TimidTurtle: Fluoxetine/Prozac withdrawal or relapse?

[TimidTurtle]

 

Sorry that this is really long and rambley. I have a lot to unpack...

 

Hello, I am a 17-year-old male teenager and I've been on antidepressants since I was 12. I remember when me and my class went on a few days long school trip at the end of my last year of elementary school and I felt sad the entire time. Back then even I wasn't really sure where it came from, but I attributed my feelings to homesickness, as I had never been on that kind of trip before.

 

But even when I came back home, that sadness didn't disappear. That was probably when I first noticed that something was "wrong". The sadness and sense that something was horribly wrong would persist for my entire summer break. But I ignored all of it and insisted to myself that everything would be back to normal once I started middle school. These feelings of melancholy weren't abnormal for me during long summer breaks, and it would all disappear once school started again. Surely once school started , I would become happy again right?

 

Wrong. The first day of school I was filled with a bunch of overwhelming emotions I couldn't process. The second day my mind burst and I was left sobbing in the shower. The next few months would be an excruciating hell filled with frequent crying spells, anhedonia, and just general awfulness. My feelings were completely out of control. Sometimes I would feel happy, sometimes I would feel absolutely miserable.

 

The whole time I was agonizing over what could've possibly been causing all this. I told my doctor that I thought my feelings were due to puberty. He dismissed it. He suggested it was due to the singulaire I've been taking, but that ended up not being the case either (I guess it could be, but why would it start being a problem now when I've been taking singulaire my whole life? I abandoned this train of thought long ago) My depression continued even after I stopped taking singulair. The uncertainty over what caused my depression just made it worse.

 

And just when I thought it couldn't possibly get any worse, it all culminated into one random really bad day, when all of a sudden I lost my sense of self and my sense of reality. I was in the school nurse's office awakwardly explaining to the lady what was going on in my mind (or lack thereof) like an idiot. Then I was face up on a bed in that office emptily wondering if I had gone mad. Then I was at home in bed. All that time wondering, "How did I get here?" Nothing felt real.

 

My sense of "self" returned, only to allow me to experience the most tortorous time in my life. I was panicking and crying like crazy for days, all over delusions of solipsism and the feeling that I was secretly living in a TV show my whole life without me knowing until recently. My vision was filled with static. I looked online, it was called visual snow. Everything looked far away, sounded far away, felt far away.

 

Living with these symptoms for years have caused me to grow used to it, but back then I couldn't handle it. I was so done with everything, I just wanted to give up. I remember one day my mom asked me if I wanted to go to a buddhist temple to pray. It was so out of nowhere and I would've normally declined. But I had nothing better to do, everything was pointless, so I went anyway.

 

I started taking antidepressants when I would've refused to before. I remember taking my first pill of lexapro, immediately feeling sleepy, then passing out and having the most vivid lucid dream I've ever had and probably will ever have. Then after a day, I would feel absolute euphoria for the next few weeks. It was so surprising! But then that euphoria would disappear to be replaced by mundane nothingness. I complained at first, but eventually I would grow to accept that feeling nothing was better than feeling miserable.

 

Still, I never figured out where that initial burst of happiness came from. My best bet was divine intervention, that by praying in front of a Buddhist statue had obtained me a blessing from some higher being. It was ridiculous, but I had nothing else. All these years later and I haven't figured out what caused my depression either. Was it the emotional gut punch from the sudden realization that life wasn't all sunshine and rainbows like naive little kid me thought? Was it the intense pressure of entering adolescence and starting middle school? Was it due to puberty, like what I initially thought, all those years ago? The last one was unlikely. I think about it a lot, what could've possibly caused all this?Oftentimes I've been satisfied with my rationalizations. But ultimately, I still don't know.

 

Fast forward to October of 2023 and I've made the decision to taper (again). I told my psychiatrist that I wanted to go off slowly, much more slowly than last time. But I made one crucial mistake. I forgot to request liquid medication. I wanted to wait until my next appointment to get my liquids before I begin tapering, but my mom forced me to decrease by 10mg monthly with the physical pills. By the time my next appointment rolled around, my 80mg of Prozac had decreased to 60mg. I finally got my liquid medication, but ultimately decided to pause tapering to exhaust all of the physical pills from my previous prescription before continuing a 10% taper with the liquid. Everything was fine, at least at first.

 

This January, I read a visual novel Umineko: When They Cry. It was absolutely life-changing, hands-down the best fiction ever. One character in particular really resonated with me, with their struggles with gender dysphoria. I am nonbinary, but I haven't had any desire to change my body in any way or become more feminine. I found it strange how attached I've grown to this character, but I figured it was just that Umineko magic.

 

But the more I obsessed and cried and the more that my feelings became disconnected from what I thought was the "source", the more that I, once again, felt that something was horribly wrong. It began in February, two months after my previous dose reducing, and it's continued until now. My mood is out of control. Feelings of depression come and go. I want to believe it's all withdrawal.

 

But what scares me is that it feels exactly like my initial depression five years ago. I would be comfortable dismissing it all as due to withdrawal if it all came out of nowhere. But that's the thing, sometimes it doesn't. Sometimes it feels like there's something weird happening in my brain, weird emotions, but with no thoughts. But other times I spiral and there are thoughts attached to those emotions. Thoughts about how I hate my body, my body hair, my fat, how I wish I had boobs. Just intense gender dysphoria out of nowhere!

 

I've questioned if I'm a trans girl before but never so desperately.  I can't describe it all that well unless I'm experiencing it in the moment. I'll probably come back here again to post while I'm spiraling. When I'm in a calmer state, like now, it makes me feel really stupid, like I'm  worrying over nothing. But I know it does happen, and it'll most likely happen again sometime in the near future. But why?

 

Could gender dysphoria be a symptom of withdrawal? I don't think that's how that works, right? Could I have been repressing it for a long time? But how? I think back to all those years ago, when I told my doctor about my symptoms, said that I thought it was due to puberty, only for him to dismiss my conjecture. Could 12-year-old me back then have been right all along? What if the hormones from puberty gave me dysphoria, which I couldn't process or express at the time because I had no idea about what being trans is, then antidepressants caused me to bury and repress that dysphoria, only for it to resurface and relapse once I'm slowly getting off them? Is this theory too crazy to be true? Am I too desperate too make things make sense? I'm not sure how "connected" this dysphoria is to my actual emotions, so maybe I'm just deceiving myself. I don't know, I keep switching back and forth between withdrawal and relapse. It's so confusing. I feel like an idiot now because I'm in a calm state. But once I spiral the uncertainty becomes unbearable, so I really need to figure this out.

Edited March 5 by FireflyFyte
Updated title

[FireflyFyte]

Hi TimidTurtle,

 

Welcome to SA. Thank you for summarizing your drug history in your signature.

 

8 hours ago, TimidTurtle said:

Could gender dysphoria be a symptom of withdrawal?

 

I don't think that gender dysphoria is a symptom of withdrawal especially if the thoughts began before you started taking medication. If possible, I would recommend finding a therapist who is savvy with the topic of gender dysphoria and work with them to better understand what you are currently experiencing. 

 

8 hours ago, TimidTurtle said:

I don't know, I keep switching back and forth between withdrawal and relapse. It's so confusing.

 

I understand it can be confusing especially when the majority of doctors discount withdrawal symptoms. Would encourage you to read our resources detailing what withdrawal is at What is withdrawal syndrome?

 

Thanks,

 

Firefly

[TimidTurtle]

I don't know how to find a therapist that knows about gender dysphoria though. I don't want my conservative parents to find out I'm trans. 

 

I have read the resources about withdrawal symptoms. It has helped, although I'm still confused and unsure.

[FireflyFyte]

1 minute ago, TimidTurtle said:

I don't know how to find a therapist that knows about gender dysphoria though. I don't want my conservative parents to find out I'm trans. 

 

https://www.psychologytoday.com/us is a good resource to find a therapist. Is it possible for you to visit a library and do some research there so your parents won't see it in your search history?

 

 

[TimidTurtle]

7 minutes ago, FireflyFyte said:

 

https://www.psychologytoday.com/us is a good resource to find a therapist. Is it possible for you to visit a library and do some research there so your parents won't see it in your search history?

 

 

Parents seeing search history isn't an issue. I'm just not sure how I'm supposed to see a therapist without my parents knowing. And I'm not really confident that it'll be helpful because my past experience with therapy hasn't been that productive at all.

[TimidTurtle]

Ok, I think I figured it out (or not, this could be another whim, I could just change my mind immediately once I'm in a bad mood again)! My symptoms line up perfectly with Biochemical Dysphoria and I think that's what is causing my problems. I think 12-year-old me was right all along, that it was due to hormones from puberty. This isn't the first time I came to this conclusion, but I kept doubting myself and changing my mind, but I'm extra sure this time! My plan is to increase back to 80mg prozac until I have access to gender-affirming care, then I'll start tapering again. Nothing horrible has happened while I was on prozac besides feeling emotionless and forgetting everything, so it's fine to stay on it a bit longer, right? It's just going to a temporary bandage until I get the tools I need to heal my wounds.

Edited March 5 by TimidTurtle
extra clarification