Nbbp3447: One year off meds CT

[Nbbp3447]

In March of 2021, just nearly one year ago, I made the very naive decision to go off my antidepressant cold turkey after years of being on something. I did not realize the mistake I was making to go off CT and wish I had learned about tapering. I did not find this page until a few months into my withdrawal. For month one I had the brain zaps, but other than that, felt pretty great actually. The zaps subsided and month 2 is when some mild to moderate depression set in. Month 4 is when severe depression, anxiety and insomnia set in and I had to go on leave at work. I also quit drinking of any kind at this time. The symptoms started to let up in Month 6 and I was able to go back to work in Month 7. I started feeling like I was healing and things were definity getting better although sleep remained an issue having mind chatter all through the night so as it would feel like I never fell asleep. In Month 8, I felt like I was almost starting to feel close to normal again and sleep had dramatically improved. Feeling good, I drank at the end of Month 8 and beginning of Month 9 and that set me off into another depressive episode that I didn’t come back out of until the beginning of Month 10. No more drinking! I felt okay for the rest of Month 10 and into Month 11. I am now in the middle of Month 12 and have been severely anxious and depressed for the last 5 weeks. The level of depression feels like it did 7 to 8 months ago, like no healing has taken place. I’m desperate and exhausted, feeling like I cannot continue living my life like this. Even in the months where I was feeling better, I was still a shell of the person I used to be, feeling like an alien talking to people, unable to connect or have conversation. I don’t know what to do at this point. TMS is an option, but I think about reinstating. Going back on meds would make me feel like the last year was completely in vain, but I am desperate to feel like a person again. I know I should never have done this CT. Any advice would be appreciated.

[Altostrata]

Welcome, @Nbbp3447

 

We have seen alcohol send people recovering from withdrawal into a tailspin. You will need to let your nervous system very gradually recover from the last exposure to alcohol. It would not be unusual for this to take months.  

 

How's your sleep?

 

To help this along, I would get as much gentle exercise as you can tolerate, drink plenty of water, eat fresh fruits and vegetables. Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[Nbbp3447]

Sleep has been rough. Really hard to fall asleep or I wake from the smallest disturbance and can’t get back to sleep. I already use fish oil and magnesium which had been helpful in the past. 
 

I have been alcohol free for 3.5 months now and only started having this debilitating depression for the last month. I feel like I am just too brain damaged. For the first time in the last year I am considering reinstatement although I am terrified to do it. Not sure how how that would work out in the short or the long term. 

[Altostrata]

It's hard to reinstate desvenlafaxine, since the tablets are not amenable to being split. As a peer counselor, in your case, I wouldn't recommend it because you appeared to recover without it.

 

However, if I were you, I would not discount the effect of the alcohol, and be patient while your nervous system slowly recovers.

[Nbbp3447]

The fact is I’ve never really been myself or felt like I had full cognitive function in the last year even when I thought I was doing better. I’m really struggling still and unable to work again. I keep thinking reinstatement of some sort would provide some relief. My doctor suggests either fluoxetine or duloxetine as they worked for me in the past. He also suggests nortriptyline as a new option, but he leaves this choice all up to me and thinks a standard therapeutic dose would be fine. I don’t know what to do. I’m desperate to find some semblance of myself again. 

[Altostrata]

Recovery from withdrawal is very slow and gradual. Though you still weren't 100%, it looked like you were on the mend until you set yourself back by drinking alcohol. If you avoid alcohol and other things that might cause further setbacks, it is likely that your recovery will resume, though it will be very gradual over months. 

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

Not sure if reinstatement of anything will compensate for a setback caused by alcohol. Since you are destabilized, more drugs might make you worse, particularly "normal" dosages. When we do recommend reinstatement, we suggest a very small dose first to see what the effect might be.

 

Since you can't actually reinstate a small dose of desvenlafaxine because it comes in larger tablets, you might substitute its sibling Effexor XR, which comes in capsules containing tiny beads. You might try perhaps 6 beads to see how you do. If you do this, please let us know how you're doing.

What is withdrawal syndrome? 

The Windows and Waves Pattern of Stabilization
 
About reinstating and stabilizing to reduce withdrawal symptoms 
 

Very few doctors know anything about withdrawal. When we recommend reinstatement, it's to address withdrawal symptoms. It appears you've talked with your doctor about treating your current condition as a psychiatric disorder. Up to you if you want to go that route.