I have too much anxiety in the mornings. Help me make it stop.

February 14, 2013 9:12 PM

I wake up too early every morning. When I wake up, I immediately start to worry about the Stressful Thing in my life. Then I get the tingly feeling in my skin and my heart starts to pound. And then I can't get back to sleep. And because I'm waking up too early, I haven't had enough to sleep. The sleep deprivation is compounding the anxiety. How do I stop this pattern?

I am dealing with the practical repercussions of having left a long-term abusive relationship some time ago. My life is infinitely better (in so many ways!!!) than it was when I was with him, but these issues have to do with our children, so it's not as if I can make a clean break.

I am prone to anxiety as a trait, but don't have any diagnoses. It's been smooth sailing for many months, anxiety-wise, but now I'm about two years out from the separation and I'm starting to feel some (perhaps delayed?) anxieties raising their head. I find that I wake up too early, at about 5 AM, and then immediately start to fret about the latest catastrophe he's created, and then that's it for my night's sleep. I get back- and butt-tingles when I'm stressed and panicky, anyone else get that??

I can't seem to short-circuit the anxiety once it's started despite some really good CBT techniques, and I find that this sense of stress carries into my day: I can't eat breakfast, I usually start to dry heave and occasionally vomit when brushing my teeth, and generally just feel nauseous and sick until after lunchtime.

I have a therapist, and we are exploring this. But his is only one perspective. Can you add your experiences or advice about how to get this to stop and get back on an even keel?

(And if you can't address the root cause, then please just address the symptoms: How do I stop early-waking and dry heaving when I'm anxious?)

posted by (F)utility to human relations (24 answers total)

Wow, that sounds terrible! I think you are having panic attacks; those tingly, dry heaving sort of symptoms are classic.

Believe me, I'm not one to recommend medication lightly, but I think you should discuss with your therapist a low dose of something tried and true. For me, Prozac worked, and I only took it for about nine months.
posted by Specklet at 9:22 PM on February 14 [1 favorite]

One practical tip that might help is to take melatonin at night so that you sleep longer. Time release melatonin is particularly good for early waking.

If you can get more sleep, it might make working on long term fixes easier.
posted by medusa at 9:23 PM on February 14

I'm on hydroxyzine for anxiety AND sleep....it is awesome for both.
posted by tristeza at 9:25 PM on February 14 [1 favorite]

I'd suggest seeing a medical professional sooner rather than later. Unless you're dead set against medication for some reason, there's a real chance that medication could help resolve your issues. But only a medical professional would be able to tell you for sure.

I suffered from severe anxiety and panic attacks for almost four years before seeking medical help. My doctor prescribed a three-med regimen, and within a week I felt better than I had in years.
posted by ronofthedead at 10:12 PM on February 14

I have had the same problems and for a short-term solution (aka, I'd like to just sleep 12 hours now), I really like dramamine. I'm not sure that it does this to everyone, but a full pill of classic dramamine and I literally cannot get up for a good 12 hours. Then start working on longer-term options.
posted by dame at 10:28 PM on February 14 [1 favorite]

OMG! For once, a question I can give actual (hopefully) good advice about. First, (F)utility - congratulations! and change your screen name! You were in an abusive relationship and you've been out for 2 years? That is awesome. Bask in that. Change your screen name to (FN-Awesome)Utility!

I was also in an abusive relationship and 5+ years out now, I've only just now realized that it wasn't so much the wtf blow-ups that screwed me up as much as it was the constant "ur doing it wrong" dialog that went on in our relationship every single day. You know what that leaves you with? Anxiety! You wake up every day with a stomachache. You don't trust yourself to make good decisions because a) you got into an abusive relationship and b) he told you were a fuck-up in both implicit and explicit ways for the longest time.

So what works? Xanax ER. Not the fun Xanax, the long-lasting Xanax. The first time I took it, I woke up the next morning and actually cried because it was the first morning in years that I had awakened without a stomachache.

Now after that, it gets harder, but not as much. You just have to keep on keeping on. You're already in therapy so keep that up. But the Xanax will help. And then, you'll build some successes and you'll get some confidence that you've earned on your own because nobody was shooting it down and then you can start cutting back on the Xanax (because it did make me sleepy and unmotivated when i really kind of needed to be motivated).

And memail me if you need a booster! I will be happy to talk you through your stresses. What people call stress for the single parent is actually what normal people call "problems". You'll have them. And I will be happy to tell you either a) things will get better! or b) yeah, that sucks. Bummer. I've found that both remarks are helpful.

But mostly - go you! You got out! You stayed out for 2 years without going back (big deal)! Celebrate! And then drugs if you need them. :)
posted by Lizlemondrop at 10:34 PM on February 14 [9 favorites]

this was the exact symptom that finally drove me to see a psychiatrist last year: up around 4 or so every night, stress thoughts instantly, paired with instant overpowering anxiety and dread. I so feel for you, it's awful. Wellbutrin worked for me -- when I was on it, it was like I completely lost the ability to feel that anxious looming dread. I also slept a lot better. I'm off it now, but it helped jump-start other healthy ways of coping psychologically.
posted by changeling at 10:44 PM on February 14

I can suggest my experience, but this is not advice. Generally speaking, I get anxiety when I cannot fully (and I mean fully) accept a situation for what it is, or when I am not willing to admit that I had some at least some role in contributing to that something which is giving me anxiety, even if my fault amount to 1% of the total problem. My inability to turn my mind's attention to myself and myself only serves to keep me attached to traumatic experiences that happened in the past, despite my desire to be liberated from all of that. My anxiety is rooted in powerlessness. Those traumatic people end up living in my head "rent-free." I also have the same kind of delay you described when it comes to anxiety - long periods where there is no problem, and then it all of a sudden crops up and renders me useless.

I don't control the fact that I get anxious - I see that as being impossible - but it is my responsibility and mine alone to process it. No one can or will do it for me. This is a particularly difficult fact for me to recognize when I have an extremely justified complaint or resentment towards another person.

Techniques I've used in the past have included writing down a gratitude list before I go to bed every night for a week, making a God box, writing down 5 areas of your life that are suffering as a result of your anxiety, simply writing down what is bothering me in a journal, and meditating. If you believe in God, the God box to me has oddly been particularly effective. I write down what's really bothering me, put it in the box, and boom, it's God's job to take care of it. The next day I am provided with an enormous sense of relief. The desire to control the uncontrollable is removed, and I am empowered again - I can focus on something I can actually change, like getting more sleep.

Setting aside all the God talk for all you atheists, what all these techniques have in common is that they involve the removal of a pressing thought in your mind, via writing it on paper or through meditative release. Pick one that appeals to you and give it a whirl. If your brain is really fucking you up, don't be shy about trying something new and unreasonable in order to get healthy again. It's really the worst when you have legitimate reasons for being riled up.
posted by phaedon at 10:44 PM on February 14 [4 favorites]

I don't have anxiety, but I used to wake up and then lay awake at night time in much the same state you're describing now.. other people will probably have more useful advice re: the anxiety, but I found distraction to be really helpful for just getting back to sleep..

for me, I like to put an audiobook on with headphones and listen intently to it. something you're interested in but not invested too heavily in the story is best. I like the harry potter books read by jim dale for this exact scenario because I've read the books a few times so I don't need to stay awake to listen, but I do like the story and find jim's reading soothing and engrossing. Someone else talking seems to drown out my own internal dialogue pretty well and I have an easier time not dwelling on things. it's almost like meditation, focusing on something other than your thoughts. you could also try meditating, it takes some training and is a little bit difficult at first, but I generally (accidentally) fall asleep during it.
posted by euphoria066 at 11:01 PM on February 14

I know what you're talking about because I have had various flavors of anxiety (from mild to laying in bed in a fetal position) for my whole life. When it's really bad, the only thing that works for me is medication. Don't hesitate to see a doctor. Anxiety is very treatable. I still get anxious sometimes, but I consider myself to have a chronic disease with occasional flares that my doctor helps me keep under control. Therapy is great, but really, when it's as bad as you describe, "exploring" it with a therapist is about as helpful as "exploring" a toothache.
posted by summer sock at 11:04 PM on February 14

When this happens I usually just get up. I'm not going to sleep so I may as well go have a cup of tea (by myself! In the early morning silence! So lovely, even if I'm exhausted!) and noodle around on the net, or read, or something else low key. No news, no TV, nothing stressful. I never fall back asleep but it short circuits the process.

Sometimes it doesn't really work, but having a panic attack over a cup of tea is less bad than a panic attack in bed wishing I was asleep.

It works for the most part, if I can convince myself to get up early enough, before the panic sets in. And the more you do it, the more likely you are to go to bed earlier and I've found I tend to sleep better as well.
posted by geek anachronism at 11:43 PM on February 14

And then I can't get back to sleep. And because I'm waking up too early, I haven't had enough to sleep.

Then don't go back to sleep. Get up, do stuff. Pay your bills, write your novel, make a big breakfast, whatever. You might be tired for a day, but just go to bed earlier that night and you'll make it up.
posted by empath at 11:55 PM on February 14 [2 favorites]

I've been there - and often, still am there, and my best advice is to get up. You wake up at 5? Then get up at 5. Use that anxiety to launch yourself into the shower. Just use it. The worst part of any sleep issue is fighting it - it takes a garden variety anxiety and turns it into something so much bigger. Anxiety, when you don't fight it, is just nervous energy - so get up, take a shower, make a good breakfast, and work that energy off. One of the worst parts of having anxiety is the anxiety you have about the anxiety. Just pull the plug. Get up, use it for good, and it will have no more control over you.
posted by The Light Fantastic at 12:08 AM on February 15 [2 favorites]

Wow, I was fully expecting to be the only one saying for this kind of thing, a low dose xanax until you feel better, but looks like the whole world already agrees. You do not need to be waking up every morning feeling like this. A little bit of xanax and you will not only get back to sleep because your thoughts won't race, but you'll likely wake up still under the influence enough to start out your morning more calmly. (Well, ymmv, but many people find this to be true.) It's possible the psychiatrist will recommend to take it at night instead. A preventive anti-anxiety/panic drug is buspar, and it's often very well tolerated.

Conversely, are you already on antidepressants? For longer term use, they can be very effective against anxiety.
posted by namesarehard at 12:27 AM on February 15

I agree with just getting up and not fighting the anxiety directly. From a half-asleep state in bed, anxiety will win. You gotta sneak up on it, pushing it back a little bit more each day. Waking up ten minutes later (or falling asleep 10 minutes sooner) is a victory. Maybe even set an alarm and beat it to the punch. Even better if you feel like hitting snooze after it goes off.

Lastly, make sure you don't skip breakfast, but do NOT actually eat breakfast until you've been awake for at least two hours (then eat a really big one). I used to eat first thing after I woke up and it tricked my body/mind into A) being very hungry first thing, and B) waking up earlier than I needed to.
posted by iamkimiam at 12:36 AM on February 15

Clonazepam.
posted by Jacqueline at 3:05 AM on February 15

If I'm reading correctly, the anxiety is related to your children and their contact with your ex?

If so, I imagine that is a pretty difficult thing to just 'switch off'.

I hate to add to the chorus of 'drugs!' but with such a horrible situation that is somewhat outside your control, perhaps medication is an option to be seriously considered.

I took Zoloft for post-natal anxiety & related sleeplessness. After about 2 years I cut it out completely with little ill-effect - in fact I felt more chilled than before the whole PPD/A thing happened. Of course, the baby also got older and it got easier anyway. As your kids get older the situation with your ex will almost inevitably get easier, too.

Also, is there some kind of peer support you can tap into for people specifically in your situation? An online group might be good if nothing is around IRL?

I wish you good luck!
posted by 8k at 3:59 AM on February 15

Unlike you, I can stay asleep, but I toss and turn in bed because I keep thinking of this which stress me out.

I listen to Youtube playlists of people reviewing makeup products. Like euphoria066 said above, focusing on someone else talking somehow pushes aside my anxiety. I enjoy makeup products so the talking makes me feel happy, but at the same time I don't get too interested (which is why audiobooks don't work for me)

By the way, I was totally against medication for a very long time. But I finally caved in after suffering for 1.5 years and went to see a professional. Even a small dose of medication really helped.
posted by xmts at 4:38 AM on February 15

If you're up anyway, put on an exercise video and work out. You'll get a rush from the exercise, feel better about doing something to take care of yourself, and you can check off "exercise" from your todo list that day. If it helps, do a kickboxing-style of video and imagine all your anxious thoughts standing in front of you as you punch or kick each of them. Go to bed earlier to make up for that hour.

I've been trying to figure out a way to force myself to get up early and exercise - look at you! already up and rarin' to go! Best of luck, we're all on your side.
posted by CathyG at 5:33 AM on February 15

Oh hai!

I used to get those. The 3AM panic attacks. I'd wake up in a cold sweat, heart pounding with the most obnoxious pop song in my head. I was exhausted but couldn't get back to sleep. I'd have to turn on Scooby Doo at a very low level on the TV and only then could my brain disengage.

I got on an anti-anxiety drug (first Prozac, now Celexa) and I have a whole new life!

Go to your GP, I get mine from my regular doc. A low dose (I'm on 20mg) and it's a beautiful, beautiful thing.

Now I'm able to drive over bridges, through tunnels and on those freeway fly-overs (Spaghetti Junction in Atlanta) without crying.

Good, good stuff.
posted by Ruthless Bunny at 6:39 AM on February 15 [1 favorite]

Oh, ouch. From some experience on this I agree: drugs, take drugs...!

SSRIs have poor efficacy in general and not much to recommend them for anxiety -- "It is disappointing to note that there is no good evidence of the efficacy of SSRIs in generalised anxiety disorder" via. And I don't know what good a short-acting benzodiazepine would do for an early waking issue, unless you have a flexible schedule and can take a pill at 5am and after that period of wakefulness nod off for a few more hours (which I have had some success with on bad nights). "Z-class" sleeping pills have been very useful for me, and after a lot of recent stresses I am occasionally adding an older antidepressant (Doxepin, Remeron) at a low dose just for the drowsy side effects so I can sleep through the night.

I also gently disagree with advice to (always, at least) just get up and go about your day. Do that regularly and you will normalise stumbling through your days as a very anxiety-riddled zombie. Not good. However, if you lie in bed, eyes closed, with the idea that you are just going to lie there until it is time to get up; don't worry about going to sleep as you're not going to do that, and let your stressful thoughts crash over you like waves instead of fighting them -- you may find that you do indeed eventually nod off for a while. Or you don't, but you will still be better rested. I enjoy replacing the mind-clogging worries with thoughts about: sex, elaborate meals I might wish to prepare, alternate endings to stories or dreams, etc.

In re. these issues have to do with our children, so it's not as if I can make a clean break: are restraining orders and supervised access centres options? Because those can be quite life-changing, wonderful things.
posted by kmennie at 6:57 AM on February 15 [1 favorite]

When this used to happen to me -- and it still occasionally does -- I would go to the fridge and drink a couple big swigs of Gatorade. I don't know why, but it usually put me back to sleep. Maybe a blood sugar or electrolyte thing? Might be worth a try.
posted by Clustercuss at 11:20 AM on February 15

Thanks everybody. I guess I was a little surprised to see the chorus of 'wow, this is pretty bad's but then I suppose I have a tendency to downplay the importance of my own needs. I'm glad I reached out for a little help here. It was really good to get the message that meds are OK. I have made an appointment with my doctor to rule out any medical reasons and discuss options.

with such a horrible situation that is somewhat outside your control, perhaps medication is an option to be seriously considered.

Sensible. This is not a situation that I can get out of, it is a situation that must be gotten through.

it wasn't so much the wtf blow-ups that screwed me up as much as it was the constant "ur doing it wrong" dialog that went on in our relationship every single day

That is it EXACTLY.

But mostly - go you!

Oh yes. Go me. Thank you Lizlemondrop.
posted by (F)utility at 7:22 PM on February 16

Sounds like you overcame a very traumatic experience... I have no firsthand experience with drugs, so I'm not going to recommend them, per se. However, it appears to have worked for a goodly number of people upthread, so I'm not going to slag the idea either.

All I can say is that twice in the last year, I have had bouts of crippling anxiety, prompted by upsetting events. Heart racing, chest tight, thinking how this wasn't helping me to do anything and yet it persisted. It was taking over my mind and I couldn't think about much else for long. I was sleeping badly and getting quite sick.

I went about looking for solutions with the philosophy that the mind creates the problem, and learning how to disengage the mind's cycle of thoughts can fix it. It's very tempting with a big problem to think that worrying about it more is addressing it... not consciously, but when thinking about why the anxiety persisted, I realized it was because my mind still believed, irrationally, that if I held onto those thoughts, I could protect myself from those original bad things happening ever again.

But that realization alone didn't help. For the first bout, I read The Power of Now by Eckhart Tolle (many, many times, every time I felt anxious). That helped me return to the present whenever my brain started wandering into the future. Any time anxiety occurs, it's because your mind is in the future trying to solve a problem or protect you from a future problem that it can't solve.

For the second time (a more deeply rooted problem), I read a combination of Thich Nhat Hanh's Peace is Every Step, and Things Could Go Terribly, Horribly Wrong. And a third book about relationships which addressed the main problem aggravating my anxiety, to tell my mind that I had learned the lesson I was anxious about. (Again, every time I started feeling the racing cycle begin, I'd return to their words.)

Some big breakthrough thoughts here included: even if you address the root cause of the anxiety, sometimes your nervous system can keep cycling the anxious physical feeling for awhile. The trick is to accept the anxiety is there. Things Could Go Terribly, Horribly Wrong was very good in thinking about *why* anxiety happens, the different types, and how to "ask" it for what it needs. Basically, fear in the present can help us jump away from moving cars or spot a predator. Fear of the future does little but paralyze us. You say you are worrying about the latest "catastrophe". Could it be that you are worrying about how you will handle it?

It's much harder for our minds to accept ambiguity than certainty. Those of us prone to anxiety (like me) may feel the need for things to be more "settled" at all times. But ambiguity happens, a lot. Sometimes you simply don't have enough information, you can't know the future. The above book also discussed how to make space for ambiguity in your mind. We all want things to be certain and secure, but part of restoring calm in tumultuous times is accepting the ambiguity that exists in many situations.

Another key thought I read (from Susan Jeffers) is that underlying all of our fears is the fear that we can't handle it. Know that you did handle things before, beautifully, and you will handle whatever comes next. Both good and bad things will happen. You'll handle them all, regardless of whether you worry about them in advance (note: worrying is not the same as taking action on something, which sounds obvious, but sometimes it's helpful to decouple them in your mind).

A lot of the healing comes from daily mental practice. Like exercise, it keeps your mental and emotional muscles strong when done regularly, and they can atrophy again when you lapse. That was a lesson I learned the hard way, after the first time, when I thought I was just *done*.

It's wonderful how many people have come before and written about overcoming anxiety and returning to the present moment. I see them as a community of teachers, and powerful tools.

Hope some of this may be useful. I daresay, drugs may be the shorter route to overcoming this and moving down the pathway to better thoughts. But I have no idea what their other effects are. Regardless of whether you go this route, it can also be extremely healthy and rewarding to strengthen those emotional and mental (perhaps even spiritual) muscles, to learn to accept and let go of disturbing thoughts, no matter what else you decide to do. There is so much beauty, peace, and depth in the present moment. I say this as someone who is still very much learning :) Best of luck, it sounds like you have come so, so far.
posted by iadacanavon at 2:55 PM on February 19 [1 favorite]