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How Does The Anxiety Subside? How Does Your Sleep Normalize?


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#1 Ramona80

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Posted 30 September 2015 - 10:03 AM

I'm not experiencing the kind of anxiety I had when in initial withdrawals in the spring.  But I have anxiety in the form of worrying ("what if" questions tend to pop up a lot for instance) and some days, my anxiety is in the form of dread and misery of the state I'm still in. My sleep is still affected by myoclonus (jerking awake) and I get so scared about the fact that it's still present. My therapist says that my anxious thoughts could perpetuate this. So now I'm anxious about being anxious.

 

The people on this board who have said that it gets better, how does the anxiety subside? How does it get better? How does it lessen? 

 

I wound up in the hospital in July because I could not sleep. My brain was cranked up so high by how my Cymbalta dose had been jerked around, it was like my nervous system had just blown out. My heart wouldn't slow down, I couldn't get sleepy. Each time I did fall asleep I'd jerk/jolt right back awake. This would happen all night long. 

 

A ways back I remember seeing things online about one's nervous system being "destabilized" after their SSRI/SNRI dose was lowered too quickly, and held there for too long. So I suspect I'm still in a destabilized state. I have had not had normal sleep for the past 6 months of Cymbalta ups & downs. Finally now I am off the Cymbalta, but the sleep issues remain. But I understand that my nervous system has not stabilized yet. 

 

Never before in my life have I experienced sleep issues like this. Having been going on for so many months, I can't remember what it's like to go to sleep normally. How will this normalize? Will this normalize? Will my brain gradually regain its ability to sleep normally?


#2 brzghoff

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Posted 30 September 2015 - 11:44 AM

Ramona, you sound like me. you have a therapist, and that is great. is he or she trained in cognitive behavioral therapy? are they teaching you skills to work on in regard to your anxiety? by that i mean actual step by step instructions to challenge your beliefs and how to move forward? techniques to build your confidence? it sounds like it based on your comment that your therp said "my anxious thoughts could perpetuate this. So now I'm anxious about being anxious." that is so true! mine says the same thing - the fear of fear. sounds like franklin roosevelt ;-) what tools has your therapist given you to work on that and other anxiety triggers?

 

i wouldn't worry too much about the reasons or the science behind why cymbalta or other drugs may or may not have destabilized you. anxiety in and of itself is a destabilized state regardless of what triggered it. the important thing is working on what your therapist teaches you. why we have anxiety does not change what we must do to get it under control. the background info is interesting especially to inquisitive folks like me, but working on the condition is more important. 

 

as for the sleep thing, that goes hand in hand with anxiety. i was always a sleep on demand kind of person until i developed anxiety upon withdrawal. the meds of course made me sleep too much, but from childhood on forward i would sleep 10 hours unless i had an alarm to wake me up - which was aways essential for school and work. now sleep is elusive. it ebbs and flows with my anxiety levels. exercise is very important . literally wear yourself out - but not within 4 hours of bedtime!  occasionally i take a benadryl if things get out of hand. that stuff knocks me out cold! i try to avoid more addictive substances like ambien but have taken one of my husband's a few time. i won't touch benzos. 

 

i also take clonidine. it is a med that is primarily for blood pressure but also works well for anxiety. i will use it before bed. it lowers your heart rate and BP which helps lower prime anxiety symptoms and can make you sleepy. i only take .1 mg every night, some folks take it 2 or 3 times a fay. i would be too sleepy if i tried that. but it is not psychoactive like anti-D's and benzos which is a good thing.  

 

i am sure you know this, but there is no magic bullet. anxiety does get better - but we have to actively participate in our recovery. it is important to work on challenging our negative thoughts - daily - to get anxiety under control. thats where your therapist comes into play. i also recommend the web site http://www.anxietyguru.net it is helpful in focusing on solutions. it is hosted by paul dooley, a former anxiety sufferer who offers his own tips and techniques to get anxiety under control based on his own self-help experience. he has since gone on to get his master's degree and will soon be certified to practice. check out the reading section where he has a blog and related podcasts. browse it to find the topics of most interest to you. 

 

i posted a really long topic (even longer than this!) on anxiety symptoms and my thoughts on anxiety in the what are you feeling section. 

 

hope this helps. 


#3 Ramona80

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Posted 30 September 2015 - 12:52 PM

Thank you, that does help. And you're right, my therapist has a CBT approach. I have had a tendency to let myself get carried away by my worries. Yes, my therapist gives me specific things to work on, particularly de-dramatizing my thoughts & words...bringing them down to a more rational level. 

 

This is what I'm worried about, though: You said your sleep was affected by the withdrawal, and it didn't return to normal. That is what worries me most. I don't want the Cymbalta to have broken that part of my brain, so to speak. That's what all my fears have centered on the past few months. I have always been a sleep-10-hours-a-night (unless early alarm) person, too. Up until withdrawals. People say "it will all get better" but then I read about people who say, no, years later they're still struggling with this or that withdrawal symptom. Sleep is essential to quality of life and this is what I fear, that it's been taken from me permanently and quality of life will suffer. Ending up in the hospital from going without sleep was the scariest thing that's ever happened to me. Going days with virtually no sleep was awful. I am on 2 other meds right now to help me sleep. I don't want to be on these forever. Even with them, I still experience getting jerked awake, just not as much. 

 

Is it possible to fully heal from the anxiety that withdrawals give us? Are there any people who have fully come out of the anxiety?


#4 brzghoff

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Posted 30 September 2015 - 04:35 PM

yes, there are people who say that years later they are still struggling with "this or that" withdrawal symptom. however, we don't really know what the cause and/or triggers are for those symptoms. we really don't. withdrawal is real but to worry about the future - something that hasn't happened - can hamper progress. it certainly hampers mine when i start "what iff'ing"

 

no doubt withdrawal makes us more sensitive to triggers that lead to anxiety. however, once anxiety has triggered its easy for it to become a habit - anxious about being anxious. that part is ours. we own it. anxiety as a condition can be long term or short term - whether or not someone has been on a psychoactive drug or not. its estimated that 40 million americans suffer from anxiety (i read that today if i can remember where i will post the link) most have never been on any prescription drug. how we deal with it is the same. 

 

you said a couple things: 

"This is what I'm worried about, though: You said your sleep was affected by the withdrawal, and it didn't return to normal. That is what worries me most. I don't want the Cymbalta to have broken that part of my brain, so to speak. That's what all my fears have centered on the past few months."

 

worry is anxiety.  what does your therapist teach you to work on that? try not to focus on whether it is cymbalta that broke your brain. my belief is that my withdrawal is over and the anxiety is mine. cymbalta did no permanent damage to my brain. during withdrawal the levels of neurotransmitters are fluctuating which can create a vulnerability but it was my own negative irrational thinking that pulled the original trigger-  therapy has helped me recognize those triggering thought processes and that is what i work on. its not brain damage that sets off my anxiety - it is me worrying about things i cannot control - fear of the unknown. 

 

you are right, i mentioned that my sleep was affected. is it the withdrawal or the anxiety? its the anxiety. and my sleep hasn't returned to normal yet. will it? i don't know but its getting better. i also recognize that when i went on anti-D's i was 36. i went on cymbalta at age 44. i quit when i was 54. that is 18 years on ant-D's… but in 18 years many people develop insomnia or difficulty sleeping with out EVER having been on any drug. its common as people get older. so for all i know - that's why i don't sleep as well anymore. what is important to me is to work on controlling my anxiety instead of playing wack a mole with each symptom. controlling the anxiety comes from the help i get from my therapist. for me it means changing expectations. there are no "must's" "should's" or "have to's". things are what they are and I can only change myself. no it isn't easy - not for me not for anyone. its not even hard. its REALLY hard. but we can and do get better! 

 

keep in mind that anxiety is caused by thoughts. the fight or flight system is triggered by a thought - "a bear is charging and is going to eat me" that thought sends the adrenaline and cortisol in motion, increases breathing rate, and heart beat and starts up the many other physical processes. that's so that we can fight or flee. thats how the system was designed. its a physical process that starts with a thought. 

 

as i've mentioned, its not about fully coming out of the anxiety - its about learning to control the anxiety. i know you realize there is no magic bullet and that it takes a lot of work - and that you like your therapist! that's gold! since you recognize that it takes work - that's what you focus on. the words you tell yourself point the way to your recovery. 





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