Anxiety & Insomnia

Health & Wellness Mental Health
1

I’ve been struggling with Generalized Anxiety Disorder (GAD) for years, and it’s caused me a lot of ongoing issues. It all started about 10 years ago with racing thoughts and anxiety, followed by six days of complete insomnia. Since then, I’ve been on various medications. I take 7.5mg of zopiclone to help with sleep and, after trying many different antidepressants, I settled on mirtazapine (15–30mg). Unfortunately, my anxiety has never improved, and some nights I sleep fine while others, I don’t sleep at all. On top of that, the constant tension in my muscles from the anxiety has caused chronic neck and back pain. Over the years, I’ve seen no improvement, and in fact, it’s gotten much worse in the last couple of years.

I’ve tried countless natural remedies—meditation, exercise, GABA, melatonin, cognitive behavioral therapy—but nothing seems to make a difference. However, I did find two things that actually helped: one is Ketamine. Long-term use of Ketamine has significantly reduced my anxiety, cleared up my muscle pain, and greatly improved my sleep. The problem is that I can’t legally access Ketamine where I live in Canada since it’s only in clinical trials, and the nearest clinic is far away. I do have a source, but it’s incredibly expensive. I truly believe that with continued use, Ketamine could cure my issues, but the financial cost is becoming overwhelming.

Recently, my source also started carrying Xanax (which I’ve tested and is pure), and I decided to try it. Initially, it felt like a miracle. It was much cheaper than Ketamine, and it wiped out my anxiety, helped me sleep better than I had in years, and made me feel like a new person. I even managed to stop taking my mirtazapine and zopiclone for a while. I went two weeks without mirtazapine and six days without zopiclone. But then things took a turn for the worse. While my anxiety was gone, I stopped being able to sleep altogether. Soon after, my anxiety came back even worse than before.

I went back on my usual medications, but continued using the Xanax. I started increasing the Xanax dosage, and while it kept my anxiety under control, I couldn’t sleep. If I did manage to fall asleep, it was light and only for a couple of hours before I’d wake up again and be unable to get back to sleep, no matter how much of the three meds I took. Now, it’s been nearly a week with hardly any sleep, and my anxiety is through the roof.

Right now, I’m on 2mg of Xanax just to take the edge off, 30mg of mirtazapine, and 7.5mg of zopiclone, and none of it is helping. I honestly regret ever starting the Xanax because it’s made everything worse after just three weeks. I don’t know what to do anymore. I have no real support or help from the medical system. My doctor wants me off zopiclone, so they won’t increase the dosage, meaning if I take two pills to sleep, I’m stuck with a day where I can’t take any. They won’t prescribe any benzodiazepines, and all they suggest are more antidepressants, but I’ve tried them all, and they don’t help.

What’s frustrating is that no one seems to listen when I tell them that I’m not depressed—I’ve never been depressed. They keep insisting that my anxiety is a symptom of depression, but I don’t believe that’s the case. My anxiety feels like the root cause, not just a symptom.

I’m feeling lost and at my wit’s end. If anyone has any advice or suggestions, I’d greatly appreciate it.

2

since you’re not getting the help you need from your current doctor, consider seeking a second opinion from another healthcare provider
look for a psychiatrist or psychologist who specializes in anxiety disorders and can provide you with a comprehensive evaluation and treatment plan!

hope that you will feel better :))

3

It sounds like you’re currently facing a significant dilemma: you’re dealing with severe anxiety and insomnia, you’ve found some temporary relief with treatments like Ketamine and Xanax, but these aren’t sustainable or legally accessible in your current situation. The mix of medications you’re taking now (Xanax, mirtazapine, and zopiclone) doesn’t seem to be providing the relief you need, and it’s understandable that you’re feeling stuck.

Given the complexity of your situation, I want to offer a few thoughts, but I do want to remind you that it’s important to work closely with a healthcare professional, especially in a situation as nuanced as this. Here are some ideas to consider:

1. Benzodiazepine Dependence and Tapering:

  • Xanax is a powerful medication, and its use can sometimes cause rebound anxiety or insomnia when discontinued or reduced too quickly. While it seems to have helped you initially, it’s important to remember that benzodiazepines like Xanax carry a risk of tolerance, dependence, and withdrawal symptoms, which might explain the worsening of your anxiety and sleep issues after you stopped taking them.
  • If you haven’t already, it could be helpful to talk to a doctor who specializes in benzodiazepine withdrawal or addiction. This could give you a better understanding of how to safely taper off Xanax (and possibly mirtazapine or zopiclone), while minimizing the risk of rebound symptoms. It’s possible that your body needs time to adjust after the disruption caused by the Xanax.

2. Sleep Issues and Medication Review:

  • You’ve mentioned that you’re struggling with insomnia despite taking zopiclone and mirtazapine. It might be worth discussing other options with a healthcare provider or a sleep specialist. Medications like melatonin or low-dose doxepin have been helpful for some people with insomnia, though every case is different.
  • Some patients with GAD find that a non-habit-forming medication, like quetiapine (an atypical antipsychotic), can help with sleep and anxiety, although it may not be right for everyone. Again, these medications should be discussed with a physician who understands your specific needs.

3. Ketamine Access:

  • I understand that Ketamine has been one of the few treatments to significantly reduce your anxiety, improve your sleep, and relieve muscle pain. While Ketamine is still in the early stages of clinical use for anxiety and depression, there are some clinics that offer Ketamine-assisted psychotherapy in a controlled setting. If cost is an issue, you might want to explore insurance coverage options or look for clinical trials in your area (though I understand clinical trials may not always be available).
  • You might also want to inquire about Esketamine, which is a nasal spray form of Ketamine approved for treatment-resistant depression and anxiety in some areas. It might not be an exact match for your experience with Ketamine, but it could be an option worth exploring.

4. Addressing the Root Causes of Anxiety:

  • It’s clear that the anxiety itself is a major driver of the sleep problems and muscle pain you’re experiencing. While medications and sleep aids are important in the short term, it might be worth revisiting strategies for managing anxiety long-term, especially given your success with Ketamine in the past.
  • Given your history with Cognitive Behavioral Therapy (CBT), it’s unfortunate that it hasn’t had lasting benefits for you. You might want to explore Trauma-Informed Therapy, Acceptance and Commitment Therapy (ACT), or Mindfulness-Based Stress Reduction (MBSR), which have been shown to help people with chronic anxiety. Sometimes different therapeutic approaches can provide a new perspective or make a more lasting impact.

5. Support System:

  • It’s disheartening that you feel you lack support from the medical system. If you haven’t already, it might be worth seeking out a second opinion or a specialist, such as a psychiatrist with expertise in GAD or sleep disorders. Even if you’re in Canada, some mental health services may offer telehealth or virtual consultations that could help you access a more personalized approach to your care.
  • You might also consider connecting with support groups or online communities where others are dealing with similar challenges, as this can sometimes help reduce feelings of isolation and provide insights into treatment options that you might not have considered.

Ultimately, I want to reassure you that you’re not alone in your journey. Managing anxiety and sleep issues is a process, and it can take time to find the right combination of therapies and medications. Be gentle with yourself and keep advocating for the care you need, even though it can feel frustrating and exhausting at times.

If you ever need more specific advice or support, feel free to reach out again. We’re here for you.