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Depression lifts in the evening

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ShySparrow

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Jun 4, 2018
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20
Hello everyone, I joined this community the other day and made a post in the 'introduce yourself' section.

One of the symptoms I mentioned in that post was about getting relief from my depression/anxiety in the evenings. I seem to be at my lowest point when I first wake in the morning, I then struggle all day with negative thoughts and emotions but in the evening, sometimes early evening and sometimes late evening, I experience some relief. I start to relax and don't want the night to end because I love the feeling so much! I make plans for the next day and can't even imagine the pain of depression anymore. Obviously, the next morning the depression hits me like a tonne of bricks and I become exhausted and overwhelmed knowing that I have to fight this battle all over again. The depression is a mental, emotional and physical pain in my head, I can smell and taste it. It consumes me.

I was wondering if anyone else experienced this evening relief or depression lift of an evening as well. My research has taken me to something called Diurnal mood disorder. I think this best describes what I have.

Thanks for reading.
Sparrow
 
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IWILLOBTAINMENTALHEALTH

Guest
I didn't see you so, :welcome: to the forum mate. I'm glad you get some relief in in the evening.
 
Passionflower

Passionflower

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I think it's quite common for depression to lift a bit in the evening. I find that it does for me too. Also my anxiety lessens as well.
 
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ShySparrow

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Jun 4, 2018
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That's good to know Passionflower. The more research I do the more it seems it is a common occurrence with depression and anxiety sufferers. Thanks.
 
Drooo

Drooo

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[Edited for errors] Ignore.
 
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ShySparrow

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Thanks for your research Drooo. I appreciate it.
 
frogsplash

frogsplash

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hello i just went and read your introduction in the introduce yourself area

one thing a lot of general doctors do (which in my opinion often totally sucks!) is if a med such as an antidepressant doesnt work, they just start telling you to increase it. i found myself in that trap many times and found i just got even more side effects and still the depression and anxiety is there in the background laughing away at me.

rather than increase the mirtazapine any more perhaps you could ask your doctor if he is willing to add something else to take with your mirtazapine. to me it just seems obvious that taking a couple of different things gives more of a chance of hitting the right spot or spots, instead of thinking you are going to get lucky and take one med which just takes care of everything going on inside you in one lucky go.

i had horrendous diurnal mood variation for many months and the only thing which gave it a well deserved kick in the teeth was to take pregabalin 300mg an hour before bed, and then take my antidepressant (venlafaxine 150mg) when i get up the next day. i used to have bad dreams also, but pregabalin has stopped that too, along with my restless legs syndrome.

if your doctor doesnt want to prescribe pregabalin, you could try prazosin instead, at night, which would stop bad dreams and give a better nights sleep, perhaps decreasing the morning depression/anxiety.

a third option would be taking trazodone at night, and then mirtazapine in the day (watch the doses combining those 2 though)... (by the way this is all assuming you take your mirtazapine in the morning, not before bed?) i hear lots of people do take mirtazapine at night before bed as it makes them sleepy. if that's the case with you, you could certainly take the pregabalin and mirtazapine at night together. same with the prazosin+mirtazapine. not so sure about the trazodone with mirtazapine, as trazodone can really make people sleepy, so combined with mirtazapine might not be a great idea. pregabalin is my fave as i have found like many others have, it neither makes you sleepy, or energized. when i take it i dont get any noticeable effect or feeling from it at all, apart from it destroys anxiety really well (people usually need 200mg+ for the anti-anxiety effect though. many people take 300mg x 2 over 24 hours, and that's ok to do. when my doctor first gave pregabalin to me he gave me 25mg capsules.. bless him. he's quite a scare'dy cat old fashioned doctor though...) it wasnt long before i went back to him saying i had to take 8 capsules at once for it to have an effect on my anxiety. after that he came around and now i get the 300mg capsules on repeat prescription. as i say i dont feel anything at all taking the 300mg capsule. no side effects, so nothing. but it does give me a really good nights sleep and no bad dreams, and a morning finally not filled with that feeling of anxiety and dread (caused by too much cortisol/adrenaline in the system i believe..)

anyway wishing you luck, diurnal mood variation is no joke of course and hope u can find a solution to it soon. if your doctor is not helpful enough, ask to see a mental health expert/psychiatrist instead. they will be more clued up about the different medications and less afraid to try a couple of different meds so that you can live ok again, instead of battling through the day!
 
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washington

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May 13, 2018
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Right, that's one of the things I hated the most about depression - when you wake up down in the dumps in the morning. I tried to arrange some sport sessions first thing in the morning, so I have no other choice but go and train. And naturally I felt better afterward.

Otherwise I just couldn't make it out of the bed until I absolutely had to. The willpower level was so low that I would just lie in bed hoping to fall asleep again, or scrolling my smartphone.

If anyone has anything to recommend (other than medication), like some useful habits/routines to struggle less with getting up in the morning, I would appreciate it. No cold showers, please, it usually takes an enormous effort to get inside that shower in the first place :)
 
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ShySparrow

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Jun 4, 2018
Messages
20
Thanks for your reply frogsplash.

I take mirtazapine at night when I'm about to go to sleep, it knocks me out so I can't imagine taking it in the morning. I do get restless legs with it. I spoke to my doctor on Tuesday about having another type of medication on top of the mirtazapine but he wants to see how I get on with this new dose for another three weeks and then go and see him again. He has referred me to the mental health team but I don't know how long that will take. He said they are in a better position to advise on other medications. He also said I could go private if I wanted to speed up the process and that is something I am looking at.

I am just completely drained at the moment. Since making this thread I have had no relief in the evening, typical. I wake up with what I can only describe as poison in my brain and the fight begins all over again. I am overwhelmed by sadness, anxiety, crushing guilt and not knowing what to do about any of it. My stomach is in knots. I am in turmoil. I can't remember being this bad at any point in my life and see no end to it.
 
frogsplash

frogsplash

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Dec 30, 2017
Messages
235
hey ShySparrow, sorry to hear about your current situation,
try not to worry we can certainly get on top of this, i know it seems like this will never end but i 100% assure you will be ok soon once you get on the right meds,
i have to do some gardening now before it rains but i will come back later with another reply ok,
i will explain some more things about how i have managed to get well again, and believe me when i say there are almost no words to describe how absolutely horrendously unwell i was with both severe depression and crippling anxiety.
i will be back later on,
best wishes from frogsplash
 
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ShySparrow

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Jun 4, 2018
Messages
20
Thank you so much for your help so far. It means a lot to me.

Sparrow
 
frogsplash

frogsplash

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Dec 30, 2017
Messages
235
hey again sparrow, first off sorry about taking longer than expected to reply to you (i wont go into the details but it was non-stop today and i was in work this evening)

i just had another read of your introduction to refresh about your details

ok so i will give you some background about myself first and then try to give some helpful advice for you after:

(by the way im not saying your answer is going to be exactly the same as mine, but figure i might as well include my story in here anyways... perhaps if u dont want to read it you can always fast forward to later on) :)

i have been on and off antidepressants for about 10 years now (im in my forties and first experienced anxiety as a teenager but just kept it to myself and struggled through life). i got away with that until around age 30 but then i started to get depression along with the anxiety, plus the anxiety worsened. at that point antidepressants were becoming more popular and less stigma attached to them (and mental health in general)

so i got on antidepressants and spent around a decade going on and off them (i would take them for several months, and then when feeling 'recovered', taper off them). however, what would happen was my depression/anxiety would always seem to come back again eventually. i started to notice that when going back on antidepressants, a certain antidepressant which worked ok in the past, suddenly the next time around didn't seem to work anymore, or i had new side effects which i did not have the first time around

so over the past decade or so i have been stopping and starting antidepressants, switching, trying different doses, reading all about them, reading reviews, etc. i tried at least 10 of the popular antidepressants (the usual common ones)

about a year ago, i was taking sertraline, it was kind of 50% helping my depression/anxiety, but with one particular side effect which i always seemed to get stuck with all the ssri's, which was vivid dreams at night along with a feeling of spending too much time in REM sleep (8 hours of it! dreaming as soon as i hit the pillow to when i woke up), and not enough of the deep refreshing restorative sleep which we all need. this led me to have aches and pains in the day along with a feeling that i hadn't had 'any sleep at all', constant fatigue, totally zero concentration or ability to learn/remember anything. i would get upset stomach sometimes also, and restless legs syndrome at night. i just couldnt shrug off these annoyances and so i finally gave up with antidepressants altogether and decided nothing could be as bad as the 50% effective antidepressants i was taking and the troublesome side effects i always ended up being stuck with. and, so began what would be the worst year of my life...

(by the way at this point sparrow, knowing u are not feeling well at all, just to say, my story does have a happy ending and i honestly believe yours will have also) :)

so, i ended up going 8 months without taking any meds at all. during this time i decided, why not simply do ALL of the things which are detailed out there on the internet regarding defeating depression and anxiety using natural means. so that's what i did. i did all of the following:

- totally changed diet to extremely healthy food only, and kept up with a big list of foods which are supposed to be good for depression and anxiety

- kept up with regular exercise (jogging about 4 times a week and also some weights, and pushups)

- practiced mindfulness stuff, spent time on breathing exercises and did meditation

- read a lot about depression and anxiety, coping strategies, positive thinking, inspirational books and youtube videos (Eckhart Tolle, Sadhguru, etc)

- took various herbal/natural things and supplements (the popular stuff which supposedly helps depression/anxiety, and also vitamins like vitamin D etc etc)

- did CBT

as the months went on and i continued doing that stuff, it just kept occuring to me that i was not feeling particularly good at all. it would be more accurate to say that i was slowly feeling worse and worse. i kept at it though and figured i just needed to do this stuff a long time. then, about 8 months later.. CRASH! and that's an understatement. i was suddenly hit with the most severe depression and anxiety i had ever encountered. it's kind of hard to put into words, but anyway the very worst of it all was i became very, very suicidal. i could ramble on about that period more but anyway, fast forward to today and im all ok again now, and it's only thanks to actually getting on meds which WORK.

the case with me was, simply, that just taking one ssri med wasnt enough to defeat the long-term and seemingly worsening complicated crap going on inside me. so now, im taking 2 meds, and they both do their job. each morning i take 150mg venlafaxine extended release, so thats always working 24 hours a day to keep my depression and anxiety under check (the venlafaxine i would say takes care of about 75% of my depression and anxiety. i took venlafaxine for about 6 weeks before coming to that conclusion, starting at 75mg for a 3-4 weeks (i started feeling better fast on venlafaxine, i would say about a week).... and then moving to 150mg). after a month or so on 150mg, i realised venlafaxine was suiting me very well (minimal to no fatigue, slightly vivid dreams but not like the other ssri's i had been on, no upset stomach or restless legs).

for me personally (everyone's different), i was getting on well with venlafaxine but i kind of had this feeling that although it was working and suiting me, it felt like things could still go 'either way', as in, i was not quite feeling as 'satisfied' as i hoped, with depression and anxiety still kind of hanging around in the background. i also had some mild, but present, diurnal mood variation going on. i felt great in the evenings, but not so great in the mornings/day.

so i did some reading around the internet and it was really dawning on me the amount of people who take more than one med to tackle depression and anxiety (or any mental health condition for that matter).

my sleep was not quite as good as i hoped, and i did have some mild diurnal mood variation going on, which i would describe as: some negative thoughts in the morning/day which i could not reason with or brush aside, and increased anxiety (too much cortisol/adrenaline in the body in the morning/day).

i knew if i went back to my doc to discuss that i wasnt quite 'there yet' with feeling better. he would just say "lets increase the dose then" or "lets switch to something else". i wasnt going to be having any of that advice anymore, i'd been there before plenty of times, switching meds around and around, never getting 100% relief with any single ssri i took. i took my 10 years of personal experience in this stuff and all the endless stuff i read on forums regarding other peoples experiences, and decided that venlafaxine was fine, i wasnt going to increase the dose at this stage as i felt it was working ok, but instead i just needed to add something extra alongside it to help with the last piece of the puzzle which needed to be addressed.

i read about all sorts of things people were taking along with their antidepressant and decided pregabalin looked like it ticked ALL the checkboxes which i needed. it appeared to not make too many people feel fatigued all day even at really high doses. it appeared to deal with anxiety extremely well (along with the constant negative irrational thoughts and guilt, and self-criticism of depression and anxiety). i also noticed that pregabalin was prescribed FOR restless legs syndrome, it increased deep restorative/refreshing sleep and reduced rem/dream sleep, it reduced bad dreams/'anxiety/fear' types of dreams, it stopped people waking up full of cortisol/adrenaline which leads to a bad day right off the bat with the uncontrollable negative thoughts and physical symptoms of anxiety, and also, pregabalin wasnt something which commonly caused an upset stomach.

so as you could imagine, i was sold. this sounded like it was exactly what i needed to add to my 75% working venlafaxine. so fast forward to present day and finally my depression and anxiety is nowhere to be seen, i sleep really well and wake up feeling really good and relaxed. my days are fine and not determined completely out of my control by a faulty broken head. diurnal mood variation has gone.

oh god, well that turned into a really long backstory!
it's about 3am here now so i better get some sleep but i will be back again tomorrow to continue ok (from reading the above you can probably guess along the lines of the advice i will give you tomorrow ok), if i can finish tonight with saying though, regarding mirtazapine which i took in the past, i had the same issues as you. it really knocked me out taking it (really sleepy!), and also, it gave me restless legs syndrome. i also didnt feel like it worked for me, so gave up on it. from reading what you said, it sounds like it is not working for you at all. one thing i do know about mirtazapine after reading around a lot about it, is it is one of the meds which should work pretty fast (often in just a few weeks). i dont want to start acting like some expert doctor here but, well from reading your backstory, it sounds like it is not working, even a little? dont worry about that though, seriously (i know you feel like total death at the moment but that's going to change). back soon ok.....
 
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ShySparrow

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Jun 4, 2018
Messages
20
Thanks for your help frogsplash. It does sound as though we have experienced similar trials with our medications.

The first medication I was prescribed was Imipramine but I stopped taking that after a couple of years because I thought I was better. Then I had a huge crash about a year or so later so was prescribed Citalopram, it did work but I got sick of the side effects and switched to Sertraline, again this seemed to work for a while but then I started getting bad side effects, the worst was insomnia and I knew I couldn't carry on with no sleep so I switched to Mirtazapine, this knocks me out completely and seemed to work really well up until this latest huge crash. I have been taking this for about 2 years I think (30mg). I have been on the increased dose of 45mg for 3 and a half weeks now and don't feel any better but I think I'm best giving it more time to settle down and start to work. I have become a very patient person over the years. My wife tells me it usually takes around 8 weeks to see an improvement in me with all the other medications I've taken. I'm hoping it doesn't take that long for the increase to start taking effect though.

I'm glad you have found that that combo works for you and that you are doing so well with it. I know what works for one person doesn't necessarily work for someone else but I am listening to your advice and I will do research on it.

Thank you so much once again for your help.

Sparrow
 
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