ForestLily: Paxil taper and withdrawal

[ForestLily]

Hi all,

 

I have been lurking around this site for a few years and I am finally adding my introduction! I'm not sure why it took me so long. Maybe something to do with mostly coming to the site when I'm really feeling poorly (in a wave) and not feeling up to writing. And when I'm feeling better, I guess I tend to be thinking about other things. Anyway, I'm actually getting pretty far along in my taper now, so I thought I might possibly have something useful to share. Plus I recently broke up with my boyfriend and realized how much I was relying on one person for all of my emotional support (not much fun for that person either). I'm hoping to find community support here, and hopefully provide that for others as well. This is a club none of us wanted to be a member of, but here we are, and I'm so very thankful for this forum. I really don't know what would have happened had I not found this website! Wish I'd come to it sooner, but that's ok; it's better late than never for sure.

 

Here is some of my history - it will be a long post, warning you in advance! I got divorced in 2007 and it was pretty out of the blue. It was of course a very stressful time, and I went to a therapist who referred me to a psychiatrist. I was having trouble eating and just had a lot of anxiety. I know that any medication they'd prescribed would have been difficult to taper, but it haunts me a little that I actually ASKED for Paxil. My Mom had taken it very briefly and had a "good" result. I'm very sensitive to medications and so is my mother, so I figured if it worked for her, it would work for me. And actually, it did what it was supposed to do. My anxiety diminished, I was able to eat again, I gained weight, etc. I also started drinking like a fish and not caring about it. After being an ultra-conscientious, sensitive, perfectionist type of person, it was kinda great for a while just not to give a crap about things.

 

So that went on for a while. Things were good. I was successful in work and my personal life, still drinking a lot, but traveling and dating a great guy and basically "succeeding" at life. I was feeling so good that I decided I didn't need Paxil anymore! I did a fast taper from I think March to May 2014. During this time I was able to interview for a new job and move to a new city. It was a little challenging but not too bad. But around October/November things started to go downhill. My beloved dog passed away, and then the bottom just fell out. One night I was alone at my apartment and started feeling REALLY WEIRD. I thought I was having a mental breakdown. I won't go into detail but it was what I now realize was just acute withdrawal symptoms. My boyfriend was able to get there and help me get through the night. The next morning I went straight to urgent care and was basically like "please give me something NOW and also put me back on the Paxil." They reluctantly gave me a few Xanax and I went to my primary care doctor ASAP and started back on 20mg Paxil. I had the same thought so many people do - that I must just have a chemical imbalance and clearly I was someone who would need this medication for life.

 

Ok, fast forward to 2017. I finally decided to do something about my drinking. I had continued to struggle with anxiety over the years, and I read an article by Annie Grace about how alcohol can worsen anxiety. I ready her book (The Alcohol Experiment) and managed to quit alcohol completely. Anxiety was still there, but better! And I felt really good about myself. Over a couple of years I decided I was ready to stop birth control, then Paxil. I wanted to be the new drug-free me. Having learned from my previous taper attempt, I did do research on how to quit anti-depressants, but what I found was on the functional medicine side of things. I went to a functional psychiatrist thinking I just needed to use lots of herbs and supplements to support me as I tapered my SSRI. Once again, I tapered quickly, thought I was doing great, then bottomed out after going from 20-10mg over the course of 3 months. This time, I was able to get through it although my doctors did give me Xanax to help with my panic attacks, and then Hydroxizine as something less addictive. It was good that they were very cautious with the Xanax and I also took it only as a last resort. I'm definitely not recommending it. I didn't know what else to do at the time.

 

At some point, thankfully I found this forum! By the time I started reading up on reinstatement and the Prozac bridge and things like that, it had already been over a month I think, so I decided to wait it out. It was not a fun time. Lots happened. COVID, I broke up with my boyfriend and started a new relationship almost immediately, I started drinking again along with the new relationship (it was never my intention to be 100% sober forever, and I had started to drink occasionally before all of this went down, but I definitely got back to drinking almost daily), after COVID I found it too difficult to return to the office and found a new job working from home. And I eventually felt able to begin my taper again.

 

So for about 3 years now I've been managing to hold down a full-time job while continuing my taper. It's been a lot of windows and waves. I haven't been able to do much beyond continuing to work and just managing the basics of life. I've cried A LOT. It's been a huge struggle and I've had to completely rethink who I am and what I'm physically/mentally/emotionally able to do. I've had many, many moments of doubt and it's the researchers and "pioneers" that have kept me going. Along with survivingadntidepressants, Baylissa Frederick's work and website have been tremendously helpful to me, as have Laura Delano and the Inner Compass Initiative. And of course all of you here! Just reading all of your stories reminds me that I'm not alone and there are others out there on this same journey and experiencing the same things. Thank you, and you WILL get through this. We will all heal, and I hope to write another post sometime about some of things that have and have not worked for me. 

 

If you've made it this far, thanks for reading! Oh yeah, you'll see in my signature, but I started at 20 mg Paxil and I'm currently at 0.84 mg. It's still tough, but I'm really proud of how far I've come.

[LostInCanada]

Welcome to SA and well done. I can hardly wait to get some tips! You should be so proud. Glad you are holding when necessary. Keep being kind to yourself. 👍♥️💯

[Emonda]

Welcome @ForestLily,

 

9 hours ago, ForestLily said:

I started at 20 mg Paxil and I'm currently at 0.84 mg. It's still tough, but I'm really proud of how far I've come.

 

That's impressive! Well done. I'm glad to read the 10% taper every 4-6 weeks is working well for you.

 

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.

 

I'd normally post more information initially, but you seem to be very informed. Sing out with any questions. 

 

Once again, welcome to S.A.

 

Emonda.

[ForestLily]

On 12/23/2023 at 2:11 AM, Emonda said:

That's impressive! Well done. I'm glad to read the 10% taper every 4-6 weeks is working well for you.

 

Thank you! I should add that I've been using the BrassMonkey Slide method and also holding when needed. For example I am holding my current dose after 6 weeks right now because 1) I'm in a bit of a wave probably also impacted by the change to or lack of routine with the holidays (although work can be stressful I do find that the structure of having a schedule is helpful for me) and 2) I traveled for Christmas and will be traveling again in a few weeks. Travel is another big stressor for me!

 

On 12/22/2023 at 8:03 PM, LostInCanada said:

I can hardly wait to get some tips!

 

Thank you! I'd originally thought I could write a post will ALL of my tips, but that feels a bit overwhelming, so maybe I will share as they occur to me.  

 

ForestLily's Tips for Weepiness and Neuro-emotions:

This has been the most frequent and challenging symptom for me. In the beginning, I would get really caught up in how I was feeling and go into all kinds of rumination and emotional spirals which made everything 10x worse. I still struggle with this and I'm still learning, but here are some things that have really helped me:

• Recognize what is happening
  • How can you tell what is a "true" emotion and what is a neuro-emotion or in some way cause by withdrawal brain? I think it might vary depending on the person. For me, if my head feels hot and everything seems overwhelming, hopeless, and "bad," that's my clue. Honestly it took years for me to be able to see this somewhat objectively and I am still working on it. I hope others are faster learners than I am!
• Don't try to explore or analyze your thoughts or feelings. Do initiate coping mechanisms that work for you. 
  • I used to try to journal and explore my feelings to better understand them. This is NOT helpful (to me at least) when in this state, because I simply am not capable of viewing things in a rational way and all thoughts skew toward the negative. Reassurance and healthy distraction are much better. 
  • If I'm really out of commission, my best coping method is to get into bed with my laptop and watch Baylissa Frederick videos. I am a member of her website, and use the video library there. Sometimes I also come here and read posts to help me remember that I'm not alone and that these thoughts and feelings are a symptom of withdrawal (or signs of healing, as Baylissa would say!). If I follow this route, the more "acute" distress usually doesn't last very long. Then I'm able to watch a comforting TV show, read, work on a puzzle, etc. Just do something you find restful and soothing to your nervous system.
• View the feelings as a physical symptom
  • If you're like me, you will try to attach thoughts to your feelings. It's normal to look for a reason that we are sad and weeping. I've found that if I view feelings as purely physical sensations in the body, it helps me to avoid analyzing and trying to fix it, which just leads to getting stuck in the emotions. Not every emotion needs a story to go with it!
  • Crying is ok; the body is healing and this is how it might display for some of us. I buy tissues in bulk!
• Rest and treat yourself as though you are recovering from an illness (which you are!)
  • This experience has taught me how ingrained it is to try to "push through" and be productive even when I don't feel up to it. I used to feel so angry/frustrated/guilty/sorry for myself on days when I wasn't able to walk the dog or do the dishes, much less go out and "live" like everyone else seemed to be. I still have these feelings sometimes, but with practice, I've gotten better at giving myself permission to rest and heal. Mentally, for some reason it helps to tell myself I just need to take a sick day. 
  • Well-meaning people will give you advice like "stay active," "get off the couch," or "take a walk outside."  That might be helpful for some, but for me it actually makes things worse to force myself into doing anything when I am in a low mood. What I really needed was to know that it was totally ok to stay inside all day and do absolutely nothing. Outside is ok but only if I have somewhere private and quiet to rest. I've tried to learn to listen to my body (as cheesy as that sounds!) and do only as much my nervous system will allow.
  • On the days that you ARE feeling good, be careful not to overdo it. That's a classic pattern of mine too!
• Avoid comparing
  • This relates to the feelings of frustration and self-pity that I mentioned above. Your life is going to look different than it used to and that's ok. Priorities have changed. Just because your aren't doing all the things you once did doesn't mean that this time is being wasted. You are rebuilding your brain and developing a tremendous amount of new wisdom and personal strength. Less DOing and more BEing is not a bad thing.
  • And don't even think about comparing yourself to others! Total waste of time, and from the outside we really have no idea of another's life, hardships, personal experiences anyway. One day when I found myself going down that road I literally said to myself in the mirror, "we don't compare; it gets us nowhere." And then had to laugh at myself which cheered me up.
• Remind yourself that this is temporary, even though it doesn't feel that way in the moment.
  • Repeat it over and over if you have to. If you have experienced windows and waves: "This has happened before and it always gets better." If you haven't experienced any windows yet, of course use this forum and the knowledge of the moderators to make sure you are doing what you can to stabilize. Beyond that, know that your brain is working right now to heal itself and that healing is inevitable.

I doubt any of the above are new ideas or suggestions, but if you're anything like me, you can hear something 1000 times and still have to learn from personal experience before it truly sinks in. In my case, these were hard-learned lessons. I hope they might be worded or organized in a way that can help someone else, and I know it helped me just to get things written down.

 

P.S. Happy New Year! I took down my 2023 calendar and saw that I was taking 1.52mg of paroxetine last January. Now I am at .84mg. Although the difference seems minute, that is a 45% reduction (if I'm doing my math right). Slow and steady wins the race, and 45% is progress!

[LostInCanada]

@ForestLily thanks so much for taking the time to write all that down. It was great. We all need repetition, reassurance and confirmation that our feelings/symptoms are not unique and just a byproduct of this drug. ♥️♥️♥️

[Paul71]

Thanks for the tips @ForestLily. Your section on rest particularly struck a cord with me as I do have a tendency to think I should be doing things all the time and end up ignoring my system when it needs rest. 

[ForestLily]

@Paul71 I'm glad you saw something that resonated for you, and thank you for commenting! It's really interesting to me to think about where that need to be doing things comes from, and why we're so darn hard on ourselves, but we can explore the whole philosophy/psychology some other time. 😆

 

It's definitely an interesting exercise to try slowing down and putting your body/nervous system in the driver's seat if you are used to more of a "mind over matter" approach. Let me know how it goes for you. I'd love to hear your observations.

[ForestLily]

It has been a few weeks since I last posted, so I wanted to check in and share an update. I've had some stressful "life things" lately; vacation with family (yes any type of travel and change to routine is stressful for me, including vacations!) and a breakup that keeps dragging on. Up until the trip I was feeling pretty good, and I did decide to wait a few extra weeks before the next reduction in my taper, which was likely a good call.

 

I wanted to talk a little about the stage in the journey where you are semi-healed, so not in acute withdrawal but still experiencing symptoms and a windows/waves pattern that is has longer and more frequent windows and fewer waves. First of all, let me say that I feel very fortunate to be at that place and if you are reading this and you aren't there yet, you will get there! Things have improved so much for me over the past couple of years. However, it's like I almost forget that my brain is still healing, and then when I have a rough day it's harder to tell if it's a wave, if I am experiencing neuro-emotions, or if I am having a "normal" emotional reaction to something that is naturally very emotional, like a breakup. Does this resonate with anyone? It's hard to know where the emotional baseline is after being on anti-depressants.

 

For example, I've spent most of last night and today crying and ruminating about something my ex said to me about how I blindsided him when I ended our relationship (we'd been dating for a few years, so it was pretty serious). I've been down this rabbit hole of trying to figure out what I could have done differently or better, do I have an avoidant attachment style that I need to work on, etc, etc. Now, if I knew for sure this was withdrawal brain/neuro-emotion, I would remind myself that this is the time for rest and gentle self-care and not a time to try to do a lot of analyzing and self-reflection. Writing this out now, I realize, yep, that's probably what is going on! But the brain is so tricky! At least mine is. I regularly convince myself that my uncomfortable feelings are telling me I need to figure something out, that I need to think about the issue until I can get the problem solved.

 

Anyway, this might be kind of a niche topic, but it's something I have struggled with quite a bit. When is a feeling caused by an issue in our life that should be addressed, and when should I just allow the feeling and not try analyze it. And how does the withdrawal and tapering experience play into that. Ugh! I do have a therapist and rest assured this will be discussed LOL, but curious to hear if anyone has had similar struggles on their tapering journey. ❤️

[Emonda]

6 hours ago, ForestLily said:

Things have improved so much for me over the past couple of years. However, it's like I almost forget that my brain is still healing, and then when I have a rough day it's harder to tell if it's a wave, if I am experiencing neuro-emotions, or if I am having a "normal" emotional reaction to something that is naturally very emotional, like a breakup. Does this resonate with anyone?

 

I can relate to this. Others have needed to remind me that it is normal to experience emotions...ADs tend to numb those emotions, and when we slowly remove the AD, the emotions may become more noticeable. Sometimes we are simply having a perfectly normal response to a stressful situation. I reckon a break-up is one such event that it would be perfectly reasonable to experience intense emotions. 

 

Emonda

[ForestLily]

Hello! I hope everyone is staying strong and feeling as well as they can be today.

 

I had a challenging day yesterday, which reminded me to post about this pattern that I've noticed pretty much through my entire tapering process. Once I was more or less stabilized and tapering, it seems that I am able to "push through" and get things done when I need to, but then I'll have a crash or wave (not sure what to call it) as soon as I have an unscheduled day with nothing I need to do. It's both convenient and frustrating at the same time. I'm fortunate that I've been able to continue working 40 hours a week throughout my taper, but then the weekend is sometimes spent just feeling very low and having 0 energy. Just curious if this has been a pattern for others on the site? My best guess is that I'm exceeding my nervous system's capacity during the work week and then it's having to do extra catch-up on the weekends.

 

As an example, yesterday I was crying, negative thoughts, very low mood, and literally unable to carry out any tasks that I wanted to do. After lying on the couch for the entire day and then sleeping soundly, I feel back to my "normal" state today and it's business as usual.

 

Just curious!

[brassmonkey]

To answer your question, yes, it is a typical patter. You just seem to have it under better control than many people.

 

This pattern shows the power of distraction. Even though it is a good thing that you can "power through" at work, it is very important to pace yourself. The modern term would be "quiet quitting". Working just enough to get things done, but not exerting oneself to the point of exhaustion. Work slower and set lower goals for the time being but try not to draw attention to yourself. At the weekend you need to take a lot of time off, but still make the effort to maintain the household, clean and feed yourself and get enough rest. Also make time to get out in nature and enjoy the beauty of the world.

 

I maintained a job as a Research and Development Engineer for a large composites firm for the entirety of my taper. It took some doing at times, had to really pay attention to movements and such, but it was doable. It's a matter of figuring out the really important things and concentrating on them and then keeping up appearances.

 

[Emonda]

5 hours ago, ForestLily said:

My best guess is that I'm exceeding my nervous system's capacity during the work week and then it's having to do extra catch-up on the weekends.

 

I can completely relate to this. For me, I somehow manage to power on until holidays from work, then fall apart once I've met my work deadlines.

 

I'm trying to do as Brassmonkey said and pace myself a little better / take on less.

[ForestLily]

Thank you so much Brassmonkey and Emonda for the reassurance that this is normal, and for the excellent advice. I will work on pacing myself this week! The getting out in nature has also been lacking and I will seek out opportunities to do that now that the weather is getting a bit warmer.