ProofofLife: Introduction - Seeking Advice/Support

[ProofofLife]

Hi SAD Community,

 

I've been visiting this site as a resource for a while now, and am at a point where I need advice/support from some of you with more experience than myself on this extremely difficult journey.

 

I'm a 32 year old male, and I've been taking Sertraline (Zoloft) since I was 22, with a short (but horrific, after tapering too quickly and going back on after several months) layoff at age 25 - so effectively for about a decade. I have also been on Gabapentin as a "mood stabilizer" since age 25. In that time, I also took Bupropion (Wellbutrin) SR for several years, but had to stop cold turkey a little over two years ago due to intolerable side effects that began when Sertraline seemed to stop working so well. I've intermittently used Adderall IR and Ritalin as well in low dosages throughout the past 7 years. Although going cold-turkey from Bupropion was very difficult, I was already at a difficult point in my life regardless, and for the most part recovered after several months.

 

One year and 3 months ago (August/September 2022), I began tapering Sertraline from 75mg, using the support of this website. I've followed protocol and tapered by 10% every 4-6 weeks using a tablet + liquid formula for precise measurement. I have gotten down to 41mg and have remained stuck at this dose for several months now. Once I realized I was stuck with Sertraline, I've tapered the Gabapentin a bit, to try and "even" the cocktail out. I'm down from 2400 to 1800mg.

 

I remain stuck at 41mg of Sertraline and 1800mg of Gabapentin. The depression, anxiety, rumination, and general lack of all motivation is about all I can bare right now. I had to move back in with my parents, as I find myself unable to even keep a job. This has put tremendous financial strain on myself and my family, who are attempting to be supportive, but are at about the end of their rope with me. I, myself, am at the end of my rope. I am barely functioning.

 

To make matters more complex, I had an appendectomy in 2016 that never totally healed correctly, and now that I'm down on my meds, it seems that some of the symptoms from complications are rearing more of an ugly head - namely, abdominal pain, a problem with blood flow to my male parts, and GI issues. I cannot really eat, as I rarely have an appetite, and anything I eat during the day makes my belly distend grossly, with worsened lack of motivation, depression, and anxiety. At night my mood seems to lift a bit and my appetite comes alive.

 

I have questioned if the issues with blood flow to my genitals are early signs of PSSD (as my lubido is certainly down, despite always having had a high lubido, even on Sertraline), but I am mostly very depressed and ruminative, and can luckily perform and finish with my girlfriend pretty much fine. The issues "down there" seem to be stemming from what I suspect are adhesions compressing my inguinal canal from surgery. I'm currently working with a doctor about the possibility of having surgery again to remove the adhesions.

 

I also suspect my GI issues are, to a large degree, the result of adhesions possibly obstructing my GI tract. I'm aware that the medications have an antimicrobial effect, and I suspect pulling them out has gradually allowed bad bacteria to flourish in an already-hostile environment. My doctor confirms this could be the case from his assessment, and we are currently awaiting imaging results to make a better judgment call before consulting a surgeon.

 

I mention the complications with my abdomen because my somatic experiencing has been highly flawed since surgery, which I numbed with medications and marijuana for years. I was a competitive weightlifter, and it completely derailed my career. I can barely workout these days without increasing pain/discomfort. I also cannot fully breathe into my diaphragm, which I used to be able to do with great affinity, being a highly trained weightlifter.

 

I'm certain that my lack of somatic experiencing is contributing to my worsening mental state as the meds have been pulled out, simply due to lack of ability to diaphragmatically breathe in and of itself. I have explored this topic in EMDR therapy and always come back to it when processing my mental states in relation to my somatic experience.

 

I'm seeking advice on what direction to take. Part of me is attempting to hold out until (hopefully) getting surgery before making anymore medication moves, to see if it frees my abdominal cavity/diaphragm so that I can begin exercising more intensely and hopefully begin addressing GI issues. Another part of me is at the end of my rope and considers going back up on Sertraline, or trying something else, to manage the extreme depressive and ruminative states. I cannot focus on anything but these problems.

 

I have always been an anxious worrier and a ruminator, since I was a little kid, as long as I can remember. I question why even bother getting off these meds, as I wonder if there's even a person "underneath" who can function without them. I should also mention that I've displayed some "traits" of borderline personality disorder since I was a teen, although never receiving a formal diagnosis. Fear of being alone/abandonment, a lack of consistent identity, and deep emptiness have typically been themes for me, although lessened to a large extent when my meds were fully in effect.

 

IF I were to try and go back up on Sertraline, what are the chances it even works still, or doesn't cause a paradoxical reaction? How would I even go about this? And, given the other issues - abdominal/pelvic problems, underlying mental illness my whole life, finances - where do I even begin to assess my situation?

 

I also consider reinstating a low dose of a stimulant, as I have been diagnosed ADHD, and a stimulant takes away at least 70% of my rumination and inability to get things done. The issue there is, while down on my other meds, the side effects once the stimulant wears off are far more pronounced (anxiety, jaw tension, insomnia). I would need something else to "take the edge off", particularly at bed time.

 

I'm very aware that no one can make these decisions for me, but perhaps some of you have dealt with a similar situation during tapering, and can perhaps help someone with a ton of executive dysfunction currently sort out these variables. I cannot keep up this level of functioning, and I'm very concerned, as I'm not even halfway off of meds yet and it's already this bad.

 

Please help, or at least just say hello.

[Emonda]

Welcome, @ProofofLife,

 

Sorry to read you've had a tough ride lately.

 

As a starting point, can you please help us out by adding your drug history by following these Drug signature instructions

 

Once we have that, we will be able to comment further.

 

I'm glad you've found us.

 

Emonda

[ProofofLife]

Hi Emonda,

 

I just created my signature. Thanks so much for your prompt response.

[Emonda]

Thanks for adding your signature.

 

I trust you've read this link?  Windows and waves pattern of stabilization. Sometimes, waves hang around for quite some time. I've seen others here hold at least for 6 months or more.

 

I'm sure you haven't, but just checking you haven't skipped doses? You take the same amount at the same time every day? Never skip doses to taper. And you are certain you are being accurate with the dose?

 

Have you changed brand/manufacturer of Sertraline at all in this time that you've been stuck?

 

Are you completely avoiding alcohol? 

 

Stability will come, and when it does, perhaps consider The Brassmonkey Slide Method of Micro-tapering. I can only manage a 2% reduction per week.

 

3 hours ago, ProofofLife said:

I had an appendectomy in 2016 that never totally healed correctly, and now that I'm down on my meds, it seems that some of the symptoms from complications are rearing more of an ugly head - namely, abdominal pain, a problem with blood flow to my male parts, and GI issues.

 

Illness/injury can make WD symptoms feel worse. It'll be interesting to see what the doctor has to say after the current investigations.

 

3 hours ago, ProofofLife said:

my lubido is certainly down

 

It's a common side effect. Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

3 hours ago, ProofofLife said:

I numbed with medications and marijuana for years

 

You're not touching marijuana or other substances now?

 

3 hours ago, ProofofLife said:

I'm seeking advice on what direction to take. Part of me is attempting to hold out until (hopefully) getting surgery before making anymore medication moves, to see if it frees my abdominal cavity/diaphragm so that I can begin exercising more intensely and hopefully begin addressing GI issues

 

Sounds like a reasonable plan to me.

 

3 hours ago, ProofofLife said:

Another part of me is at the end of my rope and considers going back up on Sertraline, or trying something else, to manage the extreme depressive and ruminative states.

 

As to going back up in dose, the smaller the increase, the better. What dose did you last feel ok?

 

Have you read these links: Emotional Spirals and Non-drug coping strategies

 

3 hours ago, ProofofLife said:

I question why even bother getting off these meds, as I wonder if there's even a person "underneath" who can function without them.

 

It's obviously completely your choice. This site exists to share information for those who want to taper off their ADs safely. After 27 years on these things myself, I thought, maybe it's just me, and I need the pills. Two years down the track of following the advice here, I've reduced my dose by ~85%. Slow and steady is working for me. Some just need to go slower.

 

3 hours ago, ProofofLife said:

I also consider reinstating a low dose of a stimulant, as I have been diagnosed ADHD, and a stimulant takes away at least 70% of my rumination and inability to get things done.

 

I can't comment on adding to the drug mix.

 

Are you taking any supplements? Two recommended on the site are: Magnesium, nature's calcium channel blocker and Omega-3 fatty acids (fish oil) 

 

3 hours ago, ProofofLife said:

Please help, or at least just say hello.

 

Why not spend some time in the success stories section of the site. I do that when I need a boost.

 

I hope some of this has helped. 

 

 

 

[ProofofLife]

Thank you, Emonda. Your correspondence is greatly appreciated.

 

I have read and am familiar with the windows and waves. I never skip doses and take my meds at roughly the same time daily. I've not had any change in brands or manufacturers that I'm aware of.

 

I don't drink aside from one or two drinks with dinner on special occasion, which I have no desire for at this time. I also stopped smoking marijuana several months ago, as it wasn't helping and possibly hurting with the tapers.

 

I have considered Brassmonkey's Slide Method and might try it whenever the next taper occurs. I find myself extremely sensitive as well.

 

In the event I decide to go back up on dose, I would probably try to go up to 50mg first and see how I tolerate, as this is the lowest therapeutic dose. I'd say I lost stability probably somewhere between 50 and 60mg, which makes sense in accordance with therapeutic blood concentrations of the drug. I'm going to check out your links about Emotional Spirals and Coping Strategies - I appreciate these.

 

You give me hope given your length of time on your AD. I get lost in hopelessness quite often.

 

As for supplements, I was taking Magnesium, Zinc, and Vit D, but stopped due to finances getting rough. I think I'll try some Magnesium again and Omega-3. Let me know if any particular brand of Omega-3 works well for you/other users, as I know quality Omega-3 can be tricky to come by.

 

I'm always looking for more success stories of users who have healed 100%...

[Emonda]

3 hours ago, ProofofLife said:

I've not had any change in brands or manufacturers that I'm aware of.

 

It'd be good to keep an eye on this moving forward. This brings plenty of people undone.

 

3 hours ago, ProofofLife said:

I don't drink aside from one or two drinks with dinner on special occasion,

 

These days for me, special occasions are not even a good reason for one drink. Personally, I find one drink flares up WD symptoms within 24 hours. I'd suggest you avoid alcohol completely.

 

3 hours ago, ProofofLife said:

I also stopped smoking marijuana several months ago,

 

I'm glad to hear this. It may well still be causing you some grief. Your brain needs all the stability it can get.

 

 

3 hours ago, ProofofLife said:

In the event I decide to go back up on dose, I would probably try to go up to 50mg

 

This site recommends no more than 10% per month on the way down, and I wouldn't consider any more on the way up. Perhaps 45mg might be a reasonable stepping stone. Make notes on how you feel / symptoms.

 

3 hours ago, ProofofLife said:

I get lost in hopelessness quite often.

 

When I get lost, I head to the success stories. There are people there who have been taking these things for 30+ years. I think Shep is in that category and is worth a read. 

 

Emonda

[LostInCanada]

@ProofofLife welcome to SA. So glad you are here. This is such a great resource with so much information.

 

16 hours ago, ProofofLife said:

 

I remain stuck at 41mg of Sertraline and 1800mg of Gabapentin.

You have done great. Holding and stabilizing sounds like a good plan. Many hold at various milestones just to give the body a break.

 

11 hours ago, ProofofLife said:

I'd say I lost stability probably somewhere between 50 and 60mg, which makes sense in accordance with therapeutic blood concentrations of the drug.

These drugs don't work linearly but hyperbolicly so your dosage is still very strong. As Emonda mentioned, the brass monkey method might be better and even going less than the 10% overall monthly reduction. But first a solid hold to stabilize.

11 hours ago, ProofofLife said:

I think I'll try some Magnesium again and Omega-3.

I use magnesium bisglycinate, just start with a low dosage. For omegas, use a fish oil or algae oil that has DHA and EPA.

8 hours ago, Emonda said:

I'd suggest you avoid alcohol completely

Emonda is right about this. Also I no longer do any caffeine. No coffee or chocolate 😞. But I figure stability is worth the sacrifice at this point.

16 hours ago, ProofofLife said:

addressing GI issues

Have you found a probiotic that helps. The gut is so closely linked with mental health.

16 hours ago, ProofofLife said:

I have been diagnosed ADHD

So many on here have been including myself. I personally feel doctors want to label everything so they can prescribe a drug and get their cut of the big pharma profits. It's okay to not react the same way to everything or think the same way as everyone else. To me drugging our individuality to meet their standard is ridiculous. 

 

 

11 hours ago, ProofofLife said:

I'm going to check out your links about Emotional Spirals and Coping Strategies - I appreciate these.

Some are also using the free DARE app and there are free online CBT courses. I like Claire Weekes, though some info is outdated she is spot on about lots. She has some books but also she is on YouTube.

 

You are doing amazing. Acceptance and kindness toward yourself is invaluable.

[ProofofLife]

@Emonda& @LostInCanada,

 

Thank you both so much for your replies.

 

I think a big part of what I'm currently struggling to distinguish between is, given that I've done a textbook hyperbolic taper and am still on a relatively high dose of both meds, is this withdrawal I'm experiencing, or return of original symptoms? My life externally is a mess currently, and independent of the withdrawals, I've had some difficult things to deal with the past couple years.

 

Anxiety, extreme rumination and overall inability to function outside of my emotional brain were the original symptoms I went on the meds for, and that's what seems to be present now. I'm not experiencing any new symptoms such as impotence, akathisia, etc., that I often hear people speak of when down on dose or all the way off meds, so how do I distinguish the difference?

 

I am not yet on any type of probiotic, as I understand this is a very tricky area to get correct, especially when one is dealing with symptoms of gut dysbiosis (which I believe I am). I undoubtedly have GI issues (I always have) and I'm working with a naturopathic MD to see what I can do dietarily in addition to the abdominal issues. 

[LostInCanada]

2 hours ago, ProofofLife said:

is this withdrawal I'm experiencing, or return of original symptoms

We have all questioned this especially after being on these drugs for so long. It's hard to be objective in the middle of a bunch of symptoms. It sounds like typical withdrawal to me. Thankfully we don't get all the symptoms. It looks like you have alot of external stressors which can exacerbate withdrawal also. That is why I think a good long hold for now and a slower rate of taper moving forward. 

[ProofofLife]

I suppose it definitely is symptoms of withdrawal. I guess the question becomes, if I'm THIS bad now on not even half the dose, it must be entirely insufferable the further down I go...

[LostInCanada]

21 minutes ago, ProofofLife said:

if I'm THIS bad now on not even half the dose,

It just doesn't work that way. That would be logical and these drugs just don't work that way. There will be points during your taper that will be harder than other times. Many factors are involved such as stress, sleep, CNS sensitivity, etc. 

Don't get ahead of yourself. You just have to get stable and let your CNS settle. Also getting your other health issues resolved will help. Take advantage of trying some CBT or the Dare app, breathing techniques, EFT, at this point and strengthen those skills. One day at a time.👍

[CeruleanSea]

@ProofofLife , I have had those emotional symptoms temporarily as part of reducing sertraline.  
 

for me, therapy really helped but it took having a wonderful therapist and a good fit. 

[ProofofLife]

@LostInCanada , thank you. A big issue for me is not having a job and having massive anxiety with every job I attempt. Depleting finances obviously makes nothing better. in the mean time, I'm going to check out the Dare app. I was also considering a DBT workbook.

 

Hi @CeruleanSea, thank you so much for chiming in. I have just begun seeing a therapist again who does IFS and EMDR. I have some good experience with EMDR in the past, so I am hopeful. What kind(s) of therapy helped you the most?

[LostInCanada]

@ProofofLife you are very welcome. I hope you are able to get some form of disability at the moment. A good attitude and being grateful goes a long way for us all. 👍You are going to do well.

[Emonda]

6 hours ago, ProofofLife said:

is this withdrawal I'm experiencing, or return of original symptoms?

 

2 hours ago, ProofofLife said:

if I'm THIS bad now on not even half the dose, it must be entirely insufferable the further down I go..

 

We all ask this question, myself included. I recall back around April / May of this year, my WD symptoms were horrible. I thought I'd reached my tapering limit and that I simply needed the meds. With a little reassurance from this site and reading various medical articles I could find online, I decided to hold my dose and give it more time. I've charged ahead since then...until the last few days (hit a bit of a wave, but it'll pass). Never did I think I'd get down to only 15% of my original dose. If I can do it, I reckon you can too.

 

As LostinCanada said, it's not a linear process/experience. Just because you feel off now does not mean that's how you'll feel in a few more months, or even at a lower dose.  

 

I enjoyed/benefited from reading the two links below when I was wondering about relapse V WD.

 

https://markhorowitz.org/academic-paper/distinguishing-relapse-from-antidepressant-withdrawal/

 

 

6 hours ago, ProofofLife said:

Anxiety, extreme rumination and overall inability to function outside of my emotional brain were the original symptoms I went on the meds for,

 

Can relate to all of this. Breathing exercises, gentle exercise and the sort of apps that LostinCanada mentioned got me past this. I also benefited from talking out loud with a trusted person.

 

1 hour ago, ProofofLife said:

A big issue for me is not having a job and having massive anxiety with every job I attempt. Depleting finances obviously makes nothing better.

 

I had to learn that we all have life stressors and that those stressors will cause anxiety - this is part of being human. Some of us (me) are prone to blow things out of proportion and spiral quite quickly, but you can do things to address this. I find the information at the "emotional spirals" link very helpful.

 

If you do increase your dose, remember, start small and keep notes of how you feel. It takes time to feel the benefit of the increase. You should wait a minimum of two weeks before reassessing...preferably longer.

 

Hope this helps.

 

 

[ProofofLife]

@LostInCanada I have considered disability as of late, which I can't believe, as a 32 year old, "able-bodied" male I'd ever have to come to. I have to wrestle with the shame of this potential move, to be honest. The family I come from doesn't help this either, as much of their take on these sorts of issues is that they're things I need to simply ignore and keep going - wherever it is I'm "going" to. I'm more than aware that this type of mentality bred into me is a big part of the initial problem in the first place...

 

@Emonda Thank you for that inspiration. It's so counterintuitive to think that I could be worse now than I could at a lower dose. I just opened both of those links to begin reading up on how to distinguish what's what. I'm going to consult with several people within my circle as to if I'll be attempting a dosage increase.

 

Out of curiosity - what's the current prevailing thinking on what's going on biologically with withdrawal? While no one knows for sure, I know that the brain is thought to return to normal within a few weeks of stopping meds. I've seen it posited that the gut may be the source of lingering issues. Every single person that I've found having trouble getting off these things undoubtedly seems to have GI issues.

 

I also recall seeing a Reddit thread from a PSSD sufferer who has cured his withdrawal symptoms, as well as those of several others, by testing for and ridding of SIBO, SIFO, and other forms of dysbiosis. Every single person he had tested had SIBO or similar condition.

 

This line of thinking would make sense to me, especially since the meds themselves don't work right away, and withdrawal symptoms typically don't even show up right away... I liken this to how antibiotics seem to work.

 

Has anyone here ever done extensive microbiota testing or tried any strict dietary elimination protocols?

[Emonda]

12 minutes ago, ProofofLife said:

I know that the brain is thought to return to normal within a few weeks of stopping meds

 

A doctor / pharmaceutical company may tell you this, but that does not match up with the reality of 1,000s of members on this site. I think of a vine growing on a trellis. If you yank the trellis out, the vine will collapse. You need to remove the trellis very slowly so the vine can adjust to its new normal. Much the same logic applies to ADs. You've got to be so slow and steady, and listen to any feedback from your body. I read another member say a while back, any reason to hold is a good reason to hold your dose.

 

The author of the first article I sent you shared his own experience on a documentary 6 months back. It's taken him some years to taper, and at the time the documentary was recorded, he still had a little way to go.

 

18 minutes ago, ProofofLife said:

Every single person that I've found having trouble getting off these things undoubtedly seems to have GI issues.

 

It's certainly on the WD symptom checklist I posted above. 

[ProofofLife]

Another question - how "bad" were some of you prior to starting meds? For myself, my childhood and adolescent years were essentially an anxious mess. Taking meds was the first time I ever felt any sense of internal calm, for any amount of time.

 

Given this, if eventually I "return to normal" from coming off the meds, what exactly am I returning to? Has anyone ever recovered better than they started?

[LostInCanada]

14 minutes ago, ProofofLife said:

I have considered disability as of late,

It is an excellent provision when needed. Would you think less of someone, dealing with what you are dealing with, if you found out they were receiving help? Why would you think less of yourself? And to be honest, it is no one’s business (including your family) if you decided to receive it. No one wants to be in a position needing help emotionally, physically or financially but the reality is we all need help in life, one way or another. We don’t have to go it alone.

[ProofofLife]

@Emonda Interesting, so the current thinking is that it does, in fact, have to do with some level of damage to brain structures? 

[ProofofLife]

@LostInCanada These are all good points. I'm not sure if it'll be enough to survive regardless. I suppose I worry about what I'll become in the aftermath, without a work history. I also worry about my "file" being out there officially in regards to mental health. A tricky situation for sure.

[Emonda]

On 12/14/2023 at 10:04 PM, ProofofLife said:

@Emonda Interesting, so the current thinking is that it does, in fact, have to do with some level of damage to brain structures? 

 

I would not use the word damage at all; it is just readjusting to 'normal' once the AD is removed.

 

These two links are worth a look: Brain Remodelling  and What is withdrawal syndrome.

 

 

[LostInCanada]

3 minutes ago, ProofofLife said:

what exactly am I returning to?

I’ve been on Paxil for 20+ years and have wondered this myself. All I know is the drugs numb us to our emotions and in many ways they stunt us emotionally because we don’t learn coping skills. These drugs were never intended for long term use and can cause other health issues as well as poop out. So for myself I have to move forward and do what I can to learn coping skills and try to work on the issues that made me take the drugs in the first place. 

[ProofofLife]

@Emonda Noted, thank you for these links as well.

 

@LostInCanada It is scary to ponder. I do recognize that I clearly never learned coping skills for many things I face. This is my thinking with pausing the taper/reinstating somewhat while I pursue therapy. Hopefully enough effective therapy can remodel my brain even whilst still on meds to make the rest of my journey off of them easier.

[ProofofLife]

Is anybody here who's recovered EVER able to enjoy their favorite foods, or a coffee, or a drink again, without a days long destabilization after?

[Emma09]

23 hours ago, ProofofLife said:

@Emonda Noted, thank you for these links as well.

 

@LostInCanada It is scary to ponder. I do recognize that I clearly never learned coping skills for many things I face. This is my thinking with pausing the taper/reinstating somewhat while I pursue therapy. Hopefully enough effective therapy can remodel my brain even whilst still on meds to make the rest of my journey off of them easier.

Hi! This is one of the more recent posts on this forum I've been like where are all the people in 2023 haha. Anyway, I saw this and wanted to give you some hope that coping mechanisms can make withdrawal "easier" or at least less traumatic and debilitating. I had my first bad withdrawal experience in early 2022, a cold turkey attempt (reinstated later) that screwed me up for about 8 months without a lot of windows. I didn't know that that was what it was I just thought I was having some kind of mental breakdown for a long time so I did a lot of therapy and self-help and all kinds of coping strategies. I did think my life was over throughout this time and never thought I would feel okay again. Coping techniques are similar to the withdrawal experience in my opinion in that we want to experience relief right away, but they take a lot of time to build. We are creating new neural pathways when we use coping techniques and it takes time to teach your brain that you are safe/don't need to ruminate (but 100% possible). The withdrawal naturally started to shift this last fall and at the same time, ACT/mindfulness and enough times in and out of bad anxiety/depression realizing its temporary helped me recover. Once the withdrawal passed and I was left with my usual anxiety/OCD I found myself so much more confident in managing it because of all the work I did to try to help my withdrawal symptoms. I used to be the queen of rumination, seriously I would do it all day, and now I doubt I even fit the criteria for OCD anymore. I get anxious and I get urges to correct it through rumination, but I find that I can't even ruminate as intensely because of how much work I've done to let the habit go. Those habits are also neural pathways, what you don't use you lose! I resonated with an earlier post where you said you've always been a very anxious person and were worried about who would be there after the drugs. I feel this completely, but I have come to realize that the anxiety that comes with me and my brain in its natural state is something I can cope with and live with, I've found my identity through it and without it in many ways. I promise you are a person still and that is not the only thing that will define your existence. The withdrawal leaves us experiencing very intense chemical experiences that are often more sticky than normal anxiety/depression symptoms. I realized this when I resumed my taper over a month ago (only went down 10% of most recent) and unfortunately have been hit pretty hard. BUT I can see very clearly now that it is different from my normal anxiety, and I am able to continue to focus on other aspects of my life because I'm not (as) worried about being chronically mentally ill forever and I know my nervous system probably appreciates my relaxation skills too. Sorry for the long response, I just very much relate to your story and wanted to give you some perspective that I gained in my experience. Holding is a good idea for you in my opinion (I regret not holding longer and enjoying not being in withdrawal before starting again). The coping strategies you gain will take time and patience but will serve you through withdrawal and through the rest of your life. 

[ProofofLife]

@Emma09, thank you so much for this. It's so comforting to have people to relate to here. This week has been particularly awful; hence making this post.

 

When it comes to my own rumination, I've spent every day this week in bed, completely stuck in my head with awful thoughts. It is especially bad during the morning and the day time, peaking in the late afternoon, and then letting up a lot as the evening hours progress. I've noticed this pattern for a while now - I tend to feel almost "normal" at night.

 

My current state literally makes me feel like I'm going crazy at times, and my anxiety and overthinking in general throughout my life has had me often question my identity. In my current ruminative cycle, I literally shift identity states several times throughout the day, making it impossible to hold onto anything.

 

Was the majority of your therapy ACT/DBT skills? I have just started IFS therapy with EMDR, and I'm going to buy a DBT skills workbook. It's really encouraging to know that therapy can benefit even in the throws of withdrawal, because I often question if therapy can penetrate this state of being. Also, how long did it take until you started to see some positive results?

 

Despite questioning if I should go back up on medication, I am holding, as I want to really give therapy a chance before making any moves either way.

 

It's also comforting to see that you, too, suffer appetite loss - I cannot bring myself to eat a thing during the daylight hours. I have no signal of when I'm even hungry anymore and exist in a constant state of starvation, making matters worse. I struggle to digest a ton of foods.

[Poppy745]

4 hours ago, ProofofLife said:

When it comes to my own rumination, I've spent every day this week in bed, completely stuck in my head with awful thoughts. It is especially bad during the morning and the day time, peaking in the late afternoon, and then letting up a lot as the evening hours progress. I've noticed this pattern for a while now - I tend to feel almost "normal" at night.

 

Hi @ProofofLife This is just what it has become like for me. Mornings bad, afternoons sometimes slightly better, evenings have been ok. The rumination has become really bad this last week. I do not know if the waves are causing the rumination or the rumination is causing the waves. There are some ruminations that are easier to ignore than others. I hope that you have a better day today. 

[ProofofLife]

@Poppy745, I totally relate. I wonder why this is the case - where the mornings are the worst, and it eases gradually as the day goes on.

 

I would liken it to having something to do with cortisol production being higher in the early part of the day. Psychologically speaking, the daytime comes with expectations. I've always been a night person, with higher energy and better concentration at night.

 

The rumination are the absolute worst. I've always been a ruminator, but this level of rumination is definitely in its own league. Some of these thoughts are absolutely all-consuming. At night I will literally look back on thoughts I've had during the day and wonder what the hell was going on, finally able to form a counter-thought to it.

 

Today is better so far because it's Saturday - no expectations, girlfriend is home from work with me. It's much worse during the early part of the weekdays. I hope you're doing ok.

[Poppy745]

12 hours ago, ProofofLife said:

@Poppy745, I totally relate. I wonder why this is the case - where the mornings are the worst, and it eases gradually as the day goes on.

 

I would liken it to having something to do with cortisol production being higher in the early part of the day. Psychologically speaking, the daytime comes with expectations. I've always been a night person, with higher energy and better concentration at night.

 

The rumination are the absolute worst. I've always been a ruminator, but this level of rumination is definitely in its own league. Some of these thoughts are absolutely all-consuming. At night I will literally look back on thoughts I've had during the day and wonder what the hell was going on, finally able to form a counter-thought to it.

 

Today is better so far because it's Saturday - no expectations, girlfriend is home from work with me. It's much worse during the early part of the weekdays. I hope you're doing ok.

Thanks for your reply @ProofofLife Yes the rumination is awful. It is so difficult ealier in the day, sometimes even later in the day depending. I hope this moves a long soon. It is easier to gain perspective the later in to the evening. Glad the weekend is gining you some relief. 

[mstimc]

Hi @ProofofLife  I encourage you to stick with and practice whatever coping skills you're learning in therapy.  I did EMDR and it was very helpful.  Health anxiety is a very common symptom of anxiety and OCD--every ache and pain becomes a crisis.  I broke a lower rib several years ago, and injuries like this tend not to heal well.  I also have a "sports hernia" which is not a true hernia, but an abdominal muscle injury.  Neither tend to heal well and surgery is crap shoot.  When I was in WD and recovery, the aches and pains these injuries caused triggered ny anxiety and OCD and I thought I had one terrible disease after another.  Therapy like CBT and ERP helped bring me back to reality and I also noticed the pain itself greatly decreased when my mind stopped exacerbating it.  Body and mind are very much tied together.  The good news is a good therapist can help you mentally and physically!

[ProofofLife]

@Poppy745 When I do gain some perspective (at this time during the evening), I wonder why I'm not just on meds for life. I have always had so many issues, that I'm just not sure where "recovery" from anything leads. Like, what kind of life is this?

[ProofofLife]

@mstimc Thank you for this, I relate so much. I can't even tell what's "real" anymore. I have definitely always had health anxiety/OCD amongst other issues. I guess what makes no sense is how it's THIS bad already and I'm only on half and 3/4's of my original doses, and I haven't tapered in almost 6 months now. It makes me feel as though "this is just me" - or maybe I just haven't learned any coping skills yet? I'm not sure. I know that right now, the basic will to even get better isn't even here...

[CeruleanSea]

Hey @ProofofLife,

I read your whole story & the issue with diaphragmatic breathing & GI stuff sounds tough!  Even without anxiety & whatnot.

 
I  followed an extreme elimination & provocation diet to find problem foods for me. It was the Autoimmune Protocol,  and I gradually eliminated tons over 6 weeks before trialing them.  I learned that gluten and too much dairy causes anxiety for me. 
 

It was not cheap!  It was basically paleo minus certain restrictions.  If I did it over again, I would just try going Paleo first. And do that as much as possible without buying any special foods. Just using food from the produce section… it’s definitely possible to do with basics Like beef, chicken, fish, root vegetables, and most garden veggies & herbs.  

recently, I added in kim-chee and I learned that it has a strong anti-anxiety effect for me. I’m learning how to ferment to make my own because it’s very expensive.

[CeruleanSea]

@ProofofLife

 

as for therapy, I think what matters is kind of what you have access to. I was able to meet a really good therapist who is affordable for me. We mostly did CBT but we also talked through childhood issues and worked through holes in my thinking that were stopping me from making the best decisions.  I also did EMDR with another person to help me resolve some tough memories about a specific event. 
 

Now, if I need to calm down, I just use the Calm app meditation. 

[Emma09]

On 12/15/2023 at 9:25 PM, ProofofLife said:

@Emma09, thank you so much for this. It's so comforting to have people to relate to here. This week has been particularly awful; hence making this post.

 

When it comes to my own rumination, I've spent every day this week in bed, completely stuck in my head with awful thoughts. It is especially bad during the morning and the day time, peaking in the late afternoon, and then letting up a lot as the evening hours progress. I've noticed this pattern for a while now - I tend to feel almost "normal" at night.

 

My current state literally makes me feel like I'm going crazy at times, and my anxiety and overthinking in general throughout my life has had me often question my identity. In my current ruminative cycle, I literally shift identity states several times throughout the day, making it impossible to hold onto anything.

 

Was the majority of your therapy ACT/DBT skills? I have just started IFS therapy with EMDR, and I'm going to buy a DBT skills workbook. It's really encouraging to know that therapy can benefit even in the throws of withdrawal, because I often question if therapy can penetrate this state of being. Also, how long did it take until you started to see some positive results?

 

Despite questioning if I should go back up on medication, I am holding, as I want to really give therapy a chance before making any moves either way.

 

It's also comforting to see that you, too, suffer appetite loss - I cannot bring myself to eat a thing during the daylight hours. I have no signal of when I'm even hungry anymore and exist in a constant state of starvation, making matters worse. I struggle to digest a ton of foods.

Your experiences with rumination are strikingly similar to mine. Summer 2022 it's all I did all day, I would chill out in the night a bit generally, but overall I felt like I lost my identity and like I didn't know what was real anymore. It completely destroyed my sense of self. I completely thought I was going crazy and would never experience a semblance of normalcy again. 

Two questions: 

- How long has this most recent "wave" been? 

- You mentioned you'd spent most days that week in bed- are you generally unable to leave? Thats okay if you are just trying to gage because some of my advice per rumination involves distraction. 

Anyway, I have had ocd symptoms since being a young child way before meds, so I think those patterns are very natural for me to fall into. You mentioned you experience ocd as well, which makes rumination literally addictive. It's compulsive, it always feels very urgent and necessary. You mention that you try to parse through your thoughts during the day and then come back to them at night to "make things make sense". I know it feels like you are helping yourself, but you are feeding a cycle and teaching your brain that you have to come back around to rumination to reach some sort of resolution. I don't know the content of your rumination but the solution regardless is to just sit with the urge to ruminate and not follow your intrusive/scary/dark thought down the rabbit hole. When we are feeling balanced and calm, thoughts like that don't tend to feel as urgent or problematic (at night for you) and you can apply logic. When we are in a fear state, it doesn't matter what logic we try to apply, the feeling of fear will not be quelled by trying to throw sense at it. The rabbit hole just keeps going down...down...down until you don't know what is what anymore or who you even are. Even today I rarely ruminate anymore but I feel the urge to when I'm in withdrawal or even just having my regular anxiety. When in withdrawal, when our nervous systems are just buzzing and set on anxious mode for long periods of time, those habits we have as those with ocd brains are going to come up because it is natural for us to try to get rid of the anxiety. It's a matter of teaching your brain that you don't need it. Which is another thing that takes a lot of time. 

 

To answer your question, I did a little bit of ERP for my ocd, and generally, my other therapies were along the lines of acceptance and commitment (most useful for me) and CBT. I wouldn't get too caught up in picking the right "method". For example, a lot of Buddhist philosophy was extremely helpful. The ancient concept of "pain + resistance = pain x 10" stuck w me as I tend to flee negative emotions and have tried to escape via any and everything (drugs, self help books, relationships, ocd compulsions, etc). I guess what I'm trying to say is explore different therapeutic modalities but be careful about being obsessive and expecting healing to unfold in the way you want it to. I would say about a year into my return of ocd/rumination problems/withdrawal I started noticing that I wasn't ruminating like I was and the thoughts weren't bothering me like they used to. It was SLOW. At first when I would resist the urge to ruminate it felt completely futile and like bs that that would somehow help the anxiety I felt. But it did and it will if you commit to it and give it time. Recovery is not linear but eventually there will be longer stretches of time when its not an issue. As you recover from withdrawal too it will only get easier. I still feel horrible when I'm in withdrawal, but with the work I've done its more and more clear that the thoughts I get during it are a symptom, they feel more separate from me despite the fact that I still feel the anxiety when in a wave.