rob1983: is this withdrawal, burnout, chronic fatigue or depression?

[rob1983]

Hi everyone,

 

Thank you for creating such an amazing resource.

 

My AD history is in my signature.

 

I have now been AD free for over 2 years, since July 2016 (26 months at the time of posting). I did not taper properly any of the 4 times I came off ADs, although I did reduce my doses from 10mg to 5mg and then 2.5mg over a period of a few weeks each time (had no idea of the importance of slow tapering).

 

Since reading various threads and posts on this forum I am aware that 1) my tapering was not nearly sufficient to avoid potential negative effects and 2) the anxiety that caused me to go back onto Cipralex within a few months of stopping (twice) could well have been withdrawal, not a return of the original anxiety. Or, at the least, both.

 

My symptoms for the past 26 months have been:

 

- significant lack of physical and mental energy (affecting ability to work)

- throbbing headaches if I try to concentrate / work too hard

- insomnia (after the first 3-4 hours the rest of the night is a real challenge)

- significant lack of motivation for any form of productive task

- significant lack of confidence in my ability

- negative, ruminative thinking

- very intolerant to alcohol

- low libido

 

It is hard to differentiate between the different potential sources of my symptoms. For example, I have had issues with my energy levels, my immune system and general fatigue that pre-date being on ADs (I think these symptoms stem from glandular fever when I was younger and multiple relapses without a full recovery).

 

And I experienced burnout in early 2016 after working too hard for too long building my business (7 years full tilt). The burnout coincided with my final last-ditch return to ADs to try to keep everything together (I fell apart about 4 weeks after going on Citalopram and was off work for 12 months before making a partial and unsuccessful return last year).

 

The title of my post reflects the fact that I am really struggling to understand what is going on with me.

 

Burnout - I know I pushed myself too far building my business and everything I have read about burnout rings true for my experience and I know burnout can take a long time to recover from. So I definitely feel that that umbrella diagnosis / description applies to me.

 

Chronic Fatigue - I also know that I have had some kind of viral / immune / fatigue issue for a long time (+10 years) which made me vulnerable to the stress and overwork of building a startup. As a result, I feel a lot of the chronic fatigue literature applies to me (and various of my lab tests back this up).

 

Depression - I had never been depressed before ADs but the burnout hit me with a big dose of dark depression that took a good few months to climb out of with yoga, rest, counselling, and a bunch of self-work. I know that my symptoms are signs of depression... but... given the depression coincided with coming off ADs (and 'burnout') it is hard to tell what the cause is. I don't believe I am currently depressed - or at least not as depressed as I was - but I do know that the symptoms I listed above are all associated with depression.

 

Withdrawal - Could a lot of what I am struggling with be as a result of the pills?? Especially going on and off multiple times. I know that the onset of the insomnia coincided with going onto Citalopram and then rapidly coming off it. For someone who has always been extremely productive and self-motivated, my current inability to bring myself to do anything is really out of character.

 

Overall I feel overwhelmed by life and all its various challenges, I no longer have any faith in my ability to achieve things, my brain operates at about 25% of its previous capacity, and my emotions are slightly deadened / numb. I feel a great deal of sadness at losing my 'previous self' and don't know how long it will take, nor what I should do to improve my health.

 

I comfort myself with the fact that regardless of cause or which umbrella diagnosis applies to me (perhaps all of the above?!) the way out is the same... rest, exercise, diet, sleep, stress management, yoga, self-care, etc. In one sense, given it is too late for reinstatement (I think?) maybe it doesn't matter and I just need to focus 100% on healing?

 

It is tragic that both doctors and family respond to my symptoms with encouragements to go back on ADs. I have felt so lost over recent months and so desperate to feel better and get some of my mojo back that I have considered it in my low moments... but I am determined not to fall into that trap again. If my symptoms are, at least in part, as a result of ADs I would be mad to go back!

 

Would love to hear your thoughts.

Many thanks in advance.

Rob

[SkyBlue]

On 9/24/2018 at 9:24 AM, rob1983 said:

 

I comfort myself with the fact that regardless of cause or which umbrella diagnosis applies to me (perhaps all of the above?!) the way out is the same... rest, exercise, diet, sleep, stress management, yoga, self-care, etc. In one sense, given it is too late for reinstatement (I think?) maybe it doesn't matter and I just need to focus 100% on healing?

 

Dear Rob,

 

Hello and welcome to SA. Glad you're here, but sorry for the reason for your being here.

 

I know that it might seem completely unbelievable, but what you are continuing to go through is very, very likely protracted withdrawal. Protracted as in "you've got to be kidding; there's no way that this can still be withdrawal," and it is. 

One of the main examples of proof of this is your statement that this isn't like the real you, feeling unmotivated, overwhelmed, and, it sounds  like, generally pretty awful. 

 

The good news is, it will get better. 

 

If this was never "you" to begin with, you're not returning to some "baseline state" of depression, fatigue, and overwhelm (this idea of "baseline condition" or "underlying condition" is something doctors seem to really latch onto). It's a physical condition caused by the neurological trauma of withdrawal. 

 

Also, it sounds like you had an immediate bad reaction to at least one of the drugs. That again supports the fact that this is *still* withdrawal, that you have been harmed by these drugs--again, the message of hope is that if it's withdrawal, it will heal in time.

 

Yes, there can be some overlapping issues -- it sounds like you have issues with chronic fatigue. Withdrawal itself can cause extreme fatigue. Again, the good news is, as our systems heal, it can get better.

 

I see myself so much in you. I'm not trying to make this about me! But like you, I have always been very motivated, achieving, etc., 

and in withdrawal I am much as you described, overwhelmed by life (but it's gotten somewhat better). Just know you are definitely not alone.

 

Can I ask, if you weren't depressed before ADs, what caused you to be prescribed them? 

 

I agree that is is completely tragic that our loved ones and doctors respond with the encouragement to go back on ADs. The crystal clear answer for most of us is that we are worse off *on* and *after* the drugs=therefore, could the drugs be the problem?

 

I think you are correct that it is too late for reinstatement. And yes, to focus 100% on healing, with the wonderful strategies you mentioned, rest, gentle exercise, nutrition, sleep, yoga, etc. 

 

Again, welcome to SA. You're in good company here.

[SkyBlue]

Here is some useful information on the waves and windows pattern of healing: https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

This description of healing is amazing--gives a theoretical explanation of what is going on in different brain structures as we heal: https://www.survivingantidepressants.org/topic/10914-what-is-happening-in-your-brain/