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trying to rebuild, or at least just not slide any farther downhill


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Didn't really know where to post this. Anxiety is the worst of it, but drug use is a hallmark of my experiences and mistakes, so it landed here.

I'm in a really bad place right now. I'm just so frustrated. I've tried everything imaginable, but I'm fried. Cashed. Burnt out.

I went to rehab six months ago after a really heavy four year opiate binge (started with surgery...), and about twenty years of drug and alcohol 'abuse' - self-medicating and partying a LOT with any and everything. It has been a hard road. Mainly because of all the mental anguish that the drugs did a fair job of keeping at bay.

I've got insomnia pretty bad. I constantly try to fall asleep naturally, but never can. So it's either stay up all night, or take some Trazadone, Seroquel, Mirtazapine, or some other crap they give us junkies (not allowed to have benzos or stuff like Lunesta). Of course I've tried Kava, Valerian, Melatonin, and about another hundred herbal and home remedies. Honestly, insomnia is one of the main reasons that I got so into using opiates and benzos. At a certain point, one will do absolutely anything in order to just get a good night's sleep.

But anyway, I always end up taking one of the sleep meds mentioned above (currently Mirtazapine), which will eventually let me fall asleep - but then I am a zombie all day the next day. Yes, I've tried 1/2, 1/4, and various other doses. Enough to put me asleep invariably makes me groggy and sore to the point of dysfunction the next day. I usually end up drinking a good bit of caffeine to counteract it. Which makes the insomnia worse. And the anxiety. I should also mention that I have pretty severe sleep apnea, so even when I do sleep, I don't wake up refreshed - actually I feel worse. I've done sleep studies and tried the CPAP devices, but I can't tolerate them - it drives me nuts to have something strapped to my face. I can't even sleep with socks on, let alone a full face mask with a machine blowing air all over my face.

So that's my sleep problems. Intertwined with those issues is maddening anxiety. I've been anxious and depressed since I can remember. I've had very serious suicide attempts over these things in the past. I've been in various forms of therapy for around 14 years, but little has helped other than medication. But medication has only done so much. Taking Cymbalta has done wonders for depression, but anxiety is much harder to beat. The amounts of benzodiazepines that I have to take to get my anxiety under control makes me pretty useless. Besides - doctors won't even give me benzos anymore since I was/am "a drug addict". So I get crap like hydroxyzine and beta blockers and pregabalin (Lyrica). Beta blockers helped for a couple of months, but now I seem to have built a tolerance - even if I take more, they don't do anything. Hydroxyzine (Vistaril) is like treating a fractured skull with a hello kitty band aid. Pregabalin helps, but only if I take a lot more than prescribed. All three together take my anxiety from an 8 or 9 down to maybe a 6 or 7.

My various therapists have given me tools to use such as CBT exercises (which helped a ton for the first three months or so, then inexplicably stopped having any effect at all), somatic 'grounding' exercises (only work when my anxiety is already pretty low - can make mild anxiety go away, but when I'm on fire I can't even concentrate long enough to do it), advice from Qi Gong (yeah, right) to exercising to going Vegan. I meditate quite a bit when I am able to sit still. Many of these things can help me out when I'm feeling just a bit worried and have some nervous energy (exercise being the most potent by far), but when I am so freaked out that I literally can't stop shaking and want to smash my face into a mirror - well, most of these things just don't do much. It's like trying to stop a freight train with positive thinking.

The worst of the anxiety is actually what I consider 'biological' or 'physical' rather than mental worrying. I can pretty much ride out the worst mental shakes, being a seasoned pro at it. Sometimes (most times), all you can do is just ride it out and try to limit the collateral damage. It's the extreme nervous energy that I really struggle with. If you've ever had restless legs at night, or gone through opiate withdrawals, you know what I'm talking about. About half the time I try to sit still or lie down, I have to constantly 'kick' my feet, and sometimes shake my hands really fast for long periods in order to 'shake it off' and try to dissipate the creepy-crawly waves of negative, nervous, troubling energy coursing through my blood, through my bones. It's just like RLS, except not just at night, not just lying down. I've had issues with this since I was a kid - opiates and benzos helped it a lot, but those aren't really an option now. Maybe it's some kind of thyroid disorder.

What compounds the anxiety I've always had is that right now I'm kind of blown out of life. After rehab, I ended up back at my parents' house for the first time since I was 17 (I'm 36 now). I left my job just before that, and totaled my new car one day after the insurance claims that I was dropped for non-payment. Basically, I've bent my life over and sodomized ever bit of quality out of it. I am literally almost forty years old, living in my elderly parents' pink, doll-themed guest room, without a car, without a job, without many prospects. And you can guess correctly that my family's dynamic is a bit off. It hasn't been that bad, compared to when I was a kid living here - but just trying to keep the peace while staying here would be a full time job, even if my head worked correctly. I clearly can't stay here much longer - I WILL self-destruct, I know that from experience. But it is also very challenging to get my ass to work right now, while my head is reeling from PAWS and anxiety and trying to shake off sleep meds. Plus, I don't have insurance anymore, so paying for a Pdoc and/or therapist is difficult (and adding to my feeling of frustration and helplessness). I've really painted myself into a corner. I tell myself everyday that it is just a matter of white-knuckling it through this down period. Time to just throw my full weight into working and saving money while my folks are letting me live rent-free. Telling myself to just walk through all the feelings of discomfort and insanity - just try to do damage control and save money. If I can get a good bit of cash saved up, I can take some steps to make my life more manageable, and maybe find some joy in it. It's just so hard to do while I feel like I can't get my leaden ass out of bed all day, then can't stop my skin from crawling all night. And all during, there are some genuinely disturbing thoughts going through my mind.

I don't mean to ramble. I'm mainly just posting this for the cathartic effect. I don't expect much in the way of advice. I certainly don't expect anyone out there to be able to pick apart the train wreck that is currently my life and make sense of it. I guess that is just something I have to do slowly, on my own. Shit, I've been doing it most of my adult life, so I should be pretty good at it. I just don't like having to do it.

Thanks for listening.

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Welcome to cb. I hope it did feel cathartic writing that. i've been in paws hell and it is hellish. i'm sorry. I hope things can improve for you and that you can find/stay with some of the things that are working and slowly rebuild.

no advice, really. just hang in there.

Anna

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As far as Mirtazapine goes, the lower doses are actually supposed to be more sedating. I took 45mg, and it helped me sleep without grogginess the next day. I also don't get benzos because of drug use, so my pdoc gave me Risperdal for anxiety. It worked in a subtle kind of way, so maybe that's another option.

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