The free-floating knot

The anxiety is back. The kind you feel in your arms and your legs and your gut but that never attaches itself to anything in particular in your thoughts. The kind that feels like the butterflies before you give a speech, the tension in your muscles when you know you absolutely have to do something unpleasant you’d rather avoid. Only, there may or may not be anything like that going on in your life at the moment. You feel the sensations anyway.

At first, I tried to stick to my regimen of herbal remedies and ignore the flare-ups. Problem is, when you’re not acknowledging you’re having an acute anxiety episode, you tend to externalize the cause of the feelings–it’s not me, it’s that f*&^% car that just cut me off on the freeway, that idiot colleague who doesn’t know how to do their job, that loved one who tried to give me some advice I neither needed nor wanted.

I was diagnosed with Generalized Anxiety Disorder fourteen years ago. And I’m fairly certain it’s a family thing, a volatile mix of nature and nurture. When I’m in the throws of my anxious feelings, I find myself cursing like father, going on ranting screeching fits like my mother. Fourteen years ago, after a disastrous couple weeks with Paxil (side effects TMI), my doctor put me on Wellbutrin. Which worked fine, for a year. Then I moved.

I fell “between doctors” and got fat for four months self-medicating with sugar (hey, beats the six-pack or bottle of wine a night my dad went with). Finally, I got to a doctor who put me on Buspar. I was on Buspar for seven years. And like the Wellbutrin, it helped. It wasn’t perfect at keeping the anxiety at bay, but it toned down the worst of it.

During that time, I also had nearly debilitating insomnia. It would go on for weeks at a time, giving me three or four hours of sleep a night, max. But I never connected the two, even though the insomnia started a few months after I went on Buspar.

Then I moved, again, and was between jobs. I had only minimal health insurance, and had to go off Buspar. I researched herbal alternatives, like Valerian and Kava, and managed my GAD that way. And I didn’t need to go back on prescription meds, for years. I noticed something else as well. My insomnia improved. It wasn’t gone, but it wasn’t torturous, either. I started to wonder if there might be a connection between Buspar and insomnia, but dismissed the possibility after I did research and every medical website I consulted told me the side effects of medications like Buspar was increased risk of drowsiness. Insomnia was only a danger, they said, if you stopped taking the medication too quickly.

It was only after I suggested Buspar to my anxious brother and he started complaining about insomnia a few months later that I went, “Hmmm….”

Back in April, I felt the anxiety flaring up again and asked my new doctor to put me on Wellbutrin. After all, it worked fine fourteen years ago. Shortly after the meds settled in and the anxiety eased up, the insomnia I was already struggling with ballooned. I was working at the time with that doctor to get into a sleep study to diagnose the insomnia. That took a couple months to arrange, but several weeks before I was to go on the study, I quit Wellbutrin. I didn’t want the medication tainting the results. I wanted to know what caused the insomnia beneath the contribution medication made to it.

I went back to my herbal remedies, but lately, the anxiety has crawled back, and you can’t keep popping Kava. It’s not healthy in anything but the most occasional doses. St. John’s Wort has the same effect as Buspar and Wellbutrin on my insomnia. I called my doctor and asked for an appointment to “review my meds.” Her receptionist called back with a prescription for Effexor. It apparently inhibits reuptake of another neurotransmitter in addition to Serotonin. What can you do, except give it a try, and let her know in three weeks if it’s torturing me at 2 am or not?

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