Developed signs of early morning wakening with a feeling of heavy heart in 2014. Ignored for a year or so. Then the problem started worsening with more heavy heart with loud pounding beats very early in the morning. Then I failed depressed or sad/ worried during day time also at times. Consulted a psychiatrist in 4/2014 who prescribed cipralex. After 4 months he added lamitor 100. Felt some improvement gor 3/4 months and stopped cipralex of my own. The state of depression recurred back and went on to lamitor 200 but no improvement. In november 2017 consulted another psychiatrist who changed the medicine and prescribed paroxetine12. 5, divalproex 250 and mirtazapine15. Felt improvement after few days. Stopped divalproex after 3 months. Then tapered paroxetine and finally stopped in april 2018. I was feeling good now. But unfortunately the condition hit back in early august this year. Now I have started paroxetine 12.5 with clonazepam .5 and continued mirtazapine15. Though I have again felt some relief but I always wake up with heavy heart and worried. During day time also I get sad or anxious at times. please suggest. Further I have elevated Triglyceride level about 500 which I heard is due to mirtazapine. Is there any alternative for that. I am also hypertensive taking amlodipine5 from last 6 years.