Sudden onset insomnia/anxiety 4 months and counting

[alex20172018]

Hi,
I'm a 35 year old female (2 kids) and am desperate for some help/suggestions if anyone has any. My problem is follows:

I have slept wonderfully for 8 hours per night for the last 35 years of my life without ever encountering a single problem but 4 months ago we did a 8 week trip over the Summer to a different time zone. I came back home and encountered some jet lag...this couple of days of jet lag has escalated into a major problem. I started with having mini adrenaline surges everytime I was on the verge of slipping off to sleep (day or night) which then kept me in a highly anxious state for the rest of night so that I don't sleep at all. This was four months ago and has accumulated into now daytime anxiety and panic episodes over the slightest thing, loss of sociability, loss of appetite and not being able to sleep without the use of drugs (zopiclone which I was given two months into my problem). My life is now hell.

The GP initially tried herbal remedies including passionflower tea, melatonin, magnesium supplements, she moved onto a stronger type anti-histamine which didn't work at all before moving onto Zopiclone which basically sends me to sleep for 5 ish hours only and then I wake up and can't go back. I was on 1/2 tablet but now have to take a whole one to have any effect and I have to have them every night (and have done so for the last month) to have any effect.... I'm really worried about my dependence on this drug. The nights I don't take the drug, I'm literally awake ALL night long and the next night I'm still not tired, or unable to nap in the daytime.

I should also mention the GP run lots of blood work for various deficiencies, thyroid, hormones, cortisol... all came back normal.

The GP has also tried me on two different types of anti anxiety (Zoloft and Citalopram) drugs as she felt my insomnia was caused by anxiety (which I wasn't convinced by as the insomnia came first and I really do not have any stress or major worries apart from this lack of sleep). I had major issues with both drugs and on both occasions on the very first dose, I had a huge reaction including severe out of control panic attacks, vomiting, shaking, diarrhoea, fever.... I obviously don't suit SSRI's and this has made me reluctant to go back to the GP as I don't want to encounter this again...

I've also tried:
- Good sleep hygiene
- Various herbs including melatonin, 5HTP, Valeria, Ashwangda, Triptholia (spelling?), magnesium, B vitamins
- Acupuncture
- Osteopaths
- Trigger point massage
- Hypnosis (CD and then a therapist)
- Meditation
- Yoga and Nida Yoga
- Various therapies including counting sheep, trying to deny sleep, listening to audio books...

NOTHING is working and every night I try to sleep without the drugs and then fail. I just so want to get off the drugs and fall to sleep normally again.

Has anyone had an experience like this and come through it ok - if so what worked?!!

I have another GP visit booked for tomorrow and I'm not sure whether to ask to try another non-SSRI type of anti-anxiety drug such as Amitriptyline or Mirtazapine but a) I'm scared of the side effects b) I'm really not sure that if it does fix the anxiety whether this would have an effect on my sleep as I don't think this is really the the underlying problem.

Sorry for the REALLY long post and any thoughts received with many thanks xxx

[specialmom]

Hello.  I'm a mom too and have had insomnia issues in my life.  Our hormones can be involved so get those checked if you haven't.  When my issues were at their peak, I was walking around like a zombie and not taking very good care of myself.  I stand by this 100 percent, my diet and exercise routines/patterns helped when they were addressed.  Exercising in the morning helps sleep at night.  I cut out a good bit of the sugar I consumed and caffeine.  All caffeine.  And took a good multi vitamin.  I felt like a total wash out for a full two weeks.  Like the walking dead.  Then I felt better.  For real.  I had more energy.  

I was offered sleep aids and declined.  I would do your very best to get away from these as you say you are trying.  You can do it.

Do you see a therapist?  

I have had the same thing you describe.  Fear of being exhausted and not sleeping.  Laying there thinking 'how am I going to function tomorrow if I don't sleep?" and panicking that I couldn't fall asleep.  My doctor told me to consider rest sleeping.  Okay, we know it's not. But it is better than nothing.  I now stay still and keep the room dark, keep my eyes closed.  Sometimes I would listen to something peaceful or a book on tape through headphones.  But that can be too activating for me so that's infrequent.  

How are the other things in your life?  marriage? kids? finances?  Can you take a day off---  have everyone out of the house and just rest?  Sleep?  No pressure to sleep but know that you can or don't have to, whatever happens happens?

Let us know how the gp visit goes.  Let the gp guide you.  No one here is a doctor or knows what is best but we are all pulling for you.  I'd be open to whatever they suggest at this point.  How old are your kiddos?

[Paxiled]

First of all, a GP won't help you.  They aren't experts on any of this stuff.  Your GP does sound like he or she knows more about natural medicine than most do, but they aren't experts on sleep or anxiety or anything else, really -- they're the general docs who do triage and get you sent to the appropriate specialist except for the minor problems they confront on a more regular basis and become very good at treating, such as the flu.  For sleep disorders you would be sent to a sleep specialist, who are usually neurologists or to a sleep center to do a sleep study, which might or might not be useful to you.  I'm no medical professional, and your description of what happened is really odd and probably not something that happens regularly, so only the most educated and concerned specialist might have ever encountered this before.  Obviously, your problem isn't anxiety as a cause, but you do have it now as a consequence.  I agree with you that because you have a specific event -- the travel -- that caused this, it probably isn't caused by anxiety, so treating the anxiety, while it might make you feel better, isn't going to solve your problem.  Generally, time zone crossing disrupts both the melatonin system and causes a lot of oxidation in the body.  Some people, for example, solve jet lag by taking melatonin.  Some do it by taking superfoods that contain tons of antioxidants -- I used to manage health food stores and there was a product that used specially formulated wheat grass sprouts for maximum glutathione manufacture in the body, and this helped a lot of my customers who travelled a lot.  What you have sounds a lot like SAD, which you can look up, though it's not what you have.  Something appears to have happened to radically disrupt your melatonin system.  Melatonin is produced in the body from serotonin, so an ssri might in fact have helped indirectly, as might have the 5-HTP (but you need to also have sufficient B6 for that to work, as they work together to produce serotonin which then produces melatonin).  I wonder the dosage of the melatonin you used, whether out was sublingual, and who made it -- some manufacturers are better and more reliable than others.  It works better at low dosages than high ones, so you start with a low dosage and work up but should never need more than 5mg.  1 mg is a good place to start, sublingual.  Given the severe disruption I would think it would take some time to have an effect.  Since you're here now and not where you started, I hope you're exercising regularly and sticking with the meditation practice -- and aren't meditating right before or near the time you go to bed, because it's very energizing when done in a way that works for you.  Different forms of meditation work better for different people.  TM is the easiest to use, but Mindfulness is more popular today.  Exercise will tire your body out to exhaustion.  A sleep specialist can determine if your problem is a melatonin problem and work from there, hopefully.  This isn't an herb, it's a hormone, and it's not really a "natural" product -- although it occurs naturally in the body it doesn't come isolated like that, it was originally studied by medical researchers.  It's cheap because as a natural substance it can't be patented.  At first, it was thought not to work because scientists usually study things in large doses at first.  That failed, and it was only brought back into research when someone decided to try small doses.  I have no idea why this happened, and maybe nobody does, but this does seem to me to be the original sin so to speak as it happened crossing time zones which is known to disrupt melatonin.  Good luck and let us know what you learn.  Oh, I should add, there is a medication approved for use in Europe as an antidepressant but not in the US that works on melatonin, not serotonin.  Something to think about if all else fails.  

[Paxiled]

And let me add, anxiety once started can become chronic.  This is what happens in PTSD sufferers.  So you may still need some kind of intervention for this, though therapy might help and you might not need medication for it.  Also, know that the longer you rely on medication that helps you sleep by having a sedating effect on you in the long term makes the insomnia worse because you become reliant on the drug and whatever is causing it gets worse, called rebound insomnia.  This can also become a problem for many people.  

[alex20172018]

Thanks very much for your thoughts. It's further complicated by me living in a country where I don't actually speak the language so for example - the GP offered to refer me to the sleep clinic (which is in a hospital quite some way away, but they don't actually speak English), so I would have to go with a translator which I'm not keen on doing. Yes I exercise regularly (I do love my sports) and am continuing with the meditation. The melatonin is 1mg of sublingual prescribed by the GP - I've also upped to 2mg but then I get funny tingly feelings. I'm not actually sure it is a melatonin problem to be honest as I'm tired - it is just when I go to fast asleep, I have a burst of adrenaline waking me....so frustrating. Do you know the name of the drug which works with melatonin out of interest -I'll discuss this with my GP tomorrow. Thanks for your thoughts.

[Paxiled]

That's what a melatonin problem does -- you get tired because we get tired but melatonin sets your body clock and determines when you wake up as well.  Again, crossing time zones disrupts melatonin, which is part of what causes jet lag -- the other part is oxidation.  So do go to the sleep study if you are able.  And no, I don't know the name of the medication, but you first have to find out what the problem is, it might not in fact be a melatonin problem.  It really bites when something suddenly goes awry -- it happened to me when I tapered off Paxil -- I haven't been able to sleep regularly since and did not have a problem before that.  I hope you find the answer.