AAOffZ: Coming off Sertraline

[Erimus]

On 5/6/2024 at 12:53 PM, AAOffZ said:

@Erimus no other changes really. I slept fine the last two nights and the writhing anxiety has passed. Now it feels like Neuro-emotions mostly. Intense, brief anxiety over things that make no sense, just like I had before when I lowered. Possibly just a wave…? 

Wave and period, likely just a double whammy of symptoms. When you feel like this just try think how you won't feel the same in 7 days time.

Edited May 7 by Erimus

[AAOffZ]

@Erimus good advice. I also had a health scare a week ago (a mole biopsy that ended up being benign) that I wonder might have contributed. 
 

Either way, thanks for responding.

[AAOffZ]

@Erimusi thought maybe I was coming out of the wave as yesterday was a tad better. But now I have this intense jump out of my skin agitation. It’s mostly physical, as I’m not anxious. I have this awful fear that this going to keep coming and I’m not going to see another window and I’m just going to continue to get worse. Is this likely considering I have had some decent days? Looking for hope. Any advice for this symptom? It’s brutal. 

[AAOffZ]

@Erimus these symptoms are ever morphing... Now I’ve got what I think are adrenaline dumps? Rapid heart rate and flushing? I haven’t had any physical symptoms until now. Maybe a delayed wave from my initial rapid taper from 150? 

[AAOffZ]

@Erimus sorry to keep posting, but I’m really really struggling. Having a hard time believing this is just a wave. Extreme restlessness, inability to sleep, distract, ANYTHING! The fear and anxiety is fierce. Having a hard time understanding how a week ago, I thought I was stabilizing. 

[Erimus]

31 minutes ago, AAOffZ said:

@Erimus sorry to keep posting, but I’m really really struggling. Having a hard time believing this is just a wave. Extreme restlessness, inability to sleep, distract, ANYTHING! The fear and anxiety is fierce. Having a hard time understanding how a week ago, I thought I was stabilizing. 

Things are going to be turbulent for a while after all the changes you made earlier this year. They will settle down as the weeks go by, but you have to find ways to cope.

[AAOffZ]

@Erimus I am in complete and utter fear that I’m in tolerance and I can’t get out unless I taper. This internal restlessness is torture. Racing heart rate. Chest is tight. Skin is burning. Didn’t sleep. 
 

the last time I felt like this was at 150 and when I reduced my dose it went away. 

[Erimus]

17 minutes ago, AAOffZ said:

@Erimus I am in complete and utter fear that I’m in tolerance and I can’t get out unless I taper. This internal restlessness is torture. Racing heart rate. Chest is tight. Skin is burning. Didn’t sleep. 
 

the last time I felt like this was at 150 and when I reduced my dose it went away. 

I can't imagine you are in tolerance. How long has it been on the same dose of 87.5mg?

[AAOffZ]

@Erimus 5.5 weeks

[Gonzo]

I honestly can not believe that such high doses of these drugs are allowed to be used and prescribed.

[AAOffZ]

@Erimus any thoughts at all here? I’m losing my mind with these symptoms. Pacing and trembling.

 

Edit- it’s passed a little. Could these severe symptoms be because I kindled myself with all the dose changes? 

[Erimus]

46 minutes ago, AAOffZ said:

@Erimus any thoughts at all here? I’m losing my mind with these symptoms. Pacing and trembling.

 

Edit- it’s passed a little. Could these severe symptoms be because I kindled myself with all the dose changes? 

5.5 weeks is nothing in the grand scheme of drug withdrawal and stabilisation. I know you want a quick solution to your problems, but there really is nothing better than holding on the same dose for many months. All you can do is find ways to cope when the symptoms become too much to manage, non-drug coping skills that is.

Edited May 7 by Erimus

[AAOffZ]

@Erimus you’re right. Thanks for the reply. I’ll tough it out and hopefully see some progress and an end to this awful wave. 

[AAOffZ]

@Erimus do you have any articles or posts that I can refer to on the changing of symptoms. I feel I have a hard time finding others who are in the same position as I am. Or those who have indeed stabilized on a dose after kindling. Most have CT’d or are at a very low dose in their taper. 
 

My symptoms seem to change frequently. I’m not having agitation anymore or increased heart rate or flushing. Which I suppose is an improvement. Morning anxiety is really strong now. And now I feel like I have all day long anxiety that has no source and waxes and wanes in severity. Not really having windows, just moments where symptoms are not as bad. I’m functioning, taking care of my kids, etc most days but I feel the need to pace and can’t really sit still very long. Sleep has been okay the last 3 nights, which I’m grateful beyond words for. 
 

Hard to believe I was stable on this drug 6 months ago.

 

It also seems like this pattern of evenings being better is coming back. 😵‍💫

 

Any of this sound concerning at all? Any improvement is a good sign, correct? Even if the symptoms are changing. 

[AAOffZ]

@Erimus one last question… I’ve been thinking today about everything that’s happened in the last several months i’m slightly confused as to why I never stabilized on 125 whenever I increased several months ago. I had given it 6 weeks at the time and I got a really bad wave at 6 weeks along which is why I increased to 150. Thoughts on the mechanisms/reasoning behind all of that?

[Erimus]

On 5/10/2024 at 9:10 PM, AAOffZ said:

@Erimus do you have any articles or posts that I can refer to on the changing of symptoms. I feel I have a hard time finding others who are in the same position as I am. Or those who have indeed stabilized on a dose after kindling. Most have CT’d or are at a very low dose in their taper. 
 

My symptoms seem to change frequently. I’m not having agitation anymore or increased heart rate or flushing. Which I suppose is an improvement. Morning anxiety is really strong now. And now I feel like I have all day long anxiety that has no source and waxes and wanes in severity. Not really having windows, just moments where symptoms are not as bad. I’m functioning, taking care of my kids, etc most days but I feel the need to pace and can’t really sit still very long. Sleep has been okay the last 3 nights, which I’m grateful beyond words for. 
 

Hard to believe I was stable on this drug 6 months ago.

 

It also seems like this pattern of evenings being better is coming back. 😵‍💫

 

Any of this sound concerning at all? Any improvement is a good sign, correct? Even if the symptoms are changing. 

Symptoms are going to change with no rhyme or reason until things stabilise. Just find ways to cope. You will have to search around the introductions forum to find other people. I can almost guarantee there is someone who has been through something similar.

 

--------From the Symptoms and Self-Care Forums--------
 
What is withdrawal syndrome?
 
About reinstating and stabilizing to reduce withdrawal symptoms
 
The Windows and Waves Pattern of Stabilization

 

Hypersensitivity and Kindling

 

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

[Erimus]

On 5/11/2024 at 12:57 AM, AAOffZ said:

@Erimus one last question… I’ve been thinking today about everything that’s happened in the last several months i’m slightly confused as to why I never stabilized on 125 whenever I increased several months ago. I had given it 6 weeks at the time and I got a really bad wave at 6 weeks along which is why I increased to 150. Thoughts on the mechanisms/reasoning behind all of that?

Too many changes in a short period of time.

[Ariel]

On 5/10/2024 at 10:10 PM, AAOffZ said:

My symptoms seem to change frequently. (...) Not really having windows, just moments where symptoms are not as bad. 

 

On 5/10/2024 at 10:10 PM, AAOffZ said:

Any of this sound concerning at all? Any improvement is a good sign, correct? Even if the symptoms are changing. 

 

Hi @AAOffZ

I'm sorry you're suffering. 

 

I just wanted to stop by and say I agree with Erimus: 

 

42 minutes ago, Erimus said:

Symptoms are going to change with no rhyme or reason until things stabilise.

 

That's the nature of the windows and waves pattern of healing/stabilization. 

When you notice, "Not really having windows, just moments where symptoms are not as bad," -- those ARE windows.

You are in fact having windows, which is a great sign!

 

I see that Erimus sent you a link to the Windows and Waves topic. It's an important one to bookmark and revisit as needed.

I've just updated it with a few posts which may be helpful to you.

Here's the topic once more: 

 

 

[Ariel]

See also:

 

 

[AAOffZ]

@Ariel thanks for the response. I guess all the up and down is exhausting. I had a REALLY GOOD day yesterday. I hesitate to say amazing. Like I would say 75 percent normal. Just a bit of random anxiety. But then today I have weird waves of agitation and restlessness again and last night I slept poorly.  Also had a weird agitation at the thought of folding laundry, which is so weird. Are these are just neuro emotions? And some really bad intrusive thoughts that make no sense are so strong in the moment and then no big deal later.
 

Maybe it’s the fact that even though I feel hugely better than 4 weeks ago, I still don’t feel stable. Maybe I’m just impatient because I want to officially start my slow tapering? 
 

Im also worried I will never know what my baseline is because ive felt so bad for so long. 
 

I still can’t watch tv and movies… although I haven’t tried in a week or so. Is this common in WD for some? To be trigger by watching tv? Stinks because that would be a great distraction.

[Ariel]

Hi @AAOffZ

 

10 hours ago, AAOffZ said:

I guess all the up and down is exhausting.

 

Word. 

The instability and unpredictability of the recovery process can be one of the most psychologically challenging aspects of this experience. 

And -- it is what it is. 

This might sound really annoying (even to me as I write it), and it is none the less true -- acceptance is key. 

When I practice acceptance, patience, self-compassion (not saying it's easy or that I'm good at it, I just keep practicing), it removes that extra added layer of suffering and makes things feel a bit more bearable.

 

11 hours ago, AAOffZ said:

I had a REALLY GOOD day yesterday.

 

This is awesome! And a very good sign.

It's important to acknowledge the moments of relief when we get them, no matter how small or imperfect. Really take in that experience of respite, write it down for yourself and remember it for the hard times. What you experienced was real, and you will once again feel this way! Healing is happening. 

 

11 hours ago, AAOffZ said:

Also had a weird agitation at the thought of folding laundry, which is so weird. Are these are just neuro emotions? And some really bad intrusive thoughts that make no sense are so strong in the moment and then no big deal later.

 

Yup, sounds like classic WD stuff, neuro-emotions and co. 

 

11 hours ago, AAOffZ said:

Im also worried I will never know what my baseline is because ive felt so bad for so long. 

 

Remember that thing about neuro-emotions? Neuro-worry is part of that. 

 

11 hours ago, AAOffZ said:

I still can’t watch tv and movies… although I haven’t tried in a week or so. Is this common in WD for some? To be trigger by watching tv?

 

Totally normal in WD! 

I had this for a while (since resolved) and most other members i've come across have had this at some point. It gets better. 

I understand the need to distract. I was usually able to find something or other I could handle, even if it was just cute-kitten or cute-puppy videos on youtube. 

Whatever works! 

Just remember it's temporary and it does get better, this too shall pass. 

 

It gets better, and healing is happening all the time, whether or not we consciously feel it. 

Healing is happening when we feel a bit better, healing is happening when we feel a lot worse. 

Healing is happening all the time! 

[AAOffZ]

@Ariel @Erimus been able to watch little bits of tv yesterday 😭 so grateful. 

Yesterday I had a very “normal” day. Good even. 

 

But today, I’m having a hard time with the anxiety again. I couldn’t imagine watching tv today. How can this switch flip so fast!!!???  It’s so much better than it was weeks ago. As I was basically house bound. 

 

But now, one of my biggest sources of discomfort now is tinnitus.

 

The thing is, I’ve had it for YEARS. And it didn’t bother me at all after the initial year of panic over it. I went probably a whole year or more without caring about it at all. In fact, just a month ago I was falling asleep listening to it with 0 issue. 
 

And now all the sudden, I’m back to thinking about it all the time. It’s so frustrating. Is this a normal WD thing? To have past issues resurface?
 

Yesterday, I barely thought of it, and now today it seems anxiety about everything is back a bit in general, and I’m back to thinking about it constantly today. And had some morning anxiety also, which the last few days have been better. 
 

I guess I venting. Maybe this is just a wave. But as I get closer to baseline, it’s so hard to know what’s, the chicken or the egg. Like is the ear noises making my anxiety worse or is it all just neuro-fears and emotions that are heightening my response to it.  My ears feel more sensitive in general since the middle of the night and today and my skin is burning a bit. 
 

How do I know this is not my baseline? And yesterday was some sort of fluke I’m doomed 

[Ariel]

Hi @AAOffZ

 

59 minutes ago, AAOffZ said:

been able to watch little bits of tv yesterday 😭 so grateful. 

Yesterday I had a very “normal” day. Good even. 

 

This is great! 

You are doing such a good job at noticing when things are better. That's a very important aspect of this journey -- practicing awareness of improvements, really taking the time to acknowledge them, and finding some way to celebrate progress. It's scientifically proven that celebrating positive change helps the brain consolidate new learning, so by celebrating we are facilitating the formation of new, desirable pathways and supporting healing. There are many ways to celebrate -- gratitude journaling, sharing with friends/family, posting an update here. You are so wise to already be doing this intuitively, and this practice will continue to serve you well. 

You're going beautifully! 

 

1 hour ago, AAOffZ said:

one of my biggest sources of discomfort now is tinnitus.

 

The thing is, I’ve had it for YEARS. And it didn’t bother me at all after the initial year of panic over it. I went probably a whole year or more without caring about it at all. In fact, just a month ago I was falling asleep listening to it with 0 issue. 
 

And now all the sudden, I’m back to thinking about it all the time. It’s so frustrating. Is this a normal WD thing? To have past issues resurface?

 

Here's the crux of it: it is a normal WD thing for our WD-brains to hyper-fixate on something. Your experience with tinnitus is a perfect example of this. You've had tinnitus for years, you learned to live with it to where it didn't bother you at all. "And now all the sudden, I’m back to thinking about it all the time." What has changed is not the tinnitus but the fact that you're thinking about it all the time. It's this particular quality of thinking that's the WD symptom -- and yes, this is one of the most common WD symptoms. 

This is your brain under the influence of WD, it's not your mind. It's a physiological phenomenon, a consequence of chemical dysregulation from iatrogenic injury. 

 

1 hour ago, AAOffZ said:

Yesterday, I barely thought of it, and now today it seems anxiety about everything is back a bit in general, and I’m back to thinking about it constantly today.

 

Same for this one. The constant thinking is a normal WD thing. The anxiety is most likely neuro-emotion. These symptoms can exacerbate each other in a feedback loop, neuro-emotions worsening looping thoughts and vice versa. All par for the course in WD.

This is where you get to learn and practice non-drug coping skills. Practice AAF: Acknowledging (oh, this is WD brain) -- Accepting (it's okay, I'm safe, this is just WD doing its thing, it's temporary, I am healing) -- Floating (whatever WD brain stuff is going on, it's noise in the background, I will continue on with my tasks or distract myself as much as possible).

 

1 hour ago, AAOffZ said:

Maybe this is just a wave. But as I get closer to baseline, it’s so hard to know what’s, the chicken or the egg.

 

1 hour ago, AAOffZ said:

How do I know this is not my baseline? And yesterday was some sort of fluke I’m doomed 

 

Yes, it's a wave. When things are tough, when symptoms are acting up, it's always a wave. 

Nevermind the chicken or egg thing. No way to know + it doesn't matter. 

When you're feeling crap, that's when you practice detachment -- remind yourself, oh right this is WD-brain. And then work on learning and practicing those non-drug coping skills! Remembering that this is temporary, this too shall pass, you have had good days and good moments of relief, and you will have them again. Healing is happening! Healing is happening all the time, even when we don't consciously feel it. 

Also, I strongly encourage you to let go of this idea of baseline, what/when it is, etc. Thinking about this is not serving you. There is no stable, reliable baseline in WD, it's a moving target, everything is constantly fluctuating and evolving and shifting. That's one of the psychological challenges, the unpredictability. Again, the key is acceptance. Practicing non-drug coping.

 

You're doing great, AAOffZ, truly! You're experiencing good days, you're noticing the good and celebrating it! 

Take gentle care of yourself -- nutritious, whole foods; mild exercise; sunshine; hydration; no drugs, alcohol, caffeine, nicotine; sleep hygiene. 

Study/learn/practice non-drug coping skills, search SA for resources and educate yourself.

 

Well done, keep going!

Healing is happening <3

A.

 

[Ariel]

Help topic on Neuroemotions below.

Read carefully through the first post -- you will find links to help topics on 

 

 

Non-drug techniques to cope with emotional symptoms

 

Dealing With Emotional Spirals 

What is happening in your brain?

 

and more.

All of these topics will be useful to you! 

Pin or bookmark or save them and return to them as needed along the way. 

 

 

[Ariel]

 

[Ariel]

 

[AAOffZ]

@Ariel thanks so much. Seriously helps so much to know that this is part of the process and not my “non-WD Brain.” 

is it normal to take so long to stabilize? Today is 7 weeks on this dose. I know I made some insane changes. But have others taken this long for stability? 

[AAOffZ]

 @Ariel @Erimus

 

any thoughts on this? I’m just so frustrated with this anxiety that comes and goes.
 

Is that how I know that it’s indeed WD, and not “me” when something that makes you anxious yesterday, doesn’t bother you much all the sudden? Or can that happen with normal anxiety, too. I don’t even know what my “normal” anxiety looks like because I’ve been on these drugs for so long. My fear is that this is ME, and the drugs aren’t working and I’m going to have to taper without any relief instead of going gradually. 
 

It seems like my windows and waves are now muddling together a bit, and I’m stuck getting a good day here and there and some not so good half days.. in reality, they’re not awful waves compared to 7 weeks ago, or even 2-3 weeks ago! But the good days make the bad days feel really awful. I’ve never had more than 2 good days in a row.. so much has improved and even gone away. What am I looking for in stability… 2-3 months of good days? Or a few weeks? 
 

Sleep used to be my escape before tinnitus starting bothering me again, but now just the thought of tinnitus (without even hearing it) makes me jumpy, which is affecting my sleep. I can’t even hear it during the day unless I look for it. I literally used to lay down and let it lull me to sleep. 
 

It seems like ALL noise bothers me now. Even my sound machine. But it seems like my ears are more sensitive right now because I’m getting these constant intrusive thoughts about tinnitus and looking for it. Is it possible that the cortisol morning anxiety is making it worse also? I’m fall asleep fine but at 4/5 in the morning, I’m waking up feeling like I can’t handle it. It seems like every remaining spec of chemical anxiety is leaching onto the tinnitus. 

Sorry that was a lot of venting, but I am wondering how long stability is going to take. 

 

One more question. Why did I never experience emotional blunting on Zoloft? … is that normal? I hear about it so frequently. And I’ve always been able to cry, experience joy, excitement, etc. 

[Ariel]

Hi @AAOffZ

8 minutes ago, AAOffZ said:

It seems like my windows and waves are now muddling together a bit, and I’m stuck getting a good day here and there and some not so good half days.. in reality, they’re not awful waves compared to 7 weeks ago, or even 2-3 weeks ago! But the good days make the bad days feel really awful. I’ve never had more than 2 good days in a row.. so much has improved and even gone away.

 

Yes this sounds like normal WD windows and waves. 

 

8 minutes ago, AAOffZ said:

What am I looking for in stability… 2-3 months of good days? Or a few weeks? 

 

9 minutes ago, AAOffZ said:

I am wondering how long stability is going to take. 

 

I hear you, these concepts can be slippery when we try to transpose them onto lived experience. 

Luckily there are a few topics to read, can be useful. Will post below. 

 

10 minutes ago, AAOffZ said:

Is that how I know that it’s indeed WD, and not “me” when something that makes you anxious yesterday, doesn’t bother you much all the sudden? Or can that happen with normal anxiety, too. I don’t even know what my “normal” anxiety looks like because I’ve been on these drugs for so long. My fear is that this is ME, and the drugs aren’t working and I’m going to have to taper without any relief instead of going gradually. 
 

 

This fear is in and of itself a WD symptom. Neuro-emotion mixed with thought spirals. 

I promise you, this intense fluctuating anxiety is not you. It's WD brain, it's not your true mind. 

And it's totally normal in WD to ask oneself, "is this me?" We all go through that. It's not you, it's your brain mitigating chemical injury. 

It gets better! 

[Ariel]

On Stability

 

 

[Ariel]

 

[Ariel]

 

[Ariel]

16 minutes ago, AAOffZ said:

What am I looking for in stability… 2-3 months of good days? Or a few weeks? 

 

It sounds like you are interpreting "stability" to mean "zero WD symptoms". As far as I know, that is not what stability means. 

 

I'm not an expert (see help topics below for more info), but my understanding is that what is meant by stability is: a fairly consistent pattern of WD symptoms over a period of time. 

 

So within stability, one is still experiencing windows and waves, i.e. fluctuations of symptoms, but these fluctuations are more or less predictable and within a certain range of intensity, without any big surprises, no huge ups or downs. 

 

2-3 consecutive months or a few consecutive weeks of good days, i.e. long extended windows, may be far down the line. It takes time to get there (just as an example, I've been dealing with PAWS for years and have yet to experience such long stretches of windows). However, that has nothing to do with WD stability.

 

Do you track your symptoms? It might be helpful to keep a daily symptom diary, logging times of day and symptom intensity every day throughout the day. This will help you notice when a steady pattern is emerging, and will help determine stability. 

 

Hang in there, AA. You will stabilize soon enough. <3

[AAOffZ]

@Ariel @Erimusim struggling in another bad wave I think. Had a decent week and a half where anxiety wasn’t gone but manageable.
 

Crushing anxiety is happening where I can’t relax that seems unnatural that I cannot reason with when my mind wanders to my tinnitus, and then I get panicky and my skin feels like it’s burning. Haven’t slept well the last two nights. Even mild agitation at times (not as bad as before but agitated nonetheless). What I think is also depression, as all interest in everything is gone. Appetite is not gone but poor. I guess it’s slightly better than the last wave… but I hate to admit that with how bad I feel.  Im trying with all my might to tell myself this is a wave. But it’s just not working well. I’m struggling. 

[Ariel]

Dear @AAOffZ

 

10 hours ago, AAOffZ said:

im struggling in another bad wave I think. Had a decent week and a half where anxiety wasn’t gone but manageable.

 

I hear you. This is how it goes. 

I'm sorry you're in a wave. They are just never fun. 

At the same time, you had a decent week and a half of things being less intense. Remember that! 

Healing is happening. I know it's hard to believe when we're in a wave, but healing is happening all the time, even when we don't consciously perceive it. 

 

Something that sometimes helps me is to imagine an ocean wave washing over me like healing is washing over me. If we can get ourselves to think of the waves as healing us, it becomes a bit more bearable to get through. 

 

10 hours ago, AAOffZ said:

I guess it’s slightly better than the last wave… but I hate to admit that with how bad I feel.  Im trying with all my might to tell myself this is a wave. But it’s just not working well. I’m struggling. 

 

It's going to be okay. You're in a wave. It's temporary. This too shall pass.

And with every wave you are that much closer to healing! Because there are a finite number of waves to go through, and this is just one less. So you will come out ahead no matter what. 

 

Be very kind and tender with yourself. You are going through something difficult and you deserve all your love and compassion.

Go gently <3

[Ariel]

@AAOffZ

 

Have you had a chance to read through the help topic "What is happening in your brain"? 

I posted it above a few days ago. 

It's very helpful to revisit when in a wave because it provides insight into what's going on behind the scenes, and how hard our bodies and brains are working 24/7 to heal! And it also says a bit about why we experience such weird, uncomfortable symptoms. 

I've read it many, many times and always find it so reassuring and humbling. 

 

Here it is again: