I was on Mirtazipine for years--just so you know. Sorry about your sleep issues. Hopefully, you will get it sorted soon.

I have had big-time intrusive thoughts difficulty over the years. The nature and content of the thoughts has varied widely, but being honest, some of them at times were potentially dangerous and frightened me. I always immediately told my pdoc everything about them. The most helpful treatments for me have been atypical antipsychotics, especially Abilify. For me, it seems to work.

So, just talk it out. Tell him/her everything, including content--if you can possibly pull yourself to do that. Your doc will be better informed and better able to help you that way.

Sending you comfort and a quiet mind and prayers.