YANMD: SSRI morning fatigue

May 29, 2019 6:53 AM

I started Prozac (10, then 20 mg) about 2 months ago. I think it's starting to work -- generally I am feeling more optimistic and peaceful. However, it has not helped to motivate me at all! The biggest issue is that in the mornings, I can't seem to get out of bed. At the height of my depressive episode, I had the same problem getting out of bed, except it was dread about facing the day. Now, it's not dread --it's just that the bed is so darn comfortable and it takes SO MUCH EFFORT to finally get up. It probably takes me 2 hours every morning to get going. I don't want to switch medications since it seems to be working on my mood-- any advice on how to get going a little faster each day?
posted by Anonymouse1618 to Health & Fitness (14 answers total)

Best answer: I have this problem, hardcore, and have had it for a long time. I have a few suggestions for strategies to mitigate it. First, I sleep with my shades open. Waking up with the sunlight helps. Because it helps me so much, I also have a sun lamp in my bedroom that is plugged into a wall timer. It points at my face and turns on at 7 a.m. I also have an automatic coffee pot plugged into another wall timer that makes coffee at 6:50, so at 7 it's ready and I can smell it in my bedroom. I have a speaker that is hooked up to my cell phone so my alarm plays music from across the room; this goes off at 7:15. Finally, I have a chair in my bedroom that is very comfortable, and when my alarm goes off and the lamp has been shining in my face for a bit, I crawl from my bed into the chair and sit in the chair to wake up. Then I go downstairs and have my coffee. When it is nice outside I drink my coffee on my balcony and being outside definitely helps wake me up.

This whole process still takes about 40 minutes, but it's definitely better than the 3 hours I used to spend lying in bed wishing I did not exist, or lying in bed feeling comfortable and lazy (after starting to treat my mental illness). And to be honest, some mornings I still just lie there with my music playing while my coffee gradually gets cold downstairs, but it works more often than it doesn't. Best of luck.
posted by sockermom at 7:13 AM on May 29, 2019 [8 favorites]

Hey there I have the same problem. Basically I set myself two alarms - one for 15 minutes before I really need to be up and the 2nd one is the one I really have to get up for. I allow myself the 15 minutes to snooze, snuggle with the cat, whatever, and then I just have to force myself out of bed. I don't have any other great answers, sadly.
posted by Medieval Maven at 7:13 AM on May 29, 2019

Best answer: My first question would be about what time you take your medications? If it's at night, maybe move that timing back a couple of hours (with your doctor's permission, of course) to see if that can help with the waking up? Whenever I've been on a medication that has sleepiness as a side-effect, timing of dosing can make a lot of difference in how easily I get to sleep/wake up/get through the day/etc.
posted by xingcat at 7:41 AM on May 29, 2019 [9 favorites]

Boy, oh boy, do I know those feelings. Both of them.

I would pick up my phone and turn on music or a podcast and open the blinds. I still had the desire to stay in bed, but it was less appealing.
posted by kbbbo at 7:49 AM on May 29, 2019 [1 favorite]

Two alarms, as suggested above.

Something to look forward to, that I enjoy, which requires me to get out of bed - either for breakfast or in another part of my morning routine . Recalling the knowledge that if I did lie in bed all day I would be sore and have a restless sleep, thus depriving me of this exact bed-joy tomorrow, and that I probably wouldn't stay in bed all day if I didn't have any other demands on my time because it makes me lethargic and unhappy (assuming it is the bed-joy and not the world-sorrow that is the cause of the problem; if it is the world-sorrow, this last one probably won't work).
posted by girlpublisher at 7:57 AM on May 29, 2019 [1 favorite]

these are my strategies, so take them with a grain of salt:

1) i remind myself that feeling groggy is better than feeling anxious or depressed
2)do some calisthenics pretty much immediately after getting out of bed. it really clears the cobwebs, and conditions your body to start ramping up at that time of day anyway.
3)doggo. even if i don't want to get out of bed, having a doggo who needs to be cared for gets me going.
posted by LegallyBread at 8:25 AM on May 29, 2019 [1 favorite]

I have the same problem. 4 solutions:
1) put your alarm clock slightly out of reach.
2) put your feet on the floor as soon as possible.
3) have hungry cats threaten to eat you.
4) keep your house cooler than you normally would.
posted by evilmonk at 12:35 PM on May 29, 2019 [2 favorites]

I'm not on Prozac anymore, but I am on antidepressants and I have this problem. I would not recommend sleeping with the blinds open if you live anywhere with a decent-sized population, due to multiple studies linking not having a dark enough room when you sleep with cancer--especially breast and prostate cancers (necessary hormones only produced in darkness not getting produced).

If possible, put your alarm in another room, or somewhere that would require you to get up to turn it off. The closet works well. Get a "rise with the sun" sun alarm clock to wake you with gently increasing fake natural light. Also, do "Parent" things the night before -- set out tomorrow's outfit the night before, make your take-to-work lunch the night before, get a coffeemaker that you can preset to brew at whatever a.m., etc. Make it as easy as you can to get up and get going.
posted by tzikeh at 2:25 PM on May 29, 2019

1) Go to bed earlier. Get more sleep.
2) Natural sunlight. Open your curtains or blinds in the morning, even if you immediately get back into bed.
3) Seconding all multiple alarm clock suggestions or putting them in places where you need to get out of bed to turn them off.
4) Find just enough motivation to kick the covers off (or partially kick the covers off). Then laze in bed, relaxing and enjoying yourself, but ever so slowly/gently cooling down and becoming less comfy.
5) You know how electronics keep you up at night? Keep your laptop or tablet or phone by your bed, and browse online as part of waking up. Crank your monitor or phone screen up nice and bright and read for a while. Preferably with the covers kicked off.

I love the suggestion above of looking at adjusting when you take your meds as well.
posted by warble at 3:09 PM on May 29, 2019 [1 favorite]

Best answer: The time of day that you take your medicine can make a surprisingly large difference in this sort of thing. You may want to discuss it with your doctor before changing, though, particularly if your prescription currently specifies "before bed" or "in the morning." When I started taking an SSRI, my doctor specified morning on the prescription, but made it clear to me that it wasn't critical, just in her experience patients seemed to get a little bit more of an energy boost in the morning when taking it at that time. However your doc may have reasons for recommending otherwise in your case so it's best to check with them if you're unsure.
posted by biogeo at 10:07 PM on May 29, 2019 [1 favorite]

This is a problem in my household too.

First — I don’t know if that’s the case for you, but for my loved one that feeling of enjoyment (of being in bed and comfortable) was a really good sign that their depression was alleviating. You’re feeling comfort and enjoyment! That’s awesome.

Second — find something that’s also enjoyable to look forward to in the morning. For my loved one, that’s having the lights turn on gradually on schedule (we both love our LIFX light bulbs), making a cup of coffee and coming back to bed for 15 or 20 minutes.

That gives them a little bit of a kick in the morning to do something even better than just lying in bed (being in bed WITH COFFEE!) but also gives a bit more motivation to get the day started.

The lightbulbs are seriously awesome, too.
posted by third word on a random page at 3:21 AM on May 30, 2019 [1 favorite]

Can you take your meds at bedtime? Doing that helped me a lot! Ask you Doc if you can take all you Prozac at bedtime. It's worth a try.
posted by james33 at 8:27 AM on May 30, 2019

Definitely ask about timing your meds differently. I didn't have that problem on Prozac. Actually I got zero sleep on it and ended up as an inpatient to get off of it. However, I did have the morning fatigue issue with Remeron. I had to move it to something like 6pm to be able to get up in the morning.

Good luck. And remember if this is interfering with your life, there are other options out there. Finding the right psych drug is very much trial and error.
posted by kathrynm at 9:41 AM on May 30, 2019

Best answer: In case anyone is looking for a solution on this thread some day, I ended up getting a Fitbit Versa 2 and tracking my sleep habits. The Prozac likely is negatively affecting my sleep quality . Also, I was setting my alarm to wake me up at a time that landed in the middle of a REM sleep cycle (intense dreams), which would lead to 1-2 hours of major grogginess.

I set the Fitbit to vibrate silently (I loathe sound alarms) at the end of a sleep cycle and so far this issue has vastly improved. Next steps are to look into taking a prescription sleep aid to get more/better quality sleep with fewer awakenings. It sucks that the cure for one problem is the cause of another problem, but alas, I'd rather be tired and content than apathetic and depressed.
posted by Anonymouse1618 at 8:41 AM on May 13, 2020