General Anxiety Disorder, could it be or not?

[vivainsomnia]

I've been suffering with what feels like constant adrenalin/cortisol rushes. I feel hyper all the time and have now suffered, as my name indicates, from insomnia for 5 years. I have tried everything, and I mean everything to help. I have followed a 7 weeks sleep programme, did everything recommended to no avail. They concluded that I needed to see my GP again as they couldn't understand why I was sleeping properly despite doing all the right thing.

I used to struggle falling asleep, or getting back to sleep in the night, but training has sorted this out and I do fall asleep ok. The problem is that my sleep is always very light and I just don't get into the deep restorative sleep as I used to. As I am menopausal, I put it down to that and have tried HRT, 4 different regimes and it's made no difference at all.

Friends have mentioned GAD, which I have dismissed because I don't think I feel anxious. My life is very good and I have nothing to be stressed or worry about. I am very lucky. Work is fine, children are fine, parents too, good friends, all ok with OH, no money problems, so nothing to be anxious about.

But... I am starting to wonder whether I could be interpreting anxiety wrongly because I maybe, I do fret about things that I think is normal behaviour but actually isn't. I anticipate everything, and I mean everything. I anticipate every conversation, every situation and always consider what could go wrong and therefore what I need to do to avoid things going wrong. This is anything from imagining the conversation I will have with my GP during a consultation, to make sure that I don't forget anything, to planning the next 5 years in terms of how much I should save each month, hours I need to work etc... so that I can retire at the end.

The one trigger that made me wonder whether I could indeed be suffering from GAD was when I was driving back from a meal in a restaurant 1/2 h from my house. Drove back at 10pm, so in the dark on a road that is known for deadly accidents, that is maybe once a year or so. From the time I pulled into it, I focused on every car coming towards me in case one was on the wrong side trying to pass a car. I wasn't scared, didn't picture it happening, I just felt I had to be prepared in case it did happen. Is this normal behaviour? Do everyone do similar? Is this some form of anxious thinking?

I'm not looking for a diagnosis, but trying to understand what is normal and what could be an indication of an anxiety disorder. Could this constant feeling of adrenalin rush and inability to shut down be an indication of anxiety?

You might benefit from reading this document on cognitive distortions to see if your thinking styles are a bit out of whack - and how to change them if they are.

And here are some simple tips on reducing anxiety which you could easily build into your life.

BTW, try not to think in terms of 'suffering' from GAD because if you assign a label to yourself you'll find yourself growing into it!

Melatonin helped my menopausal sleep. I reckon if you got your sleep sorted the rest might fall into place.

You can take anti depressants to help with sleep. Amitryptiline, Mirtazapine and Trazadone all help sleep.

I had insomnia like yours for 20 years. Sleep clinics, the lot. I was on Amitryptiline and slept really well for 16 years. However it stopped working, but melatonin has helped.

Thanks for your messages. I'm already doing all the self-help I can do. I'm doing CBT and mindfulness. I enjoy them and find the tool beneficial, but it hasn't changed the constant feeling that I am unable to relax. In terms of the sleep, I take maximum dose of melatonin and have tried amitriptyline. It worked quite well to start with, but gradually stopped to have effect after some time, despite upping up to 50 and then 75mg. The side effects were horrible too. I have low resting heart rate and blood pressure and it made me faint, eye sight all over the place, very tired during the day and then made me want to eat non stop and was piling on the weight. Not worth the minimal benefits.

I guess what I'm trying to assess whether my issues could be due to chronic anxiety despite not consciously recognising it as such, or whether there are other issues involved. I don't recognise myself much in the cognitive distortions list, only one I right thought it applied to me.

People with severe sleep problems tend to over produce cortisol. This is also linked with anxiety.

This is a new drug, but l don’t know if it’s in the U.K. yet.

www.pharmacygeoff-uk.md/Belsomra-Suvorexant-20mg.html

Cbd oil might help.

It sounds like what I have seen described in cbt stuff as a 'safety behaviour" - this constantly preparing for all eventualities. It is a coping strategy but a stressful one. So perhaps there is more going on than you are completely conscious of.

I don't recognise myself much in the cognitive distortions list, only one I right thought it applied to me.

Was it the fortune telling?

This sounds like anxiety to me, particularly the feeling that you need to be prepared for all eventualities and thinking about what could go wrong a lot. You have developed coping strategies to try to deal with the unexpected/what could happen in the future.

Do you also have high standards/perfectionist tendencies? Sometimes needing to be prepared for everything suggests an unhealthy preoccupation with never making a mistake.

Thank you for your posts

People with severe sleep problems tend to over produce cortisol. This is also linked with anxiety
yes yes yes, this is exactly what it feels like, that I'm suddenly flooded with cortisol and I feel so mentally alert and hyper. I suffer from tinnitus since this has all started and I'm sure it's linked, the more hyper I feel, the worse the tinnitus. What I don't get is why this would be the case, hence trying to ascertain whether indeed, I could be affected by anxiety without being aware of it.

This is a new drug, but l don’t know if it’s in the U.K. yet
Sadly not yet approved in the UK yet. Very interesting though how it looks at shutting the wake mode, which indeed, would maybe be what I need. The side effects look a bit frightening though!

I've tried cbd, bought the purest, finest form. It helped the first night and then had the exact opposite effect and made me more hyper!

So perhaps there is more going on than you are completely conscious of
This is indeed what I'm starting to wonder.

Was it the fortune telling?
No, I don't think so because I don't assume bad things will happen, I just feel that I needed to do things to prevent them in case they did. It was the 'should' one. I am constantly telling myself I should do this or that, every day.

Do you also have high standards/perfectionist tendencies? Sometimes needing to be prepared for everything suggests an unhealthy preoccupation with never making a mistake.
Yes, that absolutely. I am a control freak. Not with others but with myself. I feel I need to prepare for everything so that when things happen, I am in control and can do something about them.

I am starting to think that trying antidepressants won't do any harm as it sounds like there is at least some element of anxiety in my being. It just doesn't seem so bad that it would cause such problem with sleep but maybe I'm wrong.

Has your GP done bloods? Obviously this could be hormone related with the menopause but thyroid irregularities could cause some of these symptoms for one (other stuff as well).

I was diagnosed with GAD a few years ago. I have struggled with anxiety since I was a child. It peaked a few years ago (had a bereavement and my DD got a standard illness both within a few hours of each other and I peaked). However I’ve since been diagnosed as being Autistic which I feel actually explained my anxiety much better. I work hard to fit in, I’m always worried I have said/done something wrong to others, I worry about things going wrong, I catastrophise - an example would be I wasn’t included in something with work, so I concluded everybody hated me and I must be terrible at my job and an awful person. Reality is I was just not included. That’s just some examples. I tick most of the boxes on that list linked above.

I think given you feel physical sensations it’s worth investigating further. I am asthmatic and I can tell the difference between an asthma attack and a panic attack for example. There’s medication that can help with symptoms of anxiety - not just antidepressants but beta blockers can help - but if there’s a physical cause it’s obviously best to treat that!

Sleep wise I’ve found using a hypnosis app really helpful to relax my mind and body. I use Headspace.

I anticipate everything, and I mean everything. I anticipate every conversation, every situation and always consider what could go wrong and therefore what I need to do to avoid things going wrong. This is anything from imagining the conversation I will have with my GP during a consultation...

So not fortune telling then

I would suspect that the insomnia is linked to overthinking and trying to prepare yourself for any eventuality. As if your subconscious can't let you let go and go to sleep as it feels like you need to protect yourself by thinking through all of the possible eventualities of the next day/the future. You could try medication, or perhaps something like j0urnalling would help where you write down everything you need to do the next day/what you need to prepare for and then physically close the notebook and put it down. Then try some hypnosis or meditation to help you think of something else as you're going to sleep. It might help to switch off your overthinking.

You’ve tried Amitryptiline, but there are several other sleep inducing antidepressants.

Mirtazapine, or Trazadone which doesn’t affect appetite, or even low dose anti pyschotics. Particularly quetiapine in very low dose.

A pyschiatrist could help.

And by the way, l couldn’t sleep on less than 100mg of Amitryptiline.

Has your GP done bloods? Obviously this could be hormone related with the menopause but thyroid irregularities could cause some of these symptoms for one (other stuff as well)
I did consider thyroid, and became convinced I was hyper, and tests years ago had come back with high antibodies, but recent test showed my level to be normal.

I've tried beta blockers (Proponol) but that didn't help at all and just made me feel very dizzy. No benefit on sleep at all.

So not fortune telling then
I thought fortune telling assumed bad things are going to happen. I don't, often think they are very unlikely, but I just want to be prepared in case they do. It might still be though.

I would suspect that the insomnia is linked to overthinking
I've come to that conclusion too, even though I do fall asleep, my brain doesn't shut down enough to give me deep restful sleep. I just don't know firstly how to convince professionals (who keep insisting it's all about quantity of sleep and if I get enough all together, I'll get enough quality sleep too).

Mirtazapine, or Trazadone which doesn’t affect appetite, or even low dose anti pyschotics.Particularly quetiapine in very low dose.
I looked into these, although they do say that are linked with weight gain which would be an issue for me, but in any case, GPs won't prescribe these for insomnia. I would have to be referred to a psychiatrist, but I don't meet the criteria for that, so would need to go private but that would mean travelling far as no such private service where I am and no guarantee they would prescribe. It's all so frustrating.

I'm pretty sure I've looked into quietapine and that's another one they won't prescribe.

I have an appointment with the GP later so will try an antidepressant. What's another 6 weeks to wait, and by then, I will have been on every meds and treatment programme GPs can prescribe!

Thanks all for your suggestions.