Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Constant Exhaustion In A Patient With Chronic Anxiety?
Question: I wake up every morning with chronic anxiety, i have beeb taking clonezapam for 10 year .5 mg in the morning. it helps anxiety but after about 2 hours i feel exhausted and don't want to do anything. my psychiatrist thought i had bipolar2 and prescribed lamictal for a while but at 150 i just felt tired and foggy. i changed psychiatrists and he plus my therapist said i had anxiety and depression and suggested viibrid which I'm afraid to start in case i do have bipolar 2 I'm so fed up waking up like this everyday and don't start tp feel any better until evening. i also wonder if I'm doing something to cause this its ruining my life
Brief Answer:
Consultation
Detailed Answer:
Hello,
First of all, I feel chronic presentation of anxiety is more likely in unipolar disorder rather than bipolar disorder. I understand that you have concern about switch to mania/hypomania but in my opinion under supervised treatment there is little risk as it can be detected early.
I also like to state that chronic use of Clonazepam unlikely to help you in real sense as it can lead to development of tolerance and dependence.
I feel that suggestion of using Viibryd is well placed and there is nothing to worry about negative consequences. In case this does not help you, you can discuss the option of using Seroquel as this can address both bipolar as well as unipolar anxiety and depression.
I hope this helps you. Feel free to write back to me if you have more questions.
Thank you.
Regards,
Dr. Ashok Kumar
Psychiatrist
Consultation
Detailed Answer:
Hello,
First of all, I feel chronic presentation of anxiety is more likely in unipolar disorder rather than bipolar disorder. I understand that you have concern about switch to mania/hypomania but in my opinion under supervised treatment there is little risk as it can be detected early.
I also like to state that chronic use of Clonazepam unlikely to help you in real sense as it can lead to development of tolerance and dependence.
I feel that suggestion of using Viibryd is well placed and there is nothing to worry about negative consequences. In case this does not help you, you can discuss the option of using Seroquel as this can address both bipolar as well as unipolar anxiety and depression.
I hope this helps you. Feel free to write back to me if you have more questions.
Thank you.
Regards,
Dr. Ashok Kumar
Psychiatrist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I'm just confused why i wake up with chronic anxiety every morning, i have no problem sleeping at night , but anxiety startles me in the morning and i go into freeze mode. my psychiatrist suggests that it can partly be due to withdrawal from clonezapam which i only take 5mg in the morning as i didn't take it x3 daily as suggested 8 yrs ago by a previous dr. also up until a year or so once i took the clonezapam i would function ok during the day, now about 2hours after taking clonezapam and my anxiety goes down a little i often start crying feeling exhausted and most days need to sleep again for about an hour so i can get through the day, i don't understand this and haven't got any answers. except that i may have underlining depression too.
Brief Answer:
Follow up
Detailed Answer:
Hello,
In my opinion, there are two things which explain poor response till date and early morning anxiety.
First, the dose of Clonazepam is inadequate considering the duration of the disorder. This is possible as you may have developed tolerance.
Second, the untreated depression could be the cause. Once you treat the underlying disorder, there is a good possibility anxiety will be under control.
In my opinion, SSRI medication is the need of the hour. This is because SSRI are the primary treatment for anxiety and depression.
I hope this helps you.
Thank you.
Regards,
Dr. Ashok Kumar
Psychiatrist
Follow up
Detailed Answer:
Hello,
In my opinion, there are two things which explain poor response till date and early morning anxiety.
First, the dose of Clonazepam is inadequate considering the duration of the disorder. This is possible as you may have developed tolerance.
Second, the untreated depression could be the cause. Once you treat the underlying disorder, there is a good possibility anxiety will be under control.
In my opinion, SSRI medication is the need of the hour. This is because SSRI are the primary treatment for anxiety and depression.
I hope this helps you.
Thank you.
Regards,
Dr. Ashok Kumar
Psychiatrist
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
