Jennings: down in a hole

[Jennings]

Thanks Yesyes, I will look at these and implement them.  

 

Have you stabilized yet?

[arbor]

Dear @Jennings--Oh, it sounds terrible what you're going through.  I know the worry about not being able to work.  It only adds more pressure.  It doesn't sound like the rehab mental health place was particularly helpful, although you mentioned DBT.  Was it helpful?  Are you able to get any sleep?  What I've noticed about the crying is that for me it does pass, and now I can spontaneously burst into tears, but crying jags aren't happening.  I offer that as hope for this passing for you as well.

 

Please know i send you all my best wishes for getting out of this hell,

Arbor

[Jennings]

Thanks Arbor, I'm thinking maybe trying Citalopram since it's similar to Escitalopram which is the Lexapro I came off of.  I just don't know what to do.  

 

I don't want to be on meds but maybe I can get on one and somewhat stabilize, then slowly come off doing a correct taper.  This fast taper has left me feeling disabled.

[arbor]

Hi @JenningsI can certainly understand why you'd be wondering if trying Citalopram would be helpful.  You've been going through so much, it's no wonder that your nervous system would be very disrupted.  If this should be your choice, one of the other moderators could advise you further.

I make no judgement as to how you want to proceed.  What I can offer is to share with you what I've learned and noticed about reinstating either with the drug you were taking or a new one, and that is that the results are mixed.  There's a strong risk of disturbing your system even further.  Plus you'd be giving up the progress you've made so far in readapting to being free of psycho-medications.  Recovery can be so very, very slow that you may not yet be aware of the progress your system is making.

Your last reinstatement happened it looks like 3-4 months after getting to zero.   This time it would be more like 9 months out.   As you can read in this link, the more time out makes for more risk with reinstatement.  Also, please note the last statement as it may apply to your choice of Citalopram over Lexapro.

 

Again, I deeply commiserate with the suffering you are experiencing.  Most recently, I've been using the Change the Channel as much as I can.  Please also stay in touch here, no matter what, so that you feel supported. 💗

Arbor

 

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

 

 

What we have learned about reinstatement
From what we've learned from patient experience here and other online support sites:

• Reinstatement is best done immediately upon appearance of withdrawal symptoms. The more time that passes, the less likely it is to work.
• The length of this window of opportunity is unknown, it varies according to the individual. Sometimes people can reinstate successfully months or years after quitting. Others cannot.
• Often a very low dose will relieve withdrawal symptoms. If, for example, you were taking 20mg Paxil and quit rapidly or cold-turkeyed only a few days ago, 5mg may be enough. After trying the lower dose for a week, you can always increase if you feel you need more. If you've been off the drug longer, your nervous system may be sensitized and it may be wiser to try a sample dose, such as 0.5mg-1mg, to see how you react.
• Avoid kindling, start low to see what you need. You can always increase if necessary. If you've been off the drug for a month or more, many people can find some relief from withdrawal symptoms by reinstating as little as 0.5mg-1mg for 20mg citalopram, for example. Do not start at a high dose, your nervous system may be sensitized by withdrawal and you may your symptoms much worse, which is called kindling -- see a fuller explanation below.
• You may be able to reinstate an equivalent drug. Some drugs are siblings, such as citalopram and escilatopram or venlafaxine and deslavenfaxine. Fluoxetine, which is arguably easier to taper than other SSRIs, may be substituted for SSRIs such as paroxetine or sertraline. (If you have had a prior adverse reaction to a drug, it may not be advisable as a substitute.)

Additional reasons to reinstate only a low dose
Reinstating at a low dose reduces the risk of severe adverse reactions, such as kindling.

• Experiencing withdrawal may have sensitized you to drugs and a larger dose may cause an outsized adverse reaction.
• If you had adverse effects while you were taking the drug, a low dose may not trigger the adverse effects but still reduce withdrawal symptoms. Adverse effects tend to be dosage-related: The higher the dose, the worse the reaction.
• These drugs are vastly more powerful than they need to be; often reinstatement at half dosage is sufficient and many people do well with a lot less. You want to take the lowest dose EFFECTIVE to reduce withdrawal symptoms.
• Your receptors may have adjusted somewhat (upregulated) during the time you were tapering or had withdrawal symptoms and don't need as much drug to return to their prior homeostasis. See Shapiro, 2018. Subtherapeutic doses of SSRI antidepressants demonstrate considerable serotonin transporter occupancy: implications for tapering SSRIs
• If you can stabilize on a lower dose, you have less to taper when you finally do go off.
• You can always adjust the dosage upward if you find you need to. After reinstatement, most drugs take about a week to reach full effect. Wait until you see the full effect before you make an increase -- and then make only very gradual increases.

 

How long should you give reinstatement?

• Unless you have an immediate bad reaction, observe your symptom pattern for about a week to see if the reinstatement is helping. It takes about that long for your body to fully register the addition of most short half-life neuroactive drugs. If you have an immediate bad reaction, reduce or stop taking the drug.
• After reinstatement, stabilizing on the drug varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
• A slight immediate improvement is a good sign, this probably will progress as the drug ramps up to steady-state over a week. Improvement often occurs in The Windows and Waves Pattern of Stabilization
• More is not better! Your system has gotten a shock and may react badly to "normal" amounts of drug. Reinstatement may not immediately eliminate all withdrawal symptoms. It takes time to stabilize, you may still experience waves of symptoms, which usually lessen as time goes on. Give your nervous system time to settle down, be patient after you reinstate, do not leap to increase the dosage.
• Think in terms of months before you attempt to taper again. Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction. Do not attempt to taper again until you feel symptom-free, or at least until your withdrawal symptoms are mild, predicatable, and tolerable.

 

When to discontinue reinstatement

• If, upon reinstatement, you very soon feel significantly worse, most likely you are sensitized to the drug and need to take a smaller dosage or, possibly, none at all. You will need to track your daily symptom pattern to see if it's the drug causing your symptoms. If so, they generally will be worse shortly after you take the drug.
• Sometimes reinstatement does not work. The nervous system has taken such a hard hit from withdrawal, it's destabilized beyond whatever effect the drug might have had.
• You get an adverse reaction from the drug. Look up your drug at drugs.com to identify known adverse reactions. A rash is always a bad sign. Sometimes an adverse reaction can be eliminated by taking a lower dosage. Do not mistake an adverse reaction for your existing withdrawal symptoms!
• If you have an immediate severe bad reaction, reduce or stop taking the drug

 

Reinstate at what dosage?
Sometimes reinstatement not only doesn't work but makes symptoms worse -- this is called kindling. That is why we often suggest very, very low doses -- to reduce this risk. Higher doses can go wrong in much bigger ways. A very low dose is a way to explore the option of reinstatement with less risk.
 
Dosage of reinstatement is always going to be a guess. Here are some factors contributing to the decision:

• How long you've been off the drug. If you've just cold-turkeyed 20mg Celexa a few days ago, you might reinstate closer to your original dosage, such as 10mg. (It may not be necessary to go back to 20mg, standard dosages tend to be overly powerful.) Cold turkey is not a shortcut to a lower dose. Reinstatement might not work at all, and you're stuck in severe withdrawal.
• If your system has been sensitized by going on and off drugs. If you've had withdrawal symptoms for weeks, your nervous system might have become hypersensitive from destabilization. For example, if you had been taking 20mg Celexa, you might wish to try reinstating at a lower dosage, such as 0.5mg-1mg. It may seem incredible, but these tiny doses are often sufficient to reduce withdrawal symptoms. You can always increase later.
• If you have symptoms of hyper-reactivity or alerting (anxiety, panic, sleeplessness), you may be too sensitive for reinstatement. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 0.5m-1mg if you had been taking 20mg Celexa, for example.
• How long you've been off the drug. If you've been off the drug for many months, reinstatement is less likely to work. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 0.5mg if you had been taking 20mg Celexa, for example, or other SSRIs with a standard dosage of 20mg.
• Other drugs you're taking. Be very careful adding a drug to other drugs. Use the Drug Interactions Checker before even considering this. (Your symptoms may be due to drug-drug interactions.)

 

None of the above are hard-and-fast rules. There are reports of people with prolonged post-withdrawal syndrome who did better taking a drug at full dosage 2 years later. If you want to do this, please consult a doctor, we cannot advise you on it, the doctor is going to have to monitor your reaction to the drug.

 

How about substituting another drug for reinstatement? (Especially for paroxetine)

It is preferable to reinstate the drug that caused the withdrawal symptoms rather than another drug, the same drug is more likely to stop the symptoms.

[arbor]

Hi again @Jennings

 

Here are Alto's words on Change the Channel:

 

“One of the techniques I've used to deal with withdrawal symptoms is what I call "changing the channel." It's a composite of whatever works, to switch from bad feelings to more of an emotional equilibrium. Changing the channel is particularly effective with the neuro-emotions of withdrawal syndrome, which come out of nowhere, can be very intense and painful, and then in minutes or hours or days, disappear like a summer rainstorm passing through.

 

It's a way of managing the distress while not adding to it with very understandable worry, fear, or panic. The key is to understand you have a feeling self, who is sometimes overwhelmed by emotions, and an observing self.

 

You feel a feeling, and your observing self knows you are feeling a feeling: "Oh, I'm feeling so sad." The technique is very simple: When you recognize you are in the midst of an unpleasant emotion, change the channel by doing something more pleasant or constructive or healthy. It can be anything, any psychotherapeutic technique, your choice: - Switch your thoughts to puppies and kittens, or people you love. - Do slow, meditative deep breathing. - Play with your pets. - Cuddle your children, or significant other. - Phone a friend to say hello. - Take a walk in an interesting part of town, or in a park. - If you like cognitive behavior therapy, do CBT. - Do some gardening, look at trees and flowers. - Go to the store and smell all the spices. - Wash the dishes. - Read a book or magazine you've been interested in.

 

Gentle physical activity like taking walks, breathing regularly, looking at trees, flowers, and interesting sights is good for you in 4 ways -- the physical activity helps your autonomic nervous system to regularize and it stimulates the growth of new brain cells (neurogenesis). Looking at pleasant things puts pleasant images into your memory that you can replay. Plus, you are taking care of yourself and this will build your confidence. (I mentioned "changing the channel" to my therapist the other day and to my surprise, she had never heard of it. It seems I might have invented it! Anyway, she liked it a lot.) This seems like something each of us does in his or her own way. What do you do to change the channel?”

 

 

[arbor]

How are you doing today, @Jennings?  

On 6/2/2021 at 6:38 PM, Jennings said:

This fast taper has left me feeling disabled.

 

I certainly can relate to feeling disabled.  Have you noticed any changes in the crying?  

Best wishes,

Arbor

[Jennings]

Thanks for checking.  No I just seem to spiral worse and worse.  I think I just need to relax and reflect.  

 

I spoke with my psych and my therapist and both can't believe the state I'm in.  They knew me before this and can't believe I'm in this kind of way.  I hope I feel better after sleep tonight.

[Fallensoul]

Hey Jennings,

 

I read your story and feel with you.

It's unbelievable what these drugs do. They should only be prescribt in extreme rare  cases.

I also had no idea what I started when taking paroxetine for stress.

Now we are here with a disrupted brain.

 

Unbelievable you still managed it to work.

 

I think avoiding stress is realy import.

 

Hope you get windows soon!

[mva96]

Hi Jennings, i'm having a hell of a time with withdrawal at the moment (namely akathisia but all the other good stuff too), and just wanted to say you are one very brave man. We shouldn't have to brave to come off a bloody prescribed drug, but for whatever reason its the cards we've been dealt. Keep on trucking, we will get there eventually.

[Jennings]

Thanks everyone, this is the hardest thing I've ever done.

[arbor]

Amen, @Jennings--

 

Please know I'm with you--

Arbor

[Jennings]

Adverse reaction to Celexa.

 

Started at a low dose and had the reaction later that day.

 

Hell.

Edited June 24, 2021 by Jennings

[arbor]

Glad to hear from you, but so sorry you had to go through another hell--

Thinking of you💗

Arbor

[mva96]

Hi @Jenningssorry to hear that the reinstatement didn't help. Can i asked how much you tried to reinstate and what negative effects it had?

 

I'm under alot of pressure to go back on but im pretty concerned exactly this will happen. I too am struggling with pretty severe akathisia, dark depression and a plethora of awful symptoms so i really feel your pain.

[arbor]

Hi Jennings--

How are things going?

Sending you healing across the miles.

Arbor

[NeDaytoDayMJ]

@Jennings Hi,  how are you doing these days?  I’ve read the thread and there hasn’t been an update in awhile.  I am hoping to hear you are well.  Please update when you have a chance.  

[Jennings]

I'm still bed bound most of the time.

 

However I can now listen to music and watch some TV and movies.

 

I always listened to music and this took that from me, but it's now back.  

 

I don't enjoy it as much as I used to but I can feel it again if you know what I mean.

 

I am still getting off the chart anxiety, dark depression, gastric issues, vision problems, no energy, insomnia, cortisol rushes, and all types of body pains.  

 

Oh yeah also electrical shocks going through my body.  They are like brain zaps but through my body and not my brain.  

 

My doc and psych still believe this is mental illness even though I only had minor anxiety and stress prior to taking psych meds.  

 

I asked my doc last time if feeling like you are Electro from Spiderman is a common with anxiety and he just stared at me and said I must be imagining it.

 

Idiot.

[JesusSavemefromWD]

Glad to read ur small improvements…. Yea doctors are idiots when it comes to WD and adverse reactions. I can’t emphasize this enough. What does your doctor say about ur adverse reaction when u reinstated? He recommends going on another SSRi? My doctor now suggests an antidepressant and an antipsychotic…. I wish they had taken these drugs and suffer instead of us …. Idiots indeed!

[Erimus]

Time is our greatest healer friend. I know what it’s like experiencing the constant feeling of fight or flight every day for months on end. Our body knows how to reach stability it just needs time and patience to get there. It’s awful and painful and sometimes I wonder to myself how have I been reduced to this state. All we can do is keep slogging away each day until one day things won’t be so bad.

 

Keep going mate, everything in life you love will still be there waiting when you recover.

[arbor]

Good to hear from you, @Jennings

Whoa, your doctor sounds out of it--

Glad though that you can listen now to music.  Though I know the pleasure isn't yet the same, it seems like a good sign.

Thinking of you🙏

Arbor

[Jennings]

Couple months later.

 

So I broke down and ended up going on 25mg of Lamotrigine.  I'm mad at myself but I've excepted it.

 

My family and friends were at their wits end so I started taking it and..... it worked.

 

After about two weeks I started to feel a little better.  I stopped crying all the time.  I was able to watch TV and listen to all music.  I started to have hope.

 

My psych wants to up me to at least 200 mg and I said no.  So I've now been on for six weeks and I still have symptoms such as mild anxiety, parathesia, eye floaters, and nausea but nothing like it was before.

 

It feels like my other withdrawal was a dream.  It's crazy.

 

I'm going to stay on for a year or so to stablize and then start the 10% method.  

 

Oh yeah they diagnosed me with Bipolar after this. LMAO.

 

I went back and got my medical records.

 

I originally went to my GP for a physical and told him I had stress.  He offered Zoloft to me with no warnings.  He said 6 months and the worst that can happen is it doesn't do anything.  

 

I never had anxiety, depression, anything like that.  Seriously, I took the med because I trusted my doctor.

 

I had my first panic attack two weeks after I stopped.  They kept happening.  He said I now had panic disorder.  I went back and he gave me Effexor.  I took it and had an adverse reaction.  Ended up in the emergency room.  They inpatiented me gave me Klonopin and Lexapro.  Once I was released I was sent to a Psych doc who kept increasing everything.  They had me gassed I was always this way and was just coping.  

 

I can't even imagine how many people are diagnosed with bipoloar due to the effects of psych meds.

 

WARNING: Just because Lamotrigine worked for me doesn't mean it will work for you.  I was lucky so far because a lot of other people have tried it and it makes things worse.  I don't believe we should be on psych meds and that they cause harm both short and long term.  If you decide to try this it should be a decision between your doctor and you.

[Crochet]

This is such good news that you are feeling better.  I look forward to seeing you get your life back.

[tryingtosurvive330]

Hi Jennings, stopped by to check on you and wow, a lot has happened. I can't believe your doctor wants to up you to 200mg when 25mg seemed to work just fine. It's like they want us to be dependent on these drugs.

 

I felt the same way, upset that I gave in and went up on my Lexapro, but it did make me feel better. it's been about a year and I've gone from 5mg to 1.6mg now, and the slow tapering does help. So hopefully you will have a good experience when you decide to taper off. I'm really glad to hear that you're able to listen to music, I felt exactly the same last year. I know we talked about how even the most boring tv was so impossible/painful to watch. I've recently been able to watch dramas, shows that even before wd I couldn't tolerate. But I attribute this to the loads of therapy I've been doing along with my taper. 

 

I hope this nightmare ends for all of us and start turning into good dreams.

[Jennings]

Just a quick update.  Still holding at 25mg of Lamotrigine.  

 

I am going to start decreasing in 2023.

 

My plan is drop 5 to 10% a month to six weeks.

 

I am having some digestive issues and having some headaches but it's nothing compared to that hell I was going through.

 

Everyone stay strong.

[Jennings]

Going to try to update this monthly now as I go through this Odyssey.

 

I got Covid soon after I posted last time and got really sick.  For the first few days it was just a cold, nothing too bad, and after what I went through at the beginning of withdrawal it didn't bother me.  Then I got hit hard, real hard, hot and cold, sleeping all the time, fever, terrible body aches, cough, sore throat, etc.

 

A couple days after feeling better I started to fell like I did about six months into withdrawal.  I got nervous but it went away after 5 days.  

 

Now I feel like I did before Covid.  Which is much better but not my old self.

 

Prayers for all of you.  I'll see you next month.

[Jennings]

Monthly Update:

 

My allergies are so much worse since starting and now coming off ADs.

 

I always had minor allergies but this is insane.

 

Anyways, I made it through another month.  Nothing really to report.  I've been keeping myself busy.  

 

Going to work, working out, spending time with my family, housework, reading etc.  The days are really passing.

 

I'm going on a vacation next week and I haven't been on a proper one in years.  Fingers crossed.

 

I hope everyone is getting by the best they can.

[Jennings]

Monthly Update: July 2022

 

Zero issues on vacation, slept like a log.  I really really pushed it on vacation.  Daily long hikes, sightseeing, excursions, I barely rested and I was fine.  Just like I used to be.  I always had a ton of energy until I took a psych med and I started to get fatigue.  These people are disgusting who give these out.

 

My mother in law has moved in and that's a little bit of an adjustment.

 

Besides that I've had brief moments here and there of small waves however I know they will pass and they are nothing like they were at the beginning.  I know they can comeback and I'm thankful for every day I have without those horrible waves.

 

I hope everyone is doing the best they can.

[Jennings]

Monthly Update: August 2022

 

I had a little blip in the middle of August where I had two days of moderate neck, wrist, arm, shoulder, and leg pain.  

 

It lasted a couple days and slowly got better.

 

I had one beer 2 days before it started.  So I believe just a little alcohol did something.

 

Besides that I've just been going along.

[arbor]

Thanks for this update @Jennings  It's good to hear how you're doing.

Best wishes to you--

Arbor

[Jennings]

Monthly Update - September 2022

 

I went through a mini wave in the middle of the month, I'm at the point now where I just push through and the wave resolves.  I understand that when you are in a deep wave or at the beginning of this journey it feels impossible. All you can do is push.

 

It's really amazing who will come forward with their mental illnesses once you're vocal about yours.  I did a little research and I noticed a pattern with all of my friends and friends of friends who are diagnosed Bipolar. They all took an AD, some other psych drug, or were taking a large amount of some illicit drug before the Bipolar symptoms became present.  Most of them took an AD for some benign issue that seemed major at the time.  Some of them got worse while on the AD, some after they stopped.  I have this crazy theory that Bipolar isn't natural but instead is a result from taking these meds.  Maybe not all cases, but certainly with most of the cases of people I know.

 

Also, all of the people I know that started on an AD irl and I mean all of them are now on multiple psych meds.  None of these people had nervous breakdowns, none of them tried to kill themselves, none of them had psychosis.  They went to their doctors due to heartbreak, while grieving, trying to quit alcohol, had trouble sleeping etc.  They all now have at least two meds a piece, most are on up to four or five.  And they all believe they are mentally ill.  Their mental illness didn't even start until after they got on meds!!!  

 

I don't know, I just wanted to vent.  

 

I hope everyone is doing the best they can.

[Jennings]

Monthly Update - October 2022

 

I've been having some insomnia the last couple of weeks.  Not anything like early withdrawal but it still sucks.

 

Besides that, things are chugging along.

[itiscomplicated]

On 9/30/2022 at 4:20 PM, Jennings said:

They all took an AD, some other psych drug, or were taking a large amount of some illicit drug before the Bipolar symptoms became present. 

 

To add to your study - I've had mood problems which fit the pattern of Bipolar II since before I took medications, but medications have always either made things worse, or stopped working, leading to more medications.

 

To boot, I never had any psychosis or hospitalizations before this past year.

 

There's for sure a population that fits a Bipolar profile that gets worse on certain drugs.

 

Also - interesting to see someone else who has experienced electric shock sensations in their body when coming off stuff.

[Jennings]

@itiscomplicated

 

Thanks for responding, what you added makes complete sense, the meds bring it out.  I can't believe how much gaslighting goes on.

 

Those wonderful electrical shocks.  My old psych, who is the king gaslighter, couldn't even explain those.

[Jennings]

So just a quick update, DO NOT DRINK ALCOHOL!!!!!

 

If you're feeling better and then you drink, even a couple, you most likely will go back into a wave.

 

I had a wedding to go to last weekend and I had 2 beers. TWO!! That's it.  

 

Now I'm in a semi bad wave.  I'd say a 4/10.  I haven't had one like this in a while.  I know I'll get through it.

 

Don't drink.

[Jennings]

Monthly Update - November 2022

 

Besides the drinking blip everything has been pretty smooth.

 

The wave didn't last long.  

 

I also slept through the night for about 4 days the last week.  That hasn't happened in a long time.

 

My life is extremely busy right now and I'm maintaining just fine.

 

I added weights to my workout and no issues so far.  If anything I feel better.  Less aches.

[Jennings]

Monthly Update - December 2022

 

I've started being tired all the time.

 

I'm still able to handle my ish, I just could fall asleep at any time.  It's wild.  I sleep for 15 minutes on both my breaks at work.  I was the same way when I was on Lexapro and Zoloft.

 

Anyways, better than not being able to sleep.

 

Besides that?  Everything is smooth withdrawal wise.

 

I'm going to start my Lamotrigine taper soon.