Rsj95: Lost and need answers

[Rsj95]

Let me start my intro by saying that I’m not sure I belong here. By that I mean, while I am on withdrawal, I don’t know if it’s SSRI withdrawal as around the same time I fast tapered off of Lexapro, I also quit a very heavy cannabis habit (I smoked weed basically 24/7 since late 2017) about a week after. I’m just very confused and have been in dark place the last two months and many of symptoms seem to line up with SSRI withdrawal. I just need somebody to talk to about this since I don’t have anybody in my life that I can. Hopefully, you guys can help sort of out some of my issues.

 

So with that let me tell my story. I’ve had severe anxiety since I can remember and as far as I can tell it wasn’t caused by any specific trauma I can remember. I used to cry and panic about very simple things and anything that can remotely be considered scary for kids. I would also ruminate and obsess over possible future catastrophes (parents dying, going homeless, etc.). I reached my breaking point in 2009 during freshman year in high school. I was so obsessed and terrified of the idea of a school shooting (I saw a Columbine documentary the night before the first day of school). This became so bad my mom let me stay home from school for several days, to the point that a truancy officer paid us a visit. After that, my school advised I go to therapy, which I did and was diagnosed with GAD. I was then prescribed Zoloft which actually helped tremendously and was actually emotionally stable for the first time in my life. This changed during the summer of 2014, when I started going through an existential crisis after graduating HS. My psychiatrist then told I had “pooped out” from Zoloft and then put me on Lexapro. This treatment was also effective for many years until I started a cannabis addiction. Late 2017, I began to become stressed out from work and school that I started smoking weed, this lasted for four years until this year, when my anxiety came back. I tried quitting late March but relapsed because of the heavy withdrawal symptoms. I was also given Ativan and basically used it everyday until I tapered off of in June. During this time I also figured out that the Lexapro’s effect was weakening and also had caused the sexual dysfunction I have experienced for a couple of years now. My urologist suggested I switch antidepressants, which I did and was put on Wellbutrin XL. My psychiatrist suggested a two week taper to come off Lexapro, that I cut to one week, while I started the Wellbutrin. That was around May 10th and on May 17th, I CT weed. Since then I have gone through a myriad of psychological and physical symptoms that I can’t tell which drug  withdrawal caused it or if it’s both. I should also include that I started working overnight, which messed up my sleep schedule and probably exacerbated my symptoms. My list of symptoms include and have included some degree of:

• Daily background anxiety

• Anhedonia

• Muscle twitches all over my body, sometime small and sometimes strong enough to jerk my limbs

• Insomnia/Bizarre and vivid dreams

• Cortisol spikes and hypnagogic jerks when falling asleep

• Suppressed appetite

• Blurred vision and constant eye floaters

• Suicidal ideation but not actually suicidal 

• Reduced short term memory, concentration, and coordination

• Brain fog and slight depersonalization/derealization

• Restlessness, espically in legs

• Sensitivity to light and temperature

• Tingling, numbness, and perceived fatigue in my limbs/skin

• Headaches

• Fatigue

• Raised heart rate

• Brain zaps

• Head shakiness

• Ear ringing

 

Now a lot of these symptoms have stopped or have lessened in severity, mostly the physical ones but I want to be as thorough because I really want to know what’s going on. The ones that are really ******* with me right now is the anxiety, anhedonia, brain fog, and head shakiness. I have gotten better and there are waves and times where I get distracted enough that I forget the symptoms but it’s only for brief period of time. Something that is odd is that most mornings when I get off of work (around 5 am), I almost feel “cured” or at least the emotional blunting as I can actually feel and enjoy music, and look forward to the future. But as soon as I go to sleep and wake up, it all comes back in full force. It’s the strangest thing, I almost don’t want to go to sleep which messes up my sleep more. The first two months were absolute hell, I used to get bad panic attacks and got accidentally hooked onto to Ativan, which I tapered off in three weeks, so maybe Ativan withdrawal might also be a factor. The last couple of weeks have been better but I still feel like ****, I’m not debilitated like I was, but I still have this general anxiety/emptiness and inability to concentrate on anything that requires cognitive effort. This is very troubling because I start school in three weeks and since I’m a Pre-Med student I need to be able to maintain a high GPA. Also my anxiety, twitching and fatigue has me convinced that I have ALS, it used to be MS until I had an MRI, I’m even getting an EMG this week.

As for current medication I’m currently on Wellbutrin XL (300 mg), which has helped somewhat. I started Buspar which I hate because of the side effects, I’m not sure if I should taper of it considering I haven’t been on it that long. I’m also on Focalin for studying, it used to give me a mood boost but I feel the effect was diminished. I also take Hydroxyzine as needed for anxiety, which has basically been everyday for about three weeks. I feel that  my brain chemistry has drastically changed since all of this. I tried to smoke weed on 4th of July to relieve some symptoms but it gave me a huge anxiety attack and alcohol just relaxes my body but my mind is still stressed. My goal is too master my coping skills and eventually be drug-free, but don’t how or where to start.

 

I have made several lifestyle changes. My psychiatrist suggested mindfulness meditation that I have done daily for three weeks now, I started CBT, I exercise five days a week (which I used to do before this whole fiasco), started taking some supplements, try to eat healthier, I quit my job and got another one that allows me to sleep at night and I attended my first Yoga class today. I have trouble looking at the progress I made because of the general emotional numbness, I can’t feel anything that isn’t fear, depression and sadness, I can’t even cry to relieve some emotional buildup but I’ve tried. My ultimate fear is that the anhedonia is permanent and cause me to drop out of school and abandon my desire to become a doctor, which will eventually lead me to becoming suicidal and taking my own life. I’m not suicidal, the thought of dying scares the hell out of me but I just don’t see the point of living without positive emotions (happiness, love, fun, excitement) and this makes my current existence torture. I have a strong family support system that’s trying to help me but just don’t understand what I’m going through to be able. Not even my mom who herself has GAD and depression, but this is a special kind of depression that comes with drug addiction and withdrawal. I just need people who understand what I’m going through to give me some hope that my situation will get better. Like I said I don’t even know if it’s SSRI withdrawal but I’m pretty sure it’s a factor considering I’ve been taking SSRIs for over a decade. Even writing this intro has made me feel a little better. So any advice, input, and words of encouragement would really help. Thank you for taking the time to read all this. 

[Onmyway]

Dear RSJ,

welcome to the SA community. 

I was overwhelmed by just reading your story - there have been so many changes, stops and starts of various drugs that it would be impossible to know what is causing what. You might be suffering from benzo withdrawal, from the side effects from the drugs that you are currently taking, from cannabis withdrawal. It is generally not important to know which one exactly is the straw that broke the camel's back, it is more important where you go from here but in your case if some of the effects are from the drugs you are currently taking, then that would impact what to do. 

I see now that you are on 4 different drugs at the moment - Adderall (an amphetamine), Wellbutrin (a dopamine reuptake inhibitor), buspirone (an anxiolytic) and hydroxyzine (an antihistamine). Is that correct? What were each of these prescribed for, do you know? Are you taking the antihistamine for allergies? Were you diagnosed with ADHD to be taking Adderall or is that recreational?

 

The most important thing is, in general, to keep things simple and not change any drugs any more to see whether you can stabilize on what you are taking now and then you can decide whether you want to go off of those medications slowly. As you may know already, the more changes you make the more sensitive your nervous system gets (kindling). This also applies to occasional Adderall or Ativan. It might be tempting to cut new drugs you have just started taking but I don't know what the right decision is there. It will ultimately be your decision, of course. In a complex situation like this there are no clear right answers. 

 

I would also not make changes to supplements except for the additions of small amounts of magnesium (see if it will have a calming effect) and Omega-3. I find magnesium helpful personally but not Omega-3. You need to experiment starting with small doses. 

 

It seems like you have good family support which would no doubt make this easier. It is also good that you are trying non-drug techniques such as CBT. 

 

You already know this but it is important to remember that this will eventually get better. No one knows how long that will take for an individual but if you can hang in there, this will get better. You need to learn to take this one day at a time (it is a hard lesson, I can tell you from personal experience). Try not to catastrophize. Try reading the Success Stories forum to get a glimpse of how far some members have come. Also know that most members who get better don't return to write their success stories as they get busy living their lives. 

 

This will get better.

[Rsj95]

@Onmyway  Thanks for the reply!

Yeah it is a lot of drugs which is why I’m so overwhelmed and lost right now. I don’t whether to keep on with my current regimen or stop some of the meds. The Buspar gives me serious headaches and if I could stop that as soon as possible I would. But idk, I guess I’m gonna to bring it up to my psych. Do you a tapering protocol for it considering it’s not an SSRI? I don’t use Adderall anymore, I’m on Focalin and yes I have ADHD, I should’ve mentioned that. It’s the extended release, 15 mg. The Hydroxyzine was given to me by my PCP to substitute it for the Ativan, I use as needed which is usually when I got to sleep and sometimes when I wake with really bad anxiety/racing thoughts.  It’s antihistamine but it also used as an anti-anxiety aid. 
 

As for supplements, I’m taking the Omega-3 fish oil, started taking magnesium about two days ago, and also started using probiotics, which apparently according to some research helps with depression and anxiety and a multivitamin. 
 

Thanks for the words of encouragement. Like I said I have gotten better and using mindfulness to take one day at a time has probably been my biggest coping mechanism. But I’m a really impatient person and tend to ruminate a lot. I can live with the physical symptoms, it’s the anxiety and anhedonia that’s really giving me a hard time. The concentration issue seems like also going to be a problem when school starts. I’ll give reading some success stories a try. Thank you.

[siderale]

Hello Rsj95. I cannot give you advice regarding medication and tapering, however I wanted to pass by to send you some support. I believe Buspar will have to be tapered as well so you don't end up with a cocktail of withdrawals on top of one another!

Although we have a wildly different history I do relate a lot with your symptoms. I have some other ones still of course but relate strongly to the despair you feel upon experiencing anhedonia, it's so hard to live day-by-day without finding pleasure or positive emotions or even motivation. Same with anciety and brain fog/difficulty to concentrate. I botched the first part of my thesis due to withdrawal and it hurts to think about it, but what is done is done. I'm however thinking that when school starts again, having a structure and being in a different environement might help to divert my brain from the anxiety. Maybe anxiety itself is causing the difficulty to concentrate, you know? Can't know if it is the case for you, but maybe it will help. I sure hope you do experience some relief before school starts however, because it's daunting to imagine studying in this state for sure.

 

In any case, congratulations for getting there already despite all what you've been through. It'll get better and I believe that by coming here you will have helpful advice to taper off your other medications. You'll get your brain back. If you run medical examinations I hope the results will be reassuring. A sick and sensitive brain can produce such a myriad of symptoms!

 

I am trying to meditate lately, I was wondering if you have "tips" to get into mindfulness? I feel like this is very helping. I'm quite young and restless, especially since I am in withdrawal but the sole fact that I can now try to meditate helps a lot, so I've been wondering how mindfulness plays out.

[Altostrata]

Hello, @Rsj95

 

How are you feeling now?

 

What is your current daily drug schedule, with dosages and times o'clock, and work and sleep schedule?