Mental Health Insomnia and Anxiety-Questions from a current college student

[LoathingFear]

Hello everyone,
This is my first post though I have read hundreds if not thousands of threads here over the years. This is the first time I have posted because it dawned on me that this might be the only place where I can get pure, unbiased answers from people who actually know, for the most part, what the hell they're talking about.
I suffer from anxiety and insomnia and ,to cut my first post short(er):
I just started my first year of college. It's a really good private school in New England and I have a ton of opportunities here that I've been missing out on. I have a lot of trouble sleeping and even more trouble with severe anxiety. I have been through all sorts of medication throughout the years(in order): melatonin, diphenhydramine, trazodone, mirtazapine, clonazepam, fluoxetine, seroquel, and have self-medicated with: weed, alcohol, buprenorphine, hydro and oxy codone, morphine, etizolam, clonazolam, flubromazepam, and various psychedelics and dissociatives in hopes to 'reset,introspection, etc. etc.' with no avail. Medicine usually stopped working after a while and, well, we all know how extended use of benzos and opiates/oids goes and I've avoided the addiction because I care more about school right now.
I'm just wondering, for those who have suffered from the same issues, and assuming I can get anything prescribed, what is the best, long term medication for anxiety and insomnia?
I'm currently on just prozac for anxiety and seroquel for sleep though neither work.
I don't know if this is against the rules, asking what drugs to take, that is, but this is from a totally legal place. The doctor at my college literally said that I knew more about pharmaceuticals than she did and that I could say the word and I would get whatever prescribed. Any help would be really appreciated and I hope my first post was half decent and not annoyingly long.
TL;DR: What works best long-term for insomnia and anxiety, for those of you who have had experience?"Best" would take side-effects, length of
time the drug is effective, and its efficacy all into consideration.

 

[polymath]

Looks like you haven't tried gabapentin or pregabalin. They should not cause a tolerance development for the anxiolytic effect like benzos do. Good luck!

 

[AlphaMethylPhenyl]

We are happy that you reached out!

You may already know this, but addiction is almost never a choice. We have absolutely no control after the drug is ingested. So many of us here at bluelight started out being given vicodin or adderall from friends a few times month. Before we knew it, heroin or meth was needed first thing in the day, every day, by whatever means. I got to a very highly accredited school, too. I've realized that if there is anything that has the potential to ruin my semester, higher-education career, and yes, my life, it's abusing substances. I relate personally to what you've written because we're in similar positions (though I do have to say that my symptoms are reasonably under control, but that doesn't mean I don't fight them every day).

Basically my advice is that you're a lot better than that shit, and you know it. If you came poverty, had a low IQ, and generally had less opportunity, the case would be different. Hell, if I hadn't picked myself up several years ago, I'd probably be a heroin fiend, smoking two packs a day, conning doctors for a high, and so on. It's more logical for someone in that position. Their life can't get reasonably better, so why hold back a taste of what it's like to really live? But you and I know that truly succeeding in life, both in terms of career/academia and personally/spiritually, has no equivalent.

So a main idea I want to communicate is that drugs will not solve your problems. Think of it this way: you fall and break your arm, a compound fracture (recovery begins, being the guinea pig, it sucks going through tons of trials); it hurts like a bitch. The bone is sticking out of your arm. But it needs to be set. The right medication sets the bone, but it takes much longer for the bone to actually heal. You must nurture the arm, changing bandages, putting it in a sling...this is the work of re-creating a healthy mind, time spent paying special, deliberate attention toward doing what's best for the arm. If you take the bandage off and/or take the arm out f the sling, it's liable to get badly damaged, as it's still weak. This is akin to doing drugs while finding the right medication(s) and giving them at least several months to work in conjunction with therapy to heal yourself. Please don't take your arm out of that sling. At least not for several months. Now I know the analogy isn't complete, but it roughly equivocates what goes on.

"Best" is a label that can never apply to any medication. It simply depends too much on the individual. Anxiety and insomnia can be treated so many different ways, depending on your other symptoms and the psychiatrist's theories. Especially insomnia. It could literally be indicative of one of at least five different mental disorders.

Switch doctors. Any doctor that says they will prescribe you what they want are not doing their job. They're supposed to protect you against harming yourself at all costs, not letting you proceed to put whatever you want in your brain. If she really said that you know "more about pharmaceuticals" than she, all the more to find someone who knows more than you, given that they will do a better job than you. Also, no one treats themself. Even psychiatrists go to psychiatrists. This is for obvious reasons. Might as well just self-medicate with opiates, honestly. It's the same arrogant mindset: "I know what's best for me more than someone who spent almost a decade learning how to tell what's likely best for me does". Arrogance, man. Just think about it. I'm being blunt because I know you won't take it personally (I hope).

Gabapentin/Pregabalin have less predictable effects, or so I was told by an experienced/accredited psychiatrist once.

 

[Burnt Offerings]

I don't know what to tell you. If the list of drugs you listed didn't help you at all (among them booze, oxycodone, morphine, Seroquel, TCAs, Klonopin, RC benzos, melatonin...) then I don't think drugs are going to help you with your insomnia.

Personally I'm prescribed Ambien 10 mgs for insomnia and I find that it works well, although I take breaks from it from time to time to make sure that the hypnotic effect stays where I want it. That's the problem with hypnotic drugs is that tolerance to the effect builds quickly, much faster than the anxiolytic effect from benzodiazepines.

Also, pregabalin isn't prescribed for anxiety in the United States. Not even off-label to the best of my knowledge.

 

[Chatative]

Anxiety and insomnia can often go hand in hand. When I was suffering problems from anxiety, I was typically waking up unable to get back to sleep anywhere between 4-5am not to mention regular awakenings before that time. It turned out that I was suffering from mild GAD. After I started on medication (SSRIs), my sleep returned to a much more normal pattern without the need for any hypnotics or sedatives. I understand it might not be that way for everyone, but it may well be getting your anxiety under control will solve your sleep problems.

What made the real difference however was talk therapy alongside the medication. I was introduced to some basic CBT style concepts & was able to talk through my problems, getting to the route of what was causing my anxiety & learning coping mechanisms. You don't mention whether or not you have tried therapy; you've certainly tried a long list of medications so I'd be surprised if not... however, if that's the case then I recommend you give it a shot.

Have you been diagnosed with any specific anxiety disorder at all? If you could elaborate on that a bit it might help us to give you some more tailored advice...

I see you've only tried a couple of SSRIs, which can certainly be used for the likes of GAD to great effect. It might be the case that you may benefit from trying another if Prozac is not working, it can be quite finicky trying to find one that works. I was quite lucky in that the first one I tried worked for me, but certainly that's not the case for everyone.

Oh, and I agree with my fellow moderator... it sounds like your doctor is not the most clued up if they told you that you knew more about pharmaceuticals than they do & said they would prescribe you anything. That wouldn't instil confidence in me. You may just find getting doctor may help move things in the right direction.

 

[polymath]

I went to a private psychiatrist today and complained about my anxiety attacks that also involve OCD-like symptoms (obsessive thoughts about harming myself). She changed my antidepressant (citalopram) to sertraline, which should be more effective and also prescribed me 150mg Lyrica (pregabalin) a day. I live in Finland, where pregabalin is commonly used for anxiety. The Lyrica seems to be working already, I've been significantly less anxious after taking the first capsules.

 

[manboychef]

I have OCD, Panic Disorder, and Major Depressive Disorder. Because of my anxiety I also experience insomnia. I just can't turn my brain off at night, and without the stimuli I get during the day my intrusive thoughts become much much worse.

What made the real difference however was talk therapy alongside the medication. I was introduced to some basic CBT style concepts & was able to talk through my problems, getting to the route of what was causing my anxiety & learning coping mechanisms. You don't mention whether or not you have tried therapy; you've certainly tried a long list of medications so I'd be surprised if not... however, if that's the case then I recommend you give it a shot.

This is extremely true. In conjunction to my medication, I go see a therapist every Tuesday. We start with guided meditation, then just talk through some of the problems I have so that he can offer helpful suggestions on how to cope. CBT also works wonders. It helps you change your natural response to the anxiety and replace bad habits with good ones.

As far as medications go...I have been on a series of anti-depressants, anxiety meds, anti-psychotics (worst experience ever) as well as I self medicated for a long time.

What works for me is zoloft(sertraline) 100mg every morning with coffee 4-4:30am. Restoril(temazepam) 30mg with a cup of non-caffeinated warm tea at night 8pm. It took me a long time to find what worked. I cannot stress enough that you need to try whatever course of medication you are on for at least a month to notice the effects. Absolutely do not take other drugs while you are trying a course of medication as it will change the effectiveness of the medication...This may lead you to think something isn't working when really it is or vice versa! I also keep a journal so that when I feel anxiety I can write down what causes it, when I felt it, and what magnitude it was. This allows me to see patterns in my behavior and way of thinking that I can then address in therapy.

You may want to try yoga, or meditation in order to attain peace in your soul.

goodluck
chef

 

[Pretty_Diamonds]

I know it's tough since it's college, but one thing that really helped me was getting off coffee. :/