Anxiety, Depression, and stress

[Tielman]

Not sure how to say this, but here goes nothing....

It's been 6 months since I started CPAP treatment, and although the CPAP has been going great (most days my AHI is under 3) everything else seems to have gotten worse. I've had anxiety since my teens, and growing up I was very shy. My anxiety, slight depression, and stress has been going up and up over the last 6 months. My anxiety medicine has been increased (and not doing much for me), I've started seeing an allergist, psychiatrist, and a psychotherapist. Work is suffering more now than ever before (probably my worst 6 months since I started working). Although I'm wide awake (relatively) at 9-10 PM now, my anxiety, stress, etc is just as bad, if not more so.

I can't help wondering if the CPAP helping me to not have apneas has made my anxiety and stress worse. Has anyone else seen anything like this, or have you had the opposite outcome?

[Julie]

Hi, in other words you're asking if being more awake now that you're on Cpap is making the stress feel worse? Anything's possible, but don't blame Cpap for that - it's helping you to get better sleep, yes, but if you end up 'wired' as a result the answer is not to quit Cpap, but deal with the stress, as you in fact seem to be doing. Hope you feel better!

[sleepymama]

for me it's the opposite although i haven't gotten my machine yet. i suffer from depression and anxiety and take medication for it. i feel that cause i'm not getting enough sleep or good sleep, that it makes me feel worse. i hope for me that once i get treatment i can start to feel better. maybe the medication your on is not working and you might need to try another avenue. have u tried herbal remedies for depression/stress and anxiety?

[Tielman]

Hi, in other words you're asking if being more awake now that you're on Cpap is making the stress feel worse? Anything's possible, but don't blame Cpap for that - it's helping you to get better sleep, yes, but if you end up 'wired' as a result the answer is not to quit Cpap, but deal with the stress, as you in fact seem to be doing. Hope you feel better!

I'm not trying to place "blame" anywhere, just trying to understand.

Though my anxiety is worse, I wouldn't trade it with CPAP for anything, my physical health is more important.

[BlackSpinner]

For me my mood changed dramatically once I was getting enough sleep. A lot of my anxiety and feelings of hopelessness disappeared - not immediately and not without some help of therapy.

Sometimes it seems however that our minds wait until we are stronger before demanding we " deal with this old stuff NOW!!!" Just when you think you have something licked all sorts of issues come up like a band of toddlers demanding attention right now, wrapping themselves about your legs and tripping you up.

Try to see it as you are stronger and thinking more clearly so you can get this stuff dealt with and off your plate.

[Budleigh]

The most striking segment of my struggle with apnea, indeed what made me seek treatment, was the development of anxiety and depression. I was always looking for something to blame, because the character of those conditions logically calls for an environmental culprit. It's hard to accept that they can just happen. But that's sort of what they do.

It takes a while to find a winning combination of treatments. I know that SSRI's made everything completely worse, and CPAP has initially not improved my sleep, but don't give up hope (an ironic request in the light of those conditions, but truly).

An AHI of 3 is good, but like I've heard other people say, aiming for around 1 can make a difference. Not that I know how to 'aim' for AHI's, I can barely get mine consistently below 8, but there it is. So it seems like potentially your anxiety/depression and sleep apnea are separate. What kind of meds are you taking for the anx/dep? I ask because it's important to identify the traits of the depression to know if you're on the right thing. Is your depression mostly negative thoughts about yourself and/or others? Is it negative thoughts about life? Or is it total lack of enjoyment in things you used to love? Whichever of those stands out to you most can tell you a lot. To me, it was really that most things I had at one time loved or enjoyed seemed grey and superfluous to me. SSRI's are targeted more at one's problems with self image and esteem, which I didn't have a huge problem with. When my doctor and I recognized that, I switched to a DNRI, Wellbutrin, because it inhibits the reuptake of Dopamine and Norepinephrine, the former being associated with pleasure and reward. 2 months later I'm pretty much cured.

Again, don't give up hope, and try not to scapegoat, you could develop irrational negative feelings against some things you think are causing you harm when they are actually helping, like CPAP.

[tattooyu]

I believe that I have had GAD (General Anxiety Disorder) my whole life and just recently developed Panic Disorder after losing my grandmother and father in 2001 and most recently my son, Andrew, in 2008 (the baby in my avatar is our new son, Jonah). Right around then is when my OSA got REALLY bad, and I was diagnosed. So, I would say that the stress of starting a new therapy could temporarily increase anxiety but that once you are settled into it, your anxiety and depression should abate somewhat. Mine did

Currently, I am taking clonazepam (0.125 mg) as needed. CBT (Cognitive Behavioral Therapy) and guided meditation has really helped me a lot. Do you happen to have IBS or digestive problems? They usually go hand-in-hand with anxiety and depression. Just curious. My digestive system has always been crazy.

I also wanted to add that I found out that my vitamin D levels were very low. Once I started taking supplements, I noticed a dramatic improvement in my mood within a week or two.

[WearyOne]

.
tattooyu, do you take prescription D or OTC?

Tielman, so many things can affect our moods and increase or cause anxiety, depression, and stress. If you haven't already, I would get a blood workup including things like Vitamin D. If you've started any new meds make sure they don't have side effects of anxiety and/or depression.

It's possible that if your apnea was affecting your life in a big way, that your mind was concentrating more on that than the other issues and now that the apnea is under control, your mind is back on the anxiety and depression.

I've suffered off and on for most of my life with stress and either anxiety or depression, and sometimes what seemed to be all three at the same time. And sometimes severe anxiety will hit me out of the blue and I'll have no earthly idea why. I know it's miserable and I truly hope you can get some relief soon.

[Tielman]

What kind of meds are you taking for the anx/dep? I ask because it's important to identify the traits of the depression to know if you're on the right thing. Is your depression mostly negative thoughts about yourself and/or others? Is it negative thoughts about life? Or is it total lack of enjoyment in things you used to love? Whichever of those stands out to you most can tell you a lot. To me, it was really that most things I had at one time loved or enjoyed seemed grey and superfluous to me. SSRI's are targeted more at one's problems with self image and esteem, which I didn't have a huge problem with. When my doctor and I recognized that, I switched to a DNRI, Wellbutrin, because it inhibits the reuptake of Dopamine and Norepinephrine, the former being associated with pleasure and reward.

I started on 10mg of Lexapro, and about two weeks ago they upped it to 20mg. Last week I just started a new round of meds for my alergies (From: flonase to nasonex, and from claratin otc to clarinex, and added new: advair, and ventolin).

I've had major self-esteem issues so I think the SSRI is probably the right thing. I've just lost interest in a lot of things lately: work (which I use to enjoy is now pure hell), gardening, my birds, etc. I just want to be alone most of the time, as most things easily overwhelm me, though I can still function. The big thing is that I can do things, but the recovery from anxious stressful situations / issues takes a long time.

I've had three major things happen in the last 6 months: 1) New boss at work, with the old boss (whom I loved) leaving the company, 2) Started CPAP, and 3) Lots of changes at work in terms of responsibilities. For over 3 months I had to do all the work I was doing, all the work my frmr boss was doing, and a bunch of new things. That alone just overwhelmed me, and I'm feeling it now, but I can't get out from under all of what's still on my plate. There are other things at home, including a step-son with Schitzoid / BiPolar issues who will be here for two months in November (he's killed at least 2 of my birds, so that's another concern ).

I'm just trying to understand why I've gotten so bad, and how to deal with it to get better.

Thanks for all the help and suggestions!

[Tielman]

I believe that I have had GAD (General Anxiety Disorder) my whole life and just recently developed Panic Disorder after losing my grandmother and father in 2001 and most recently my son, Andrew, in 2008 (the baby in my avatar is our new son, Jonah). Right around then is when my OSA got REALLY bad, and I was diagnosed. So, I would say that the stress of starting a new therapy could temporarily increase anxiety but that once you are settled into it, your anxiety and depression should abate somewhat. Mine did

Currently, I am taking clonazepam (0.125 mg) as needed. CBT (Cognitive Behavioral Therapy) and guided meditation has really helped me a lot. Do you happen to have IBS or digestive problems? They usually go hand-in-hand with anxiety and depression. Just curious. My digestive system has always been crazy.

I also wanted to add that I found out that my vitamin D levels were very low. Once I started taking supplements, I noticed a dramatic improvement in my mood within a week or two.

I believe I have the same thing (GAD), though I haven't heard it directly explained to me. I went through panic attacks for several years that finally stopped with the lexapro. My Dr's have all steered me away from any benzodiazepines due to the addictive issues, and that they aren't as effective as the newer SSRIs. I have been taking a vitamin D supplement as I was reported to have a low level, though not for about 2 weeks as I ran out (guess I should get some today ).

Thanks for the info, and congrats on the new baby!

[Budleigh]

Sounds like you could possibly benefit from supplementing the SSRI with something like an SNRI. That's a very common combination. I was on a combo of Cymbalta 60 and Wellbutrin 100 before I realized the WB was all I needed. Talk to your doc about that supplementation.

As far as the other meds - my anxiety was horribly exacerbated by Nasonex and antihistamines. I cannot account for why, but they do. The docs didn't have an opinion other than to steer me away from them.

[joeattardi]

I'm with you, bro. I've had some major anxiety and depression for many years. At times it gets paralyzing - I fall behind on work, home responsibilities, etc. I'm taking a SSRI as well (Paxil, ugh) but it doesn't really do much for me.

This probably contributes to my crappy sleep, because when I go to bed every night my mind's just racing with anxious thoughts. But thought you'd like to know you're not alone!

[Tielman]

Sounds like you could possibly benefit from supplementing the SSRI with something like an SNRI. That's a very common combination. I was on a combo of Cymbalta 60 and Wellbutrin 100 before I realized the WB was all I needed. Talk to your doc about that supplementation.

As far as the other meds - my anxiety was horribly exacerbated by Nasonex and antihistamines. I cannot account for why, but they do. The docs didn't have an opinion other than to steer me away from them.

Thanks for the info about the SNRIs, as that's where I had been looking; glad to see a confirmation.

I don't seem to see any additional issues with the Nasonex -vs- Flonase. The Advair did leave me with some shaking (not visible, but the feeling of) of the arms and legs for a few hours on each of the first 2-3 days, but that's gone now.

I'll talk to my Dr. about the SNRIs next Friday.

Thanks again.

[tattooyu]

tattooyu, do you take prescription D or OTC? ...

I take Now Foods OTC vitamin D supplement (pure D3 softgel in olive oil). I take 1,000 IU a day + my multivitamin which has 800 IU.

I believe that I have had GAD (General Anxiety Disorder) my whole life and just recently developed Panic Disorder after losing my grandmother and father in 2001 and most recently my son, Andrew, in 2008 (the baby in my avatar is our new son, Jonah). Right around then is when my OSA got REALLY bad, and I was diagnosed. So, I would say that the stress of starting a new therapy could temporarily increase anxiety but that once you are settled into it, your anxiety and depression should abate somewhat. Mine did

Currently, I am taking clonazepam (0.125 mg) as needed. CBT (Cognitive Behavioral Therapy) and guided meditation has really helped me a lot. Do you happen to have IBS or digestive problems? They usually go hand-in-hand with anxiety and depression. Just curious. My digestive system has always been crazy.

I also wanted to add that I found out that my vitamin D levels were very low. Once I started taking supplements, I noticed a dramatic improvement in my mood within a week or two.

I believe I have the same thing (GAD), though I haven't heard it directly explained to me. I went through panic attacks for several years that finally stopped with the lexapro. My Dr's have all steered me away from any benzodiazepines due to the addictive issues, and that they aren't as effective as the newer SSRIs. I have been taking a vitamin D supplement as I was reported to have a low level, though not for about 2 weeks as I ran out (guess I should get some today ).

Thanks for the info, and congrats on the new baby!

Luckily, I don't have the addiction problem at such a low dose and taking it as needed. I tried one SSRI, Celexa, and let me tell you: I doubt I'll ever try another one again. It made me feel SO much more anxious and jittery; hot skin (like a sunburn). Not sure I want to go down that road again. I am looking into BuSpar (buspirone) which is non-addictive. A lot of people get VERY dizzy for about 30 minutes after taking it, so I'm not sure I want to try it. I might just stick with my clonazepam. I've had the same prescription for over a year and have never needed a refill (getting close though).

[Budleigh]

Oops, not SNRI's, those are a bit volatile. I meant DNRI's (dopamine and norepinephrine). SNRI's have more the effect of SSRIs but I found the side effects worse.