FEAR - any advice please?

[HelenM]

For many years I have been dealing with depression and anxiety. The first bout 13 years ago was traumatic. For the third time in 6 months an overwhelming fear of going back there has come to me, despite my depression being very mild. This time it's much worse owing to a return of a particular symptom. 

I am having major problems with my sleep. Not sleeping I can cope with but I'm having highly distressing symptoms of anxiety - palpitations and a lurching of my stomach (really horrible) as I'm dropping off, and so waking me up. Eventually, back then, I found I didn't want to sleep because of the symptoms. The high alert my mind is on stops sleeping tablets working.I have been working on my breathing. I keep reminding myself that I was very ill then and although this is happening it is only one part of that episode. My fear seems to override these things. All those years ago the problem went as soon as I began to respond to anti depressants.

So I have to live with this. Two very good friends assure me that the fear that sneaked in for no reason will go again as I continue to get on with my life, which I can manage even with very poor sleep. I don't think I've levelled out with my sleeping problem yet and I wonder if  that is making my fear worse.I go to see my gp on Tues.

This is 99% association is it not? In Scotland it's dark and wet. It was the same time then that these symptoms were worst. I wonder if it would be just as bad if it were Summer.

Perhaps everyone has their own demons in their illness and I guess we're all different. This is one of mine. I don't think there are any answers on this but if anyone could advise me as a way I could see this without getting so scared I'd really appreciate it.

Thanks, Helen

[Beltane]

I can definitely understand your fears here.

Firstly, i think many of us who have been through a significant time of depression/ anxiety fear "going back". I thank my lucky stars every day I have recovered and I too become paranoid if one of my symptoms returns. I too get heart palpitations when anxious, as well as nausea and hot flushes/ sweating hands and shaking etc. So if i get a little nauseous- even if its because of something else, like i've eaten too much food- i'll become very scared that "it's coming back".

As for the sleep, i went through a period of several weeks where every time i tried to fall asleep i felt like i had stopped breathing, and i woke up gasping for air. This wasnt actually real obviously, it was just my anxiety. But for a few nights in a row i was too scared to sleep, and just like you, sleeping tablets didnt help. They made me very tired of course, but everytime i tried to fall asleep i had those awful feelings.

Bu then I went on a new medication for anxiety/ depression/ bipolar 2 and all my symptoms went away. All my anxiety symptoms, all my depression symptoms, all those awful sleeping problems all went away.

The point is- you're trying to treat the symptoms which is the trouble falling asleep by using sleeping tablets- but the REAL problem is the anxiety, so you need to treat THAT. Ask your doctor for Medicare funded visits to a psychologist who can teach you techniques to deal with anxiety (and not just "deep breathing"- there are lots of different techniques. You might also consider going onto a medication, or swapping medications if you're already on one.

also for me, what finally broke the cycle of the fear of going to sleep cos i had the feeling of stopping breathing was actually just getting a good nights sleep. it was a fear thing- you know every night i had the breathing problem, so the NEXT night i'd be scared and it would happen again. also what was happening was that i was extremely tired and sleep-deprived, so my mind was becoming very confused and it was making the breathing problems even worse.

i know it can be really hard to get that first good nights sleep, but i'm hoping very much that if you can get that one good night without these horrible symptoms, that will start to break the chain of fear, plus your mood and anxiety will be a lot better after a good nights sleep, which will make it easier the NEXT night,

[Neil_1]

Dear Helen

You’re probably getting sick of me – but here I am again.  🙂

That five letter word is such a hot topic for so many people – “sleep”.   Where we simply need to do it, in order to become rested enough to take on another day.  The act of like, going to an unconscious state and for a lot of us, it’s so so difficult and hard;   and yet for others, I know where they can fall asleep within a minute of their head hitting their pillow.

But for the struggle that we face, I hope that that’s all it is – a struggle and that it doesn’t develop and become something bigger – as when it does that, the stress that’s related to that, just makes the process, that more difficult.

Breathing techniques are a good start, as you’ve mentioned.   Obviously sleeping tablets can very much help, but I’m reading that you’re perhaps in too much of a worked up state for them to take effect;  so we’ve got to get you to a level where you’re more relaxed and calm.

So yes, breathing is great;  nice and controlled and slow.

Trying to remove any issues, bad thoughts from your mind in the time leading up to bed.

Being very settled in your night activities – so try and reduce as much stimulation where you are as possible.

Reading can sometimes be a help as well.

With regard to your upcoming GP appointment, are you currently on any meds?   And so what they may prescribe for you could be helpful to you?   But as with the above, and the sleep tablets that you have;  I believe also, you’ve got to try to have your body unwind and relax, so any kind of medication will be able to have its full effect.

I’m not sure if I’ve been of use in this post, but I do hope so.

Write back as soon as you get a chance as well.

Neil

[HelenM]

Dear Belatane and Neil,

Thank you so much for your replies and no Neil I never get tired of hearing from you -being cared about is very warming. When I see My GP Neil I plan to have a good talk with her. I am on quite a lot of meds and I did discuss them with her a couple of months back. They.ve helped me for years and she said that if she were to contact the psychiatrist it is extremely unlikely they would change anything. Although the dose for depression is higher and so if it was needed she would increase.

The good news is, two nights ago (I'm in Scotland here) did sleep and slept well. Because of that a good part of Friday I enjoyed. Last night I also slept pretty well. Our Drs will not give out many sleeping pills at all so it would be impossible to take them nigjhtly.  So, although the fear is here today a bit of me feels more hopeful - maybe I've made a crack in the ice.

Beltane, I hope you don't mind me saying this, but when you mentioned your symptoms and the fear of going to sleep, I thought, thank God,someone else has had that fear.

Last week I started on a mindulness course and have really struggled to do the 'homework' in between which really upset me. I went yesterday thinking I should give it up but the psychologist running the group encouraged me to carry on. I think that was a good idea as I can do the exercises in the group and I found the session a positive experience.

So, all in all I can see things are a bit better. I can't say I'm confident but what I do know, which helps, is that I'm taking a very level headed approach and I think can only be a good thing - it gives me a sense of control. In mydepression all those years ago I didn't know what

hit me. Perhaps I was like a 5 year old trying to do a doctorate. Where now I'm busy on post grad work!

Honestly, I thank you both from the bottom of my heart. Knowing you are with me in my struggle makes it more bearable. Bless you both a hundred times over!

Helen xx

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[Beltane]

Hi Helen, glad to hear back from you.

I'm glad my experience has helped you- I hope it also helps you to know that it has been 3 or 4 months since I had a nasty sleeping experience like that- and my sleep has been wonderful ever since.
I am on a type of drug called an antipsychotic for my severe anxiety which a psychiatrist trialled me on after failed attempts at antidepressants; it has been a godsend to me, improving my anxiety very well, improving my sleep, improving my mood. I'm just saying that to give you hope that there is a drug or drug combination out there that should help you a lot.

I also do therapy called "Acceptance and Commitment Therapy". Its a little different from the more common CBT, which I also did but didnt find useful. I love ACT- it really helps me.
A great book based on ACT is "The Happiness Trap" by Dr Russ Harris. The techniques in the second half of the book changed my way of thinking, and thus helped me beat my anxiety. (They're based around teaching you to identify anxious thoughts as what they are- just stories- and to remove their power over you). You can get is as an e-book off Amazon on your smartphone or Kindle, or buy it second hand off eBay.
I also love apps like Smiling Mind and Get Some Headspace (both guided meditation apps with lessons that get harder as you progress) and ACT Companion which is a fun little app where you learn techniques.

I don't know about you, but when i'm anxious/ fearful i'm full of all that anxious agitated energy and its very hard to try to sit and meditate when you're that worked up- so i get the energy out in a healthy way first. I chose some interesting hobbies that are distracting and require thought and energy (eg sewing patchwork quilts, exercising, dancing and singing along to powerful music, playing bongo drums). As I find techniques or ideas that work, i write them down so that when I'm overwhelmed and cant think of what to do- i already have what works written down, and can just choose what i want to do.

This gets that excess energy out, so I can find a measure of calm, and THEN i can go through problem solving techniques to actually resolve the stress/ think through the problem etc.

Deep breathing is really useful once you learn it- i use it when panicking.

Daily exercise is really good for getting pent up energy out- find a sport or class (yoga, dance, karate) that interests you, not one that seems like a chore. I do it in the evening- it gets me tired & relaxed for sleep.

[HelenM]

Here I go again,

I thought of starting a new thread but I guess it's all related. My sleep is becoming more manageable. My fear however is no better. It's as if my depression has manifested itself in a different way. I'm getting on with my life. My dr who I saw the other day is happy with my meds.

I'm sick of having to struggle. I've never really got out of the depression that came last January although I've had spells where I've been somewhat better. I was coping pretty well for a couple of months until this hit. No one has a magic wand but I wonder if this sort of thing sounds normal in a chronic depression. Or will I just have to get on with it for years. And honestly our doctors do not consider this level a reason to alter meds. Being scared/miserable is seen as life in Chronic depression. I am on a mindfulness course . But does this, as friends tell me, ease off on its own.

Thanks Helen

[Beltane]

Well.. What is "chronic depression". For some of us we're certainly probably going to be more prone to having spells. That diesnt mean our life will be and endless nightmare of deoression- just that we have to be extra careful to put prevention measures in place, and get early treatment of we're noticing stuff is getting hard...

but it as for your belief that you'll have to live this way forever.... It's a common belief- when we're in an acute phase of anxiety/ depression it becomes almost impossible to picture life without it. I know, I've been there. It just overtakes your life so bad, you literally can't imagine not having it.

its true that you won't wake up and it'll be gone. It'll be more like every day is just a teensy bit easier. Sometimes you'll get a bad day where you go back one step, but the general trend will be up. 

you should absolutely seek a second opinion from another doctor (ensure to book a long session not a quick 10 minute session- they're also covered by medicare". Ask the receptionist at your clinic to give you a copy of your Mental Health Care Plan so you can take it to the new doc. 

A med should ideally (and realistically) help quite noticeably. Many people who've been on meds that didn't work, and then found one that did say things like "everything is easier now. Depression is much milder (or gone), ajxiety is much milder (or gone). 

meds don't work by themselves- they help immensely but they're only one piece of a big puzzle- other pieces include lifestyle changes, coping skills, therapy, hobbies, exercise etc...

i highly recommend therapy. If you haven't lked it before, find someone else. There are some super cool therapists out there with clevel minds who can sort you out 🙂

also worth asking your doctor as you can get a one-off appointment to a psychiatrist Medicare-funded for a "medication review". After 6 failed attempts at various antidepressants, they put me on a different type of medication (called an antipsychotic). Besides, it turned out I have bipolar not depression. Needs totally different treatments.

point is that med, on top of a good therapy done by a clever therapist, changed my life in the most amazing ways.

definitely well worth persisting with another doctor or try to get that psychiatrist. A different type of medication could be the perfect puzzle piece to put you back together..

[HelenM]

Hi Beltane

I live in Scotland and so things are very different here. It is totally up to my gp to refer me, though I think I may see a different one. at one time they were fairly good at sending you to a psychiatrist but with cuts on our health system you have to be at the very bottom, which is crazy I think. I'm inclined to think I need a different med. It's served me well but in the last year depression has turned to anxiety and I don't think this one does a good job

I am so glad you're doing well. You deserve it.

Helen x

[Neil_1]

Dear Helen

Can’t think why I haven’t been here in the last week posting to you – it all seems a blur;  I guess you get that when you’re sober and on an alcohol free run.  Ahhh beer, is there anything it can’t do.   Stop it Neil – 21 days and counting.  Keep going, it’s all good;   but wow, that pink and blue butterfly with the orange wavey patterns on it, is quite beautiful.

Sorry about that;  I’m better now.

Helen, I don’t mean to harp on this, cause sometimes doing that, can be not so helpful as the subject is always raised, but how have you been going with your sleeping this week?

I’m hearing you also with regard to your medication that ‘may not’ be working.  Perhaps a question to ask is how long have you been on this particular one?   And in the past, has it seemed to have helped?   If the 2nd answer was “Yes”, then perhaps it may just be a need for upping the dose … as you’ve already got that particular medication in your system and so an increase in dosage will be able to work for you much quicker;   than perhaps the wean-off phase of getting off it;  the wash out phase;  then the reintroduction of a new one – which in turn, as you’d know, takes a number of weeks before its benefits are revealed.

Just thinking out loud, I guess.

Cheers

Neil

[CMF]

HI Helen,

I've just read through your post and in your first one you mention 99% association, Scotland, wet and dark etc. I found this info, it may help.  people in Sweden suffer high rates of depression because in winter there is not much daylight which prompted me top look this up;

cold weather and lack of sunshine bring on more than the usual winter blahs. It can bring on a form of clinical depression called Seasonal Affective Disorder (SAD). If you live in a northern region, where skies are normally gray from October to March, it’s not uncommon for a lack of sunshine to make you feel depressed. Research has proved that brain chemistry is affected by bright light, although the exact process is not clear.  It’s more common in women and usually first appears in one’s 20s. People with SAD typically feel better when spring comes, and then experience symptoms again in the late fall.

Maybe a stab in the dark but hope it is helpful.

CMF