This topic is about a person who has a permanent colostomy and has been dealing with a lack of appetite, minimal food intake, and insomnia. Recently, they started taking the antidepressant Mirtazapine, which led to some unexpected reactions. Here are some insights and advice based on their experience:

1. After starting Mirtazapine, the person experienced a significant increase in appetite and energy, which was a positive change. However, this also led to increased stoma activity, including more gas, cramping, and frequent pouch filling.

2. The adhesive on their ostomy appliances began to lift during light activities, raising concerns about potential leaks. This could be due to the increased food intake and output, more physical activity, or possibly a defective batch of supplies.

3. If you're experiencing similar issues, consider trying stronger or different wafer/barrier systems. Many manufacturers offer free samples, which can be helpful in finding a better fit.

4. It's important to communicate with your doctor if Mirtazapine isn't helping with insomnia. They might suggest alternative sleep aids or adjust the dosage.

5. Some people find that having a full, well-balanced meal in the evening can naturally improve sleep quality.

6. Be cautious about using prescription sleep drugs like Ambien, as they can be highly addictive and difficult to stop using.

7. A non-drug option that has helped some individuals is "Sleepytime" herbal tea from Celestial Seasonings, which can provide gentle and reliable sleep without side effects.