommendation.

[anxiousjomo]

Great. All good today, no issues.

Also - I tried a supplement last night - GABA plus from Eurovital - which contains:

• Niacin (as inositol hexanicotinate) 400mg
• Inositol Powder 1200mg
• GABA (gamma amino butyric acid) 200mg


I took it about 40min before bed - felt noticeably calmer and slept for 7hrs! It could be a placebo effect, but I don't think so. I am also not sure if I believe that GABA does anything (due to the blood/brain barrier issue), but I know inositol is highly thought of by many on this site, so I wonder if it was that.
Either way, nice to have another option in the cupboard if I have a run of bad nights.

[Belleblue]

Hi Jomo, so glad you had a positive experience with the psychiatrist and that you know you can use his service if needed in the future.

I agree with his assessment of how things work in the NHS. The spin is that things have improved regarding mental health, but the reality is somewhat different.

Take care.

Belle x

[pulisa]

MY GP agreed that things have not changed at all re mental health.

[anxiousjomo]

yeah - seems like no progress has been made in the last 10 years or so.

Got the report from my psyc - he says I have GAD + depression, with the latter being made worse by stress/insomnia etc. Plus trauma from meds experience and from abusive relationship I was in before I met my wife.

He is going to look into off label ways to boost my GABA and get back to me in a few weeks, otherwise he is happy for me to try Inositol + Melatonin and see how that goes (I took 1250mg Inositol and 1mg Melatonin last night and slept for a good 7hrs or so). If things get worse and I want to try meds, he suggests Pregablin.

Now I just have to work hard to stop thinking about all of this stuff all day, and to learn to let go of the anxious/depressed thoughts and feelings when they come. I am doing fine, and need to give myself a damn break. I am not a bad person, I am not broken, and I will be fine. I just need to get some rest and get better at handling stress/worries.

Best wishes to you all.

[pulisa]

Your psychiatrist is certainly one to be recommended and a refreshing change from all the meds-pushers.

You've had an extended period of high anxiety/insomnia and now you need to calm things down and give your nervous system some time to settle after some inappropriate medication and the subsequent mental upheaval this provoked.

It's great that this is being endorsed and supported by your psych.

[anxiousjomo]

Thanks, and I agree.

Unfortunately the Inositol experiment has failed - I had no sleep last night and, when I took another 1g at about 2am, found it woke me up and increased my adrenaline levels rather than calming things down. So I will stop taking it now. I suspect the good sleep the night before was more the melatonin and exhaustion than anything else...

I emailed the psyc as was feeling pretty rubbish this morning, and his new suggestion is 300mg Gabapentin at night only, which would mean it was less likely to give me daytime issues as its short half life would mean it was pretty much out of my system by morning. I said this sounded like an interesting idea, but am not quite at the stage where I am desperate enough to try it yet.
Going to try more CBT, a sleep clinic and 5-HTP first, then will re-visit.

[pulisa]

You may want to do some research into Gabapentin because it's notorious for "Gaba Fog". Obviously your psychiatrist knows best though and you would have a lower dose. Hopefully the sleep clinic will be able to help you significantly without the need for powerful meds.

[anxiousjomo]

Thanks - yeah I am aware of the issues - I think any med that helps with sleep is going to have problems with fogginess! I think the idea would be to take the one low dose at night and due to its short half life, most would be out of my system by the morning. But, regardless, at present I am not going down this route. I have to remember I am undoing nearly 40 years of mental bad habit, so it will take time! And I am doing much better than I was, even with this damn insomnia.

[chrismex89]

Very good Jomo, sounds good option always under the supervision of the psychiatrist, my psychiatrist told me to start lowering the mirtazapine from 7.5mg to 3.75mg remembering that I take escitalopram of 10mg, to see how it goes

[anxiousjomo]

Good luck Chris!

[emily67]

used to do one of these years ago. it did help me a lot

will also follow this thread

[pulisa]

Hope you are doing ok, Jomo? Have a good weekend!

[chrismex89]

Jomo how have you been in general and applying the advice of Dr. Weekes?

[anxiousjomo]

All,

I am doing good thanks - still not sleeping great (maybe have 2 or 3 nights a week with only an hour or two of sleep), but am working on it and feel like it is improving.

In general, I am managing the anxiety and depression well at the moment - getting better at watching the negative thoughts/catastrophising etc in the early stages and re-framing/re-directing/telling them to bugger off.

One thing I read which has helped was to imagine myself in 5 years time. One version I still have insomnia and anxiety, and am spending all my days worrying about it, not doing things I love etc because of it. And the other version I still have the insomnia and anxiety, but am not wasting time worrying about it, and am just getting on with living and enjoying my life. Which would I prefer? What is the actual benefit to me of all this worry and rumination? Nothing. So stop wasting time on it.

Still seeing my therapist maybe once a week, or once every two weeks. That is helping too. Went to a Buddhist meditation session last week, which I really enjoyed - a good 30min sitting meditation and then a 15min walking meditation.

Work is still insanely busy and stressful, but I am managing it. Just, as Dr Weekes says, relaxing and letting it all be as it is. Changing or preparing for what I can, but when it is out of my control, just letting it go.

Not on any supplements - just magnesium and calcium before bed, and fish oil and a 250mg inositol and choline in the morning. Not sure if the latter does anything, but cant be doing any harm. Still go to the gym 3-4 times a week, which also helps. Drinking lots of water, and eating less sugar etc.

Coming up to 2 months off meds, and feel like I am doing ok. I know there may well be blips and bad times in the future, but hopefully I have techniques in place to deal with it when it comes.

Hope you are all doing well.

J

[pulisa]

You're doing great, Jomo. You're not treating recovery as a crusade-just being sensible and not overthinking the situation.

You're dealing with your recovery whilst under a lot of pressure at work too so all the more credit to you for keeping yourself stable and well. Whatever works for you and helps, stick with it. Doesn't matter whether it's "recommended" or not. Most of the fancy techniques are common sense anyway.

Best of luck and have a good and productive week!

[chrismex89]

How you doing Jomo?

[anxiousjomo]

Hi Chris,

All good - thanks for asking. Sleep is a little better (had 3 nights in a row of 6-7hrs!) - just working on meditation/mindfulness and generally just not giving so much of a s**t about how I feel or what tomorrow might bring! Still a struggle at times, but nothing I have not been able to handle before.
Still seeing a therapist once a week, which is good. A lot of stuff to work through - much of the anxiety is really coming from my low self esteem (i.e. because I am a useless piece of rubbish I won't be able to cope with whatever will come) - once I get better at accepting I am actually a perfectly decent human being, and am strong enough to cope with whatever life chucks at me, that lessens the anxiety.
Still exercising 4 or even 5 times a week, just taking magnesium and calcium in the evening, and fish oil and a 250mg Inositol and Choline in the morning.
Am two months without any meds now, so feeling proud of that. I know I am bound to have some relapses or other issues in the future, but hopefully I can keep hold of the knowledge that I have dealt with them before, can do so again, and that they will pass...

Hope all is well with you

[anxiousjomo]

although - re sleep, and just as a reminder that this is the way things go - I of course have just had two nights in a row of about an hour or two's sleep...But I am working on differentiating between the physical unpleasantness this causes (upset stomach, headache, tiredness, sore muscles etc) and the psychological baggage that my brain wants to dump on top of it (anxiety, worry, self-pity, depression etc). The former I can't do anything about, the latter serves absolutely no purpose. So I just have to stop wasting time with it....

[chrismex89]

Under the supervision of my psychiatrist, I suspended mirtazapine, staying with escitalopram, some nights I had insomnia but my CBT therapist and my psychiatrist say it is because of anxiety. I think you're doing well Jomo, how are you going with the CBT?

[habari]

Good luck!
I find it wears off (15mg) about 3 pm and I get rebound anxiety--anyone else get this?
Good for sleep though. Hopeless for depression -(((


Best w
D

[anxiousjomo]

Chris - good luck with the med change - my best advice for anxiety related insomnia is to try to work on not caring about whether you sleep or not, recognising that your body will always make sure you get enough sleep to ensure nothing terrible happens, and that there is really nothing you can do about it. You are waiting at a station and sometime the sleep train comes, sometimes it doesnt, but you are not in control of that, so the best thing to do is wait patiently and calmly. I find the meditation helps a lot with that - I lie in bed focusing on my breath and the sensations in my body etc, and when anxious thoughts come I recognise them and let them go. Still a work in progress, but I can feel it helping. CBT/Mindfulness/Meditation are all helping a great deal with the anxiety in general - I am getting much better at spotting the anxious thinking at a very early stage and letting it go. Being present, focusing on the positives, re-framing the negative and the worry. Hopefully things keep on getting better (but, if I have a re-lapse or if things get worse, which they may well do, I know I have techniques to help, and I know I have been there before and could cope with it then, so there is nothing to worry about).

D - Mirt is a strange one, I think, and it affects everyone so differently. Some people do 15mg at night and 7.5 or 15mg in morning, I believe. You may find 30mg better for you. It never did that much for my anxiety or depression either, and the help with sleep wore off pretty quickly, but my mum is on 15mg and it works excellently for her... Good luck

[chrismex89]

and how is going with anxiety Jomo?

[anxiousjomo]

fine thanks Chris - ups and downs as always, but generally ok - working on recognizing and stopping the anxious thoughts at very early stages, which seems to help. Meditation, exercise, and generally just trying to enjoy life and stop caring so much about the negatives seems to be the way to go.

[Maca44]

fine thanks Chris - ups and downs as always, but generally ok - working on recognizing and stopping the anxious thoughts at very early stages, which seems to help. Meditation, exercise, and generally just trying to enjoy life and stop caring so much about the negatives seems to be the way to go.

Good to hear, although I don't post much here I am finding your Diary really helpful Pl's keep posting.

[anxiousjomo]

Just an update: I had been doing well - still not sleeping properly, but coping well with it emotionally. Then I decided to try the NHS Sleepio Insomnia course which involves sleep restriction. I had to force myself to stay awake until about 1am each night and get up at 6am. If I took more than 15min to fall asleep, or if I woke and was awake for more than 15min, I had to get out of bed and go to another room until I felt sleepy.

I lasted 4 days and nights of this before having massive anxiety issues (partly triggered by very stressful work stuff), and bursting into tears on the train. Ended up taking a lorazepam (the first in over 3 months). Feeling pretty rubbish today.
I have decided the sleep restriction does not work when the issue is anxiety - it just adds all this additional pressure to the whole thing. I was doing much better when I was just relaxing and letting it be. Now I have to try not to worry about this blip, or let it pull me back into bad habits.

Seeing my therapist tonight, so hopefully I can get myself back on track.

[Belleblue]

Hi jomo, sorry to read that the NHS Sleepio Insomnia course caused such distress and didn't work out. But as you said you were coping well emotionally with not sleeping properly, so you will most likely be able to return to that. I hope your therapist was of help.

Take care.

Belle x

[chrismex89]

Your original strategy of not worrying about insomnia is the correct Jomo, this is going to pass, you're doing very well

[anxiousjomo]

Thanks all - yes, am returning to my original strategy and it is helping. Just keeping breathing and not letting myself get worried about the effect of the lack of sleep on my health etc

hope you are all doing well

[chrismex89]

How you doing Jomo?

[anxiousjomo]

Struggling a bit the last couple of days. Anxiety and insomnia still taking their toll. Ended up having to take 2mg of Lorazepam last night, which i am annoyed about (I had not take anything for a month). Some nights I sleep, but at least 2 or 3 nights a week I am awake for most of if not all of the night, and this has been going on for nearly a year now. During the day I have gotten pretty good at managing the anxiety, but at night, when i am alone in my head, it all just flares up. I am going to try yoga and acupuncture to see if either of those help. I also have 5-htp to try if I feel like I need to and, of course, there is also my psychiatrist's suggestion of 300mg Gabapentin at night so that it helps with sleep but has pretty much worn off by daytime. But I am very reluctant to do that. Feeling very down and groggy today, partly from feeling like a failure for taking the medication, and partly due to the effects of that med which make me depressed etc. Seeing my therapist tomorrow, and doing my first yoga class, so we shall see.

Hope everyone on here is doing well. I try not to come on that much at the moment as one of my symptoms is obsessive researching/googling/commenting on symptoms etc, which is not healthy, so I am working hard not to do that.

[chrismex89]

I understand Jomo your health first , your CBT therapist what think about these situation?

[anxiousjomo]

Yeah - he told me there is nothing wrong with taking an Ativan a couple of times a month if I need to, and he is right.

Did my first yoga class last night and really enjoyed it. Felt like it did me some good. My feeling is if I work on being healthy and looking after myself as much as I can, it will help mitigate any negative effects of the things I cant control - the sleep and at least parts of my mood. Feeling good today so a reminder that there will always be ups and downs and I should not pay too much attention to them.

Also taken 500mg taurine that last couple of nights, and have slept pretty well. May be nothing to do with it, but some research does seem to show it can help with relaxation/sleep. Either way it has no negative effects so will keep taking it for a while and see what happens.

[anxiousjomo]

Just a note to say have been doing well the past month. Including having to take an unexpected work trip to Singapore for a week (with a 13hr flight and a 7hr time difference!) which was very stressful and busy. But am doing fine. The Taurine does seem to be helping - just takes the anxiety down about 10% or so, which is enough to let me sleep much better. Still have the odd bad night, but in general doing ok. Yoga and exercise and meditation helping with mood generally.

[Maca44]

Just a note to say have been doing well the past month. Including having to take an unexpected work trip to Singapore for a week (with a 13hr flight and a 7hr time difference!) which was very stressful and busy. But am doing fine. The Taurine does seem to be helping - just takes the anxiety down about 10% or so, which is enough to let me sleep much better. Still have the odd bad night, but in general doing ok. Yoga and exercise and meditation helping with mood generally.

Onward & upwards

Good to here your feeling better.

[Belleblue]

Just a note to say have been doing well the past month. Including having to take an unexpected work trip to Singapore for a week (with a 13hr flight and a 7hr time difference!) which was very stressful and busy. But am doing fine. The Taurine does seem to be helping - just takes the anxiety down about 10% or so, which is enough to let me sleep much better. Still have the odd bad night, but in general doing ok. Yoga and exercise and meditation helping with mood generally.
Thanks for the update Jomo. It's good to know things have improved for you.

I am still struggling with insomnia and I may finally need to accept that I should go and see someone about it. I find I am putting a lot of social activities and other stuff off because I never know how I am going to feel on that particular day. I am considerably older than you Jomo, so there is probably some older age related insomnia feeding into my problem. In my head I still think I'm thirty :ohmy:

I have a health issue which doesn't help, silent reflux which affects me mostly in the small hours or very early morning. I wake up with sore throat and feeling headachey and rubbish. Unfortunately I cannot take the medication prescribed for this which are PPIs. They cross the blood/brain barrier and make me feel worse, anxious and depressed. So quality of life is definitely being affected. Some days are fine and I think I've got this, it's not so bad. I can be so stupidly stoic and keep thinking I can solve this by myself. I have an appointment with a GP next week and may ask for to try Mirtazapine again. Or I may go privately when I would be given more time to sort out the best route and possible medication.

I take Zopiclone (just a quarter of a tab), when I am desperate, and I don't know why because the rebound of anxiety and depression the following day isn't worth it.

Anyway am really pleased for you :yesyes:

Belle

[anxiousjomo]

Oh Belle, I am so sorry to hear that. Insomnia is still an issue for me (I got no sleep at all last night so am feeling pretty rubbish today!) but the only thing that has genuinely helped has been working hard on acceptance. On what Pema Chodron calls "discomfort resilience" - seeing the bad times as opportunities to practice being ok with the discomfort. Those of us who have struggled with anxiety and all the rest are actually really tough. You have to be just to keep going every day! But whenever I have a bad day or a bad night, I try to be in it and not run away from it/label it as "bad". It is just a particular experience. It may not feel very pleasant, but it is just a bunch of physical sensations and it will pass. I ask myself "can I control this?" and if the answer is "no", then I try and let it be. Seems like I cant do anything to control the sleep. Sometimes I am fine, sometimes not. So I am working on just letting whatever will be, be.

But you have the addition of silent reflux, which makes it all much harder. I certainly think talking to the GP is a good idea. I hear you about zopiclone - I think I have taken it maybe 4 times in the last year and a half and hated it each time. I also rarely take my Lorazepam for similar reasons (I feel like crap the next day).

For the sleep, have you tried 500mg of taurine before bed along with some magnesium? That helps me a bit I think. I am also trying acupuncture just out of curiosity.

[Belleblue]

Thank you Jomo for those helpful suggestions. I'll give the taurine a go and will be near an H&B today and will get some. I suppose their brand is as good as any? I already take magnesium for my bones, but am not really aware if it helps or not. But maybe if I stopped taking it I would find that I am worse.

I love what you say about discomfort resilience/ seeing the bad times as opportunities to practice being ok with the discomfort. I agree with the philosophy of practicing acceptance, and that can work at times. But sometimes, like you sleep just wont come.

Take care of yourself.

Belle x

[chrismex89]

How you doing Jomo? its been a while since your last post and I think this a good sign, improvement.

[Belleblue]

I started back on mirtazapine. Last night was my first night so am not feeling great today. I feel I need to try and stick with them though as my insomnia plus anxiety is getting worse. Lack of ability to switch off at night and then taking some zopiclone which only leaves me feeling like death the next day is not a good strategy. If I accept the sleeplessness I feel like death the next day too. So I am trying to accept that I need to take something as none of the therapy strategies work for me and this may be something chemical which I cannot control.

I took mirtazapine several years ago and was mostly fine on it, but after about 9 months I started feeling run down with flu like symptoms and had to come off it. I am of course worried that the same thing will happen again, but I won't know 'till I try.

Belle

[anxiousjomo]

Sorry to hear that Belle - and I wish you the best of luck.

Apologies for not posting before, but I rarely come on this site anymore, as part of my problem was all my obsessive worrying about "My" anxiety etc, so I am trying just to let it all go...

I am doing well thanks - still up and down with the sleep but I understand it and have accepted it. Some days my old brain just gets itself feeling unsafe and keeps me awake to protect me. That is fine. It is what it is.

Anxiety all staying under control - I had my appendix out and 6 weeks of no gym last month but was fine with the whole thing. Just keeping up with the mindfulness and the therapy and all the rest. I think I took Ativan maybe twice in the last 3 months, so that is good. I have learnt that most of my anxiety was coming from low self esteem (i.e. I won't be able to cope with something, hence I get anxious about it). Once I started to learn that I am way tougher and more capable that I give myself credit for, the anxiety really lessened.
Basically once I was able to realise I could cope with whatever my body threw at me, I was able to just decide to ignore it and get on with my life.
I no longer worry about needing to "fix" myself, and know from experience there is no magic pill out there that works for me and will make everything easy and perfect. I can cope. I know I will keep on having ups and downs, but that is life. I just have to ride the waves.

Wishing all of you the best

[pulisa]

What a fantastic post and so very true! It's great to hear that you are doing so well, Jomo and have so much insight into how anxiety "works" and how acceptance and carrying on regardless can be so beneficial when you are no longer searching for that elusive "fix".

[Belleblue]

Sorry to hear that Belle - and I wish you the best of luck.

Apologies for not posting before, but I rarely come on this site anymore, as part of my problem was all my obsessive worrying about "My" anxiety etc, so I am trying just to let it all go...

I am doing well thanks - still up and down with the sleep but I understand it and have accepted it. Some days my old brain just gets itself feeling unsafe and keeps me awake to protect me. That is fine. It is what it is.

Anxiety all staying under control - I had my appendix out and 6 weeks of no gym last month but was fine with the whole thing. Just keeping up with the mindfulness and the therapy and all the rest. I think I took Ativan maybe twice in the last 3 months, so that is good. I have learnt that most of my anxiety was coming from low self esteem (i.e. I won't be able to cope with something, hence I get anxious about it). Once I started to learn that I am way tougher and more capable that I give myself credit for, the anxiety really lessened.
Basically once I was able to realise I could cope with whatever my body threw at me, I was able to just decide to ignore it and get on with my life.
I no longer worry about needing to "fix" myself, and know from experience there is no magic pill out there that works for me and will make everything easy and perfect. I can cope. I know I will keep on having ups and downs, but that is life. I just have to ride the waves.

Wishing all of you the best
Great to hear from you Jomo, I always find what you have to say inspirational. I had a feeling your absence from the forum meant you were coping with everything. Also I remember you mentioned in past posts that you don't want to become obsessed with it all, which makes complete sense. I have also gone for months in the past without visiting here. You have done really well to cope what with having to have an operation and everything .. Ouch!

I think you are on the right track for you when you say you no longer worry about needing to fix yourself and are practicing acceptance around it all. And I have to say that deep down I don't believe that for me there is a magic pill either. I definitely don't want to be on a medication every single day as put simply, I don't feel awful every single day, not even every single week. So I haven't stuck with the mirt, I just took one and felt deep down that it wasn't the way to go. I shared on the zopiclone thread a couple of weeks ago that I had a bit of a melt down and went into panic mode that I cannot cope with either the extreme lows or even the extreme highs of life at times as I get so anxious or extremely overstimulated which causes sleeplessness with the knock on effects from that. As shared in previous posts I take maybe half a zopiclone and then feel even worse the next day, so that's not a good strategy at all.

Anyway to update, for the past 10 days I have been doing some relaxation exercises and being a little more selfish with my time. I have referred myself to the NHS backontrack team for anxiety and sleep issues. I realize it is quite a basic service, but I feel one will always learn something of use anyway. If I am experiencing difficulties beyond this I can ask to be referred on for therapy. Or I can ask about seeing someone privately.

I am going to see my brother in another country for a week at the end of next month and was really panicking about feeling overwhelmed by all the talk and catching up, but swung that around to now feeling excited which I always used to feel years ago. I was frightened of feeling out of control in that situation, but will need to be assertive when I start feeling tired or I have had enough of the day. I won't be staying with him, but have a hotel booked which means I will be able to get some space for myself. I think these strategies for want of a better term are healthier than the alternative of pills, for me anyway.

All the best to you too.

Belle x