Emma: I need advice

[Emma]

Hi, I am new here. I've been reading your website for some time and I've learned a lot. I was on paroxetine three times within 12 years (each time from 10 months to two years) because of anxiety. I was on 20 mg and it always worked very well. I went off paroxetine because I put really a lot of weight on. I thought I was very reasonable to give myself almost three months to go completely off (instead of 2-3 weeks as the doctor suggested). After 2 months I "crashed". Acute anxiety hit me so hard I couldn't leave my bed. I went back to my psychiatrist. He prescribed Zoloft (no weight gain effect) but suggested to wait and see whether it would improve. It did. I didn't take Zoloft. I started therapy. And I also entered windows and waves pattern. I had no idea it was WD related. After six months and another crash (acute anxiety, inability to function normally) I was prescribed Zoloft again and this time I took it.

 

Within 6 months I went up to the maximum dose. It didn't work. Still windows and waves. Then I was put on Effexor. I was on it only for a month because it effected my blood pressure. The doctor suggested increasing both Effexor and BP drug but instead I went off it within a week. I was feeling bad anyway and the withdrawal from Effexor didn't make much change. I've been off any AD since May (over six months now). There have been no days without anxiety. Morning cortisol spikes are awful. Sometimes windows make me believe it's going to be ok. I am really working hard: CBT, Zumba class, I eat well, read a lot, mindfulness (although I am not very good at it). Since I've been off Paxil I lost 16 kg (acute anxiety helped here). But waves like the one I am going through now leave me excluded from life. Anxiety is unbearable. I cannot live normal life, I cannot eat. I decided I cannot go on like this.  I made an appointment to see my doctor this Friday and I desperately need advice.

 

I'll be honest with you. If it wasn't for this weight gain (on Paxil I went from being overweight to being obese) I wouldn't think twice. I am scared of trying anything new risking it would not work. I am also scared of going back to Paxil because of all I have read here and what I read about no chance of being on Paxil and not putting on a lot of weight. But I cannot go on like this. I am so tired and so scared. I desperately need your advice. 

I apologize for my English.

Edited January 3, 2018 by Shep
added username to title and added paragraph breaks for readibility

[Shep]

Hi, Emma.

 

Welcome to Surviving Antidepressants.

 

Here is some information on withdrawing from antidepressants:

 

What is withdrawal syndrome? 

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

How psychiatric drugs remodel your brain

 

The best way to come off these drugs is slowly. Please see:

 

Why taper by 10% of my dosage?

 

It sounds like you're dealing with a destabilized nervous system from coming off and on antidepressants. I'm not sure about advising anything just yet because it's unclear about your timeline for when you were last on an antidepressant and the timeline for coming off the previous ones.

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

Please use this thread to provide updates on how you're feeling as well as to ask questions.  

 

[Altostrata]

Welcome, Emma.

 

How long have you been off Paxil? What is your daily symptom pattern?

 

 

[Emma]

I have been off Paxil for two years (since December 2015).

 

My symptoms are:

 

When in a window, morning cortisol spikes (pounding heart, anxiety) and then throughout a day almost normal.

 

When in a wave, severe cortisol spikes in the morning and then constant anxiety, feeling of dread, lack of energy, some dizzinness.

 

And then, when in a really deep wave (like the one I am going through now which seems easing a little bit since yesterday), anxiety is unbearable, usually with some mild pain situated somewhere in my abdomen area giving me the most scarry thoughts, no energy to move. I'm all anxiety, nothing else.

 

I know it sounds contradictory: mild pain and severe anxiety but, yes, the pain is mild, going away when I am focused on something and still I feel as if I was dying. It was the series of some somatic pains/disomforts raising acute anxiety that lead me to seek help in the first place. Another two times when I was prescribed Paxil it was also that stage of anxiety when I had physical symptoms (mild pain situated in one place as a constant reminder that something seriously bad is starting).

 

It all started after prolonged stress when my mother was ill and then died. Also it was the time when I entered a perimenopause (I thing I am very sensitive to hormon changes as I have had mild post-partum deppression after my two CCs; although any symptoms after the "normal" birth of my middle son). I think those two factors contributed to my anxiety. I did start a therapy then but it was the therapist, who was also a psychiatrist, who prescribed Paxil.

 

Then I had another attempts with therapy but with little results. Now, I do CBT since June 2017. It is  better than the previous ones but I can't see much result, either. I am really frustrated when when I am entering a wave and the therapist keeps asking me "what happened", "what thoughts provoked this". It was a relief to find this website and learn that it does happen becasue my nervous system is in a mess and not because I failed again to identify a destructive thought.

 

Now, I feel trapped. As I wrote in my first post, I went off Paxil only becasue I was really worried about my weight. Despite diets and working out regularly, I was still putting on weight. I felt great on Paxil, I enjoyed life, I wasn't constantly inside myself. But I had no idea how destructive ADs were. Now, it seems only logical. If you have your serotonine served on a silver tray every day, how can you be back "normal" when the tray is no longer there and your brain suddenly has to manage without it. 

 

When I am better, I belive I can do it. I keep giving myself deadlines. "I will hold another few month, another year. I can do it. If it is not any better, I give up but, for now, I can still manage." And this fall I tried to sum up the last year and I had to admit that there were many advantages: I lost 16 kg, waves were not so deep, windows felt almost like I was back myself (except for cortisol spikes in the morning which never go away; well, actually they do when I wake up with a headache; I am now glad of headaches because it's either headache OR cortisol spike and anxiety - interesting), I somehow managed through my taking care of my aunt who has a cancer.

 

But then two very deep waves hit and I am no longer sure I can go on like this. 

 

I have to add that each time I had to seek help (i.e. ended up on Paxil) it was after some prolonged stress (first my mother's lung cancer and death, then my close friend's bowel cancer, then my another friend cancer and death). I can see it is obviously something to be worked out on therapy but I cannot say I have had any success in therapy in this matter. And now I am taking care of my lonely aunt who also has cancer. It is sometimes overwhelming for me. Most of the last six months she lived with us. I have to take her to hospital, I took care of her after the operation (then I went through a terrible experience when I took her to her place after sometime time after the operation and as soon as I left to join my family on vacation, the whole wound opened and she had be operated again; I felt shock, guilt and felt and heard accusations from my father, i.e. my aunt's brother, and her friend; my therapist really helped me then), and now I am taking her to chemo and then she's staying with us for a week. Next week she will have her last chemo but her prospects are not very good and I don't know how I manage with what is going to happen when I am such a mess myself.

 

I learned a lot reading your website but one question keeps coming back. What about the issue which made you seek help in the first place. We were all prescribed ADs becasue we had some serious issues and we couldn't manage. I am not saying that AD were the only options then (I wish I had a good therapist then and I wish I have now as I am not sure about the present one) but sometimes they were. We all agree here that ADs make a mess in our brains and we wait for the waves to subside. But what about the original issue? Probably it is still there, still difficult or amost impossible to bear. I really lose heart when I read here stories about symptoms not improving even after 4+ years. I try to look for success stories and I recently find only those disheartening. 

 

Please, I desperately need advise.

 

 

 

 

 

 

[Shep]

Hi again, Emma.

 

The fact that you're getting windows is very, very good and should bring you much hope. You are already about 18 months off and slowly healing.

 

You may find some helpful information about perimenopause here:

 

Female hormone issues: perimenopause, menopause, WD or something else?

 

A couple of videos on ways to encourage windows through neuroplasticity:

 

Healing from antidepressants: The power of neuroplasticity video (7.5 minutes)

 

Healing from antidepressants. How to speed up the recovery process video (5 minutes)

 

Now there is a kind of "dark side" to neuroplasticity and that can happen if you're surrounding yourself with too much stress. You're doing a great deal of care taking for other people, but are you taking the time to nurture your own recovery and health? Do you have activities that you find restorative and can recharge your batteries? I know this can be hard when you are feeling poorly, but it's important. Are you able to take a yoga class? Go swimming? Meet up with friends for a movie night? These kinds of things can really help.  You mention Zumba in your opening post and that's a great way of releasing stress. 

 

Here are some non-drug coping strategies that may help:

 

Non-drug techniques to cope with emotional symptoms

 

As you look through the non-drug coping strategies, take note what you think may really help. Perhaps CBT is not for you, but you may find that mindfulness is. Or you may find art therapy or journaling something you'd like to try. I've been using music therapy for a couple of years and really enjoy it. There are a lot of ways of healing beyond talk therapy. 

 

We don't recommend a lot of supplements on SA, as many people's nervous systems hyper-react to them, but many people find that magnesium and fish oil are calming to the nervous system. Please only add in one supplement at a time and at a low dose to see how you react.

 

King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

Edited January 3, 2018 by Shep

[Emma]

Thank you, Shep. The single word "hope" in the first sentence in your post brought tears into my eyes.

 

I've watched the two videos you linked. I was happy to see that my recent preoccupation with quizes and Sudoku is my brain's way of rebuilding itself. I've  sort of sensed that it's been helping me and even stopped feeling guilty of wasting my time. I've thought it provides distraction from anxiety thoughts but I hear that there is more to it.

 

I will go an see my psychiatrist on Friday. Most probably he will suggest going back to Paxil (or something new). My today's position is that I want to have it at home so that I can make a decision NOT to take it. It would be MY decision and not simply the fact that I am left with no choice. I don't know if I am clear. I want to feel in control. Does it make any sense?

[AliG]

5 hours ago, Emma said:

I learned a lot reading your website but one question keeps coming back. What about the issue which made you seek help in the first place. We were all prescribed ADs becasue we had some serious issues and we couldn't manage. I am not saying that AD were the only options then (I wish I had a good therapist then and I wish I have now as I am not sure about the present one) but sometimes they were. We all agree here that ADs make a mess in our brains and we wait for the waves to subside. But what about the original issue? Probably it is still there, still difficult or amost impossible to bear. I really lose heart when I read here stories about symptoms not improving even after 4+ years. I try to look for success stories and I recently find only those disheartening. 

 

Hi Emma. A lot of us were prescribed AD'S for the wrong reasons ~ I was prescribed for post natal depression? Sure - I had a hormone drop, no sleep, heat, colicky baby and moved to central Australia with no support network whilst healing from a Caesarean section. Was I mentally ill? No. Did I have a Zoloft deficiency or serious issues ~ I don't think so.

 

There are also a lot of off- label A/D  scripts for pain, sleep, fibromyalgia etc,etc... The list goes on.The medical model now is that normal emotional responses to loss of a loved one, job loss, hormone imbalance, overactivity ( children) classed as ADD & ADHD all need to be medicated. Apparently the length of time to mourn for the death of a loved one keeps coming down in time ~ pretty soon, it will only be a few hours before needing to be fully medicated. 

 

There are numerous nutritional /hormonal and environmental reasons for depression and anxiety today, especially given the poisonous world that we now live in full of toxic chemicals distributed through our air, water and food not to mention EMF'S and the many chemicals that abound in our homes and offices.

 

1 hour ago, Emma said:

 

I will go an see my psychiatrist on Friday. Most probably he will suggest going back to Paxil (or something new).

 

if you do reinstate, which is highly questionable, as to the efficacy - this far out  ~ please check in here first , or at least start on a very low dose of 1- 2 mg to start with. Most doctors don't have a good idea of withdrawal or tapering and may start you on too high a dose. As you are probably highly sensitized, this would not be good and could make everything worse.

 

After about 3 months, reinstatement is a bit of a gamble. No one can really say how it will go. 

 

I came here at 9 months out and decided not to reinstate, at that point. It's all individual and up to each of us to decide which way to go. All we can do is offer information and what has worked for others ~ then, ultimately it is up to you. 

 

There is lots of hope and I say that all the time. Read my thread (only the end, as it's far too long). LOL.

 

Ali 

[Emma]

Thank you, Ali. I read the beginning, some bits in the middle and the end of your thread. You are an inspiration. I desparetely need hope and your story brings hope.

 

You are so right when you write about overmedicating for whatever reason. The first time when I was prescribed Paxil I was in mourning and badly distressed after a prolonged period of stress during my mother's illness. My visit at the therapist/psychiatrist now seems really weird. He said that there was nothing wrong with me and that I was in mourning and that I had every right to feel as I felt. I remember the feeling of relief. And he also said that I did not need meds. And then somewhere during our conversation I said something about not accepting my being overweight. He thought and then said: "I belive, after all,  you will benefit from taking Paxil." (!!!!!). And I belived him! When I think about it now I feel he treated me as a kind of guinea pig. He made some kind of great internal conflict out of my lack of acceptance of my weight. I ended the therapy after three or four meetings and stayed on Paxil for another few months. I wish I had a good therapist then. Or some more knowledge about what was going on with me.

 

 

[nz11]

2 hours ago, Emma said:

The first time when I was prescribed Paxil I was in mourning and badly distressed after a prolonged period of stress during my mother's illness. My visit at the therapist/psychiatrist now seems really weird. He said that there was nothing wrong with me and that I was in mourning and that I had every right to feel as I felt. I remember the feeling of relief. And he also said that I did not need meds. And then somewhere during our conversation I said something about not accepting my being overweight. He thought and then said: "I belive, after all,  you will benefit from taking Paxil." (!!!!!).

This is simple disgraceful.

Paxil is known for putting weight on for goodness sake.

I believe this may be the revealing of hidden agendas. It was well known that GSK were paying doctors paxil prescribing kickbacks. So who knows what this pdoc was really thinking. Maybe it in fact was he who was going to benefit from you taking paxil.

 

Emma do you have a complaint process in your country. Maybe you could make a complaint against these people.

 

[Emma]

It was back in 2004. I can't even remember his name. But I also remember his comment when I came for the second visit. He said: "I can see you put on some more weight". I was shocked. It was rude, it was not professional and, what's more, it was not true. It was only after some time of taking Paxil that I started putting on weight.

[Emma]

I called the appointment with the psychiatrist off. I know all he would have to offer is going back on AD. I decided to try to carry on. My wave is getting a little better but I feel scared and overwhelmed.

[nz11]

I just want to tell you I think you have made a good decision. It’s called keeping yourself safe.

They don’t acknowledge withdrawal  so they basically have nothing helpful to say. Quite the opposite they are dangerous and I agree with you they will simply continue offering the drugs. They will insult your intelligence and very cleverly get you doubting your own convictions. They will drag you into conversations that are unnecessary. Anything you say will be used against you.

Far better spending time reading insightful helpful  info at sa. 

Wishing you strength for the healing journey

So glad you joined sa 

you will make it. You are not alone.

[Emma]

On 5.01.2018 at 6:11 PM, nz11 said:

I just want to tell you I think you have made a good decision. It’s called keeping yourself safe.

 

Thank you, nz11. Yes, I belive I made a good decision.

 

If I didn't find this site and learnt that most of my symptoms were WD related I would be back on Paxil by now. That's for sure. I am coming out of this really bad wave. I had two such bad debilitating waves in 2016 after I went off Paxil and then another in October 2017 and now on the turn of 2017/18. I don't mention other waves which have been pretty bad, too, but did not interfere with most of my activities.  I could feel even very anxious inside but I could still go on with most of my every day stuff.

 

Could anyone direct me to a link I found here on this board some time ago to an article written by a doctor acknowledging the existence of a protracted WD syndrom and describing it? I would like to translate it and give it to my therapist so that she knew what I am going through and did not waste our time trying to work out what triggered the change in my mood. 

 

I bought and downloaded "The Mood Cure" by Julia Ross. I have just started reading it. It seems very interesting. 

[nz11]

4 hours ago, Emma said:

Could anyone direct me to a link I found here on this board some time ago to an article written by a doctor acknowledging the existence of a protracted WD syndrom and describing it?

Maybe you are referring to the Shipko article or articles I think there were 3 each one an updated version

I think there is a Fava article that was descriptive of the wdl symptoms.

Check out the journal article section.

Ill do a google and see if I can find the Shipko one...Later didn't take long could this be it

 

 

 

 

[Emma]

Thank you, nz11.

 

I read the Shipko article and it is not very optimistic. If I was to sum up, what he says it would be: if you take AD you better don't go off it becasue you can have nasty withdrawal symptoms that may never end and all the supplements are just placebo. So he suggests benzodiazepines but, oops, they are dependency-forming.

 

Sooo depressing!

 

 

 

[Gridley]

I read Shipko a while back and was very upset until I realized that he is, in my opinion, wrong.  I find much more credible people on this site like Alto, Shep, Brassmonkey and all the others who are healing, slowly, yes, but healing, as documented in their threads.

[Emma]

Thank you, Gridley. 

My first reaction was my heart sinking. Then I read some comments under this article, among them Altostrada's very reasonable and reassuring one. 

[nz11]

Papers on diagnosis of antidepressant withdrawal syndrome

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Dysautonomia (autonomic dysregulation)

[bhasski]

On 1/3/2018 at 4:03 PM, Emma said:

What about the issue which made you seek help in the first place. We were all prescribed ADs becasue we had some serious issues and we couldn't manage.

 

Ofcourse there were issues which we couldn't manage and there comes social support.

Thats how I feel now. 

If I was given time... support and they didnt turn my panic into theirs...

I was not ever be on APs, SSRIs, Benzos or SNRIs.

 

I had  memory issues, not severe ... just exams related technical stuff missed ... 

 

Now I know those issues were given by earlier ill informed psychotropic drugs. There is a long cycle there.

[Emma]

I just wanted to update that I am recovering from this last deep wave. Every day is a little better than the previous one. I try to enjoy it and not to worry that it won't last. Is there a way to prepare oneself for another hit? It seems that each time it should be easier as we know that it won't last but once you in it you feel what you feel and it feels very real.

 

Thank you for all your support.