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

[Jemimapuddleduk]

Posted also in chat for more traffic.
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!

waves back to all the insomnia friends

Jemima it's hard to say how long recovery will take, as you have good days and bad days for quite a while. The bad days (nights) gradually get fewer and further between until you reach the point when even a bad night doesn't make you particularly anxious anymore. As others have said, bad nights are normal, and you reach a point where if you're not anxious about them anymore, you usually make up for it with a really good night the following night.

I would say after my DD it took a good year to get back to feeling somewhere close to "normal" (whatever normal means!) but when I got insomnia / anxiety after DS was born (4yrs later) my recovery was much quicker, I think because I'd been through it before, got the right help and treatment quicker, and mentally knew that there was the hope of recovery.

I got off all meds completely 2 years after DD was born and was able to be medication free during pregnancy with DS, which I was grateful for, but I know others have taken during pregnancy and all has been absolutely fine. I took mirtazapine again when DS was 6 months old because I started to recognise I was going downhill (sleep went haywire, anxiety rocketed, feelings of being out of control etc.) DS is 3 years old now and I still take mirtazapine. I've weaned myself off a few times, but it has not ended well and I've had a bit of a meltdown and ended back on them. But I don't beat myself up about it. They help me for now keep on an even keel, and I know I won't be on them forever. When the time is right I will start cutting down again. I don't feel bothered about being on them for now and neither should you.

I really hope you start feeling better soon. It;s good you got some sleep last night - hurrah! Give the ADs at least two weeks to work. Also the side effects will settle down too after a few weeks. Hang in there lovely. You will be ok!

Hey BBL and countrylover (as was), and orangeflutie and getdown! I remember you all and our threads helped me so much! Glad everyone is doing so well!
OP I really feel for you, I suffered exactly the same when I first had my DD now aged 5. I felt like I was trapped in a nightmare and that if only I could sleep everything would be okay but otherwise everything was going to fall apart. It was absolutely horrendous. It ruined my first few months with her which is still quite hard to accept especially as we have only had one. she is amazing fun now though!
I am pleased to say that although I have had other issues, the sleep problems have resolved themselves over time and now my only problem with sleep is that I sleep too much!
What helped me was a combo of the over the counter antihistamines (if you are not breast feeding), nytol - the non herbal variety (valerian gave me nightmares) or sominex (promethazine hydrochloride - the stuff they put in nightnurse, then I rotated those with low dose of amitriptyline. I rotated because otherwise they stop working. I occasionally took zopiclone but didn't like the way I felt the next day.
One tip is not to make what you are going to do the next day dependant on how well you sleep - otherwise you lay there thinking that you are going to miss out the next day.
Also remember you can feel rubbish after a good nights sleep, but can manage on very little sleep better than you think. I know that horrible anxiety the next day though, partly caused by the lack of sleep.
I always did yoga and getting back to that, and gentle exercise like swimming, was great.
Best of all though is to get bored of worrying and talking about sleep! Eventually you will, I promise you.
Hang on in there, you will feel better soon! X

Ohhh hello orangeflutie and arcadia! It is so lovely to see those names again :)

I actually felt a bit anxious last night going to sleep because I had college today. But like arcadia I think I also sort of got bored of worrying and knowing that however crap I feel after a bad night I always manage to sleep the next night. The next thing I knew DH was handing me a cup of coffee.

I'd love to try yoga. I go to Zumba on a Monday and that completely finishes me off! I tried Pilates last week for the first time and that really helped me relax. I'm sure these sorts of things help.

Hope the ADs work for you Jemima. Don't feel bad about taking them. They help so many people and I would have taken them too if I'd been given the chance to take something other than fluoxitine. I can remember how frustrated I felt that nobody seemed to be able to help me, nobody in the real world anyway.

Hello-last night was the 4 th night on the dosulipin. I am still struggling to drop off and seem to have alternate nights of good sleep (5 hours and no wake up) to waking every hour like last night. I feel panicky today. How long does it take for Dosulepin to kick in? Is this a sign it's not right for me as I still can't sleep?
Also I am very anxious about the fact I sm sleeping in the spare room. I don't wabt tI be one of those couples! I just want to sleep soundly next to my Dh. Did anyone else sleep in a different room whilst having sleep problems? Did it get back to normal (ie sharing a bed again).
X

Jemima it's early days yet. You probably need to wait at least two weeks for the full effects of the dosulepin. If you feel things aren't improving in a week's time I would go and see your doctor. It's possible 50mg is too low a dose for you. I seem to find 75mg better for sleep but it's all very individual. Also make sure you're getting lots of fresh air and exercise in the day too.

I can't comment on the spare room question. We don't have one??

Hi Jemima, just a few thoughts for you...

1. If you read your original post, there has been a slight improvement. 5 hours is not enough in the long term, but you absolutely can function on that.

1. My problem was always early waking and being unable to get back to sleep. When I started my escitalopram I was waking at about 1.30 or 2am and not sleeping again. It took me a full two weeks on my full dose (not start up dose) to start sleeping until 6am. This means I am getting between 6 and 7 hours and while pre-baby I used to like 8 hours I have decided this is good enough and to call myself cured. The way I see it these poor pills are trying so hard to squash our well-developed, crazy lady, anxiety and that can't be an overnight task! Orange is right, if after 2 full weeks you aren't seeing an improvement then perhaps a dosage increase is required.

1. I too didn't sleep with my OH for about 4 months...just his body near mine caused the anxiety to sky rocket and if the poor man moved a muscle I would wake up and start bitching at him. Totally unsustainable; my then therapist told me to sleep separately as my anger would be far more damaging to the relationship. Within 3 weeks of my sleep improving we went on holiday alone together and started sleeping together again (no option in a hotel room) and it was absolutely fine. Since returning home we now sleep about 50% of time together and 50% of time apart and we are delighted with this in the long term. His snoring and mountain of iPads and iPhones in bed means I do like the option to escape and it actually improves romance factor. Once your sleep has improved and your anxiety reduced, you will absolutely be able to sleep with your husband again.

1. I think you mentioned zolpidem in an earlier post...what if you took a bit of pressure off by saying for the next 10 days (until you hit two weeks on your new AD) you are allowed a low dose of this 30 minutes before bed? Say 5mg for the next 3 days then 2.5mg for the following week (2.5mg is in no way a therapeutic dose, need a pill cutter, and basically a placebo effect). As you have trouble getting to sleep in first place take your zolpidem 30mins before you get into bed to absolutely minimise time spent in bed awake. Get into bed when the room is already swimming a bit....

What do you think? Xx

Thank you both for responding. Lahottie you have reassured me on the separate room situation and yes maybe I do need to add in the zoplicone too. Aaaargh, I hate this.

Jemima, how has your sleep been since Tuesday? Only if you feel like sharing...xx

Hello-thank you for checking in. Wednesday night was terrible but last night was great (I upped dose to 75mg). Getting there!

Great to read that things are improving for you?? Fingers crossed for another good night tonight.

Well done Jemima! I predict that once you get a few decent nights under your belt, your confidence will start to improve and that helps the sleep even further. I hope you felt wonderful today!

Feeling so low today, didn't sleep at all last night despite taking the 75mg of Dosulepin. I seem to have got into a pattern or one good night, one bad. After a bad night I just feel that life is worthless and everything is impossible. I am following the effortless sleep method and doing all of it except the getting up if I can't sleep, for some reason I can't bring myself to do this, I am worried it will wake me even more. Did you all follow this rule? What did you do?
Those who took Dosulepin did it take a while to fully work? I have been taking my dose at around 8.30 and then feel very drowsy by 9 but then wide awake at bedtime (10ish). Should I try it later say half an hour before bed? I am now really regretting taking this medication as it doesn't seem to be helping much.
Feel so panicky and worried today. I just want to be back to my normal carefree self again.
Thanks for your ongoing support. I hate this so much.

Sorry you had such a bad night. I know it can really get you down but try and stay as positive as you can. When you're in bed next time and can't sleep and you feel yourself getting anxious, try and break the pattern. Maybe go downstairs, eat or drink something, read or listen to music for a bit then go back up when you feel tired enough. This worked for me and meant I was more able to accept not sleeping for a bit.

Things are getting better as you're now getting good nights. Hang onto that. Re the dosulepin I think you're taking it at the right time. Any later and you might feel groggy in the morning. Also if you've just upped your dose you need to give your body time to adjust. Stick with it and you will feel better.

Hope this helps x

Jemima, you and I are so similar. I refused to do the 'get up if I couldn't sleep ' thing too; I just couldn't accept leaving bed just IN CASE I was about to fall asleep (I never ever was).

At my worst I also could feel wonderfully drowsy around 9pm (oooooh tonight I might sleep!), even sleep on the sofa (big mistake according to sleep experts), but by 10pm I was WIDE awake. And by the time I got into bed I could not have been more wired. I wasn't ever going to sleep because clearly as bedtime approached a stress hormone released in my brain. I could take 10mg of zolpidem and it still couldn't beat my crazed, frantic wakefulness. Major fear of bedtime...

You have also decided that you get one ok night followed by one bad one...so you are making sure that happens now. I bet you have full on panic on the expected bad night. You are so sure that unless you are destroyed with exhaustion, then your brain won't let you sleep. So it won't.

As I mentioned above I am taking 10mg of escitalopram (in the morning) and have been for about a month (as well as hormone treatment, which I describe in another current live thread called PND, therapy and medication). My sleep and anxiety is much improved (and certainly no depression), but I still have some residual side effects like daytime fatigue which I hope will pass. I do not know the drug you are taking, I suspect it is in the same family as amitriptyline...the latter did not work for me, neither did trazadone (another of the older antidepressants used for insomnia). I felt groggy but this didn't turn into actual sleep. It was like my phobia was too powerful for the drug to beat me. There IS a drug out there that will be more powerful than you, and you will find it.

I think only two things....

1. However long you have been advised to try the dosulepine for, you should do...at the 75mg or whatever is the maximum you have been advised to take. Don't pussy around with smaller doses, take the max you are allowed. Give it a full month on the maximum dose.

1. What works for one person, will be different for the next. It doesn't really matter what works for all of us, what matters is what works for you. If dosulepin turns out to be wrong for you then it is hard for me not to urge you to suffer through the side effects of trying a really good SSRI ( but probably just because it works for me, and you are not me...so I'm not trying to advise you, just sharing my experience). When I had insomnia before pregnancy I found venlafaxine absolutely excellent. I know you want to avoid an SSRI due to side effects and lack of sex drive, but I am willing to bet you aren't hanging from the chandeliers right now either. FWIW a month into escitalopram and I have only experienced minor libido decrease and can still orgasm. Frankly the sleep more than makes up for this for now, and my new good mood has made me rather more, ahem, generous in that department.

You have been suffering since Christmas, so for about 3 months? As you are about 2 weeks into dosulepine already, I predict it will take no more than 4 weeks to reach proper effects if you take full and proper dose. That is a third of the time you have been suffering for, really not long.

What do you think?

Lahottie- thank you so much for all your help and wise words. Yes I do need to try a couple more weeks to see if things improve. I am so impatient and waiting for a miracle cure. I will then look at other options if there is still no improvement.

Lahottie- I just read the other thread. Did you see Prof John Studd in person? I am really interested in the hormonal theory. I already suggested to my gp that going on the contraceptive pill may help but she wasn't in agreement. Thank you

Hi Jemima!

Yes I saw Professor Studd in person. I was very persistant by phone to get a fast appointment, and that first appointment is expensive. But for me so worth it. I now get the gels prescribed by my GP so I haven't had to spend more on him. It made a big difference to me..lots of post pregnancy issues like dry skin, flaking scalp, brittle hair, peeling nails also dramatically improved as well as my low mood and energy. It just didn't do enough for my anxiety and sleep, thus adding the escitalopram about a month later. But I think both solutions have been key to my recovery.

Have you decided to stick with the dosulepine, max dose, for longer? Do you feel committed to this?

Hi Lahottiereturns - thank you for that. I live up north so would prob be difficult to get down to see prof Studd. I also think that dosulopine is contraindicated with oestrogen based contraception (so I guess oestrogen gels too). I am sure I read that somewhere (whilst crazily googling side effects, withdrawal etc and worrying myself stupid!).
I am going to continue on the 75mg dosulopine and hoping I may start to see some benefits soon. It will be 2 weeks on Friday since I started it. Have another cbt session on Wednesday, having missed last weeks. That usually sorts my head out for a day or so! I hope you are doing ok. Felt rotten today after a decent nights sleep. All head achy and dopey. I think my body is used to running on very little sleep now and adrenalin from stressing about it!

Stick with it Jemima! Achy and dopey is exactly what happened to me when things started to turn the corner. I have been sleeping well for about 3-4 weeks now, and it definitely took the first two weeks for the adrenalin you rightly describe to diminish, and the long term sleep deficit to even out. It won't be immediate but I promise you that your body will remember what properly rested feels like. xxx

How are you doing Jemima? 5 days since we spoke...keen to know!

Hi Lahottiereturns- I have had some great sleep since Sunday night. I feel like a different person, it's amazing! My anxiety has almost gone too. Thank you for your support and you telling me to be patient!
How are you doing?