I want to do some complaining about insomnia but in order to do so I have to do some complaining about SSRIs. So! Let me start right out with a content warning of sorts: if you don’t want to read about someone’s non-ideal SSRI outcome, because maybe you are considering medication and all the anecdotal Internet reviews (“It literally saved my life and I worship at an altar dedicated to GlaxoSmithKline!” *next comment* “This drug ruined everything I have ever loved and I am now but a husk of my former self”) have you in a goddamned tailspin, this may not be the post for you.

Anyhoo, early this year I started taking Wellbutrin, which was prescribed by a doctor who chose it for its relatively mild side effects along with other reasons I honestly can’t remember. My dosage started out small then increased a bit, and at some point, I realized I wasn’t drinking my normal amount of coffee anymore — one cup was absolute max or I’d feel like Uma Thurman with the adrenaline needle hanging out of her chest in Pulp Fiction.

I noticed a few other things, too, like how I didn’t feel regular anger but more like an incandescent full-bodied rage? But on the other hand, shit was hugely enraging during this timeframe so maybe I was just legitimately mad? But on the other other hand, my jaw was always clenched in a knot, my legs were always jiggling, and I always had this heavy anxious feeling in my chest like something somewhere was just terribly WRONG, and even though there was and is plenty of wrong to get het up about this felt very specifically like something biological had gone haywire.

Back to the doctor I went, virtually, and she was like “Oh yes, AGITATION. Yes, agitation can be quite common with this drug, because [brain chemistry stuff], here’s an extended-release version that should really help with that.”

The XL version did help with the agitation, I felt maybe more energized than usual but that edgy high-strung anxiety retreated. However, that’s about when I stopped being able to sleep. Somewhere around early July insomnia set in, and it was a particularly miserable variety that came with what I can only describe as whole-body restless legs syndrome. I’d have to get up and just walk around, over and over, throughout the night, because lying still was impossible.

Meanwhile, the doctor I had been seeing left the clinic, and I was assigned a new doctor, who was like — hand to God — “Wellbutrin? I would never have prescribed that to you, wow.”

So this new doctor tapered me off the Wellbutrin and onto Paxil, which she said was sure to help with the sleep issue plus being much better for what the Wellbutrin was supposed to help with in the first place. Instead, it made me sleepy and foggy and headachy but still wide awake at night, and also as the weeks went by one of Paxil’s most notorious side effects made itself known, which is to say an, ahem, inability to seal the deal, even if one uses a Magic Wand while having inappropriate thoughts about Oscar Isaac. You with me?

Stopping the Paxil wasn’t difficult because I hadn’t been on it that long, and I’m now on what I described to the doctor as “a break” from trying to figure out if sanctioned mood medication is right for me. At this point, I don’t see a compelling reason to experiment again any time soon. I’m seeing a seriously amazing new therapist (she’s so good and of course she doesn’t take insurance, arggh), I’m doing all the self-care things, I feel pretty decent and stable these days. Life on life’s terms for nearly 12 months now, check.

My sleep still sucks a whole lot, though. That crazy restless feeling subsided but no matter how tired I feel when I get in bed I am reliably getting on board that insomnia train, destination 2-ish A.M. Is it some sort of left-behind effect from the meds? Is it just the tax of modern life? ♬ Maybe it’s menopause? 🎶 Who knows, but I sure have plenty of time to ponder the possibilities each night.

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Kim
Kim
6 months ago

Okay, more internet stranger SSRI anecdotes. My therapist ALSO could not believe some doctor thought Wellbutrin was a good idea for me. Along with the symptoms you describe, I also felt like I’d taken hallucinogenics and not in the fun way I had done in the early 90s. I have general anxiety plus a fun opiate problem, so the answer for me was a low dose of Xanax and Suboxone. The scary part is when various professionals are trying to find the magic combo that will fix us and can’t seem to do it.
And the insomnia…I’ve heard it gets worse with age and if that’s the case, by the time I’m 55, I figure I’ll be averaging two hours a night.
I’d say it’s a nightmare, but I don’t sleep enough to actually know what those are anymore.
And I know you exercise already, which is the only thing that slightly alleviates the problem for me, so I’m no help at all!

Stephene
Stephene
6 months ago

I’m also a passenger on the insomnia train. My brain seems to wake up and whirl around for HOURS. Only thing that helps me is listening to a podcast in bed. It HAS to be This American Life and is HAS to be Ira Glass. I cannot even with Radio Lab or Fresh Air. Interesting? Yes. Does it put me to sleep? Nope. It must be the sweet dulcet tones of WBEZ Ira. Its totally worth playing hide and seek with my AirPods in the morning and the slightly hurty ears.

Hope you find something soon. Sleep is so elusive. I’m jealous of all the hours I slept as a teenager. Maybe I was only allowed so many and I used them all? Siiiggghhhh

Kate
6 months ago

Research and try Trazodone. It’s worked well for me. Depending on dose, it can be an anti-depressant, anti-anxiety, or a sleep aid (lowest dose). Email me if you would like details. :)

Nine
Nine
6 months ago

Finding the perfect drug cocktail for one’s particular brand of heebie jeebies is the 7th layer of a hell burrito.

For another internet rando’s experience: I was diagnosed with drug resistant major depression and an anxiety disorder after prozac, zoloft, wellbutrin (made me feel like I had a head full of crack) and xanax did nothing, or at least nothing good. Magical elixir to stop my crazy train was 300 mg of effexor XR and 2.5 mg of zyprexa at night so I could sleep. Zyprexa was being used off label and made me gain a metric shit ton of weight so they changed it to klonopin (bleurgh). I weaned myself down to 150 mg effexor until I could sleep without the nighty night pill because klonopin made me super dumb. Getting help & drugs dramatically changed my life for the better, it made me realize I’d been white-knuckling it through crippling anxiety/depression basically my entire life.

That said, if I miss a dose of effexor, I have the dreaded brain zaps and generally feel like ass until I take a pill. I don’t really like being dependent on it but the way things were going before the drugs kicked in was not a livable situation.

My brain weasels tried to eat me when I was in my early forties so I’m sure some of that was hormone related. Now that I’m on the dark side of forty I’m wondering if I really have undiagnosed ADHD x typical aging bullshit. I probably should get that looked at.

Rae
Rae
6 months ago

I’m gonna take a guess it’s related to hormones. I’m the same age as you are and my sleep was suffering, anxiety was high, going through depression and now I’m on effexor. I know a ton of people hate it, but I was on it for years when I had to be forced into menopause at a young age. It works really well for me and I’m sleeping through the night again or if I wake up at least I can get back to sleep quickly. Obviously having some onboarding side effects and that whole body restless insomnia for a couple of nights, but overall it’s been a relief. Thanks for sharing and good luck!

MC
MC
6 months ago

Chiming in to say that it makes such a difference to find a med that works well! After a couple years of struggles with a teen who has anxiety (going therapy and doctors for some medical issues related to stress/anxiety), she’s now on a medicine, which has been a game changer. Her symptoms are so much better. I finally got my kid back!

Hope you find a good solution.

Lisa
Lisa
6 months ago

Oh man, I can relate to this post! I think it’s a combination of middle age and late stage capitalism that has like most of Gen X feeling this way. I was off the hook anxious and having trouble sleeping this time last year and I tried Zoloft and it literally made me feel like I was having a stroke- bad headache, slow thoughts, dry mouth- and it did nothing to touch my anxiety. I quit immediately. I have a good therapist too (also not covered by insurance) so I committed to doubling down there and trying meditation (using guided ones- I like Insight Timer) and yoga and while I’m not always consistent with those it helped. Melatonin helps too. Yay, middle age is awesome. Thanks for sharing & glad we’re all not alone in this!

Samantha
Samantha
6 months ago

No shit I had that exact type of insomnia + RLS and I would just pace the bedroom at 2 AM and sob while everyone else was asleep. I got bloodwork done and my thyroid was off plus I was anemic. I had been doing ALL THE THINGS to help my RLS too. I slathered on magnesium lotion, I used essential oils, I took Unisom. And then. THEN. I went to ye olde wives tale and HAND TO GOD put a regular bar of soap in a sock and put it between my legs to sleep and IT WORKED. It. Worked. Seriously just give it a try. It can’t hurt!

Beth
Beth
6 months ago

I stopped sleeping well when my hormones started the fun little trip that is perimenopause. My current fix that is working well is 150mg magnesium glycinate before bed, and 3mg extended release melatonin. It’s magic! No more wakefulness 2-4am.

Belle
Belle
6 months ago

I never had a problem sleeping until two years ago. Now it has drifted into insomnia. (I also have RLS, but Ropinirole has saved my life on that.) I either stay awake all night or sleep 3 hours at a time, get up for several hours, then take a long nap. I’m 71 now with no real health/financial/family worries so you’d think the anxiety meds wouldn’t be needed but they are.

I blame a lot on the agitation of the four years of the Trump term – but hell, I dunno. It is a miserable situation, tho. I take a Tylenol PM every night and that seems to help but then my dr. said “no, that’s bad for you”. But isn’t getting no sleep worse?

I hope you get some relief! Insomnia sucks.

Jessi
Jessi
6 months ago

My therapist suggested getting the GeneSight test done since my meds were JUST.NOT.WORKING. Turns out I was getting prescribed the wrong type (SSRI’s vs. SNRI’s). It made a huge difference for me.

Here’s to finding what works for you.

sooboo
sooboo
6 months ago

I read an article recently that said there are biological reasons for waking up in the middle of the night such as you’re better rested the second half of the night (your sleep deficit goes down the longer you sleep) and you start to get signals from your brain to wake up. Apparently, waking up starts to happen long before you actually do wake up. Add a little stress or hormonal changes and it gets more extreme. I have stopped eating and drinking (even water) about 5 hours before I go to bed and while I don’t love doing that, it helps me sleep through the night. I hope you find what works for you. Being wide awake in the middle of the night is the worst!

Pinkiebling
Pinkiebling
6 months ago

Another vote for Trazadone!

rebeccaeee
rebeccaeee
6 months ago

Wellbutrin sucked for me. Was on Prozac for two years (because RAGE and angry crying all the time) and Prozac made me feel less murderous. Wanted to wean off it, missed it. doc said try Wellbutrin instead. Nope nope nope nope nope. Helpless, despair, insomnia crying. Back on the prozac. I second checking thyroid– tried that before prozac and have been improving steadily ever since with bigger and bigger doses of thyroid meds.

Anu
Anu
5 months ago

Same. I lost my ability to sleep after a month long hospital stay, brain surgery for a rare cancer and a 6 week foray into simultaneous radiation and chemo. I took a few weeks of SSRIs, they triggered a seizure and then my Harvard oncologist recommended medical cannabis and therapy. So far it’s working, and I’ve taken myself off the cannabis other than around my chemo treatments (finally over) and my period.