Post-appointment anxiety has worn off some, so here's what we came up with:

1 - discontinue Lexapro (she says, AD-induced insomnia is relatively uncommon - but "you're my Uncommon Side Effects patient!")

2 - discuss Mirena IUD with my gyn (as it happens I have an appt Sept 1)

3 - resort to Prozac the week before & week of if absolutely necessary but only during those two weeks per month

4 - get therapy woman! (paraphrased; of course she was much more diplomatic )