Am I untreatable?

[Shinyshiny2]

I’m really struggling and could do with some perspective from people who’ve been through this.
I have severe sleep anxiety – worrying about sleep to the point it stops me sleeping, then panicking the next day if I’ve had a bad night. This is the fourth time I’ve been through it. The previous three times it eventually resolved with fluoxetine and time, and I went back to sleeping normally.
This time feels different and I’m scared I’m stuck. I’m 8 weeks into fluoxetine (first 6 weeks on 20mg, now 30mg for 2 weeks) and I’m still very anxious, constantly monitoring my sleep and worrying about not sleeping, which of course makes it worse. I’m also seeing a sleep therapist.
When I don’t sleep well I panic badly and keep phoning in sick to work because I feel like I can’t cope. I can’t look forward to things anymore because everything feels dependent on whether I’ll sleep. I’ve even started worrying about an upcoming holiday and whether I’ll ruin it by not sleeping.
Logically I know I’ve had this before and it has passed, but emotionally I feel terrified that this time it won’t, especially as I’m still so anxious at 8 weeks on medication.
Has anyone had sleep anxiety this bad and come out the other side? Did it still lift even when you felt completely stuck and obsessed with sleep? Did medication take longer to work for you one time compared to others?
Please be honest – I just need to know this isn’t permanent. I just want my life back!!

Do you do any exercise or yoga that focuses on relaxation and reducing stress and anxiety?

I'm not sure if what I experience is the same as what you are describing OP.

I have a fear of actually going to sleep: when I get to the point of going from drifting towards sleep and transitioning into actual sleep I'm seized with a terror of being unconscious and a dread that I will never wake up. So I drag myself back from the brink of sleep repeatedly and will only actually give in to sleeping when I'm too exhausted to stay awake.

Is that sleep anxiety? I've never given it a name.

There’s better antidepressants that can help with sleep. Fluoxetine has a known side effect of insomnia. Mirtazapine or amitriptyline specifically.

I had fluoxetine and it left me wired. I’d explore alternatives safely with a psychiatrist.

I was going to suggest a different AD too - I’m on trazodone which has been great for me anxiety/depression but also is very helpful when it comes to sleep.

It says online that fluoxetine causes insomnia, it is a well-known side effect. Found that out just by googling a minute ago. It also said that taking it in the morning lessens that side effect.

But if you have specifically been prescribed it in order to help cure your anxiety about your insomnia... I can't understand why the GP has prescribed it to be honest.

Sorry you’re a feeling like this. My adult DS has periods of going through this, although not on an SSRI (although he should be) and not for as long. The only thing that (eventually) works for him is convincing himself he doesn’t care if he sleeps or not.

He's been like this since the second lockdown so nearly 5 years now. It’s 100% worse when he’s stressed as well.

Fluoxetine can cause insomnia.

Mirtazapine or Amitryptiline will be better. They cause sleep,

You have posted before about your sleep issues?

The issue is anxiety, generalised. Poor sleep issues a symptom.

You truly need the help of a mental health professional. You sound in a very dark place and I imagine just be very difficult for your family too.

Good luck, you owe it to yourself and family

Thank you. I am seeing a therapist and sleep therapist. I just want to know it’s possible to get through the other side!

With the correct meds for you alongside extensive professional mental health support for your generalised anxiety… I would be optimistic

Thank you. I’m generally a very level headed person. I work as a teacher, socialise and run four times a week. I just can’t shake the worry about not sleeping.

It’s not just sleeping
Sleeping is the symptom of generalised extreme anxiety

Yes the brain is neuroplastic, it’s posssible to feel less anxious day to day and it’s certainly possible to reduce anxiety from the levels you are feeling.

Try a self compassion and self acceptance exercise: put a hand on your heart and say “I feel anxious. It’s ok to feel this way. I will be kind to myself.”

Repetition of compassion exercises like this are surprisingly effective.

I am sleeping well. That’s not the problem - I worry I won’t sleep.

Generalised anxiety

worrying about sleep to the point it stops me sleeping, then panicking the next day if I’ve had a bad night

This isn’t “sleeping well”

I didn’t find they made any difference. 6 months in so far.

Sorry to hear that. I’ve been journaling using a couple of different self compassion exercises every day and it’s made a huge difference after only a couple of weeks. Perhaps you need a different strategy.