Post natal insomnia- didn't sleep at all last night and feeling so anxious

[Jemimapuddleduk]

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I have been struggling with awful insomnia since Christmas. I have 2 under 2 and my youngest is just 6 months. The first 4 months of his life were shocking sleep wise as he struggled with silent reflux and colic and breastfed non stop! The lack of sleep really started to get me down at Christmas and I made the decision to slowly swap to formula to give me a break. Around this time I felt as though I was having a major mental breakdown- panic attacks, severe anxiety, obsessive about nap/feed times and very weepy. I ended up at an out of hours gp who diagnosed pnd. I got a prescription for setraline and sleeping tablets. I only took one of each as I ended up having another panic attack so stopped taking them. Around this time (January) I stopped sleeping. I now have my anxiety about my children under control but I am constantly anxious about not sleeping. I feel as though it's really ruining my life and my time off with my precious children. I didn't sleep at all last night despite listening to my paul McKenna track several times and doing my relaxation exercise. I am now absolutely full of panic about the day ahead and how I am letting my children, husband and friends down by not being on the ball and my happy self. On days after I haven't slept welli have several panicky times a day when I just can't stop crying and feel totally overwhelmed. I am utterly exhausted and just want to go babk to being a great sleeper again.
I suppose I am looking for any words of advise or someone to tell me it will get better.
Sorry for the essay!

I had severe pnd, anxiety and insomnia. Ds is 2.5 yrs now. So feel for you. The best thing you can do is take the antids and sleeping tablets. Zolpidem worked for me. Zopiclone didn't. They work differently. Zolpidem helps you drift off. Also, short term treatment for anxiety might help you while the ads start to work. Go back to gp. Get allthe support you can. Do you have family around? Friends? Are your dc in some kind of routine? Ie can you set time aside each day to relax, read, sleep etc?

Antids take a couple of weeks to kick in. It might be that you take sleep tabs and anxiety treatment until they kick in.

I was also prescribed sertraline, amongst other things

Jemima, I sympathise so very much. Without boring you with endless dull history, in brief I have suffered from insomnia for about ten years now. Since having my first baby 8 months ago my insomnia has become cripplingly worse...my DS causes no trouble at all, I just couldn't sleep!! It got especially bad with anxiety, panic attacks and even some depression when I stopped breastfeeding him at 4 months.

I only reply because I agree with the other posters advice to you. I am a professional insomniac, I have tried literally everything, and I just don't have any evidence that any non meds approaches work. Once you are obsessing all day about not getting any sleep, I think you need some proper drugs. I have always hated being addicted to sleeping pills, (zolpidem also only works for me) and don't feel able to take more than 2.5mg anyway unless someone else has the baby monitor. I also thing zolpidem contributes to my 3am waking.

Before and after pregnancy I wasted far too much time trying and failing to get properly onto a SSRI drug to address my sleep and anxiety about sleep....so many times I stopped in under a week because I found the side effects so awful. The two times I have stuck with it, my sleep has returned and life has been joyful again. Before pregnancy I had success with venlafaxine, and since pregnancy I am now having success with escitalopram. I know every person is different, these are just what have worked for me. Both times it took up to a month for side effects to go away, and sleep to get really good again. But my god was it worth it. Suddenly I am enjoying my beautiful son the way everyone promised I would.

You have so much sympathy but my prediction is that only proper meds will cure you, and the faster you decide to get over the initial start up hurdle, the faster joy will return to your valuable days.

Good luck and please keep us informed!

I developed awful insomnia postnatally - by the time DS was 10 weeks old I was sleeping a bit on alternate nights, and the other nights nothing at all. It was horrendous. I have had bad experiences with SSRIs in the past (do you think your panic attack was triggered by the Sertraline? - it's possible as these drugs can make anxiety worse in early stages of treatment). What worked for me was a low dose of amitriptyline (one of the older class of tricyclic ADs, they're sedating) combined with Nytol. Can you talk to your GP about whether an alternative medication might help you more? Is there a specialist perinatal mental health nurse you can talk to? (I was seen regularly by one, she was great).

The drugs didn't cure things instantly for me (and I was still being woken up many times a night by DS who is a shocking sleeper) but things did gradually get better. 11 months in I still take a low dose of amitriptyline but don't really suffer with insomnia now. It WILL get better - keep pressing for help, both from the GP, and any family/friends who can support you and take the DC for a bit to give you a break. (And use that break to rest!)

SSRIs can definitely make anxiety and panic attacks much worse at first...Sertraline was one that I never stuck with due to intolerable anxiety....again every person reacts differently to different meds. Doing the first week on a very low dose can help a bit....generally the whole start up phase is horrible though as nothing good is yet happening, and often makes sleep worse for a short while.

I was on Mirtazapine (antid) & Sertraline (antid) together. Also Zolpidem and Diazepam for anxiety and Quetiapine for anxiety. Mirtazapine was prescribed to "normalise" my sleep. Worked v well. I was admitted to a specialist pnd mother and baby unit for several weeks and my specialist was incredibly competent. I urge you to reach out with all the strength you have, and get the medical help asap. The sooner you start treatment, the quicker you'll start to improve. Will be thinking of you and checking back

Btw, I dont for one minute think you'll be prescribed that much! Just wanted to be honest about my situation so you didnt feel so alone.

And I wondered how I'd ever recover.. but i did! You will too, but you NEED to reach out and accept the help.

Thank you all so much. I saw my gp this afternoon and I have been prescribed one of the older tricyclics that has a sedating effect (begins with a p- have forgotten already!). Unfortunately none of the chemists in my area stocked it so having to pick it up tomorrow. I will have a zolpidem tonight to ensure a better night. I had awful panics this morning but managed to go for a swim and met a friend. Felt lots better this afternoon. Feeling positive that this may help. I do worry that I may become dependent on the ad but that's another worry!
With the newer antidepressants I worry about the side effects- symptoms worsening for a few weeks, insomnia and loss of libido. Decent sex (very irregularly I must add) seems to be the only thing connecting me and Dh at the moment (he really doesn't understand why i am so anxious, can't sleep and keep cancelling things).
I have a meditation class tonight which I also hope will help.

So glad you're on the road to recovery. You'll get there Op

Thanks cinders. How long did you have to take all the medication for?

Hi Jemimapuddleduck, BBL here (I have a different name on here now). I meant to add a message yesterday but it was so hectic here - college, children, work etc. I hope you had a better night's sleep last night, I was actually wondering about you as I was going to bed and hoping you were sleeping, and good that you've been prescribed something to help. My GP was rubbish. The only thing he wanted to prescribe to me was Fluoxitine which made me feel so ill and made the insomnia worse so after three days I stopped. I think this is why I went the non-medical route and tried homoeopathy, herbal tablets (oh and also hypnotherapy as my mum is a trained hypnotherapist) and I think the combination of all of them at various times, plus CBT, got me gradually to a state where my mind recovered from the anxiety about sleep. I also think that hormones play a large part in it and as time passed and my postnatal hormones settled down I recovered. I hope you've had a better day today.

Hello thegianttap, thank you for your support so far. Your story sounds so similar. I am also convinced that hormones have played a big role in this and actually suggested to the gp that I try going on the pill to stabilise things but she didn't agree it would help. I have been almost constantly pregnabt and or breastfeeding for 4 years as I had 3 mc's before my ds then fell of again whilst still bf'ing her at 9 months.
I have been taking homeopathic remedies since January (my cbt counsellor is also a homeopath). They seemed to work for a while but I think I have got myself so anxious this last week or so that I am not letting anything help! I had half a zolpidem last night and dropped off fine but woke 4 times. I did re settle easily but it's annoying. Felt so much better today though compared to yesterday. Almost a different person! I have the paul McKenna book and cd which is mentioned a lot in old threads but I have found it stimulates my mind rather than relaxes so far!
I picked up my prescription today for Dosulepin and I think I am going to start that tonight. I wish I could conquer this without taking antidepressants but not sure I can. I am pretty sure the initial pnd with worry about my baby have gone, it's now just worry and severe anxiety about sleep and not being a good mum if I don't get my sleep. Vicious circle that is so hard to break.

Apologies for typos! Should read 'fell pg' not 'fell of'. Need to read back first! X

Just read this. I had awful post natal insomnia and anxiety surrounding the insomnia after my first. I went on Mirtazapine which did help but which was very hard to get off. This time around I was prescribed the medication as the insomnia hit again immediately after birth. However I have managed to go without taking it. I found a book called the effortless sleep method which has been fantastic. It isn't all suitable for life with a baby so I have had to ignore some of it but it works. I have had a few times over the last six months when I have had anight or two without sleep or with bad sleep and this triggers my anxiety. Rereading the book and concentrating on the method has so far resolved it every time. It is very cheap on Kindle so it might be worth a try.

Thank you crocodileclip. I have that book on order already and hopefully it will arrive tomorrow. I am so unsure whether to hold off taking the meds until I have exhausted all other options. I realise that if I start the antidepressants I really need to persevere and stick with them. So indecisive and it's hard as I feel great today after an ok night last night (albeit with half a sleeping pill!).

Hi Jemimapuddleduk, I really feel for you as it sounds so similar to what I experienced 7 years ago after my DD was born. I struggled so much with sleep anxiety and it got so bad I almost became phobic about going to bed. It was desperately hard, and there were days I crawled out of bed after literally NO sleep and really did not know how I was going to make it through the day... but just want you to know you WILL sleep properly again! It feels like it will never end, but you will come through it. I took mirtazapine which really helped me, but also time is a great healer and your body will get back its normal rhythm eventually. I'm sure much of it is connected to hormones and looking back I can see now that it was an illness and I shouldn't have been so hard on myself about why I was so unable to sleep. You feel alone because everyone else in the world seems to be able to go to bed and sleep normally, and you get the comments "oh, if you're tired enough you'll sleep" which are really unhelpful! It makes you feel like you're the only one. But you're not the only one. I had lots of help from MN on here from people who experienced the same thing. Thegianttap helped me hugely and we are now friends . You will get better. Keep telling yourself this over and over. xxx

Thank you getdown - I recognise your name from some of the old threads I have looked at for help. How long till you felt better and was it hard to come off the medication?
I think what I find so hard is that I have always been a fab sleeper previously. In fact I adored sleeping! I got myself in such a mess trying to sort out my baby's terrible sleep and now that is sorted I have become the terrible sleeper. It's ridiculous! I would happily go back to him waling half a dozen times a night as at least then I was getting an hour or so easily between feeds and could drop off whenever I liked!
It helps so much to realise that this does happen to others and is a valid condition x

Another old poster from the thread myself and getdown were on, what seems like many years ago! I was countrylover then but I'm sure if you search those threads you will see the dreadful state we were all in.

But I am happy to report that life DOES get back to normal. Admittedly it did take many sessions of CBT and a proper course of AD's (I was on Dosulepin, an older style AD which has a mild sedative effect with very minimal side effects) but since having crippling PND / Anxiety / Insomnia I have made a full recovery.

I often think back to those dark days and I literally don't recognise the person I was but I have grown in to a much stronger person because of it. I can remember feeling so utterly trapped in my own head, in my circumstance and the bone crushingly omnipresent sense of responsibility which I felt at the time, I just couldn't handle.

Now I have 2 lovely DS's and family life is pretty damn good! I do on occasion suffer with anxiety but it is very mild and totally manageable. As for sleep, I"m still not what I would call a "great sleeper" but it honestly, hand on heart doesn't bother me anymore. If I have a bad night, which is very rare these days, then it makes no difference to me the next day and I usually sleep well the following night.

In a nutshell you WILL get over this, myself and getdown are living proof.

Waves to getdown

Oh hello porridgeandwasp (I was BeckyBendyLegs). So good to hear from you too! Gosh it seems so long ago, doesn't it, since we were helping each other deal with this. I really hope our stories help you Jemima. You will get better, I am sure of it. And also I hope it helps to know that it's not that uncommon but it doesn't go on forever. Paul McKenna has helped me and I do still use him on my ipod now and then and when I do I am usually gone by the end of the tape. But I also had another sleep hypnosis CD by some guy from Essex and I really struggled with his voice! I hated it and only used it twice because his voice wasn't relaxing at all, it was too stimulating.

Honestly it means so much to have you all post your experiences. It has made me feel less scared and weird!
Thank you.
Porridge can I ask how long you took the Dosulepin for and what dose. I have been prescribed the same thing and took my first dose of 50mg last night. I still couldn't fall asleep but blimey when I did I slept for a full 6 hours, amazing! I must say it took me ages to get going this morning and I do feel foggy still now. Is this normal and does it continue? I took the tablets at 8pm, does that sound about right?
I am longing to feel normal again soon!
Also can I ask those who took meds too- did you do the paul McKenna, gentle sleep, meditation etc alongside the meds or as you came off? I am already worried about telling my cbt counsellor next week that I have started the ad's as I was pretty adamant I could crack this with cbt and homeopathy alone (and she agreed!).
I am also already worrying about rebound insomnia when I come off the meds. I am sure I never used to worry this much, it's ridiculous!
x

Jemima don't worry about coming off meds or rebound insomnia for now, just enjoy getting better, and not thinking about sleep for a good while ( because you will be getting plenty!). You deserve it.

Whenever I have got a med working I have been able to ditch all my other (usually failed) methods like breathing, McKenna, relaxation, because candidly I don't worry any more. I can get into bed, even SHOCK HORROR dare to watch some TV in bed and still drift off like a normal sleeper when I am ready. For me this is so much of the thrill of a medication working (I happen to be sorted by SSRI but totally respect many people hate them)...I just love ditching all the obsessive sleep hygiene rituals because I know I am going to sleep anyway. All part of dropping the anxiety.

Will you let us know how you get on? You will surely have some side effects from the dosulepine, so do aim to do a minimum of 3 - 4 weeks before drawing a conclusion. If morning grogginess continues beyond start up, maybe someone who knows about this med might recommend you take even earlier in evening?

Jemima I take 75mg dosulepin at about 8.30pm. When I first started taking them I felt a bit shaky and groggy in the morning but this seems to have worn off now.

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