BetterStill:Introduction

[BetterStill]

I've been on various antidepressants since around 1985(?), not continuously, but nearly so. First Imipramine, then Prozac, then Lexapro, and in recent years (since about 2010) Sertraline. Last prescribed dose was 50 mg. I've tried stopping several times on my own.  I'm 58 years old.  Today is my birthday.

I tried to taper off Sertraline in 2017 over a period of 5 months. A few months after stopping, the depression and anxiety symptoms came back (along with other weird withdrawal symptoms) and I assumed it was relapse and restarted the Sertraline at dose of 50 mg. It was a very difficult period and I didn't realize I was suffering from withdrawal and not relapse. After several very difficult months back on the Sertraline I seemed to recover. I never knew about this site or withdrawal issues until recently.

Last year I tried tapering the Sertraline (too quickly) again. I tapered for about 5 months again starting in late December 2022. I took 25mg for 3 months and didn't notice any changes. I then tried to cut the Sertraline tabs into 1/4 pieces (12.5 mg) and took each day for 1 month. After that, I mistakenly tried to skip every other day with the 1/4 sertraline tab (12.5 mg). This lead to anxiety attacks on each day I took the 1/4 Sertraline tab, so I stopped them completely in early May 2023.

Withdrawal symptoms arose again in Early August of this year, but they went away after one week. They returned again in early September (the 8th) and I've been dealing with severe withdrawal symptoms ever since. I found this site in early September as well, approximately one month ago.

Based on what I've read on the site in the past month, I've reinstated Sertraline in an attempt to ease the withdrawal symptoms. I mix 1/2 of a 50 Mg tablet (25 mg) in 25 ml water, and have been taking 5 ml (5 mg Sertraline) each day for the past 11 days.

I'm not sure if this has helped with the withdrawal symptoms yet, but the anxiety seems to have subsided a bit and I feel a bit more sedated.

[Emonda]

Happy birthday @BetterStill 🎂, and welcome to S.A.

 

Thanks for completing your drug signature.

 

2 hours ago, BetterStill said:

I tried to taper off Sertraline in 2017 over a period of 5 months. A few months after stopping, the depression and anxiety symptoms came back (along with other weird withdrawal symptoms) and I assumed it was relapse and restarted the Sertraline

 

This is a very common story. I'm sorry it's been your experience, too.

 

2 hours ago, BetterStill said:

I never knew about this site or withdrawal issues until recently.

 

I'm glad you found us. I was just like you. I'd never heard about WD symptoms either before finding S.A.. Now that you are aware of WD symptoms, you'll be able to set yourself up for a successful taper down the track, But first, give yourself plenty of time to stabilise at your current dose. 

 

3 hours ago, BetterStill said:

the anxiety seems to have subsided a bit and I feel a bit more sedated

 

That's good that the anxiety is subsiding. I'd still give yourself a few months before contemplating tapering. 

 

Have you read about the maximum 10% monthly taper approach? Why taper by 10% of my dosage?  This is the approach that has given me much success after being on ADs for close to 30 years...I've still got a way to go on my journey, but it's not a race. Going forward, make sure you don't skip your dose as a way of tapering.

 

We don't suggest many supplements, but two that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. Add one at a time and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

Avoid alcohol. It can leave you feeling anxious the next day.

 

Please post any updates here in your thread. It is helpful to keep everything related to your journey in one spot. You are very welcome to jump onto someone else's page and interact with them. The encouragement members give each other on this site is wonderful to see.

 

Sing out with any questions. 

 

Once again, welcome to S.A.

 

Emonda.

 

 

[BetterStill]

Thank you for your kind words Emonda.  I look forward to getting feedback and insights from you and others on this site who have been working through these very difficult issues.   God Bless You~

[BetterStill]

It's unclear to me if reinstating 5 mg Sertraline 12 days ago has made a difference or not at this point.  I know its early and the effect of reinstating will likely take more time to resolve.   I try to be objective in tracking symptoms and how they change over time in a journal off line.  But it's still difficult to know whether the WD symptoms simply vary in nature and severity on their own, or if reinstating has changed things.  I must admit that the decision to reinstate at a dose of 5 mg was a shot in the dark and I don't know if a different dose would have been better.   I realize that reinstating so long after stopping Sertraline completely (4 months?) probably makes the whole process a crap shoot.  But severe WD symptoms only started about 1 month ago, and the reinstatement occurred about 3 weeks after that.  I was finding the WD symptoms unbearable and was barely functioning. In general I've noticed a feeling of being sedated, especially in the hours following  taking the Sertraline (around 9 AM).  There also seems to be more variation in symptoms after a few hours.  There haven't been any noticeable changes in my pervasive negative mood/lack of pleasurable feelings/worries.

 

It SEEMS that today, 12 days after reinstating the Sertraline, my WD symptoms have become more variable in terms of how they fluctuate in severity throughout the course of several days, with more ups and downs in a given day, and more variations one day to the next.  Often it seems I have one really bad day, then a day that's a little better, then a bad day or two again, then a better day again.  Like others who have posted here, evenings tend to be better than mid-day.  These variations could be attributed to my nervous system being destabilized because of withdrawal to begin with.  Early stages of reinstatement might be adding more destabilizing effects on top of that.  That said, there are some possible changes that seem positive, even if the symptoms might seem more variable:

 

o In general, overall anxiety levels seem to be reduced slightly, however spikes still happen with stress and negative thinking

o blurry vision seems improved at times, other times I have very dry eyes and subsequent blurry vision seems worse though

o tingling in hands and feet MIGHT be a little bit less noticeable (constant tinnitus not changed)

o ability to taste/enjoy food comes back periodically, appetite is back sometimes, eating isn't such a chore all the time

o weight has stabilized after having recent unwanted weight loss due to lack of appetite

o brain-fog seems to be less severe, with some periods of little or no brain-fog (an important improvement probably related to lower anxiety)

o slightly better sleep (crossing fingers).  Less waking in the middle of the night with a jolt of terror.  Fewer nightmares.

 

PS

It's fascinating that so many of the WD symptoms talked about on here (if not all of them) are also the very same potential side effects listed on the antidepressant drug warning sheets. 

 

[Emonda]

3 hours ago, BetterStill said:

I know its early and the effect of reinstating will likely take more time to resolve.

 

Agreed, it'll take more time. Years ago I had experience with Sertraline. For me, it took 4-6 weeks to notice improvement.

 

3 hours ago, BetterStill said:

WD symptoms simply vary in nature and severity on their own, or if reinstating has changed things.

 

I'd say both of these are true. I've definitely noticed my WD symptoms vary by type and intensity over time.

 

3 hours ago, BetterStill said:

I have one really bad day, then a day that's a little better, then a bad day or two again, then a better day again

 

Have a read of this link: Windows and waves pattern of stabilization. 

 

3 hours ago, BetterStill said:

there are some possible changes that seem positive

 

All the points you list sound positive 👍

[BetterStill]

10/27/23.  An update and a request for opinions.

 

As of today It's been 32 days since reinstating 5mg Sertraline.  I'm still experiencing waves and windows much like before, and its hard for me to assess objectively whether I'm feeling any better that one month ago.  I try not to over-think my condition, and try to focus on real life, but it is very difficult (if not impossible) when symptoms are severe.  My wife and my adult daughter believe that I've shown some very slow improvement over the last month, and so I am taking their word for it.  Unfortunately, the waves seem to be just as severe as before and I'm still very depressed a lot of the time and concerned that I'll never recover.  My long list of symptoms seem to match pretty well with those from others mentioned here. 

 

On a positive note, the Windows MIGHT be getting slightly more frequent or longer in duration.  Evenings still usually seem to be better that daytime hours.  Sleep is somewhat better (though not consistent).  I will say that very minor negative events are still are triggering bouts of anxiety, and its still very hard for me to function in any public setting though I'm continually trying as much as I can... Even very slight stressors make me over-react with anxiety, negative feelings, even though somewhere deep inside me I know its ridiculous to get so worked up.    My cognitive functioning is still problematic.... I'm mentally scattered, lack focus, am disorganized and forgetful (long-term and short-term) and this is probably my greatest worry. I don't have the confidence to find work or even look for a simple job.  I can drive, but not in heavy traffic.

 

I've been trying to stay busy as much as I can, getting out of my head as they say, doings small projects around the house.  But this is a far cry from my normal activities.  I've been going to the grocery store or other shops (usually with my wife), going out to eat sometimes, walking extensively.   I keep trying exercise.  Sometimes it seems to make me feel anxious and so I stop.  I'm probably only tolerating about 20 minutes of moderate exercise at a time (inclined walking, light jogging, light weight lifting).  I've been trying to dispel the flow negative thoughts, and making serious efforts to calm my nerves by listening to guided meditation for relaxation, sleep, healing, depression, some yoga, etc.  They do seem to help calm the nerves, however my perpetual negative mood is a tougher nut to crack.  I could go on, about symptoms, but I'd like to get to the crux of this:

 

I'm looking for opinions on my prior reinstatement of Sertraline at 5mg one month ago.  I'm wondering if this small dose is doing anything at all, and if up-dosing might be worthwhile to give me some more traction to function in the world.  I've been on anti-depressants for so long (perhaps nearly 40 years on and off ), I'm concerned my body just can't adjust to not having them in my system.  

 

Should I try to up-dose a little bit now since it's been a month, and the relief has only been minor?  I want to avoid kindling, which I've experienced before (or at least much more severe symptoms when trying to get back on anti-depressants in previous years).  Should I stay the course for a few more weeks?  If I were to try a higher dose, what increase should I try?  10% higher?  5mg * 1.10 = 5.5 mg?  How long should I stay on that dose to evaluate its effects before trying to up-dosing again?

 

Thank you in advance for sharing your thoughts.

[Emonda]

8 hours ago, BetterStill said:

My wife and my adult daughter believe that I've shown some very slow improvement over the last month, and so I am taking their word for it.

 

I'd take heart in their observations that they have seen gradual improvement.

 

8 hours ago, BetterStill said:

concerned that I'll never recover

 

With time and continued patience, you will recover.

 

8 hours ago, BetterStill said:

My long list of symptoms seem to match pretty well with those from others mentioned here. 

 

I'd take that as encouragement that it's the pills/WD symptoms, not a return of the depression.

 

8 hours ago, BetterStill said:

On a positive note, the Windows MIGHT be getting slightly more frequent or longer in duration.  Evenings still usually seem to be better that daytime hours.  Sleep is somewhat better (though not consistent). 

 

This sounds encouraging.

 

8 hours ago, BetterStill said:

I will say that very minor negative events are still are triggering bouts of anxiety

 

This sounds normal...I find I am vulnerable to stress. It sets off my WD symptoms.

 

8 hours ago, BetterStill said:

I keep trying exercise.  Sometimes it seems to make me feel anxious and so I stop.  I'm probably only tolerating about 20 minutes of moderate exercise at a time (inclined walking, light jogging, light weight lifting)

 

Only do what you find helpful...no need to push it.

 

8 hours ago, BetterStill said:

I'm looking for opinions on my prior reinstatement of Sertraline at 5mg one month ago.  I'm wondering if this small dose is doing anything at all, and if up-dosing might be worthwhile to give me some more traction to function in the world. 

 

The smaller the up-dose, the better, to avoid the likelihood of some sort of unwanted reaction that you referred to. You mentioned 5%-10%. Why not consider smaller, maybe a  2.5% increase and reassess over another two weeks?

 

8 hours ago, BetterStill said:

I'm concerned my body just can't adjust to not having them in my system.  

 

It just takes time and much patience. You're at 40 years of use... I'm only at 27 years of use, but I am making slow progress that I never thought was possible.

 

You can do it, too.

[LukeUK]

I'm sorry you're having a hard time.

 

It seems as though your main symptoms are anxiety/ low stress tolerance, depression, not great sleep and cognitive difficulties.

 

It sounds as though although it is rough, it's been a month and those symptoms are improving. You could try a very, very small increase in dose but this is not without risk so it is worth considering whether it would be better to keep waiting for more improvements.

 

I do not mean to alarm you, but as rough as it is right now you're able to exercise and do things around the house after cessation after 40 years of use. That's pretty remarkable, and it could also be a lot worse. You just need more time to keep healing and building those improvements.

 

Therefore, I would recommend staying the course and waiting for further improvements. If you do decide to updose then keep it very small as Emonda suggests. 

 

As for exercise, it might be beneficial to try gentle walks in nature rather than "working out".

[Rhiannon]

I concur with what Luke says. 

 

Exercise causes an increase in cortisol, which can be unpleasant during withdrawal. I found early on that gentle walks, slowing down or even stopping when any anxiety seemed to be ramping up, were the best. Also gentle yoga, stretching, massage, focusing on slowing down and creating calm.

 

This is very early days in a withdrawal and healing process after decades of chemical alteration; your nervous system is going to need patience.  Healing will happen but on a scale of years, not weeks or months. It's best to be gentle with yourself and take it slow.

 

I've always found that changing things up just made the withdrawal worse and made it take longer to settle down. Stability is always what seems to allow me to heal. I know it's miserable, and like you've said, other people will notice improvement but subjectively you will just feel awful. That's pretty normal. Unfortunately there is not a quick or simple way out of this that we've found. Time, and being gentle with your nervous system, seems to be the only thing we've found that works.

 

I'm not around here as much as I once was, so if I'm wrong and anyone has discovered anything new, please chime in! 

[BetterStill]

Thank you Emonda, LukeUK, and Rhiannon for sharing your thoughts and kind words.

 

I've been through this process of stopping antidepressants many times in my life and the results have generally been the same each time.  I will stay the course with 5 mg Sertraline for the next few weeks and report back.  

 

My best wishes to everyone who visits this site, and to the many people who are trying their best to help others here.

[Jakeblack14]

On 10/28/2023 at 1:28 PM, Rhiannon said:

Exercise causes an increase in cortisol, which can be unpleasant during withdrawal. I found early on that gentle walks, slowing down or even stopping when any anxiety seemed to be ramping up, were the best. Also gentle yoga, stretching, massage, focusing on slowing down and creating calm.

I have found the same, I originally thought the more exercise the better, however, I found every time I was in a window and took the intensity up a notch, the quicker another wave would come. Yoga and walking will be my next steps. I was searching for a thread for what other people were saying about exercise, but struggled to find anything. Does anyone know of anything on here? I have been a very active athlete my entire life, so forcing myself to not be active is just the worst.

[Poppy745]

7 hours ago, Jakeblack14 said:

I have found the same, I originally thought the more exercise the better, however, I found every time I was in a window and took the intensity up a notch, the quicker another wave would come. Yoga and walking will be my next steps. I was searching for a thread for what other people were saying about exercise, but struggled to find anything. Does anyone know of anything on here? I have been a very active athlete my entire life, so forcing myself to not be active is just the worst.

Hi everyone. I totally understand. I was a long distance runner, along with cycling, hiking, the gym, yoga. I feel like I am grieving the loss of these things (for now). I hope to get back to them once this is over. I do some walking, yoga, stretching. These seem to work ok for me at the moment. I am trying to think of it as giving my body a break from the more intense exercise, but can hopefully return to it one day. 

Edited November 2, 2023 by Poppy745
Spelling mistake

[Jakeblack14]

Hey @Poppy745, 

If you don't mind me asking, how it your diet? Has it changed when experiencing withdrawal?
If you do mind, don't worry about it

 

Keep on keeping on. 
 

[Poppy745]

1 hour ago, Jakeblack14 said:

Hey @Poppy745, 

If you don't mind me asking, how it your diet? Has it changed when experiencing withdrawal?
If you do mind, don't worry about it

 

Keep on keeping on. 
 

@Jakeblack14.  Hi Jake. I don't mind at all. During cold turkey I completely lost my appetite. Once I had reinstated I felt really hungry. I now try and eat more vegetables and fruit, nuts and generally less processed food. I have started eating fish (didn't before as I was veggie) but hope it is helping with recovery. Because the neuro anxiety has returned (due to stress induced waves, that were so much better ) I sometimes overthink what I am eating, which for me personally do not think is a good idea as it causes more stress, and don't want to cut out anything major that I might need, so am trying to be balanced if possible. I stopped alcohol (didn't drink very much so not that bothered about that) and coffee (so sad about my one flatwhite a day) I also hope that once I am the other side of this that I can have a bit of coffee again. I eat less sugar, but have not cut it out completely. 

Well done on getting off meds all together. I wish I was already in that place! I hope that you are recovering quickly. I have been watching some Angie Peacock video's on Youtube. She sometimes talks about her experience of returning to exercise after withdrawal. 🙂