anxiety/ depression

[bike mad]

Hi everyone,
I'm new to this site and was hoping for a little advice... I started with anxiety about four months ago which led to servere insomnia that has persisted.. My doc tried me on mirtazapine which was an awfull experience, so I stopped it, I was then given sertraline which was even worse so it was decided that anti depressants were not suitable for me and I should try zopiclone tablets.They didn't touch my sleep problems and I developed many intrusive thoughts and due to the sleep issue I think...I've been back to the docs since and been given diazipam to take at night which is helping but I've now developed wierd images and memory's that flash as I'm trying to sleep... I also now get an image of what I think about.... I find this a little strange and wondered if anyone could relate to or know what's causing this... I saw a therapist who said it's just a tired mind... Anyones input would be greatfully received.... Thanks

[lior]

What do you mean 'get an image of what I think about'? What kind of image? Is it interesting to understand more about what you think about?

You probably do have a very tired mind! Doesn't mean it's pleasant. Accepting that this is how things are right now is meant to help.

[bike mad]

Hi thanks for the response.... It's like my mind has gone from bombarding me with intrusive thoughts of going crazy and losing it to images of all sorts of things, memory's I've totally forgotten about, random images of things I've seen.... It's as if my brain is in a tranced kind of state and isn't working properly.... Kinda thinking I've lost the plot.... Wondered if it might be the tablets making me like this...

[lior]

I really don't know, but from having had an insomniac friend, I think that sort of thing can happen because of a lack of sleep.

I guess it can also happen as a side effect of some meds though. It sounds like you're in good touch with your doctor, so the other thing you can do is keep track of when this happens.

At the moment I am taking a log of when I wake up and fall asleep, when and what I eat, when I take my tablets, how happy I feel, how motivated I am, what activities I do, and any side effects of the medication. This will help me find patterns.

[bike mad]

That's sounds a good idea... Im stuck really.. I carnt take anti depressants the side effects were horrendous, I couldn't see properly, tingles all over, shakes, enlarged pupils, muscle convulsions just to name a few... This has scarred me mentaly, The zopiclone didnt work and I went three wks with about six hours sleep, got to the point where I could only crawl to the bathroom... These diazipam help, I get around 5/6 hours on them but I carnt take them for long so I'm worried how things are going to turn out for me.... I've gone from being able to sleep for England to getting anxiety and sleep no more... I'm lost..

[Theincrowd]

Hi Bikemad,

I feel your pain. I have been having similar problems of insomnia, vivid dreams, waking early and generally poor sleep. I have tried a lot of things but these help the most:

1. Religiously practice sleep hygeine. This are things like cut out caffeine, alchohol, etc; have a set bed time; exersize; sleep in a cool dark room, don't sit on screens before bed. Your problems are due to a racing mind by sounds of it but if you practice sleep hygeine you know you are taking care of common reasons people do not sleep well. There are plenty of tips on the Internet here.

2. Work on toning down the thoughts and racing mind. It is paradoxical that the more you try to sleep the less you can. For both anxiety and the crippling effects of poor sleep I have found attempting to non-judgmentaly accept the feelings and attempt not to react (hard I know). You have many techniques here including challenging negative thoughts about sleep and other issues, imagery, mindfulness, etc. I am personally getting most joy from Jon Kabat Zinn's course of mindfulness from the book full catosphrohe living - my sleep is still not where I want it to be but is getting better. Part of this is acceptance of not sleeping and using the time in bed to relax and not get worked up by lack of sleep - this is recommended by the UKs sleep school - and is an excellent way to go - have you noticed if you start tossing and turning and getting angry it makes it worse? Next time try just lying in bed focusing on each In breath and out breath - you will sometimes fall back asleep but if you don't you will be more rested I promise.

3. Work on the pre-bed routine. I try to have a routine which includes yoga, breathing and reading and getting away from bright lights and screens. If I don't do this I feel like I sleep worse. They do say that practicing 'sleep restriction' is good but I am too tired to try this at the moment.

4. Work on countering avoidance because of how you feel. Be kind to yourself but also push slightly out of your comfort zone. Realise that you CAN get through the day despite feeling awful, albeit not at your best.my observation has been when I push myself to do things I both sleep better and even if I don't I can get through the day. This approach has slowly but surely made myself feel better.

5. Focus on all the things in your power for general health. I have started eating fruits, vegetables, and lots of oily fish - as recommended by a Neals Yard book I brought. Exersize despite not feeling it - I never regret it after - even if I feel 1/10 before I might be a 1.5/10 after. So basically here I try to ensure that all the other building blocks of health are being cared to and thus are feeding into better sleep.

I hope that helps as a start. I am still working on the poor sleep, and I am going back to work soon and am concerned I will be too tired but I will just keep practising the above. All the best.

Theincrowd

---------- Post added at 08:41 ---------- Previous post was at 08:29 ----------

P.s. Lior's tips about logging everything is a good idea to note what works. Here focus on what time you got into bed, time lights went out, how long did it take you to fall asleep, how many times did you wake up and for how long, and what time was your last awakening. There are some apps that can track this for you but easy to do in the old school pen and paper way - I noticed from doing this I slept more than I thought!

Oh - one more tip that worked for me - don't spend ages in bed waiting for sleep to come, e.g. Going to bed at 8pm to try and sleep and getting out of bed really late. Set bed time and get up time.

In general 1. Accept uncomfortable feelings; 2. Focus thoughts outwards on activity rather than inwards on poor sleep/anxiety; 3. Try and act as far as possible (but take it easy) as if you do not suffer from anxiety and poor sleep.

I do not mean to preach any particular approach either - what I say has just had some element of success for me - but like you I am still working on it but I hope that any of the above can help.

[bike mad]

Hi thanks so much for the great post... I've been doing some of that already, cut caffeine out completely, I don't drink and go to bed same time every night...

There's so much that's happened to me over these past four months since it started I feel totally bewildered..it's like my brain is on high alert for everything.. My vision went funny a few times, my hearing has become sensitive or sometimes numbed down or ringing in ear.. My body is always totally shattered even after five hours or so of sleep... I feel strange and carnt fathom why and as for my mind we'll that's just haywire.....

I've gone from my mind telling me constantly I'm going crazy to images in my head of all the times I've done something and not felt right, I get random memory's that pop in my head with no trigger, all other types of mad stuff...

I've always been a confident person having a clear mind, outgoing, spontaneous and a great sleeper, now I'm the complete opposite and carnt figure out where I've gone

How the hell do you recover from this.. All my symptoms of anxiety have faded like the shakes, dizzyNess, panic Have all past, I'm left with a head that's in a complete mess. Please tell me this goes aswell because I find it so hard to put up with... Many thanks....

[Theincrowd]

Maybe others can assist with the thoughts etc, as I have not experienced this. Are you working? Are you seeing a therapist? Have you brought any self help books?

I am still recovering but I am in a better place than I was as had a host of physical symptoms and whirring thoughts of what was going on and when I would get back to normal. I had to accept that things were just like that and I am going to have to try to function with the problems. the following could help:

(I) write down a plan of action of the things that are in your control that this week you will take care of. This could be eating healthily every day, doing some form of exersize every day and practicing yoga before bed.

(Ii) ban yourself from googling anything despite how bad you feel. Rely on the medical professionals you are seeing to guide you and know you best.

(Iii) has anything you have done in the last four months made you feel better? Perhaps it's watching a movie that you would have done when you were well. Perhaps also try doing something challenging relative to where you are now.

In the early phase of my troubles I desperatly sought answers for what was happening and did nothing but worry about was wrong with me, read about possible causes and then subsequently always think about it. I was looking inwards for answers. Then I realised this was not helping and started looking outwards, trying to normal things and focusing on 'external ideas'. For example I tried to run 5k, felt awful but managed it, then recorded my time every two days. I started reading on certain parts of history with the focus on engaging the brain on other things. I also felt bad, and still do sometimes, but did it regardless. It's thst which seems to be pushing me in the right direction. Bear in mind it's not going to happen over night so don't expect immediate results.

---------- Post added at 16:28 ---------- Previous post was at 16:24 ----------

And I am no expert. There is some amazing literature out there on these problems and effective techniques. Seek some out which is based on empirical evidence and put it into practice. Here the help of a really good therapist is worth investing in to guide you as putting it into practice is incredibly difficult with how you are feeling.

[MyNameIsTerry]

The issue to resolve with insomnia is usually a matter of sleep hygeine as already discussed and the anxiety itself. Treating the insomnia with medication may not resolve it if its the anxiety that is the primary cause and you can't stay on Zopiclone usually longer than a month and long term treatment with Benzo's just leads to other problems and advice to GP's is not to use them for long, although I don't know about specialists.

It could be that your GP is hoping by getting you some sleep for now, it will then readjust long term. Personally, and this may not be the case for you, but I don't believe this because you still have the underlying problem. However, if you have a real spike, as I did with Citalopram side effects, they can really get you through a rough patch.

Is it the intrusive thoughts that cause your anxiety? How did it start? Are these intrusive thoughts that you find are disgusting?

Intrusive thoughts can make us react to them so that reinforces their validity as a thought process, not an acceptance that they are correct, and this just makes them 'fire' more often and the response gets worse. The way out of this is to stop reacting, however its a lot harder than that to put into practice. I found Mindfulness did this far more than the CBT I had. It teaches a non judgemental view of your thoughts but also how to focus and refocus away when it strays into areas you don't want it to. It can take time to learn but it does help and has lots of clinical evidence thesedays.

I'm wondering whether its these thoughts coupled with heightened anxiety that causes your insomnia and now you are anxious about even trying to sleep. If so, by reducing your anxiety as a whole, it could resolve the insomnia with it.

Maybe practicing Mindfulness, especially the relaxing meditation form, would help if you did it right before trying to sleep so that it relaxes your body & mind but also encourages you to be more relaxed just prior to the time when you struggle the most?