Early Morning Anxiety - what meds helpful?

[WembleyBear]

It’s been a while since I posted on here, but I keep an eye on what’s going on! I’ve had a massive escalation in my early morning anxiety in the last month. Usually worst on a Monday morning, it starts with me waking about 4.30am with a pounding heart and feelings of dread. I usually sit up and eat a small snack and try to breathe abdominally but this normally makes no difference and I spend the next 2 hours feeling sick to the stomach. I’ve tried pinpointing my negative thoughts but the thing is I have no thoughts – I just wake up and bam! It instantly hits me. Eventually, I get up (although once or twice I haven’t and taken the day off sick even though I don’t get paid) and feel awful, tearful – usually cry in the shower, force myself to eat breakfast and drive to work. Feelings gradually dissipate but I feel exhausted from the early wakening. I have no concentration and generally feel overwhelmed. By the end of the day I feel better, like I can cope, do anything, take on the world, happy etc. But next morning it’s like someone has pressed the reset button, and the whole exhausting process starts over again.


Medication wise, I had taken Dothiepin 75mg at night for nearly 10 years and it worked perfectly for me, but then it was withdrawn a couple of years ago due to cardiac concerns. I was tried on SSRI including Cipramil, Sertraline, Paroxetine, Fluanxol and Prozac. Without exception they gave me awful side-effects, the worst being the kind of electric ‘buzzing’ in my whole body and with Fluanxol, I was literally unable to sit still or even lie still in bed! Eventually, I was put on Amitryptiline 50mg at night with no side effects, but also no real impact on my anxiety and now it’s got worse. My doctor tried me on Duloxetine earlier this year, but again side-effects worse than anxiety and after 4 weeks had to stop and go back to Amitryptiline. Pregabalin was mentioned but was told it was very expensive and they didn’t prescribe it.


Now at wits end, I only work 3 days a week, don’t get paid if I’m off sick, so if I have bad side-effects from a med it’s a real problem. I have an appointment with a student counsellor tomorrow at the college (for free!) and maybe 6 sessions if we get on OK. Still waiting after a year for appointment on NHS for CBT, tried MIND but because of postcode I couldn’t go to group 5 miles away which offered 6 free sessions and a chance to join a relaxation group. I would have to travel 30 miles and pay £20 a session, so worked out too impractical. I already do Progressive Muscle Relaxation every night for 30 minutes and Yoga each week, but neither of these seem to help with the morning anxiety.


Looks like I will have to go back to the Docs as well (they must think here he comes again!) and ask for a different med but really have no idea what to suggest as the SSRI & SSNI seem to give me side effects and I never get over that initial hurdle to where improvement seems to start for others. I know you guys are not doctors but hoping someone will have had similar situation and can tell me which meds have worked for you/how you got over the initial side effects. Curse Dothiepin for being a dirty drug – it worked for me….




Thanks
Martyn

[ankietyjoe]

Hi Martyn

I went through a bout of early morning anxiety too, and it's particularly hard to deal with in my experience. For me it lasted several weeks, and in fact I've had a little relapse into something similar recently, although not nearly as bad.

I'm a great believer in using the non medication route, although I know that's not for everybody. Seeing as you have valid concerns about using pills though I'll share my methods with you anyway.

First and foremost I use meditation as an overall magic bullet for any and all forms of anxiety. It's not something I use to alleviate the symptoms as such, but something I do on a regular basis to accept and deal with certain thoughts and feelings.

You've already identified that it passes, so why not take it to the next step and not do anything at all when you wake up at 4.30am? From my own experience eating can be a trigger to palpitations when I'm feeling anxious and it's certainly not going to help you get back to sleep.

Meditation is about experiencing and being aware of what your mind and body are experiencing, but not reacting to them. It's just observing them. It's usually my own reaction to 'sensation' that causes the anxiety/fear cycle, not the sensation itself.

Even though I still suffer from the early morning horrors sometimes, I'm able to shake them off and go back to sleep within about 10 minutes. If somebody told me that was possible 2 years ago I would have either laughed at them or slapped them for being so utterly foolish.

[WembleyBear]

Thank you for your comments, very reassuring. I think I'm hypersensitive to a lot of the newer meds, so the idea of meditation is something I'll have to explore more. The reason I eat something as soon as I wake is because it was suggested to me that blood sugar may play a role (and I certainly do feel it takes a little away when I eat something).

It will be interesting to see what the counsellor says tomorrow as well but I do feel I will need something medication wise too to keep me on an even keel. It just is so difficult to find the right balance. I go from the deepest dread in the early morning to feeling euphoric at 6pm. I feel like I'm constantly on this circular conveyor belt of emotions!

Last time I was at Docs she mentioned Pregabalin but then muttered about the cost, so may pursue that too.