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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by jasmineneroli on March 9, 2005, at 20:28:11
Although I've had a lot of stress lately, I've been managing OK on .5mg Klonopin and 1gr tryptophan daily.
Not perfect, but I would've expected to feel a lot more anxious than I have done, given my current circumstances.BUT, I have a return of symptoms I had until about 4 months ago. That is, when I get up in the morning I feel really grumpy, irritable & gloomy. And I mean more than "just not a morning person" type of thing!! I can get motivated to be ready for work, but I'm pretty slow again. And I start having "low-grade" physical anxiety symptoms, such as slight nausea or stomach butterflies.
Two-three hours later - around 9:30 am, I'm totally fine. Cheerful, energetic, no physical anxiety.
Prior to my GAD blowing up a few years ago, I never had moodiness or lethargy like this on waking.
Anyone else ever get this? Any ideas as to what causes it. I take all my meds mid-evening, and magnesium, plus D3 at bedtime.
Thanks for your input!
Jas.
Posted by TamaraJ on March 9, 2005, at 20:49:26
In reply to Anyone feel miserable, anxious on waking, only?, posted by jasmineneroli on March 9, 2005, at 20:28:11
Hi Jas,
I was feeling like that in the mornings for a while as well. I started experimenting with some supplements before adding or increasing any med, and found that the feelings of irritability and lethargy as well as the nauseated feeling subsided when I added about 250 - 375 mcg of chromium. I think part of my problem was a blood sugar problem, and chromium helps to stabilize blood sugar. Anyway, it seems to help me.
All the best to you.
Tamara
> Although I've had a lot of stress lately, I've been managing OK on .5mg Klonopin and 1gr tryptophan daily.
> Not perfect, but I would've expected to feel a lot more anxious than I have done, given my current circumstances.
>
> BUT, I have a return of symptoms I had until about 4 months ago. That is, when I get up in the morning I feel really grumpy, irritable & gloomy. And I mean more than "just not a morning person" type of thing!! I can get motivated to be ready for work, but I'm pretty slow again. And I start having "low-grade" physical anxiety symptoms, such as slight nausea or stomach butterflies.
> Two-three hours later - around 9:30 am, I'm totally fine. Cheerful, energetic, no physical anxiety.
> Prior to my GAD blowing up a few years ago, I never had moodiness or lethargy like this on waking.
> Anyone else ever get this? Any ideas as to what causes it. I take all my meds mid-evening, and magnesium, plus D3 at bedtime.
> Thanks for your input!
> Jas.
Posted by med_empowered on March 9, 2005, at 21:08:42
In reply to Re: Anyone feel miserable, anxious on waking, only? » jasmineneroli, posted by TamaraJ on March 9, 2005, at 20:49:26
Hey! I used to have that problem FREQUENTLY--the instant I woke up, I'd be thinking about how meaningless my life was, how pointless everything was, and I'd start having anxiety problems. For a while, I managed by having my Klonopin increased so my morning dose was a bit larger (I also started leaving my morning pills on my nite stand, so I could take them the instant I woke up) and by adding low-dose propranolol to the mix to kill off the physical symptoms of high-anxiety/panic. But...these were band-aid approaches. I found that trying to change my life and day-to-day behaviors helped out tremendously, and soon I was able to reduce the Klonopin dose. When I'm feeling low, I still sometimes get a similar feeling...I've found that sometimes getting up a bit earlier, if possible, helps...also, sometimes going a nite without sleep when I'm feeling low temporarily helps me feel normal and also elevates my mood overall for a while. As for meds...I always take my 1st dose of Adderall in the morning, pretty much the instant I wake up. The adderall itself seems to help alot...if I make myself wake up earlier, I take my adderall once I wake up then, too, and use the extra time I have in the morning to write down what I'm feeling and try to answer the "why?" question while also devising strategies to make it a little better and easier to deal with. Good luck!
Posted by Phillipa on March 9, 2005, at 22:16:56
In reply to Re: Anyone feel miserable, anxious on waking, only?, posted by med_empowered on March 9, 2005, at 21:08:42
Gee, I don't want to sound selfish but if it only lasts a couple of hours it almost sounds normal. Fondly, Phillipa
Posted by MoparFan91 on March 10, 2005, at 1:39:06
In reply to Anyone feel miserable, anxious on waking, only?, posted by jasmineneroli on March 9, 2005, at 20:28:11
I was in the same boat before I got back on medications and the right supplements. For me, it seems to be bipolar ultra-ultra-ultra-ultra rapid cycling.
Here's the headline:
When I was off all medication at one time, I would wake up with anxiety and stomach butterflies. Right before getting out of bed in the morning, I would feel like I was about to have an anxiety attack. I felt nauseous as well. I would wake up in Fogsville, too. I also would feel kinda drunk (though I don't drink). Also, earlier in the day, my mood would be crappy, and I would be in a daze, or Fog. As the day, progressed, my mood would drop a little more, then I would have a number of hours of emotional numbness/flat mood. Then later in the day, my mood would be a little elated and I would have more energy, and I would be laughing a lot about silliest things.
My sleep was also so extremely messed up, that it was funny ;-D, and I would have few consecutive nights where I would get 1-2 hours of sleep a night and 10 hours on the other nights. Even 8 sleeping pills didn't get me to sleep at times. At work, I would joke about my sleep problems, employees would feel sorry for me and say to me, "I heard you didn't get any sleep last night ;-D". I also played jokes with other coworkers about how I'd bee waking up in a Fog/Daze and talking about "Fogsville".
> Although I've had a lot of stress lately, I've been managing OK on .5mg Klonopin and 1gr tryptophan daily.
> Not perfect, but I would've expected to feel a lot more anxious than I have done, given my current circumstances.
>
> BUT, I have a return of symptoms I had until about 4 months ago. That is, when I get up in the morning I feel really grumpy, irritable & gloomy. And I mean more than "just not a morning person" type of thing!! I can get motivated to be ready for work, but I'm pretty slow again. And I start having "low-grade" physical anxiety symptoms, such as slight nausea or stomach butterflies.
> Two-three hours later - around 9:30 am, I'm totally fine. Cheerful, energetic, no physical anxiety.
> Prior to my GAD blowing up a few years ago, I never had moodiness or lethargy like this on waking.
> Anyone else ever get this? Any ideas as to what causes it. I take all my meds mid-evening, and magnesium, plus D3 at bedtime.
> Thanks for your input!
> Jas.
Posted by mmcconathy on March 10, 2005, at 19:32:15
In reply to Anyone feel miserable, anxious on waking, only?, posted by jasmineneroli on March 9, 2005, at 20:28:11
I dont cope well with problems, i know, i have innerpersonal worries, then external issues.
not in the mood to post. But good post
Posted by jasmineneroli on March 10, 2005, at 19:46:35
In reply to Re: feel miserable, anxious always., posted by mmcconathy on March 10, 2005, at 19:32:15
Sorry you feel bad Matt.
I've been reading your posts a lot, and I haven't felt good enough to respond, even though I know you deserve the care and attention.There isn't much I can say to help you really.
I know others have advised you to go to the hosp. to get evaluated/treated, but I don't think you really want to go, right?It's prolly a good idea, if you can handle it.
I'm MUCH better than I was, spent a long time trying this and that, in terms of medications and supplements. So now my main problem is this morning thing.
I wish you patience and persistence to keep working at getting the right medication for you, so you too, have only got a small problem left!!
Best wishes,
Jas
Posted by jasmineneroli on March 10, 2005, at 19:56:19
In reply to Re: Anyone feel miserable, anxious on waking, only?, posted by Phillipa on March 9, 2005, at 22:16:56
> Gee, I don't want to sound selfish but if it only lasts a couple of hours it almost sounds normal. Fondly, Phillipa
LOL, Phillipa!
No you're not selfish......I had to grin when I read your post.
Yeah, it's not as bad as it once was. Not after years and trying diff. meds, 9 & counting ( I think, or is it 10 now?).
It's not normal though, at least not for me. I've been working hard on everything, meds, supplements and behaviour modification and thought I had it more or less managed. But when this am thing came back again, I was wondering what it was. Is it me going to go back downhill again? Is it something I can find out about and deal with?
I've been around this board for a coupla years, and have always spent most of my time trying to help others, until recently. I've tried to keep away a bit, as part of behaviour mod., and only really read posts or ask questions now. Even tho' it's a small problem, I was interested in opinions!I'm just trying to get to perfection in terms of my condition being treated!!! Isn't that possible, huh????
Warm wishes,
Jas
Posted by jasmineneroli on March 10, 2005, at 20:01:07
In reply to Re: Anyone feel miserable, anxious on waking, only? » jasmineneroli, posted by TamaraJ on March 9, 2005, at 20:49:26
Hello Tamara:
I actually take chromium already in the am and at lunch time (and have for about 10 years or more). I do have blood sugar regulation problem, I go dizzy and spacey and irritable.
Maybe I should take another at night? Just split my dose 3 ways. That's a good idea, and worth a try. Thanks.
Take care.
(Nearly time to go back to work,hey? Very very best wishes with that :) ).
Jas
Posted by jasmineneroli on March 10, 2005, at 20:07:10
In reply to Re: Anyone feel miserable, anxious on waking, only?, posted by med_empowered on March 9, 2005, at 21:08:42
Thanks a lot for your input.
You made me remember that I did used to take my Klon. split into .25mg doses, am and pm, instead of .5mg at night, which is what I'm doing now.
I think I'll go back to that, and follow up on Tamara's suggestion of nightly chromium as well.I actually already wake up about 2.5 - 3 hours before I need to leave, because I'm just so slow and grumpy. It hasn't really changed anything. I just lie there trying to make myself get perky!!
I'm thinking of doing the opposite....sleeping in a bit more!Thanks again & good luck to you!
Jas
Posted by jasmineneroli on March 10, 2005, at 20:23:52
In reply to Re: Anyone feel miserable, anxious on waking, onl » jasmineneroli, posted by MoparFan91 on March 10, 2005, at 1:39:06
> I was in the same boat before I got back on medications and the right supplements. For me, it seems to be bipolar ultra-ultra-ultra-ultra rapid cycling.
>
> Here's the headline:
>
> When I was off all medication at one time, I would wake up with anxiety and stomach butterflies. Right before getting out of bed in the morning, I would feel like I was about to have an anxiety attack. I felt nauseous as well. I would wake up in Fogsville, too. I also would feel kinda drunk (though I don't drink). Also, earlier in the day, my mood would be crappy, and I would be in a daze, or Fog.*** Well, that really describes me perfectly, but my Pdoc absolutely insists I'm not Bipolar, in any of it's forms.
As the day, progressed, my mood would drop a little more, then I would have a number of hours of emotional numbness/flat mood. Then later in the day, my mood would be a little elated and I would have more energy, and I would be laughing a lot about silliest things.
**** I don't really go down further like you do, but it does go up again like that, but not too high.
>
> My sleep was also so extremely messed up, that it was funny ;-D, and I would have few consecutive nights where I would get 1-2 hours of sleep a night and 10 hours on the other nights. Even 8 sleeping pills didn't get me to sleep at times. At work, I would joke about my sleep problems, employees would feel sorry for me and say to me, "I heard you didn't get any sleep last night ;-D". I also played jokes with other coworkers about how I'd bee waking up in a Fog/Daze and talking about "Fogsville".**** I've always had sleep problems, but my sleep isn't too bad right now....maybe I need to do that sleep deprivation thing for a night, as another poster suggested. Hmmmmmm.
What meds and supplements are you taking, and how often during the day...is timing an issue?
Thanks for your response, it really helps me to think things through.
Best regards,
Jas
Posted by MoparFan91 on March 11, 2005, at 0:03:49
In reply to Re: Anyone feel miserable, anxious on waking, onl » MoparFan91, posted by jasmineneroli on March 10, 2005, at 20:23:52
I'm currently on Lamictal 100mg 2xday and Geodon 10mg 2xday. I take 0.5mg Klonopin as needed when I have anxiety.
I also take the following supplements:
Fish Oil 1,500 mg EPA/DHA combo 3xday
Magnesium Glycinate 200 2xday, 400mg 1xnight
Selenium 200mcg 1xday
Vitamin C 3,000mg 3xday
Vitamin E 400 IU 3xday
Niacin 500-1,000mg 3xday
Tyrosin 500mg 1xday
Zinc 50mg 2xday
Vitamin B12 2,500mcg 2xday
Vitamin B6 400mg 2xday
Vitamin B-50 Complex 1xday
Chromium Picolinate 400mcg 2xday
Kelp/Iodine 1 tablet 1xday
Multivitamin 1 tablet 1xday
Taurine (as needed)
Glycine (as needed)
Melatonin (as needed)
Benadryl (as needed)
Posted by TamaraJ on March 19, 2005, at 14:41:37
In reply to Re: Anyone feel miserable, anxious on waking, only? » TamaraJ, posted by jasmineneroli on March 10, 2005, at 20:01:07
Jas,
How are you doing? Has there been any improvement? Hope you are doing well, and starting to feel at least a bit better. I am thinking good thoughts for you.
All the best to you. Take care,
Tamara
Posted by Spriggy on March 20, 2005, at 10:08:17
In reply to Re: Anyone feel miserable, anxious on waking, onl » jasmineneroli, posted by MoparFan91 on March 11, 2005, at 0:03:49
I'm coming in late on this but I do the exact same thing. I wake up every morning with that horrible jittery pit/butterfly in my stomach. It's miserable.
However, I recently found out I am diabetic and when I take my blood sugar in the morning's I'm lingering around 70- which is kind of low. It explains why after I eat a little something, get up and going, I seem to do better.
Then in the afternoon, this "achy" weird head feeling seems to appear. Once again, I have found that in those times, my blood sugar is either at or over 200- so it is blood sugar related obviously for me.
Until I KNEW it was my blood sugar, I just thought I was going nuts, because at times it really feels that way.
Have you been checked for hypoglycemia or diabetes??
Posted by KaraS on March 20, 2005, at 17:42:53
In reply to Anyone feel miserable, anxious on waking, only?, posted by jasmineneroli on March 9, 2005, at 20:28:11
Hi Jas,
I too feel horrible upon waking. I'm always at my most depressed in the mornings. I have a terrible time getting out of bed to face the day. I used to have horrible anxiety in the morning as well - the butterflies in the stomach panicky feeling that Spriggy was describing. The low dose doxepin has taken care of the anxiety part completely but I still can't drag my butt out of bed in the morning. This feeling worse early in the day is quite typical of depression so (if this isn't just a blood sugar thing for you), perhaps you still have a little ways to go in treatment. I think that the HPA axis is involved with causing this morning problem somehow. (Don't cortisol levels rise when we're sleeping?) I used to think that more re-uptake of neurotransmitters was occuring while we sleep and that's what was responsible for the increased depression upon waking. I was told be other posters here that that isn't the case though. I am hoping that if my depression is ever adequately treated, then the morning problem will go away too and I'll joyously leap out of bed in the morning to meet the new day. (Well we can always dream, can't we?) Anyway, I hope you figure out what's causing this for you and that you find a way to defeat the problem. You seem to have made a lot of progress so far so I see no reason why you can't get over this part as well.Take care,
Kara
Posted by jasmineneroli on March 23, 2005, at 20:08:25
In reply to Re: Anyone feel miserable, anxious on waking, onl, posted by Spriggy on March 20, 2005, at 10:08:17
> Have you been checked for hypoglycemia or diabetes??Hi Spriggy: Yes, I've been checked for both, and both were negative. However I KNOW I'm hypoglycemic - the tests for this are notorious for being mis-intepreted, per the individual's response. I had all the symptoms several years ago, so I started taking chromium picolinate, which helped tremendously. Since then I've laso changed my diet to high protein, low simple carbs.
Tamara suggested the same thing, so I thought I'd add an additional 200mcg at night time.
Since I posted, I've also been back to my Pdoc, who feels the extended stress I've been under lately, in conjunction with my GAD, has caused the onset of mild depression that has worsened. He's upped my Tryptophan back to 1500mg per day.
You make a good point about noticing the blood sugar though, because, in addition to the AM stuff, I was beginning o get grumpy, lethargic in the evening too. When I analyzed how I'd been eating during this period of stress, I realized that I was often not eating AT ALL, missing several meals a day. No doubt that was contributing too! Back to eating regularly, whether I feel like it or not!
SOOOOOOO....I'm hoping that this change will help.
Just shows how many things we need to be aware of, always.
Thanks for your interest, and take care.
Regards,
Jas
Posted by jasmineneroli on March 23, 2005, at 21:53:51
In reply to Re: Anyone feel miserable, anxious on waking, only? » jasmineneroli, posted by KaraS on March 20, 2005, at 17:42:53
Kara:
Yes, I've read that Cortisol is supposed to rise in the morning and "activate" your body to get roused for the day.
Mmmmmmmm, I'm wondering if it does, and in people like us, it simply causes anxiety. I don't know if it relates to other brain chemicals. For instance, does higher cortisol levels USUALLY increase dopamine and/or NE, so drive and reward centres are activated, thus the "rise & shine" effect..that I'd like to get back :).Perhaps, for us "female" hormones are at issue. High progesterone causes lethargy, sedation and depression. Maybe it's an early am increase in Progesterone!!
I've often pondered about the HPA being a really key part of my problems. SOOOOO many things to consider always. Woiuldn't it be great if we could be hooked up to machines every night for a week, that analyzes blood/brain tissue levels of all hormones, neurohormones and neurotransmitters.
And also measures brain electrical activity, muscle activity over the entire body. Plus, skin temperature and body temperature. Oh yeah, don't forget blood sugar and electrolytes!Then in the mornig we press a big red button and get a complete print-out of what was happening physiologically and neurologically overnight. We could addd in our anecdotal observations about how we feel both re emotions/mood and energy.
What fascinating reading it would make, and how our Pdocs would hate it, when we show up with sheaves of paper to analzye! But it would be VERY helpful.
How long have you been taking the Doxepin? What dose do you take and have you noticed any side effects?? I'm glad it's helping the anxiety, because it's so wearing.
At my Pdoc's last week, he felt that the symptoms I described in my original post are due to a developing depression (my GAD does have depressive periods, for some reason i never recocgnize them coming!). I'm now on increased tryptophan for a few weeks. There's probably a seasonal aspect to this too.
And yes, I've improved a lot overall since my first GAD "blow-up" 4 years ago. So I do have to remind myself about that every now and then. But like all of us, I just wish I was WELL!
Warm wishes,
Jas
Posted by jasmineneroli on March 23, 2005, at 22:03:35
In reply to Re: Anyone feel miserable, anxious on waking, only? » jasmineneroli, posted by TamaraJ on March 19, 2005, at 14:41:37
> Jas,
>
> How are you doing? Has there been any improvement? Hope you are doing well, and starting to feel at least a bit better. I am thinking good thoughts for you.** Hey Tamara:
As far as the early morning thing, I believe there is an improvement. I'm not as anxious or as slow in the am, as of the past few days. This may well have been caused by low blood sugar as you you suggested, because I noticed that I'd started eating very poorly recently, due to stress and often missed meals all together. So I've tried hard to eat properly and take an extra 200mcg of chromium at night. Thx for the idea :)The depression (and that's what my Pdoc is now calling the am irritabilty etc.) hasn't really abated yet, but at least it doesn't last all day!!! My doc was concerned that the depression would progress, and so far it doesn't seem to have worsened.
>
> All the best to you. Take care,
>
*Thanks Tamara, you too. Are you back at work now?
How's the wrist, too? I'd love to know how everything's going for you.
Best wishes
Jas
Posted by KaraS on March 24, 2005, at 2:14:54
In reply to Re: Anyone feel miserable, anxious on waking, only? » KaraS, posted by jasmineneroli on March 23, 2005, at 21:53:51
> Kara:
> Yes, I've read that Cortisol is supposed to rise in the morning and "activate" your body to get roused for the day.
> Mmmmmmmm, I'm wondering if it does, and in people like us, it simply causes anxiety. I don't know if it relates to other brain chemicals. For instance, does higher cortisol levels USUALLY increase dopamine and/or NE, so drive and reward centres are activated, thus the "rise & shine" effect..that I'd like to get back :).
I don't really know much about cortisol. It's so critical to know about when you suffer from anxiety and depression yet I haven't been able to force myself to research it. I think I read once a while back that when levels of cortisol are raised due to stress, that it negatively impacts the production of neurotransmitters, thus accounting for the connection between increased and sustained anxiety leading to depression. I could be remembering this incorrectly however. Hopefully someone more knowledgable about it will chime in here.
> Perhaps, for us "female" hormones are at issue. High progesterone causes lethargy, sedation and depression. Maybe it's an early am increase in Progesterone!!
> I've often pondered about the HPA being a really key part of my problems. SOOOOO many things to consider always. Woiuldn't it be great if we could be hooked up to machines every night for a week, that analyzes blood/brain tissue levels of all hormones, neurohormones and neurotransmitters.
> And also measures brain electrical activity, muscle activity over the entire body. Plus, skin temperature and body temperature. Oh yeah, don't forget blood sugar and electrolytes!
>
> Then in the mornig we press a big red button and get a complete print-out of what was happening physiologically and neurologically overnight. We could addd in our anecdotal observations about how we feel both re emotions/mood and energy.
>
> What fascinating reading it would make, and how our Pdocs would hate it, when we show up with sheaves of paper to analzye! But it would be VERY helpful.
Yes, it would be great to have those kinds of automatic printouts on the state of our health!! (Have you ever considered a career writing science fiction?) That's a few hundred years away however. I'd settle for being able to get a full work-up when I go to the doctor's office. You have to fight tooth and nail these days just to get things like cortisol, Vitamin D, full thyroid panel etc.
> How long have you been taking the Doxepin? What dose do you take and have you noticed any side effects?? I'm glad it's helping the anxiety, because it's so wearing.I have been taking the doxepin for a few weeks now - over a month at 25 mg. I used to take 25 mg. of it for many years starting over 20 years ago. It has saved my life twice now when I've had a severe agitated depression. If I am not on any medication, I become completely incapacitated by anxiety and depression. The anxiety could not be any worse. I have to say, however, that SSRIs have also been able to completely take care of my anxiety. So even though my anxiety can be so severe, it responds well to treatment.
The side effects I've had from the doxepin are an increased appetite. I'm glad I'm able to eat again but I just wish my appetite weren't so strong. There's a little bit of grogginess I think. I'm not sure if that's the right word for it. I had some heart palpitations. It seems to be happening less often though. It may be unrelated to the medicine. I just had an EKG to make sure all is ok. I don't have a problem with dry mouth at this dosage nor have I had problems with orthostatic hypotension. (Don't know why as I used to have that problem when I took it years ago.) I don't know if there's significant memory or cognition problem at this low dosage. (I'm considering switching to Remeron partially because of the palpitations and partially to see if I would have better memory and cognition on it. Also, because of the cardio issue I think I'd feel more comfortable increasing dosage of Remeron and I wouldn't want to do so with the doxepin.)
> At my Pdoc's last week, he felt that the symptoms I described in my original post are due to a developing depression (my GAD does have depressive periods, for some reason i never recocgnize them coming!). I'm now on increased tryptophan for a few weeks. There's probably a seasonal aspect to this too.
I tried tryptophan many years ago. I only took it a few times for sleep. I really should look into it further. I'm glad it helps you. Do you find that it decreases your appetite? Could that be the reason you haven't felt like eating much lately? I would think that the increased dosage would help with anxiety as well, no?
> And yes, I've improved a lot overall since my first GAD "blow-up" 4 years ago. So I do have to remind myself about that every now and then. But like all of us, I just wish I was WELL!
I hear you! It's human nature to think about what we're missing rather than how far we've improved. But you're definitely headed in the right direction! Anxiety problems are the worst. People who don't have them have no idea what we go through. Anyway, I hope the tryptophan increase helps a lot. Keep us posted.
Take care,
Kara
> Warm wishes,
> Jas
Posted by laura k on June 19, 2006, at 7:51:09
In reply to Re: Anyone feel miserable, anxious on waking, only? » jasmineneroli, posted by KaraS on March 24, 2005, at 2:14:54
I wanted to follow up on the previous posts... I did a google search on anxiety in the morning and this came up. Ten years ago I was diagnosed with bipolar disorder (bipolar I mixed, most recent episode depressed) was on medication for over ten years with varying success, never really got a handle on the depression and it only got worse. I suffered seratonin syndrome and severe seratonin withdrawal in december thru march and was taken off all meds.
I started eating organic food only to get rid of all chemicals and toxins. I went thru liver and gallbladder detoxification. My cholesterol, blood sugar and weight dropped to normal as of mid-march. I felt good for about 6 weeks, then started waking up with severe anxiety. During all this I lost my job and my insurance, my home has been put on the market, my daughter and granddaughter moved in with me and my daughter's husband jailed. So the stress has been enormous, but my mood in general remains good. I am not suicidal, not manic.
Yet, I wake up with anxiety several times in the night, always accompanied by thirst and the need to urinate. I cannot pinoint any bad thoughts, sometimes I have a song in mind. This goes away as the morning progresses, whether I eat or not. I had been sleeping well for a month or two. 5-6 hours (that's a lot for me!). I am not sure what the change is or how to reduce this anxiety! I went to a pdoc last monday (the county paid for it) and he seems to think it is generalized anxiety disorder and will prescribe Ativan, but it has to be approved by the county, so I still have no meds whatsoever. Any thoughts on this?
> > Kara:
> > Yes, I've read that Cortisol is supposed to rise in the morning and "activate" your body to get roused for the day.
> > Mmmmmmmm, I'm wondering if it does, and in people like us, it simply causes anxiety. I don't know if it relates to other brain chemicals. For instance, does higher cortisol levels USUALLY increase dopamine and/or NE, so drive and reward centres are activated, thus the "rise & shine" effect..that I'd like to get back :).
>
>
> I don't really know much about cortisol. It's so critical to know about when you suffer from anxiety and depression yet I haven't been able to force myself to research it. I think I read once a while back that when levels of cortisol are raised due to stress, that it negatively impacts the production of neurotransmitters, thus accounting for the connection between increased and sustained anxiety leading to depression. I could be remembering this incorrectly however. Hopefully someone more knowledgable about it will chime in here.
>
>
> > Perhaps, for us "female" hormones are at issue. High progesterone causes lethargy, sedation and depression. Maybe it's an early am increase in Progesterone!!
> > I've often pondered about the HPA being a really key part of my problems. SOOOOO many things to consider always. Woiuldn't it be great if we could be hooked up to machines every night for a week, that analyzes blood/brain tissue levels of all hormones, neurohormones and neurotransmitters.
> > And also measures brain electrical activity, muscle activity over the entire body. Plus, skin temperature and body temperature. Oh yeah, don't forget blood sugar and electrolytes!
> >
> > Then in the mornig we press a big red button and get a complete print-out of what was happening physiologically and neurologically overnight. We could addd in our anecdotal observations about how we feel both re emotions/mood and energy.
> >
> > What fascinating reading it would make, and how our Pdocs would hate it, when we show up with sheaves of paper to analzye! But it would be VERY helpful.
>
>
> Yes, it would be great to have those kinds of automatic printouts on the state of our health!! (Have you ever considered a career writing science fiction?) That's a few hundred years away however. I'd settle for being able to get a full work-up when I go to the doctor's office. You have to fight tooth and nail these days just to get things like cortisol, Vitamin D, full thyroid panel etc.
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> > How long have you been taking the Doxepin? What dose do you take and have you noticed any side effects?? I'm glad it's helping the anxiety, because it's so wearing.
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> I have been taking the doxepin for a few weeks now - over a month at 25 mg. I used to take 25 mg. of it for many years starting over 20 years ago. It has saved my life twice now when I've had a severe agitated depression. If I am not on any medication, I become completely incapacitated by anxiety and depression. The anxiety could not be any worse. I have to say, however, that SSRIs have also been able to completely take care of my anxiety. So even though my anxiety can be so severe, it responds well to treatment.
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> The side effects I've had from the doxepin are an increased appetite. I'm glad I'm able to eat again but I just wish my appetite weren't so strong. There's a little bit of grogginess I think. I'm not sure if that's the right word for it. I had some heart palpitations. It seems to be happening less often though. It may be unrelated to the medicine. I just had an EKG to make sure all is ok. I don't have a problem with dry mouth at this dosage nor have I had problems with orthostatic hypotension. (Don't know why as I used to have that problem when I took it years ago.) I don't know if there's significant memory or cognition problem at this low dosage. (I'm considering switching to Remeron partially because of the palpitations and partially to see if I would have better memory and cognition on it. Also, because of the cardio issue I think I'd feel more comfortable increasing dosage of Remeron and I wouldn't want to do so with the doxepin.)
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> > At my Pdoc's last week, he felt that the symptoms I described in my original post are due to a developing depression (my GAD does have depressive periods, for some reason i never recocgnize them coming!). I'm now on increased tryptophan for a few weeks. There's probably a seasonal aspect to this too.
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> I tried tryptophan many years ago. I only took it a few times for sleep. I really should look into it further. I'm glad it helps you. Do you find that it decreases your appetite? Could that be the reason you haven't felt like eating much lately? I would think that the increased dosage would help with anxiety as well, no?
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> > And yes, I've improved a lot overall since my first GAD "blow-up" 4 years ago. So I do have to remind myself about that every now and then. But like all of us, I just wish I was WELL!
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> I hear you! It's human nature to think about what we're missing rather than how far we've improved. But you're definitely headed in the right direction! Anxiety problems are the worst. People who don't have them have no idea what we go through. Anyway, I hope the tryptophan increase helps a lot. Keep us posted.
>
> Take care,
> Kara
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> > Warm wishes,
> > Jas
>
>
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
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