Enitharmon: What to do? (undiagnosed PAWS from SSRI, on benzo, 3.5 weeks on Mirtazapine)

[Enitharmon]

This is a very long story, and it's only a part of it.

I have been taking SSRI for 20 years, with several attempts in between to stop, the last ones destroyed my life and only now I realize that they were probably the reason.

This is a long and ***** up story that been going on (the extreme phase) for more then a year, but the spiral began around 2020. I'm in severe wd issues for years now (which I only became aware they are wd issues recently, I've been having them I think ever since I tapered down to a smaller dose too fast on the previous AD, not knowing I'm in wd symptoms, I was dysfunctional, not working etc, then stopped it last year while being very unstable, and too fast.... and following other 2-3 extremely fast tapers in the past). This combined with life-long untreated trauma and attachment issues led to an unending spiral of hell and bad decisions, mostly starting 2020 and at its peak now when I recklessly (and in self-sabotage) found myself on Mirtazapine, a nasty powerful drug, while I haven't even started to recuperate from previous and ongoing severe wd issues and side effects.  Since end of April I started taking Attivan and recklessly continued it until realizing I have to taper - around two months after - and also did it inaccurately without a scale, and with kindling... Now holding at a little less then 0.5 gram, taking at night (this all started due to sleep issues, sleep anxiety and obsession).
 

I'm also on the waiting list for a psychiatric hospital but now even more doubtful about it since they will want either to give me higher doses of mirt or to replace with another drug, probably. But I'm completely dysfunctional, I had a but light at least from understanding now for the first time how I've been in wd for years, but then this was ***** by going into the mirt.... it was done without intention or thought. And after a whole year of resisting people's advise for me to go back to the previous med from which I never really managed to wd... So instead I made things more complicated.

 

I wanted to write my case here already 6 months ago or even before but couldn't have enough concentration to do that, to manage all the details - my state was so severe already! Severe almost constant agitation, especially when trying to express myself. Even to go here and write. This could have saved me.... i really believe reinstating to the previous drug would have saved me, almost did that couple of times this year (stopped completely around January 2023 after a taper of 5 months following 20 years of being on it, and despite some windows life been hell from then on).

 

I was afraid of having the side effects again, even though they were not even close to what I have endured these couple of years... and much less frightening and debilitating than mirt. In the meantime I continue taking the mirt since 25 days now, minus one night, and suffer worse every day due to its fatigue and breathing issues and the thought about how I will need to taper for years.

Just add that I've been in what felt like complete nervous breakdown/burnout/dysautonomia for more than a year now, especially extreme around a year, before starting the mirt. (What I only now come to believe is a type of ) Inner akathisia, inability to stop talking and to listen, inability to control and resist urges - especially emotional ones such as getting approval for my mistakes, punishing myself by over-communicating my mistakes and misbehavior to others and how I feel awful about it - which led to my spouse leaving me, on top of the financial burden I became for years without realizing what it means to be one (she begged me to reinstate, especially when things really got extreme this last year, when I really began to not control my actions - either not being able to act or decide which completely incapacitated me, really, inability to decide on almost ANY action, really felt like a brain injury.  Many traumatic and indescribable things when this collided with my parents (the cause of my trauma) and partner losing all compassion for me and any understanding (now when I realize it was all med related). An uncontrollable and out-of-the-ordinary feeling of guilt for every "mistake" I make which led to me endlessly talking about my "state" and trying to solve it in words instead of what REALLY helps me such as body work or even just relaxing and letting things go. Stopped meditating, don't dare to smoke weed which I used to to now and then - not deserving to feel bodily good and at ease until my guilt is "solved". Even writing this now is instead of breathing and meditating which used to be a main aspect of my daily life. The more this crisis evolves the more I'm not allowing myself and kind of fearful of letting go and relax. As if it's dangerous or not allowed, the more I got the habit in being stressed and "in crisis", "needing" someone else to solve it. All along the way I found stuff that REALLY help with some of this  - youtube talks about CPTSD and toxic shame, vagus nerve activation, Dharma talks etc. - but I allowed it few and in between until another crisis or "huge mistake" or huge decision led to me NOT ALLOWING them to myself, or simply forgetting how they benefit me (this forgetting thing is really curious) until I do them "too late" and then immediately feel guilty ABOUT NOT DOING THEM, which leads me to stop pursuing them further on... I've been doing this, the rationalization and explaining of everything instead of feeling, for almost an entire year now - when what actually helped and benefited me are the non-verbal elements. I've been exhausting myself to death with this. The fear from feeling and being with the involuntary has become just messed up, despite strong progress along the way, for small periods. As if I needed someone's answer all the time, instead of relying on myself, or instead of realizing I deserve to feel good first, before solving everything (with reinstatement for example, when I couldn't sleep or live out of utter restless inner feeling and indecisiveness, or with pursuing other means that actually felt are doing good - such as microdosing mushrooms which I stopped mid-way). Hardly breathing most of the time due to this struggle and this constant feeling of no clarity and lack of GROUND. It really feels like an addiction being with the negative, the struggle, the hard, the "heavy" in order to live or allow myself to live.
 

I'm in constant stress mode for more than a year, really extreme plus that dissociation and indecisiveness, and a feeling I MUST ACT AGAINST MY INTUITION and harm myself, that led to me almost being hospitalized a few times in my home country, which I didn't do eventually, and one night hospitalization here in Belgium where my spouse and I used to live to which I came back in October, where they gave me Mirt for one night and ruined my life, since I continued taking it since (that "uncontrollable acting against my interest and intuition" in order to then punish myself and be in constant fighting mode). I can't remember when I had a baseline, probably few years ago. I also suspect I have ADHD and/or autism but can't tell anymore due to all the wd issues.

My two main axes throughout all this have been - FEELINGS and emotions and SLEEP. The more secvere the crisis became, the less I would able to be with and feel emotionally what is going on, instead dissociating and making things worse inside of me, charging with energy without being able to let it out. I cry very little through all this - the most extreme suffering in my entire life - when a little before, around two years ago, while still in a kind of crisis, I was crying much more.  It is a trick of faith that I discovered a very good sleep channel on youtuve which really help me, and right after started taking Mirt which simply knocks you to sleep and works against your natural sleep mechanism.

So, it's been almost four years since things started to go "off" for me, some monthjs after a fast taper and then a fast return to 10mg Paroxetine. Since then I was kind of in constant struggle with my feelings, motivation, intuition, spontaniety, executuve function and concentration. A kind of restless anhedonia and extreme urge to punish myself and feel guilty. The indecisie and confusion became stronger in parallel with insomnia issues becoming worse, which became an obsession. Interestingly, in the past when things became too bad like this I reinstated, but this time it didn't even occur to me to upper the dose when it all began - even though my work and relationship were severely harmed by this. Instead, I chose to taper off completely thinking psychedelics will "solve" it all, but unable to follow through with the psychedelic protocol. As I said, this crisis began around 2020 after a fast drop which I reinstated back to only 10mg. Then last year I tapered off during 5 months, after which some things improved while other deteriorated. It's this inner conflict between wanting to contribute what improved and not wanting to go back to old side effect of the med which led me to continue deteriorating despite reaching such a poor state that it made no sense. Of course not everything can be attributed to wd or the meds - but I think my judgement was already so impaired that made me not realize I'm suffering so bad it's not worth to continue like this. I continued where most people would stop and reinstate much much sooner. Really extreem and nasty stuff - while not working and not even able to arrange my stuff around the house, to clean, losing more and more ability to do more and more things. When this became bad enough - but still not as bad as can get - I was staying a few months alone in me and my spouse's place in Belgium, she wanted me to pick myself up and stabilize somehow. I didn't, even though important insights came to light after, including after a mushroom trip with friends (while still having SSRI in my body that block it). My sensory burnout and really lack of energy or clarity to do anything, and sleeplessness, led me to go to our home country and "rest". But there the indecisiveness and guilt became stronger and stronger (although with windows in between), that I got "stuck" there without accepting my need to rest and stay there, obsessing over going back to Belgium while unable to purchase a ticket or even go to visit friends in another city inside Israel. Then last October I forced myself, litterly to go back, while being highly unstable, her as well, and while she was worried she couldn't provide me the support I need. I then arrived (after two plane tickets bought and money wasted) back to Belgium to feeling of incredible guilt and self-hate and confusion and sensory burnout that it made things worse with her. Of course now I realize I should have accepted arriving back, even if did recklessly and against the needs of my body. I also now realize I should have reinstated the med all along, like she begged me to. Eventually she had enough of me staying in a miserable state which became so unbearable to her she nearly lost her mind as well (endless talking in a frenzy about each "mistake" I made, of coming back like this, etc., while not functioning, not finding therapy, not working nor reinstating).

So now I'm highly destabilized, she decided to separate, she has zero compassion left for me, I don't want to go back to my home country, but also too weak to start things on my own. On top of it all - which is why I'm writing this - is the fact that I started Mirt without intending to, and kept on it for 3.5 weeks. It is making things worse


All throughout this escapade I have managed to find things that really help so so much, like the body-oriented things I mentioned. But I didn't allow it to continue as long as things are not "settled" medically (meds or mushrooms? meds or ashwaganda? etc. each day obsessing about it). So they came and went...  At a certain point in home country I managed to try again after months without, to mediate and discovered vagus nerve activation exercises. This gave such a huge benefit. But then I continued to be torn between the meds or alternatives, home-country or Belgium etc., that I went back into the loop and gorundlessness.  And this happened also, again, back in Belgium, in a similar manner.
Now since the whole mirt thing I'm not allowing myself even a moment of rest, not to mention meditation or other grounding exercises. And even while writing this I feel how I focus on the negative so much when I have so much positive in me! It's like a constant battle and I feel so bad about it - I feel guilty about being negative again and again... But really, I feel all this is without hope  now that I ruined my last chance of stability and an acceptable existence  (which is with my spouse in Europe and not with my parents in home country. Which is lost.)
 

I became so guilty and unsure about everything that I couldn't even find the therapy I need all throughout, or to pursue it. I think body-oriented work is what I need the most, but also trauma-oriented etc. But I couldn't start with anyone and continue. Now I realize I became like this due to wd issues, more than anything else. I don't know what to do now. I have to find a stable base to begin to heal from all the damage and trauma of this not only last years, even just from last couple of months... And I feel I not only ruined it because of making my partner leave me, but also by starting a new harmful drug. It's while being on the mirt that I start reading for the first time about the proper way to taper, realizing what I've done with the previous drug and benzo, and realizing what I "had" for many years are probably wd issues and not just trauma issues I have to solve by myself.

I met with Mark Horowitz two weeks ago, but sadly listened to him and not my intuition about stopping the mirt while it was still a good chance doing it with less wd issues.  I also had one meeting with another wd counselor that I may meet again.

Right now I feel utterly hopeless, especially knowing this could be solved or bettered so easily already a year ago, and many people tried to tell me that. That I can't control myself anymore and that it could get worse.

Drug history:

2003-2004/5: 40 mg Paroxetine
2004-2006: 20mg Paroxetine
2006: fast taper to 0, holding for several months
2006-2011: 20 mg Paroxetine
2011: attempt to fast taper to 0, reinstatement after a few weeks
2011-2014: 20 mg Paroxetine
2014/5: fast taper down to 10mg
September 2015: fast updose to 20mg
September 2015-2020?: 20mg
Winter 2020: attempt to fast taper to 0, after a few weeks on 0 back to 10mg
Winter 2020-September 2022: 10mg (crisis, deterioration of old symptoms plus new symptoms starting throughout 2020)
September/October 2022: start 4-5 month taper to zero
December 2023: macrodose of psylosibin, mostly blocked by SSRI still in body
January 2023: zero mg
End of April 2023-now: Attivan, changing dosages, the most was 1.5 gram. Tapering since, with kindling by mistake, now on little less than 0.5 mg, at night
Spring 2023: trying micro-dosing as well as macrodosing psylosibin
August 2023: trying out Amanita Muscaria mushroom microdosing for 3 weeks
February 2024-now: 3.5 weeks on 15mg Mirtazapine




 

[Erimus]

Hello and welcome to Surviving Antidepressants.

 

We are a peer-based community designed to aid people in tapering off, or recovering from, psychiatric medication.

 

Please could you add mirtazapine and ativan to your signature, along with the dates and dosages. Edit your signature here.

 

I'm sorry you have been through such difficulty at the hands of psychiatric drugs.

 

From my understanding you are currently dealing with protracted withdrawal from tapering off years of paroxetine usage at varying doses. This has evidently massively impacted your personal life.

 

You are stuck between a rock and a hard place regarding your current drugs. You can either continue to hold on your current drugs, in the hope your nervous system recovers further from paroxetine withdrawal, or you can continue micro-tapering them, in the hope that your nervous system improves as the dosage reduces. Ultimately, only you can decide the path that is correct for you going forward. Your mind and body will heal, given time and the right circumstances, but nobody can predict how long it will take.

 

Did Mark Horowitz have any suggestions for you?

[Enitharmon]

In fact, I'm angry at him (and at myself for not expressing how bad this drug makes me feel and for not following my body's intuition) for recommending me to stay with the Mirtazapine when it was still relatively safe to stop (after 10 days) - since it's been doing me more harm than good, and tapering from it can take YEARS. I hate it so bad and the fact that I'm starting a new drug, that it savbotages my entire healing process and the intense unimaginable grief I have to face from losing my spouse and life-base to due all this undiagnosed wd story of a few years.

 

If a drug is making you feel so bad there's no point in continue taking it for years when you can avoid it, since it hampers my need for stabilization by its effect and by the mere idea of taking it. In these 4 weeks I have been deteriorating even more, and I should have stopped it and face the wd effects now that I'm more wise and educated about them. It was this miseducation that ***** me all these years - once realizing what you have are wd symptoms it's a world of difference. So, this realization that I'm in PAWS and what to do onward with it is now destroyed by overloading my self with this poison, to the level of not being able to do anything, litterly, the entire day, other than eating, going to the toilet and feeling miserable. It was better WITH the sometime severe panic attack and indecision before the mirt (since it does reduce some of the panic) - at least then I could allow myself to relax at least a small (sometimes very very small) portion of the day once the "panicky" part has passed.