If you suffer from anxiety does it have a ‘peak’ time during the day?

[Grownyourownway]

I have suffered from anxiety for most of my life but it’s becoming worse and has been just awful the last 5 years.

I have been under a lot of stress for several years and am also in perimenopause which is most probably not helping at all. I also have some health issues which are exacerbated by stress/anxiety so that starts a whole vicious cycle of anxiety/symptoms/more anxiety etc.

One thing in notice though is that my anxiety is at it’s peak from when I wake until at least lunch time/mid afternoon. This makes for a very uncomfortable start to every single day. I also have IBS which is obviously triggered by anxiety so I’m in this constant state in the mornings and am finding that I can only enjoy the end part of each day (I feel much more relaxed every evening and love going to bed).

I literally wake every day with a racing heart, extreme panic, an upset stomach and nausea and a general feeling of awfulness. Every sodding day!

I try every thing to make it better. I eat well. I only drink water, I exercise, do yoga and hypnotherapy and listen to relaxation (Calm app) every night. All the things we are supposed to do for good physical and mental health yet nothing is helping.

I have tried several antidepressants but they make me feel dreadful. I’ve tried hrt but that makes my health issues worse (endometriosis). I just don’t know what to to ease this feeling of panic, anxiety, upset tummy and nausea every morning.

I literally dread waking up every day.

What more can I do, I feel dreadful? I long to start each day feeling calm but I just feel
manic.

I'm exactly the same as you. On the weekends I go for a long run to burn off thr cortisol (not today as I've got a virus). Weekdays I get up at 5.30 and go to work. I'm a teacher so there's always loads to do. Bring busy distracts me until lunchtime when I usually feel better. I'm on mirtazapine citalopram and HRT. Sympathies, anxiety is evil

Also I gave up alcohol completely over a year ago, it is a gift not having hangover fear

I often have my worst physical symptoms anxiety when I wake up in the morning - I also have IBS like you.

I think for me it’s linked to the fact that cortisol levels are highest in the hour after you wake up. I’ve found it helpful to be mindful of this and literally tell myself “I feel like this because of the cortisol rushing in. It will pass soon and I’ll feel much better.”

I try not to doom scroll as soon as I wake up - and my work phone no longer even comes up to the bedroom with me, so I’m not tempted to go straight into reading emails.

Goldenmemories just awful isn’t it? You have my utmost sympathy, do you find the combination of the meds and hrt are helping somewhat?
I’m desperately trying to find that sweet spot with medication but so far it’s been a case of getting one issues sorted and exacerbating or creating a new one, urgh!

Goldenmemories Alcohol is literally a poison for me, I’ve not touched any for at least 20 years.

cherryassam I definitely feel as though something is raising my cortisol levels higher than they ever were. Mornings have always been a shitty time for me and I’ll always be a night owl and never a lark but I’m pretty sure perimenopause is causing everything to go into turbo mode. It’s just making my mornings so god damn difficult, I can’t even eat or start working until midday because of my gut issues.

Yes, 5am worse then it's usually gone by mid afternoon. It's because cortisol peaks around 5am.

I suffered terribly with anxiety until the last two months. Mine would peak in the evenings and I often woke up having a panic attack in the night. I ended up basically having a breakdown and being signed off work for 2 months.

Luckily sertraline has been a life changer for me and has given me my life back. I would say keep trying with different medications, it can take a while to find the right one and a good 6 weeks at least for them to have a proper effect. My meds made me worse for a couple of weeks but then I turned a corner. The previous medication I tried was awful for me (propranolol).

Which meds have you tried OP? If you say names and doses, how long you took them for, and what happened when you took them in terms of side effects and efficacy, can see what would be a next step

Sertraline has also been a godsend for me - I couldn’t tolerate fluoxetine at all as it made me horrendously nauseous all the time.

Have you got anything to help with the IBS?

I’ve switched to a sunrise alarm clock (not set at actually sunrise…) but I find that does also help with not feeling like I’ve been dragged out of a very deep sleep which means it’s less likely to be a heart thudding eyes crash open type of waking

Can totally relate @Grownyourownway I have literally woken up this way for the best part of the last 8 months and it’s only recently started to ease as I’ve reached the therapeutic dose on my antidepressants. How long do you give the antidepressants before you stop them? Most will make you feel awful, some for a good few weeks before they start to become effective and side effects ease. I also take promethazine which is basically an antihistamine but I can take it as and when I feel particularly anxious and it does help calm me especially if I take one when I wake up. x

I like propranolol.

3 years ago, I was off work with the most awful anxiety I had ever experienced. It was there as soon as I woke up, around 5 pm and in to the evening, it would ease. Sometimes, it still hits out of nowhere, but luckily, I'm so much better.

Thank you everyone, sorry you have all experienced this too.

The meds that I’ve tried so far have been

Citalopram 20mg which left me with awful diarrhoea and nausea so came down to 10mg but still upset my digestive system too much - took for 4 weeks

Sertraline 20mg - side effects as above but I stopped after 2 weeks as my stomach was so bad

Fluoxetine 10mg made my aura migraines worse - took for 3 months

Duloxetine 30mg but ended up with awful upper gut issues including nausea which has never left me.

I have also tried TCA’s for my IBS in the form of Amitriptyline but these made me like a complete zombie and I put on loads of weight, changed over to Nortriptyline the sister drug but these made no difference to the symptoms. Took the amitriptyline for 5 months.

My main issues with side effects of antidepressants seems to be that they greatly exacerbate my already overwhelming gut issues, it’s a terrible vicious cycle. I need to reduce my anxiety in order to help reduce my gut issues (which are stress/anxiety driven) but taking meds which make gut issues worse gives me additional stress/anxiety! My GP just suggested taking imodium which I already do but I then end up constipated, once for 2 weeks which was so bad I ended up having to go to A&E from the pain. It’s so darn difficult to find something which helps both conditions.

Whycantgiraffesdance I will ask my GP about something like promethazine. I was given this in the form of Phenergan to help me to sleep as a child as I was hyper and just could never rest.

RoderickHosclassicblackhoodie is propranolol easy on the digestive system?

cherryassam very little that I do or have tried helps my gut issues. I follow a special diet, exercise, have removed all of my known triggers, listen to gut directed hypnotherapy every night, am dairy and gluten free but in all honesty I don’t think that I will ever gain control over my gut issues until my anxiety subsides but the gut issues cause me anxiety so it’s a horrible catch 22 situation.

Mine is definitely worse in the morning first thing. It eases off around lunch time I have GAD so take diazepam to ease it a bit it's awful though 😞

IBS and anxiety are a horrible vicious cycle - I will say it took a good 4 weeks until my stomach settled on Sertraline, but mebeverine really helped me during that period.

It is horrendous though and very difficult for others to understand.

Are you a member of the IBS Society, I have actually found their newsletters very helpful, if nothing else I feel much less alone.

Mine is worse at nighttime. Propranolol is a wonder drug for me though.

I’m on venlafaxine @Grownyourownway which I have had absolutely no issues with (I have ibs too so I know what it’s like!) whereas Setraline gave me an awful stomach. Obviously everyone reacts differently though but might be worth a try?

I just couldn’t settle the diarrhoea on Sertraline for some reason, it really ramped everything up and sadly mebeverine has never helped me either (really wished they both did help me as I’m at quite a loss having tried so much).

I’ve been a member of the IBS society for many years, they are very helpful.

Amx for some reason, even though I’ve been bad and forth to my GP for decades regarding my anxiety issues they’ve never offered me propranolol, is it ease on your digestive system?

Thank you Whycantgiraffesdance, I will definitely ask my GP about that, that’s one I’ve not been offered or tried yet.

in these circumstances try mirtazapine
start on 15mg at night
increaee dose very slowly, after 2 weeks increase to 30mg if you tolerate 15mg well

only increase further if this is tolerated well

Suggest trying this before trying venlafaxine

You’re clearly very sensitive to SSRIs- something to add to your patient record alerts

hope that helps - give it 6-8/52 of trying it

First thing upon waking. Weekends or time off work are the worst as I am not in a rush to get busy and get on with my day. Otherwise it can be debilitating for a couple of hours - and then I feel exhausted by mid morning when the anxiety wears off.

That’s exactly how I end up - exhausted