OP, I sort of know what you’re going through, I have been suffering from this for years and it’s gotten worse since going off a MAOI in March and a titration off benzos. I have a clinical diagnosis of Major Depressive Disorder but I am worse in the mornings. I wake up most mornings in a state anywhere from annoying heart palpitations/chest tightness to outright panic attacks, “grey area” suicidal ideation, and crying. It doesn’t matter what day of the week it is and doesn’t just happen during my monthly cycle. It’s almost always with me.

I’ll tell you what I’ve found and things I’ve tried:

1) I have been suffering with chronic low back pain and gastritis concurrently with this, so I’ve had all the bloodwork in the world done. No abnormalities. I had a sleep study in August and they diagnosed me with mild sleep apnea. I only had one outright stop in breathing, but over 30 times my oxygen levels dropped below 85% which is not good and my neurologist said it was enough to be concerning. I am having another sleep study done in 3 weeks with mild C-Pap intervention this time (nasal mask only) to see how I do. They are aware of my morning “spells” and mood. Maybe a sleep study is something you could consider. By the way, no one sleeps well during a sleep study but they can still gather enough data. I feel that it was worth the hassle, I scheduled it on a Friday night so I slept it off the next day.

2) I had to have an upper endoscopy last month because of the gastritis I mentioned above. My gastro wanted to make sure I did not have any ulcers, polyps, lesions, bacteria, celiac disease, you name it. He didn’t find anything serious other than the obvious stomach inflammation, but his biopsy of my esophagus showed evidence of GERD and heartburn. I had no idea I had reflux or heartburn at all because I didn’t feel the symptoms. They told me that acid reflux/heartburn can “present” as heart palps/chest pain and not always that classic burning feeling. Like you, I have a big appetite for sugar and inflammatory foods but I have made some changes. I still get the anxiety attacks in the mornings but I feel like I can ride out the discomfort.

3) I started going to acupuncture in May for my back pain, but it turned out that helped with my anxiety. My acupuncturist asked me if mornings were stressful in my household growing up, and after I thought about it I realized they were...I never wanted to eat anything in the mornings (I still don’t but I force it).

4) My psychiatrist told me to use a light box every morning for 30 minutes. I’ll admit that I’m lazy about this one.

Anyway, just wanted to let you know that I empathize with you and that there could be other things in play besides the psychological depression. I know that part of my horrific anxiety is due to the fact that I’m having trouble finding the right antidepressant (which I need to be on) and the titration off benzos, but there is definitely more going on here. All of this stuff is connected (sleep affects depression and anxiety in a major way and it is underrated). Good luck.