The fear of not getting back to sleep / depression / anxiety / Hell!

Signs and symptoms
1

Hi all - I'm sure a few of you can relate to this problem.

After 12 months of on and off sleep problems, I'm currently struggling with very early wake ups again. Even when I'm very tired still, I'll wake up at the crack of dawn and then the thoughts start coming:

'Please go back to sleep'

'Oh no, it's happening again'!

'Why me'?!

'How the hell do I stop this'?!

My problem is that I've gone through life attaching an intense importance to life events that worry me. At the moment it's sleep and lack of.

I do this because of a problem I had up to the age of 15 which severely affected and damaged my self-esteem.

I seem to go through life sub-consciously looking for the new 'albatross'- even when I've get over a problem, I seem to look for the next one. As much as I don't want another one my sub-conscious does!

So here I am, it's midday and as usual I'm exhausted purely because of lack of sleep. I have just started citalopram after a period on fluoxetine as I'm also suffering from depression and anxiety. These two conditions amplified when my sleep problem emerged out of nowhere 12 months ago. Up until then my sleep was relatively normal.

I'm hoping the mindfulness and new SSRI will help me to let this fear go and allow myself to have a happy life. God knows I really want one, but on certain days I wonder what the hell is going on or what I've done to deserve this.

I really wish I could snap out of this like some people can but something won't let me.

It's so damn miserable, I can't tell you.

2

I have read on another forum that early waking is a symptom of cortisol levels either being too high or too low. Sorry, I can't remember which. It might be worth having your doctor check cortisol levels for you? Best wishes Marion

3

Hi David

I totally understand your plight.  I have not had a good night sleepin over 20yrs.  I have had pains in my hands, back, shoulders and neck for over 20 yrs and that is my main reason for lack of sleep.  Only in Aug 2014, I was diagnosed with Fibromyalgia. I now also have to contend with night sweats and I have been checked for being menopausal, but got the all clear.

Cognitive Behaviour Therapy has played a big part of my life over the past six months.  Although it hasn't taken the pains away, it has given me a mindfulness of thinking. I push stresses away and try to stay calm and positive. This has helped me not to worry about everything in my life but just to deal with a day at a time. Enjoying each moment of the day is more beneficial to me than being stressed.

Hope you can get a good night sleep soon.  x

4

Hi David,

I'm similarly a worry wort (diagnosed with OCD when I was 5 or 6), so when I started having problems with frequent wakenings a year ago, it was pretty hard for me to not dwell on it. Thankfully, I've found some things that have helped immensely. Maybe you could try something similar.

My therapist also took me through mindfulness. I sort of morphed that into telling myself little lies to make the sleep issue seem less catastrophic. The most important one was to tell myself that bed isn't only for sleep, I can just lie there, relax and be comfortable. Then I think on something interesting, and I calmly drift off to sleep. I also assure myself that I can be productive at work the next day if I really put my mind to it, regardless of sleep. When I start my sleep in a calm state of mind, my entire bedtime is more peaceful. I still wake up sometimes, but it is less disruptive.

I also used to check the clock every time I woke up. I wanted to know "how I did" during that sleep segment. When I stopped doing that, my sleep improved further.

There are other things that I do as well: strict sleep hygeine, exercise, and no big stimuli before bed like TV.

Hopefully those suggestions help. I've been there, and I know how awful it is, but trust me - you CAN get better.

5

Hi all thanks for your replies - much appreciated.

Anyway to give you a bit more detail, my sleep issues started about 12 months ago after a sleepless night that came out of nowhere. Before this I has slept pretty well most of my life (I'm 38) BUT ... I did start taking a Nytol more often than I should in my 30s to get off to sleep. Also, my anxiety levels increased over the last 5 years, ususally to do with a couple of work / social situations that were becoming increasingly problematic and to be honest, embarrassing. I'd have a nightly episode of falling alseep okish, then waking around 3am to use the bathroom and then the thoughts of this particular anxiety situation would engulf me for around an hour. However, I would normally fall back to sleep.

12 months ago when my sleep went completely, I had a meltdown and thought I'd never sleep again. I was in an anxiety / insominia viscious cycle and didn't know to escape. I had a lot of GP appointments which resulted in:

1) Prescriptions of zopliclone - a sticking plaster that I was keen to limit the use of and did thankfully.

2) Recommendation of SSRI's - I took fluoxetine for 7 months and have now switched to citalopram. I was also taking 20mg amitriptyline at night also.

3) Told to try and find ways to relax

4) Referreal to community mental health team - I had several 1-2-1 sessions, an anxiety group and a mindfulness group all of which I found helpful but obviously they didn't solve the issue outright.

In my opinion what had happened (and is still happening) is mainly phsychological as I have a tendency to let everyday challenges like sleeplessness engulf me. I almost give them permission. This then leads me to ruminate almost daily about how to solve them while getting nowhere, just increasingly anxious.

I've had tests for thyroid and that came back fine and I've had no major health problems in my life to date touch wood.

So, so far I think much of it is down to my own mind. The last 12 months have also coincided with a very stressful period at work and in relationships. I'd say mild depression has been there for some years and has surfaced through the severe anxiety period I had last year plus of course the sleep issue. The way I managed depression in the past was through cardio exercise at least every other day.

This time last year the depression and anxiety was surfacing but I could still sleep 7-9 hours every night until that one sleepless night. I was never the best sleeper but I was normal in my opinion. Now that the anxiety has moved towards depression (and some anger) this is my current strategy to try and overcome and manage the depression / anxiety / insomnia:

1) Trying to accept I have the condition and that it can be undone - somehow!

2) Mindfulness and meditation - I do 15 minutes a day with a really helpful app called Headspace

3) Using the advice from 'The Effortless Sleeping Method' book

4) Exercise - I cycle 60-70 miles on a Sunday and gym 2-3 times a week

5) Good sleep hygiene where possible

I'm currently on day 5 of Citalopram 10mg moving to 20mg tomorrow. I was on Mirtazapine for 4 weeks but I was feeling very groggy as a result but it did help me sleep. It's like chicken and egg as my GP says the citalopram will help with the overall problem thus helping sleep.

I do take the odd diazepam at night which I know isn't ideal but what price a good night's sleep??!

So in all-in-all I'm trying to address the sleep issue for what I and various practitioners think it is - a result of anxiety and now depression. As I sit here, tired as usual - I bloody hope it works!

All the Best.

6

I am also suffer from this problem, When I go to bed 2-3 hours I am not able to sleep and these 2-3 hours, I just irritate with my self.

7

"I just irritate with myself." Getting out of the habit of feeling that way is key. I went through something very similar, so know how hard it is. When youare trying to fall asleep, don't think about sleep. Just enjoy being able to lie down and relax, and think about something pleasant - a nice vacation you had one time, times with good friends, etc. Anything not sleep related.

As for during your waking hours, see the rest of the discussion for some other things to try. Good luck!

8

"This then leads me to ruminate almost daily about how to solve them while getting nowhere, just increasingly anxious."

Yup, I've been there. That's something that the SSRI can help with.

As for the diazepam, its good that you are careful with it. That's in the benzodiazepine class, which are really good for inducing sleep but also among the most addicitve sleep aids. Is melotonin available in the U.K.? Here in the U.S., it is over the counter and dirt cheap. It's not as effective, but it helped me a little bit. It is also minimally addictive. Ask you GP first, but it could be a less risky sleep aid.

Everything else you are doing sounds fanastic (60-70 miles?! Wow, I feel like a chump now). Now try looking for ways to manage being tired. I take a 5 minute walk every hour or so at work, which helps. Consider snacks too. I find fruits are good, maybe because they tend to be digested more slowly than other sweets, so it may help to regulate blood sugar. I like almonds too - high protein, but not very filling. Try some things out.

Being able to manage your fatigue and be active despite it should reinforce the positive-minded narrative you are constructing. That should in turn help with the anxiety, and therefore help you sleep better. And whatever you try, be sure to stick with it for awhile ... not for five days, but more like five weeks.

God bless you man ... I've been there too, but I am certain you will find something that works.