Went to the Dr. today. FRUSTRATED!

[cnote]

30, Male.

Thank God for medhelp and medhelp trackers/journals. Since last October, I've been self medicating myself to help get some more restful Zzzz's at night.

My cycle would go as this:

for a few nights I'd take bendryl, then maybe i'd alternate to zyrtec for a few nights, then back to benedryl. After that would poop out, and my mood would start to be effected by sleep deprivation, I'd start taking Remeron/Mirtazapine (and old antidepressant that is also a giant antihistimine). I would take Remeron for maybe a month, then ween off, only to have trouble sleeping again, then starting the benedryl/zyrtec cycle again... then back to Remeron...

I've been doing that since October of 2012.

Last Month I started Remeron again due to mostly anxiety, and sleep. It helped, but then I weened off about a week ago. The 1st 2 nights were okay. I slept, but felt like I was hot and sweaty in bed some.

Nights 3 and 4 with No Remeron were bad. When I drifted off to sleep, I would get these jolts of adrenaline in my body that would not allow me to fall asleep. Followed by rapid heart rate. It sucked!

Last night was bad too! I layed in bed from 10:30pm-4am. I kept going into the living room, trying to read a book, then try again... nothing worked, I finally broke down and took 3.75mg of Remeron last night at 5:00am to hopefully get a couple hours of sleep in before I had to wake up at 9:30am for work. I was also having NIGHT SWEATS all night again last night. That makes anxiety worse too.

So today I made an appt. with my Dr. for a peace of mind. I wanted to ask him a few questions about insomnia, to give me PEACE OF MIND about NOT SLEEPING, and get reassurance I WILL SLEEP AGAIN.

He dodged EVERY QUESTION, and kept pushing me to go back on Remeron 7.5mg for anxiety and Sleep. I told him I just got off, my day time anxiety is good! It's my fear of sleep at night. He said he wants me to take 7.5mg for a week, see him next week, and if im not doing better then he wants to take BLOOD. That gives me anxiety right there, b/c I fear "why would he want to take blood for?". That's just my dumb anxiety taking over. lol.

The questions I asked were: (and Id like for you guys to help answer them for me if you would?) lol.

1. Are the adrenal surges and night sweats at night from anxiety? He did answer this one and said he does think so yes.

2. Can I break this habitual process of thinking i need to take something every night to sleep?

3. Do you think I'll eventually sleep again without drugs?

4. How long can I physically go with little to NO sleep?

5. Can you die from insomnia?

6. I've gotten SO much better over the past 2 years with my anxiety without meds. How can I become EVEN BETTER without meds?


Thanks!!! I'm debating if I'm going to follow his orders on taking Remeron again... I just got off of it about 5 days ago... I don't want to keep the habit of taking something for it's sedating effects...

[feelingblah552]

Your not alone my friend, I too suffer from sleep anxiety (28 y.o.f) My insomnia started about a year ago when my twins were about 1 yo. I think the sleep deprivation I experienced in the first year messed up my sleep.  The insomnia  got pretty bad at some points so I threw in the towel and went to my doctor for help. She gave me zopiclone (not sold in US, similar to lunesta) but only 30 days worth to be taken "as needed" well it worked like a dream, best sleeps of my life without any crappy side effects (I was also new to sleep aids at that point), but ended up taking them every night or else I wouldn't sleep.  Once I ran out I would try to get back to normal which took about a week of no sleep before my body sorted itself out then the insomnia would hit again and back to my doctor I went, did this about 4 different times over the course of a year and was starting to feel like this insomnia was ruining my life.  The zopiclone also stopped being as effective and I wasn't always getting sleep on it and felt I needed something longer term.  Then tried ambien and trazodone, did not have much luck with either and it was at this point that the anxiety really started, I figured if sleep pills aren't working anymore I am never going to be able to sleep normally again and this thought scared me because I know how crappy I feel when I am exhausted, I just want to feel normal again, be able to focus, think clearly and have energy and no more headaches!  Went back to doctors office about a month ago, at this point I am feeling defeated by my insomnia and loosing hope of ever getting back to normal, she decided to try me on zoloft (sertraline) to treat my anxiety and suggested I see a therapist for cognitive behavioral therapy which I agreed was a good approach.  I was very hesitant to take zoloft after reading the reviews, many people had side effects (nothing major and goes away after a couple weeks) and takes about 4 weeks to take effect but the overall outcome for most was very positive.  I waited until last week to start it, had a few good days before i decided to start it with 0 anxiety and 0 sleep issues so I wanted to wait until I started this drug.  My anxiety came back so I gave in and now I am on day 4 of zoloft.  The side effects suck but don't last all day long, based on other reviews I expect to feel better in a couple weeks, hope this will make me feel like myself again.  

Just wanted to share my experience up to now.  Will let you know if zoloft does the trick to treat my anxiety which will hopefully in turn help me sleep again. I am still taking ambien FYI, I plan on stopping however ironically enough one of this pills possible side effects is insomnia (wonder if my doc knows that). Hope this works if not I will need to try therapy.  

[cnote]

Another interesting story. My sister is a nurse at a local hospital. My old psychologist works with her in her unit now. She called me last night and told me she asked him out of curiosity, What would someone experience when stopping Mirtazapine? His answer: A day or 2 of Flu Like Symptoms, and then typically Cortisol surges, since Remeron suppresses Cortisol.

At least I know it wasnt just my anxiety! I'm down to 3.75mg still, getting ready to cut down again here in a day or so. Wish me luck this time around. I'll make it! :)

[cnote]

Thanks Paxiled! I'm back down to 3.75mg of Remeron. DUDE! I found out I WAS INDEED having Remeron withdrawal!!! I must have tapered too fast? Remeron suppresses cortisol. So when I went off completely, my adrenals were flooding my body with cortisol freely... a little TOO freely let's say! lol. I'm doing a slower ween this time! :) Thanks for caring!

[Paxiled]

My own opinion is that I admire your strength of mind to not take these meds long-term.  By doing so you've avoided the possibility of permanent problems the brain can have adjusting back to working without the artificial effect of these drugs, which is why so many, and so many on this forum, keep ending back on drugs long-term.  As you've learned with the Ativan, drugs don't cure the problem and they often don't eliminate all the anxiety anyway, so if as in your case you can go a couple years without drugs I think that's a good thing.

[cnote]

Well, went to the Dr. again today for a follow up from last week. He said that all was good. He said that he was proud of me for not being on such a high dose of Remeron, and proud of me of quitting smoking almost over a year and a half ago. He also congratulated me on being ativan free for 2 years.

With that being said, I jumped right in and asked a few questions/concerns still.

I told him I still struggle with the fact that I have anxiety... and I might NEED medication... while I also struggle with the fact that my anxiety MUST stem from somewhere, and that I need to FIX THAT... and maybe I won't NEED medication.

He said that he was again proud of how well I have been doing over the past 2  years, with little to no medication at all.

He said most people take 15mg of some pill then 30mg 50mg 80mg until it all just poops out and they run out of options and are in a mess.

He said for me to be only on a very small amount from time to time and getting off etc. that he was proud of that.

I'm still frustrated b/c he keeps going back and forth on how he's proud of how I can do great without it sometimes, and when I do need it, it's not much... but then he'll turn around and say to me "You'll probably need to be on something for the rest of your life."

How is he to judge that? Only God can foresee my future, dont you think?

I dunno... I know I DO fight taking medicine. But I think that can have it's PERKS in the long run. I'm also though to the point where I CAN treat myself with and am not scared to get medical treatment for my rebound anxiety.

I just have to keep my head up and KNOW that time heals everything.

I really think my biggest fear right now is SLEEP and those DAMN Adrenal surges last week... it's almost like a little mini PTSD. lol.

Peace my friends.

[cnote]

You know, this all could be stemming from going ON and OFF Remeron in such a strange pattern. Maybe my brain is confused? lol.

I think if I go off this time, it will be OFF for as long as I can. Unless I really need it for anxiety in the future.

I also need to just stop seeing my general practitioner Dr.. He only treats symptoms and throws me back into the game of life.

I need to see my old psych who got me off ativan, who looked INTO my game of life and see what changes I can make IN IT. However, he is the one who put me on Remeron to get me OFF ativan. He thinks I do have an anxiety issue to a point. But I believe I can use CBT to deal with it vs pills. Pills are not the answer in my opinion.

[cnote]

Thanks Paxiled! I'm going to the Dr. today. I went back on 7.5mg of Remeron for about a week, last night I cut down to 3.75mg. I will do that for a week, then I will cut down to 1.75mg for a week, then to practically dust for a week. Then be done.

If I have issues again... I don't know where to start...?

[Paxiled]

Agree about he benadryl.  There is an herb that is pretty good at reducing cortisol, if that's what it really is, and I don't know that it is, called Holy Basil.  Gaia and New Chapter make good ones.  It also lowers blood sugar a bit, and will make you a little tired after a couple of hours sometimes because of this.  May be all you need to get emotionally centered again with no problems stopping and without the significant effects medications cause that right now you're trying to avoid.

[cnote]

Thanks girl! :)

[nursegirl6572]

You're still over-analyzing!  :0)

I'm sorry, but IMO, the way in which you took the Remeron, the short duration you took it and the fact that you DID indeed taper, plus the fact that Remeron doesn't typically have a signifcant discontinuation syndrome...leads me to believe this has nothing to do with w/d.  

Just my opinion, but I think if it IS a mental hang up, you trying to convince yourself its w/d will only sweep that issue under the rug.  Either way, even if SOME of your symptoms are w/d related, there's definitely a conditioning going on, you've said so yourself, that you can't "relax" at bedtime without taking "something".  You need to start working to address that thinking.  Taking Benadryl isn't the answer either, IMO.  It would be best if you could try to allow yourself to readjust to being able to be calm and sleep WITHOUT taking anything at all.  You need to undo that thinking.

Just my two cents.

[cnote]

I found another older forum online and a man had the same experience it looks like with the adrenals. This below is HIS quote from suffering Remeron/Mirtazpine withdrawal:

"I can't get to sleep at night and the adrenaline pumps through my body all night long. Loss of appetite, nausea, neck and back pain, headaches, fear, anxiety, exhaustion, hot and cold flushes, a constant sick feeling in my stomach like something terrible is about to happen and the this list goes on........"

[cnote]

Thanks for writing!

I think it is partial withdrawal, and a mix of anxiety about withdrawal? Especially the insomnia? But the adrenal surges I was having at night and at night only when drifting off to sleep was the worst. Those lasted for nights until I started back up on it again at 7.5mg.

I'm going to do a slower ween this time maybe. I didnt think I weened too fast last time. I wasnt on it but maybe a month and a half, maybe 2 months max.

Most people are on these drugs for 6 months at a time with little to no issues.

I thought remeron too was an easier one to get off of, but maybe this time around it was tougher for some reason?

I think my game plan is to ween off, and if I still get the adrenal surges every night, instead of reinstating the drug, I'm going to start taking benedryl again for a short duration til those go away.

Because if I'm correct, Remeron in LOWER doses mainly effect the histamine receptors, which causes the drowsiness.

I also do believe that Remeron is a noradrenergic... I don't know if that means it keeps adrenaline at a low? So maybe when I came off my adrenals/cortisol were misfiring when falling asleep?? Also causing night sweats? It sucked b/c I tried to fight through it, but 3 nights of almost ZERO sleep was not acceptable only heightening anxiety and making me feel crazy and super anxious during the day.

I think if I switch off to benedryl for a week or so, that will help keep the adrenals low for a bit until I can come off benedryl.

Thanks for writing!

[Paxiled]

Have no idea what's happening, so don't take this as me thinking I do.  Just want to say that when you take a medication you've stopped taking and your symptoms go away, that's an indication it was withdrawal.  That's what makes this medication business so difficult -- withdrawal causes the very problems we are trying to fight and that makes it tough to know if the problem is a recurrence of your symptoms or withdrawal.  In drug studies that only came out after lawsuits, it turned out healthy volunteers who worked for drug companies suffered withdrawals after stopping the medication -- they had not mental problems whatsoever before taking the drugs, but did after stopping, as well as physiological withdrawals.  However, that being said, my understanding is that Remeron is one of the easier ones to stop taking -- the really tough ones tend to be the ones that strongly target serotonin, meaning the ssris and the snris, and Remeron isn't one of those, so that's an important consideration.  I know you've taken this medication before -- did you ever have withdrawal from it before?   Boy, this is a frustrating business!

[cnote]

Also I want to add, that I AGREE with you on "over-analyzing everything, want a CONCRETE solid answer/reason for everything"

I have been pretty good at that in my life. But looking back at some of the other CRAZY things I over-analyzed in the past, that at the time, I thought I'D NEVER get over... I DID. And most of those things are a BLUR now to me, which is good. :)

Thanks for always chatting with me. You are a piece of my toolbox that always encourages me, and for that I am grateful! :)

[cnote]

nursegirls, what would I do without you? hahaha.

You know though, I do believe Remeron does work pretty instantly for SLEEP, like Xanax would. B/c of it's antihistamine effects. BUT! At the same time, I think you are right about the CRUTCH.

However, I DO also think there are times I deny I have anxiety still b/c I've been doing SO MUCH BETTER over the past couple of years.

I have to remember that anxiety can show itself in different ways as the years go by.

I've beaten it before, and ill beat it again. :) I will undo the conditioning of thinking I NEED something. But I got myself into a funk to where I actually DO need it to get through this. Does that make sense? lol.

Once I chill out, and possibly FORGET about this experience.. I'll brush my shoulders off and try again. :)

Hi, my name is Chris, and I have ANXIETY. :) LOL.

[nursegirl6572]

You know my old friend...you're doing it again, the thing that drives you nuts.  You're over-analyzing everything, want a CONCRETE solid answer/reason for everything.  You've been doing that as long as you've been coming here.  How many lectures have I given you huh?  LOL  ;0)

I agree that sometimes medications are necessary, but I think, from what you've said in your own words, that you're conditioning yourself to think you NEED the Remeron, and when you don't take it, you get very anxious.  As soon as you take it, boom!  You're fine.  It's not Xanax where it would work like that.  I DO believe this is a mental hang-up, I really do.  If you feel you aren't quite ready to tackle that, then give it some time, but I think at some point, you would be wise to do so...it's become a crutch.  You have to undo that conditioning where you think you NEED it.

Withdrawal isn't an issue IMO because you don't get any symptoms until bedtime.  W/D would have you feeling poorly all day.

Hang in there!  :0)

[cnote]

nursegirl, special mom, Thank you so much for replying. Last evening I was feeling kind of rough due to sleep deprivation. I felt confident though, and anxiety was pretty low. But I knew some anxiety was there.

I took 1mg Meletonin, took a shower, got into bed. Got really tired. Felt relaxed, so I thought, tried drifting off to sleep, and then what do you know? That adrenaline feeling went over my body once again... same crap.

Finally I became rational and said "I'm going to do what my Dr. said and take 7.5mg of Remeron. I can't go on without sleep like this any longer."

So I took it, and what do you know? I slept great! I NEEDED that so bad!

So, if I took the Remeron and the cortosol shocks stopped, and night sweats... what does that tell me? ANXIETY/STRESS. I don't' think it was withdrawal anymore. And even if it was anxiety/stress on "the fear of sleeping"... I HAD TO STOP IT. The anxiety was going to get worse with little to no sleep.

Today after having a more "clear" mind after finally getting the rest I needed. I think that MAYBE, JUST MAYBE, it is possible that I'm just still having anxiety, and I wasn't ready to come off the drug??? A month and a half isnt that long of a time to be on it.

I just moved into a new house. That is probably a HUGE stressor to me, and I don't even know it? I'm taking on a huge tv project at work, I don't feel stressed about it, but maybe subconsciously I am?

I've read that moving CAN indeed cause anxiety/depression in some people who do not do well with change. EVEN GOOD CHANGE. I'm not depressed/anxious about moving into this new beautiful home. But it's still CHANGE. I've only known what I've known for the past 7 years, and that was my last house, where my wife and I brought both of our babies home to. It was my safe spot. It was home. :) Now I have to get used to this new home. We've only lived there for a little over 2 weeks.

My wife said it's going to take some time to call it home b/c we havent had a chance to make memories there yet.

Thanks for all your advice. I'm going to take 7.5mg til next week, see my Dr. and see what he wants me to do.

I probably need to see a talk therapist soon though. Because I know I can beat this without drugs. :) I've done it before.

Also while taking this small amount of Remeron for a while. I'm going to do the things I need to do to ensure a good nights rest. Quit caffeine, start working out more etc.

[specialmom]

Hi there and welcome.  Well, why are you stopping and starting Remeron?  That could be part of the issues you are having.  Self medicating isn't really the best way to handle our health care concerns.  Remeron takes a bit of time typically for symptom improvement.  If your sleep issues are related to depression and anxiety, how long of a period of time do you take the Remeron before discontinuing it?  

I think what you've been doing on  your own schedule is actually contributing to your sleep issues long term.  If you are going to take Remeron, stay on it and give it a chance to do its job.  Full effect does not happen immediately and most drugs have transient side effects--  you are setting yourself up to experience that over and over rather than regulating yourself to a point of sleeping and feeling less anxious on a regular basis.  

It is a very common problem with those who suffer anxiety to think that they don't want to be on medication.  As they start to feel better, they wean themselves off and then wonder why they have problems again.  It almost becomes part of the anxiety to doubt whether one needs medication.  The simple truth is that many have an episode or two of anxiety.  but for others, it is a chronic condition that needs treatment on a regular basis.  

That could be you.  

A doctor would question you if you alter the directions they gave you for taking a medication.  That is a huge no no.  I don't know if you were forthright with your doctor about the schedule/routine you've had but I would guess no doctor would really think this was a good plan.

I would find a new doctor if you don't like this one and let THEM manage your trial and error with medication.  But psychotropic medication is not short term to take one month, off the next, back on the next.  Even when using Remeron as a sleep aid, it is more of a chronic care medication.  

Hope that helps although I know it's not exactly what you are looking for.  

Extreme sleep deprivation isn't good for you, obviously.  It can cause inability to concentrate, slow reflexes, mood issues, memory issues, etc.  But I don't think you can die from it.  It's just miserable though. (been there).

I would absolutely stop trying to be your own doctor and work with someone that can give you direction on when and how to take your medication.  And if you need it, you need it.  Don't wean yourself on and off like this.  good luck

[nursegirl6572]

1. Are the adrenal surges and night sweats at night from anxiety? He did answer this one and said he does think so yes.  My opinion is yes.

2. Can I break this habitual process of thinking i need to take something every night to sleep?  Yes, it will take some time, but you can.

3. Do you think I'll eventually sleep again without drugs?  Yes, again, it will take some time and you will likely have some trouble sleeping for a while, but you will readjust.

4. How long can I physically go with little to NO sleep?  Sleep deprivation is different than insomnia.  If you're getting at least a few hours a night (or at some point during the day), you'll be tired but okay.  If you haven't slept at all, then after about 2 days, it can be dangerous, with the risk of hallucinations, delayed reaction times, etc (meaning...doing things like driving could be dangerous).

5. Can you die from insomnia?  No

6. I've gotten SO much better over the past 2 years with my anxiety without meds. How can I become EVEN BETTER without meds?   I think you already know the answer to this...by using your coping mechanisms, pushing through and facing your fears.

I agree with you about the Remeron.  I think it's clear that taking SOME kind of pill at bedtime has become a mental hang-up for you, hence why you're experiencing anxiety at nighttime.  THAT is the thinking process you need to change.  Are you still in therapy?  That's where a therapist would be beneficial to help you break that cycle and thought process of thinking you NEED something to feel okay.

You've overcome so much, every time your anxiety shows its ugly self, you can do it again.  Just remember to be patient.  As much as we would like it to, these things don't change overnight.