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why morning is so much worse?


LexAnger
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I have always wondered why morning is always so much worke than evening for many of us. I heard about cortisol level plays a key role but anything else also impact the daily pattern?

 

Most days in the past years, I feel like a total different person in evening, completely livable with most symptoms either subsided it completely gone even feeling near death in morning.

 

It seems nothing to do with dosing time, except for the immediate drug reaction I started to get, which goes with my dosing time.

 

I like to hear others experience too, if cortisol level is truly the only factor, then everyone of us should have the same daily pattern.

Drug free Sep. 23 2017

2009 Mar.: lexapro 10mg for headache for 2 weeks.

2009-2012: on and off 1/4 to 1/3 of 10mg

2012 June--2013 Jan,: 1/4-1/3 of 10mg generic, bad jaw pain

2013 Jan-Mar: 10 mg generic. severe jaw and head pain;

2013 Mar--Aug. started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg by July. first ever panic attack, severe head/jaw pain

2013 Aug.: back to 2.75 mg; Nov: back to Brand Lex. 2.75mg -- 3mg,

2014 June: stopped PPI, head pressure/numbness. up-dosed 4.5mg, severe reaction mental symptoms added on

2014 Aug--2015 Aug: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks.

2015 Aug 15th, Accidental one dose of 4.2mg. worsening brain non-functional, swollen head, body, coma like, DR

2016 Feb., started dosing 10am through 11 pm everyday 2/13--3.2mg, 3/15-- 2.9mg, 4/19-- 2.6mg, 6/26--2.2mg, 7/22 --1.9mg, 8/16--1.8mg,8/31--1.7m g, 9/13--1.6mg, 9/27--1.5mg, 10/8--1.4mg, 10/14--1.3mg, 11/1--1.2mg, 11/29--1.1mg, 12/12--1mg, 12/22--0.9mg

2017: 1/7--0.8mg, 1/15--0.7mg, 1/17--0.6mg, 1/20--0.52, 1/21--0.4mg, 1/22--0.26, 1/23--0.2, 2/13--0.13mg, 2/20--0.06mg, 3/18--0.13mg, 6/1--0.12mg, 7/6--0.1mg, 7/14--0.08mg, 8/17--0.04mg, 8/20--0.03mg, 8/28--0.02mg, 9/6--0.0205mg, 9/8--0.02mg, 9/17--0.015mg, 9/20--0.01mg, 9/21--0.0048mg, 9/22--0.0001mg,

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Great question it is the same here. Cortisol absolutely comes into play from what I've researched and as you mentioned dosing time.

2005: Began switching from one ssri to the next. Very little tapering time was instructed by my psychiatrist. Tried just about every drug on the market. Some two or three times. Nothing reallly helped my moderate depression and anxiety. They only made things worse most of the time!!

2014: Began experiencing severe symptoms while still taking Zoloft, oddly enough. Was forced to quit drugs altogether.

2017: A new year begins having experienced substantial improvement. Still not sure if my symptoms were severe protracted withdrawal or a severe reaction to a med, or possibly a combination of each.

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If only there was a drug that could lessen the symptoms for those in severe withdrawal! Or better yet, a natural supplement that could achieve this. But who knows the side effects that could come with such a drug, or even the long term effects. But I know I'm not the only one on here that would've given almost anything a shot to lessen the disabling symptoms.

2005: Began switching from one ssri to the next. Very little tapering time was instructed by my psychiatrist. Tried just about every drug on the market. Some two or three times. Nothing reallly helped my moderate depression and anxiety. They only made things worse most of the time!!

2014: Began experiencing severe symptoms while still taking Zoloft, oddly enough. Was forced to quit drugs altogether.

2017: A new year begins having experienced substantial improvement. Still not sure if my symptoms were severe protracted withdrawal or a severe reaction to a med, or possibly a combination of each.

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My mornings are generally a lost cause also.  I can 'function', but have no appetite for breakfast nor energy for chores, etc.  Generally wind up on the couch letting the TV play muted.  Somewhere around 11 a.m. I get motivated to shave and have a piece of toast or something.  I try not to schedule anything like a doctor's appointment before noon.  

 

As the folks above have mentioned, my afternoons are good, energetic, get things done, etc.  Feel like eating a good meal around 3 p.m.  I last until around 10 p.m. when it is time to turn in for the night.  

 

This has been the case for me for a couple of years.  I often attribute this to my age (79) but also realize that the effects surrounding my medications are also in play.  I will do some research for myself around 'cortisol', first I had heard of this playing a role.  Thanks. 

1989 -1995: Nortriptlyline, then Zoloft.  1997: New psych Dr. T; ‘Weaned’ off Zoloft; medication carousel next 3 years. 

1998-1999: Open heart surgery; divorce; prostate cancer treatment.

1999-2001:  Horrible period, new psych Dr. B; hospitalizations, ECT; medication carousel: Paxil, Zyprexa, Lithobid, Depakote, Wellbutrin, Effexor, Nortriptyline, Lamictal, Serzone, Seroquel (what a mess).

January 2001, new psych Dr. R, whom I have been with ever since.  He saved my life after a long period of experimentation. Seroquel as high as 600mg; added Remeron & Paxil.

Stable last several years: Quetiapine 75mg, Mirtazapine 45mg, Paroxetine 30 mg, Clorazepate 3.75mg, L-methylfolate (Deplin) 15mg

2015: Weaned off of Quetiapine completely over several months; no problems.   

Paroxetine: 10/6/2015 - 30mg -> 20mg; 11/24/2015 - 20mg -> 15mg; 12/14/2015 -15mg -> 10mg; 1/29/2016 -10mg -> 5mg; 2/25/2016 5mg -> zero.  All under psychiatrist supervision. No ill effects seen so far as of 12/22/2016.   Continuing Mirtazapine and L-methylfolate.  

I have lost about 22 lbs. (207->185) over the last year or so; probably Paroxetine discontinuation (leptin effect). 

 

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Cortisol is probably the main reason.  Briefly, once our CNS is destabilised it doesn't regulate our cortisol properly.  So instead of receiving the 'proper' amount of cortisol that non-w/d people do (which helps them wake up) we get much larger amounts - and that is very activating, causing our w/d symptoms to ramp up.

 

Over the course of the day it all settles down again, leaving us feeling better in the afternoon and evening.   

 

Another factor, for some people, is lower blood-sugar levels in the morning.  Personally if I don't eat straight after getting up in the morning, I can't function.  I am weak, shaky and grumpy.  And it's hard to feel good about anything in that state.  I've also noticed that I need to eat something just before I go to sleep, or hunger will wake me during the night, and I'll feel extra weak in the morning.      

2010  Fluoxetine 20mg.  2011  Escitalopram 20mg.  2013 Tapered badly and destabilised CNS.  Effexor 150mg. 

2015 Begin using info at SurvivingAntidepressants.  Cut 10% - bad w/d 2 months, held 1 month. 

Micro-tapering: four weekly 0.4% cuts, hold 4 weeks (struggling with symptoms).

8 month hold.

2017 Micro-tapering: four weekly 1% cuts, hold 4 weeks (symptoms almost non-existent).

2020 Still micro-tapering. Just over 2/3 of the way off effexor. Minimal symptoms, - and sleeping well.
Supplements: Fish oil, vitamin C, iron, oat-straw tea, nettle tea.

My story of healing:ContinuedHealing

***I am not a doctor; please do your own research and be able to take responsibility for decisions you make.*** 

           'The possibility of renewal exists so long as life exists.'  Dr Gabor Mate.

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I guess I am an exception, for me evenings are worse. In the mornings I usually feel happier, although sometimes anxious, and in the nights I feel depressed and with a lot of brain fog.

About me ------------------------ College student with a history of anxiety, excessive worrying and health anxiety.

April 2014 - May 2015----------    Prozac 20mg On and Off.  Second time on it I developed apathy, changes in personality, asexuality.

May 2015  -   July 2015-----------------  Tappering off prozac. Still no feelings,anhedonia, apathy, no libido, asexuality.

Current symptoms--------  pssd (asexuality in my case). Anxiety and depression developed some months afer stopping prozac, could have been caused by obsessing and beating myself up too much when I found myself unable to like girls again. The best thing to do with pssd (which in my case is asexuality) is accept it and move on.

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Yes, I agree - MORNINGS ARE HORRIBLE! My whole body aches in the morning. I feel so hopeless. It takes me a few hours to snap out of it. I dread going to bed the night before. 

2016: 

Aug 15  - Aug 25  - Amitriptyline

Aug 26  - Sept 26 - Topamax 

Sept 27 - Oct 4  Pamelor

Oct 13 - Nov 13 - Amitriptyline

 

Currently taking Alprazolam .25 at night to sleep (have only been since Jan. 7)

 

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