How Long Will It Take to Recover from Anxiety and Sleep Issues?

How much longer will it take to return to normal?

Response from Dr.
Wang Chenyang, Psychiatrist:
Hello, regarding your gastrointestinal pain related to autonomic nervous system dysfunction, it is usually associated with anxiety.
The Lorazepam you previously took is an anxiolytic that helps alleviate anxiety and aids sleep; however, long-term use can indeed lead to dependence.
Trazodone is an antidepressant with sedative effects, and Quetiapine is a tranquilizer (what was the dosage? 25 mg?).
Both of these can assist with sleep and are less likely to cause dependence with long-term use.
None of these medications will cause brain damage.

From your letter, it seems you may be prone to anxiety and tend to think negatively.
Sleep issues are related to mental health conditions, stress, and personality traits.
Medication is one treatment option, but other methods such as developing good sleep habits, relaxation training, cognitive behavioral therapy, and psychotherapy can also help improve sleep.
I suggest discussing this thoroughly with your treating physician to find a suitable treatment approach for you.
Negative and pessimistic thoughts may worsen your situation; believe that you will gradually improve and find the right treatment method, which is the path to recovery.
Regarding your current medications, you mentioned taking Quetiapine 25 mg and half a tablet of Trazodone.
You have been experiencing insomnia for three months after stopping Lorazepam, which you had taken for over three months.
You noted that your insomnia is not due to autonomic nervous system dysfunction, as your symptoms are limited to gastrointestinal pain and nausea.
Interestingly, after discontinuing Lorazepam, your gastrointestinal symptoms have decreased.

The physician who prescribed Lorazepam previously suggested that long-term use would not be harmful, but your current doctor is uncertain about why you were advised to take it for an extended period.
He mentioned that there are many alternative medications available.
You are concerned about how long the insomnia after stopping the medication will last (you stopped after three weeks of tapering, which may have been too quick).

Currently, with Quetiapine and Trazodone, you are only able to sleep for 2-3 hours before waking up.
Although you can lie down and fall back asleep, you feel increasingly fatigued during the day.
Your current doctor believes that your condition will gradually improve, hence the prescription of lighter medications, but you are unsure how long it will take to return to your previous state.

You have read online that discontinuing medication can lead to poor sleep in the latter part of the night, which may persist for months or even years.
This information leaves you uncertain about how much longer you can endure this situation or whether you should resume taking Lorazepam.
I hope this response provides clarity and guidance.
Thank you.

Xiao Hao, 30~39 year old female. Ask Date: 2021/11/17

Dr. Wang Zhenyang reply Psychiatry

Hello, regarding your concerns, it is recommended that you consult the physician who initially treated you.
Wishing you health and happiness.
Dr.
Wang Zhenyang, Department of Psychiatry, Taoyuan Psychiatric Hospital, Ministry of Health and Welfare, No.
71 Longshou Street, Taoyuan District, Taoyuan City, TEL: 03-3698553 ext 2030, FAX: 03-3699498.

Reply Date: 2021/11/17

More Info

Recovering from anxiety and sleep issues can be a complex and individualized process, often influenced by various factors including the severity of the symptoms, the underlying causes, and the treatment methods employed. Based on the information provided, it seems you have been experiencing significant sleep disturbances and anxiety, particularly after discontinuing Lorazepam, which you had been taking for over three months.
Firstly, it's important to understand that withdrawal from certain medications, especially benzodiazepines like Lorazepam, can lead to rebound insomnia and heightened anxiety. This is a common occurrence, as your body may have become reliant on the medication to regulate sleep and anxiety levels. The symptoms you are experiencing—waking up after only a few hours of sleep and feeling increasingly fatigued during the day—are not uncommon in this context.

The timeline for recovery can vary widely among individuals. Some may start to notice improvements within a few weeks, while others might take several months to regain a stable sleep pattern and reduce anxiety levels. Factors that can influence this timeline include:
1. Individual Differences: Each person's body reacts differently to medication changes and stressors. Your personal history with anxiety and sleep issues, as well as your overall mental and physical health, will play a significant role in your recovery.

2. Treatment Approaches: The effectiveness of the treatment plan you follow will also impact recovery time. As mentioned, medication like Trazodone and Quetiapine can help with sleep, but they should ideally be combined with non-pharmacological approaches such as cognitive-behavioral therapy (CBT), relaxation techniques, and good sleep hygiene practices.

3. Lifestyle Factors: Your daily habits, including diet, exercise, and stress management, can significantly affect your sleep quality and anxiety levels. Engaging in regular physical activity, maintaining a balanced diet, and practicing mindfulness or relaxation exercises can facilitate recovery.

4. Support Systems: Having a strong support network, whether through friends, family, or mental health professionals, can provide encouragement and assistance during your recovery journey.

In terms of specific strategies to improve your situation, consider the following:
- Sleep Hygiene: Establish a consistent sleep schedule by going to bed and waking up at the same time every day. Create a calming bedtime routine to signal to your body that it’s time to wind down.

- Limit Stimulants: Reduce or eliminate caffeine, nicotine, and alcohol, especially in the hours leading up to bedtime, as these can interfere with your ability to fall and stay asleep.

- Relaxation Techniques: Explore relaxation methods such as deep breathing exercises, progressive muscle relaxation, or meditation to help manage anxiety and promote better sleep.

- Cognitive Behavioral Therapy (CBT): This therapeutic approach can help address negative thought patterns and behaviors that contribute to anxiety and insomnia. Working with a therapist trained in CBT for insomnia (CBT-I) can be particularly beneficial.

- Gradual Medication Adjustment: If you are considering returning to Lorazepam or adjusting your current medications, it’s crucial to have an open discussion with your healthcare provider. They can help you weigh the benefits and risks, and explore alternative medications that may have a lower risk of dependence.

In conclusion, while it’s difficult to predict an exact timeline for recovery from anxiety and sleep issues, many individuals find that with the right combination of treatment, lifestyle changes, and support, they can gradually improve their sleep quality and reduce anxiety symptoms. It’s essential to remain patient and proactive in seeking help, and to trust that with time and appropriate care, you can regain a sense of normalcy in your sleep and overall well-being.

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