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Severe Anxiety Upon Waking


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I had a thread somewhere on anxiety when waking and can't find it now. Glen posted an abstract about bipolar people with high cortisol levels in the morning.

But what's happening now is every time I awaken, even from a nap, I get a severe shot of adrenaline (or is it cortisol). And the worst part is if I'm taking a nap and drifting in and out of sleep I get the anxiety over and over again. Depression is bad, so I can't make it through the day without a nap. I'm very slowly reducing Depakote, which is somewhat sedating and I'm not able to sleep as much. I'm not even getting enough sleep now.

Does this happen to anyone else? It's torture.

For Dee: I asked my new pdoc about Gabapentin and he said he thinks it doesn't do diddly (he used a different word). But next time I see him I think I can convince him to let me try it. He's old, seems very knowledgeable, a pharmacologist, very laid back and accomodating (sp?). So far I like him. But I'm doing worse since I've made a couple minor changes. ;)

I know Lamictal isn't for anxiety but I'm really hoping that will somehow lessen depression which will lessen anxiety.

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I've had something similar, last year. I was on some sort of medication at the time, but can't remember which one exactly when this was happening (either while on WB or one of the SSRI's).

Every morning as soon as I started waking up, I got extreme feelings of sadness and despair. I would lie there for a long time, crying and wallowing in self pity and dwelling on things and thinking it was a hopeless situation and that the only way out would be to end it all. During those episodes I was utterly convinced there was no hope for me due to my emotionally abusive childhood permanently scarring and ruining all aspects of my adult life.

I would have this every morning upon waking, like I had some sort of chemical imbalance upon waking up, because once I was fully awake I wouldn't feel so bad.

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I can't think of any reason why awaking would a sudden rush of adrenaline/cortisol. Now, from experience I know that with sleep apnea, the opposite is happening. The apnea happens, the body struggles for oxygen, adrenaline is released, heart races, body jumps and suddenly I am awake with a racing heart and breathing hard and a feeling of anxiety/fear, whatever.

Is there any chance you have some flavor of apnea? Do you snore?

BTW, the natural low for cortisol is around 4 a.m. That's why asthmatics often awaken around this time and often have their worst symptoms early in the morning.

a.m.

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for me, the instant i become aware that there is anything around me (people outside the apartment, the roommate being home, any noises like neighbors flushing toilets, cars, tvs, radios) i go into an adrenaline rush. it's most common for me as i wake up, but happens throughout the day, as well.

it's part of why i wake up so easily and never sleep very deeply. i only wake up to the classical music station because it is gentle. my buzzing alarm sends me into such a panic i refuse to hear it so i won't get up to it lol.

so is it the waking itself, something you notice, or something that wakes you up that causes the problem?

abifae

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AM, I don't know what the cause is either, but before the gabapentin I had the same problem with waking with horrid anxiety. Then it became waking with suicidal thoughts and shitty depression.

Why are these things worse in the morning with some of us?

I don't know Lemon. I know alot of people think gabapentin/neurontin is useless shit. My ex-pdoc is also a psychopharmacologist and he did a study that showed gaba to be useful in bipolar anxiety and agitation (not as a mood stabilizer). It's on Pubmed. Note, it was only in bipolar, not in anxiety disorders. It definitely works for me.

p.s. I can find the study for you if you want. PM me. I don't want to drop my ex-pdocs name.

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AM said:

>>>Is there any chance you have some flavor of apnea? Do you snore?

BTW, the natural low for cortisol is around 4 a.m. That's why asthmatics often awaken around this time and often have their worst symptoms early in the morning.<<<

I don't think I snore that much. My wife hasn't noticed it. Plus it happens when I drift in and out of sleep where I'm not snoring.

The one thing I just realized from what you said is that when I wake up in the middle of the night around 4:00 a.m., I don't get this anxiety.

Helena said:

>>> If you have no problem going back to sleep, try putting your alarm clock one hour before you need to get up, take a Valium and then go back to sleep.<<<

I've tried this with Ativan and it didn't help unfortunately. But I have become tolerant of the dose I'm at so it's not that effective in general anyway.

abifae said:

>>>so is it the waking itself, something you notice, or something that wakes you up that causes the problem?<<<

It's the actual waking. However if it's something that causes me to wake up it's even worse.

I'll PM you Dee.

I'm going to once again try increasing the Lexapro but this has backfired in the past.

Thanks.

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when i was pregnant, i must have had some weird hormonal stuff going on, because i'd wake up for work (before the alarm) and suddenly panic. it was terrible. and of course, i only have klonopin, nothing faster-acting, so i'd chew my klonopin and try to wait it out. i'd hit the snooze on the alarm a couple of times (planned ahead for this so the alarm was set early), and just tried to calm myself down so i could get out of bed (my klonopin and water were on the table next to me).

have you thought of a longer-acting benzo, like klonopin? ever since my episodes with freaking out at night thinking someone was going to break in, i've had to take 2mg klonopin to go to sleep and stay asleep. hey, whatever works.

i think i have sleep apnea too, but i haven't had that proven in a sleep lab or anything.

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have you thought of a longer-acting benzo, like klonopin? ever since my episodes with freaking out at night thinking someone was going to break in, i've had to take 2mg klonopin to go to sleep and stay asleep. hey, whatever works.

This is why I switched from Ativan to Valium. Valium has about the same half life as Klonopin. However it is a little less potent but does act very fast. I tried Klonopin a few years ago and it made me irritable for some reason. I may try it again just to see what happens.

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yeah, i'd give it a go. benzos are cheap enough to buy. yeah it takes longer for klonopin to kick in, but when it does, it calms your ass down. it calms me right into a beautiful sleep if i take 2mg. my normal dose is 3mg/day, with 1mg split into 2 doses during the day and 2 mg at night.

i still woke up with panic attacks, but now that i'm not pregnant i don't anymore. i think it was my wacky hormones.

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Hello Lemonflavor:

No wonder you dug up that post so fast. You have a similar problem. I have it going to sleep, you have it waking up. I went to the specialist for anxiety in our state. Not that I'm special, but he's from my county and will see anyone living here, although he only gave me 10 minutes. He determined it's sleep apnea with me, and they want me to take the test. I disagree.

Anyway, about Neurontin. It varies from person to person. I was prescribed it for day use, but couldn't get out of a chair all day. This went on for 6 months until every single test said I was fine. It was then determined the Neurontin was making me sleepy. So now I take it at night.

If you can afford it, I highly recommend the Nuerontin liquid. It's the "real deal". They don't make Gabapenten in a liquid form. And somehow, this makes a difference with me. I really like it at night, because on a night without panic, I go to sleep fast. It has kind of a warm feeling to it which is relaxing, and because it's liquid it absorbs faster. I take a pretty high dose because of my panic attacks, but it's worth it. The problem would be cost.

If this sounds good to you, go through the whole capsule, pill, and whatever else Gabapentin form comes in and tell them it's not working. That's how I got to the liquid. My insurance company doesn't like it, but I really prefer it and can tell a difference over the generic.

Good luck.

Also. I don't have issues with depression. But have you considered that you might have a low startle reflex? And that any noise in the morning is causing you to "bolt' awake? I have a low startle reflex too. It doesn't happen when I'm sleeping but it does happen throughout the day. Maybe it's as simple as that.

Nah......too easy. But check out the Nuerontin.

Oh and increasing the Lexapro will only make you more alert. It's really stimulating as SSRI's go.

Breeze

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Thanks for the thoughts. I do have a low startle reflex or there is another term for it I can't remember, and anxiety makes it worse. But it happens when I wake up no matter if there are any sounds or not.

I'm going to ask my pdoc for Gabapentin which I can get through rxoutreach.com. I don't see any way I could afford Neurontin being underinsured.

I've been increasing the Lexapro and so far it hasn't made it worse or better but my digestive system is better so that's a plus.

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I'm going to ask my pdoc for Gabapentin which I can get through rxoutreach.com. I don't see any way I could afford Neurontin being underinsured.

It would be the same to you as Lexapro. I made it out to sound really spendy, but it's simply the non-generic form.

Hopefully the Gabapentin will do the trick for you.

Breeze

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I used to wake up in a full blown panic. I was even on seroquel then too. But part of it was that I had been drinking the night before and I think that had something to do with it. I stopped drinking and the morning panic attacks decreased but didn't stop. when i stopped taking the seroquel the attacks stopped too so who knows. Now if I wake up panicked I reach for a klonopin, do breathing exercises and wait it out. It's strange the things that set me off. it's been a few weeks since I've had a panic attack but a while since I've awakened panicked. Maybe you had triggering dreams as well and were waking up with them on your mind.

I hope you can find something to help

lilie

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I've raised the Lexapro gradually from 10mg to 20. As of now, I still have bad anxiety upon waking in the morning, but not quite as severe. Although I still want to be dead for the first hour after I wake up and get up. But I haven't been getting the anxiety when waking from a nap. So that seems to have helped a little. It has also provided a constipating effect so that I don't have diarrhea in the morning from anxiety. I hope it lasts. Only on my third week of Lamictal titration.

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lemonflavor,

do you know if you have high cortisol levels?

see if you can get your levels tested. there are reasons why you could have high cortisol levels in the morning, or throughout the course of the day. sometimes stress becomes cyclical and once you're in cortisol overproduction *some people* stay there. i am not saying this is happening to you, this is just what is wrong with me. the blood test was a bit pricey though, unfortunately. there are also saliva tests.

mine are through the roof all the time. he has me take this supplement called seriphos which is a special form of phosphatyl sterine. (something that bodybuilders take, heh. something about coritsol preventing muscle bulk, i dunno.) only try this if you find out you do have high cortisol. repressing cortisol when your levels are fine will can make you feel like ass, and it's just a bad idea to mess with hormones when they don't need messing with.

if the gabapentin doesn't work out for you, you may want to ask about lyrica, which is similar but like all meds that are similar is also quite different. it has been my wonder med.

this is all just in case what you're taking doesn't work out. and i really do hope it does. waking up in a panic is awful, and it makes it nearly impossible to get fully rested.

hope you feel better,

penny

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I wake up with panic sometimes. The only thing I've found helps is clearing your thoughts, relaxations techniques, praying and then daydreaming before falling asleep. I'm not saying you should pray, we don't all believe, but some meditation/relaxation techniques should be helpful in giving you a good night's rest. And for me, the better I sleep, the less anxiety upon waking. The clearing your thoughts part is really important, don't lay dwelling on your mistakes during the day (at least I have a tendency to do that).

Just an idea. Some of these techniques I learned in DBT, and I still have some exercises on my computer. If you're interested I could translate parts of them.

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I haven't had my cortisol tested. Insurance (minimal major medical) won't cover it so blood tests are tough financially because I also have to pay for the pdoc. I will ask him about it though.

Being a Christian I do pray everyday along with Bible reading etc. Believe me I've tried everything for better sleep but still have bad dreams every night and no amount of relaxation techniques help other than trying my best to block out the anxious thoughts while I'm still lying in bed before I get up.

I would be interested in the DBT exercises.

Thanks for the comments.

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Since money is at a premium for you, check out this web site. I have all 5 of the Sounds of Source CD's. But if I were to choose one, I'd get Volume 4. After you've read about that, go back and read why this works so well with the brain.

These are meditation CD's. But they are specially designed for different brain areas. These are for the "theta waves". I had no idea how cool they were in design, I only knew that they helped me to sleep, and left me feeling rested in the morning.

It might be worth trying this for awhile. If you can get your brain "retrained" to sleep without nightmares, you might be rid of them altogether.

Check it out.

Breeze

Sounds of Source Vol. 4

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maybe these will save helena from going to the trouble of translating...

i have found this sleep protocol to be helpful. it is from the behavioral tech website, which is marsha linehans's company. (she is the woman who invented DBT.) so that sleep protocol is pretty much a DBT sleep protocol. (i am a huge fan of DBT, and i think there are very few people it can not help. don't think that these techniques don't work because i've been having sleep problems. i have hormonal imbalances and some other things going on right now. DBT saved my life, and this protocol has worked for me many times in the past.)

the DBT Self Help website also has links to worksheets on many of the core skills of DBT.

helena, are either of these like what you have?

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