I took 25 mg, the smallest dose. And when I could tell that it was time to come off of it, I broke pills into smaller and smaller doses over a few weeks to wean off slowly. That worked really well for me. It helped with the anxiety a lot. When nothing else works, a lot of ladies on the forum in the past have gotten relief from antidepressants. I have a dr appt tomorrow, and plan to ask him if that would work with my situation (bfeeding still) if I don't improve soon. Also, my friend told me she just tested low for DHEA (not from Mirena but other BC). Fatigue, malaise, hair loss, anxiety are among the side effects of low dhea, so I'm hoping he can test me for it too. I guess it's one of the hormones related to the adrenals. Will post back if anything comes of it.