Trying to understand why my anxiety/depression spikes
March 24, 2011 6:15 PM   Subscribe

What might cause a marked spike in my anxiety/depression symptoms from 5pm-8pm (almost to the minute)? In terms of body chemistry, sleep/wake cycle, hormones, etc what does my body have going on during this time?

I'm a 40 year old male who's had moderate anxiety/depression for about 15 years. After a sleep study, I learned I had severe sleep apnea which my doctor suspects is root cause of the anxiety/depression. After 6 months of sleeping better using a CPAP, my overall mood has improved, but... I now experience a marked spike in depression/anxiety from 5:00pm-8:00pm. While this timeframe coincides with evening rush hour, picking up kids, dinner time, kids homework, I sort of like doing those things and don't think they're the trigger. Other info, caffeine is limited to 2 cups of coffee in morning, I eat pretty regularly, I don't exercise and bed time is 10:00pm-6:00pm. Oh, and I stopped taking 20mg Paxil recently after 11 years.
posted by punkfloyd to Health & Fitness (21 answers total) 8 users marked this as a favorite
Could it be related to your blood sugar? Maybe a certain number of hours after lunch, your blood sugar is low and brings your mood down?
posted by xingcat at 6:21 PM on March 24, 2011 [1 favorite]

Could it be twilight and sunset? Daylight and mood are linked for a lot of people.
posted by nebulawindphone at 6:25 PM on March 24, 2011

I too have been suffering with anxiety disorder for a number of years. Obviously I don't know what is causing the spike for you, but when I was married, the reason why I would get panic attacks between the hours (roughly) you stated, is because while I loved my spouse and child and wanted to be with them, I did NOT want to do all the "work" that needed to be done - making dinner, cleaning up, etc. Of course, I didn't realize this until AFTER I ended the marriage but, hey, hindsight and all lol.

I would eliminate the coffee altogether. Caffeine, even in the morning, can affect a person prone to anxiety all day. I know it made a huge difference in my life.

Did you have this surge in anxiety while on Paxil? Stopping that in itself may be the culprit.
posted by iNurtureTheOdd at 6:25 PM on March 24, 2011

Response by poster: iNurtureTheOdd ... (your name is perfect) stopping Paxil is a main suspect. I wonder how long a Paxil-related effect might last?
posted by punkfloyd at 6:28 PM on March 24, 2011

Response by poster: (Ummm ....obviously my sleep time is 10pm to 6am)
posted by punkfloyd at 6:30 PM on March 24, 2011 [1 favorite]

Some people come off Paxil with no problems at all (I did) and others have significant issues. From what I know of those issues they would take up way more than that amount of time.

Is this Mon-Fri?
When is your last break before 5pm? Can you get a break in just before that?
posted by episodic at 6:55 PM on March 24, 2011

Response by poster: Every day of the week. Usually no snack or "mental" breaks after 12:30pm.
posted by punkfloyd at 6:58 PM on March 24, 2011

This, to the letter, was part of my experience shortly after I got all the way off Effexor.

How long has this been going on? For me it was 1-2 weeks, but Effexor goes out of your system quickly and I'm not sure how Paxil compares on that front — aside from also being known to be terrible to try to get off of.
posted by heatherann at 7:16 PM on March 24, 2011 [1 favorite]

When do you eat dinner then? "no snacks" after 12:30 equals super hungry in my world, not "eating regularly"
posted by tristeza at 7:24 PM on March 24, 2011 [1 favorite]

Response by poster: Starving by 5pm, so I eat dinner between 5 and 5:30.
posted by punkfloyd at 7:44 PM on March 24, 2011

Response by poster: Oh and first week fully off paxil (I weaned off it) was constant mood swings, severe anxiety/depression, dizziness, nightmares etc. That phase has ended.
posted by punkfloyd at 7:49 PM on March 24, 2011

If you were me the problem would probably be blood sugar. Any chance you could get a little food in the late afternoon? Could you eat a piece of fruit or a granola bar on the job?

If I drink any coffee in the morning I tend to have a weird mood spike in the evening— I call it the Hour of Hate— so I'd suggest changing your coffee intake in some way and see if it affects your mood.
posted by hattifattener at 8:05 PM on March 24, 2011

When that happens to me, I attribute it to caffeine crash.
posted by J. Wilson at 8:19 PM on March 24, 2011

Rather, I think caffeine crash plays a part in it. The vanishing light could contribute. The fact that earlier you're gearing up to do stuff, and now you're winding down and have time to contemplate and get stuck in your head but aren't on the verge of sleep, also seems likely to play a part.
posted by J. Wilson at 8:25 PM on March 24, 2011

to take this in a different direction - according to chinese medicine, symptoms that happen between 5 and 8pm every day are often attributed to the kidneys. just food for thought.
posted by andreapandrea at 5:27 AM on March 25, 2011

I've experienced anxiety (an awful feeling of dread) late afternoon through early evening since I was a child. I call it "Dusky Syndrome." It feels like the beginning of the end -- sort of how the autumn can have that same, "everything happy is leaving now and there will be only the cold of winter."

I also have wondered what it means as far as cyclical nature of hormones and neurotransmitters.
posted by DMelanogaster at 5:38 AM on March 25, 2011 [2 favorites]

Echoing hattifattener, if this were me it would be a blood sugar issue. I have, for as long as I can remember, had serious late afternoon blood sugar issues if I don't get a decent snack around 3 or 4. By decent I mean some fat and protein as well as carbs (oh, cheese, what would I do without you?). Even with a largish snack at that time I still feel a little off, but at least I can make it to dinner without harming anyone.
posted by mollweide at 6:08 AM on March 25, 2011

I sometimes get this feeling because I get a short burst of energy when I realize my time is now minve (no logner at work!) but then realize theres no way to do everything I want to do before I become a tired useless sloth person (which happens by 8) once I resign to being a sloth person I'm content to just laze around before bed, but prior to that point, the initial thoughts of possibility quickly followed by the realization of time limits gives an underlying sense of anxiety. Even being productive in those hours doesn't make it go away because theres always something else I could be doing.

So I suggest you take a vacation from work or your normal schedule if possible.
posted by WeekendJen at 7:20 AM on March 25, 2011

Space your caffeine intake; it works better that way. Stop by noon or 2 p.m. Keep some healthy snacks available, esp. those w/ some fiber, which helps modulate blood sugar. A few dried apricots and some almonds around 3 or 4 should help you keep it evened out.

I have trouble with changing locations; it makes me anxious, although I'm fine once I go wherever I need to be. Seems to be a social anxiety thing, but may be some other, unnamed anxiety thing.

Prozac caused panic attacks for me. Do a little research; I've had some reactions to drugs that were known side effects, but never occurred to me were related to that drug. (One anti-depressant caused me to itch terribly.)
posted by theora55 at 9:26 AM on March 25, 2011 [1 favorite]

Response by poster: Follow-up report here. It's 5:30pm (day after posting question) and with NO caffeine and healthy fruit snacking after lunch, I sense a big improvement...except for caffeine withdrawal headache which will pass. Thanks to everybody for taking the time to consider my situation and share their insight.
posted by punkfloyd at 3:32 PM on March 25, 2011

Fruit is good, 4-5 grams of protein is better.
I use that as my rule of thumb, and buy nut bars, yogurt, cheese etc accordingly.
Also, carry something in your bag as an 'emergency stash' (nut bar?) so you don't get caught out by what I experience as the 'Space Out'. I need a nibble about every 4 hours past midday.
Anyway, glad that previous posters tips are helping!
posted by Elysum at 4:40 AM on April 1, 2011 [1 favorite]

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