PileOfLeaves: Do I fit in here?

[PileOfLeaves]

I found this site a week or two ago and I’ve been reading the threads here pretty much nonstop. First of all, thank you to everyone who’s shared their experiences. I’ve learned a lot. I’m still a little unsure as to whether I belong here, but I wanted to share my experience (so far) in case it could help someone else. Any insight into my situation is also very welcome.

 

It seems like the general consensus on this site is that antidepressants do more harm than good and that most people feel they were prescribed them unnecessarily. But that wasn’t really my experience.

 

For context, I’ve struggled with generalized anxiety and panic attacks throughout my life, starting when I was around 5 or 6 and worsening through my teen years. I was never medicated; I chose to just live with it. Then in my mid-twenties I experienced a series of major losses that threw me into a deep, dark pit of depression that I absolutely could not climb out of. I eventually asked my doctor for help, and she put me on sertraline… which completely levelled the playing field for me. That’s the best way I can describe it. Sertraline allowed all the therapy, social support, mindfulness meditation, exercise, and other coping strategies I’d been dutifully practicing for ages to actually start helping. Plus, I was no longer experiencing anxiety or panic attacks. I was able to rebuild my life and also thrive in a way I never had before. Without question, sertraline changed my life for the better.

 

So that’s my backstory. Now comes the hard part.

 

After almost 4 years on sertraline, I felt I was ready to stop taking it. Following a doctor's advice, I went from my usual 100mg down to 75mg for one week, then 50mg for one week, then 25mg for one week, then stopped. I had pretty typical withdrawal symptoms for a few weeks - mainly dizziness, brain zaps, and some mood swings - but these were tolerable. They started to fade, and I did notice some waves of anxiety creeping in from time-to-time, but I figured this was just a return of my old, lifelong anxiety.

 

Then, at around the 8 week mark of being sertraline-free, I had an especially stressful experience that seemed to trigger a breakdown of sorts. I rapidly became overwhelmed by the worst anxiety I had EVER felt. For two straight weeks I felt like I was in a panic attack that wouldn't end. I would wake up in the morning shaking so hard my teeth would chatter; I couldn't focus, couldn't eat, and I would cry constantly; my head was filled with horrible thoughts and I was consumed by existential dread.

 

Out of pure desperation and not knowing what else to do, I decided to go back on sertraline. Doctor started me back at 50mg and said I could increase to 100mg again after a couple of weeks, but 50mg ended up being enough to completely bring me back to normal and I ended up staying on 50mg for another 2 years - and for those 2 years I was again happy and flourishing.

 

Now we’re in 2024, and I’ve decided to make another attempt at tapering off.

 

At this point I have a new doctor. At her recommendation, I took 25mg for 4 weeks, switched to every other day for 2 weeks, then stopped. Just like the first time, I experienced a few weeks of dizziness, brain zaps, and irritability. Those symptoms faded, after which I started noticing minor waves of anxiety. And then it happened again – I "crashed". The all-consuming panic and existential dread took over. There was no trigger this time, but it happened about 8 weeks after taking my final dose, just like before.

 

That’s too coincidental to be a coincidence, right? So that's when I started really looking into SSRI withdrawal. That's what eventually led me to this website, and thanks to the info here, I now know that both my tapers were too fast, and that alternating days was a bad idea. But alas… what's done is done.

 

I'm currently 11-weeks free from sertraline, and I’m seeing… some improvements? I’m still nowhere near as stable and content as I was while on sertraline, but the extreme anxiety isn’t as extreme as it was even a week ago. I’m tracking my moods and noticing a pattern - my anxiety is highest first thing in the morning and generally fades throughout the day. I’m still struggling to eat but it’s getting a little better. I’m not crying nearly as much, and I'm not ruminating or having negative thoughts as often or as intensely as I was.

 

I did talk to my doctor a week or so ago about what I've been going through, and she was very sympathetic and essentially said yeah, not enough time has passed for my brain/nervous system to balance back out yet. She offered to prescribe me a low dose of ativan that I could take "as needed" whenever the anxiety gets too bad to cope with, but I haven't taken any and I would prefer not to. My instinct at this point is to just keep pushing through with non-drug coping mechanisms, since I am seeing some improvements. But I won't lie, the stories here about withdrawal symptoms coming back repeatedly, even months or years after the fact… they do scare me. 

 

I guess only time will tell.
 

[Catwoman73]

Hi @PileOfLeaves, and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications, and their associated withdrawal syndromes. 

 

Thank you for completing your drug signature!  

 

I'm so sorry for what you've been through. The vast majority of doctors don't have a clue about withdrawal.  They continue to believe what the pharmaceutical companies say- that withdrawal is 'mild and short lived.'  Sadly, we have learned otherwise!

 

So you already know that your tapers were very fast- here at SA, we recommend tapering at a rate of no more than 10% of your current dosage, no more often than every 4 weeks.  This is known as hyperbolic tapering, and is designed to minimize withdrawal symptoms by  releasing the receptors in our brain from the drug in a very slow and controlled manner.  You can read about how these drugs affect your brain, and about why hyperbolic tapering is so important in the following threads.

 

How Psychiatric Drugs Remodel Your Brain

 What is happening in your brain?

Why taper by 10% of my dosage?

 

By doing a rapid taper, or a cold turkey stop, unfortunately you have put yourself at risk of protracted withdrawal.  You are certainly not alone in this- I once stopped three psych meds at once, and experienced seven years of intermittent withdrawal symptoms.    Not saying this to scare you, only to help you set realistic expectations- healing takes time and effort.  It was not all terrible when I was in protracted withdrawal, but there were rough times.  You can read more about protracted withdrawal here:

 

Protracted Withdrawal or PAWS (post-acute withdrawal syndrome)

 

If your symptoms do become unbearable, you could attempt to introduce a very small dose of sertraline to try to mitigate the withdrawal symptoms.  Though in your case, I would likely not advise this.  It is most likely to be successful if done within 3 months of stopping your meds, and you are outside of this window now.   But you can read more about reinstating here- the idea would be to stabilize the withdrawal symptoms, and then do a hyperbolic taper once more stable.  I would rather see you do this than take Ativan!

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

As you proceed through your healing process, you will notice that you have times when you feel better, only to be plunged back into having symptoms again.  This is absolutely normal, and we refer to this as the windows and waves pattern of stabilization.  Read more here:

 

The Windows and Waves Pattern of Stabilization

 

It is a good idea to start keeping a symptom journal to help you identify your windows and waves.  Not only do I keep track of my symptoms, but also my activities, other medications, supplements, and foods.  Symptom waves do come and go, but sometimes, by keeping track of all of these things, we can identify things that trigger our symptoms as well.  For example, hard exercise is a huge trigger for me- I have to keep it gentle right now. 

 

Things you can do to help facilitate healing include eating a healthy, whole foods diet, staying adequately hydrated, getting gentle exercise.  Avoid neurologically active substances, including caffeine, alcohol, nicotine, and recreational drugs.  Your instincts were right on the Ativan- we strongly advise against using other psychiatric medications to deal with the withdrawal effects of psychiatric medications.  The results can be unpredictable, and you could end up putting yourself in a situation where you have to taper off of yet another med down the road- and endure more withdrawal.  No thank you lol!

 

We only recommend two supplements on SA- magnesium and omega-3 fatty acids.  See the links below.  Do be mindful, however, it is very common to develop hypersensitivities while in withdrawal- to medications, supplements, and even foods.  If you do decide to try these, start with a very low dose, and see how you fare.  I fall into the hypersensitive camp myself- magnesium gives me brain zaps, and has me waking up every 15 minutes all night long!  Again- no thank you!

 

Magnesium, nature's calcium channel blocker 

 Omega-3 fatty acids (fish oil) 

 

It looks like you have developed some wonderful non-drug coping mechanisms over the years you were taking sertraline.  I, too, am a huge fan of mindfulness and meditation.  These things are literally the reason I've been able to get through the days over the last couple of years.  Keep this up- these things will carry you through not only your withdrawal recovery, but the stress that life will bring you even after recovery!  

 

All in all, congratulations on being drug free, and on developing some tools to help you through the ups and downs that withdrawal and life can bring!  Please don't be afraid of protracted withdrawal- it is what it is, and you have the tools to be able to cope with whatever comes up.  And now you have a community of like-minded people who understand!  That's what we're here for- to support you on your journey!

 

This is your introduction topic- every member gets one introduction topic.  Please post updates, questions and concerns here.  But don't hesitate to explore the rest of the forum, and engage with other members by reading their intro topics, and following their journeys.  That's the beautiful thing about this forum- everyone is kind and supportive.  You will never feel alone here.  

 

Sending you healing vibes... I look forward to following your journey! ❤️‍🩹

[PileOfLeaves]

Thank you so much for your response, Catwoman73.

 

I am now about 16 weeks/4 months free from Sertraline. After my first post, things continued improving very gradually. I still experienced daily anxiety (worse in the mornings, fading throughout the day), but the level of anxiety became lower overall. My appetite slowly came back as my nausea/digestion issues slowly faded. I even started thinking "maybe I've made it through!" but I told myself it was too soon to be sure.

 

And yeah... over the last week or so I've been sliding back down into the worst of it. Waking up super early trembling inside with racing thoughts, feelings of dread and horror, sickening existential angst and fears of the future. Also extreme nausea with dry heaving first thing in the morning, digestion issues, no appetite. Some crying spells, struggling to think and focus, etc.

 

I'm SO glad I found this website and learned about waves and windows - this knowledge has allowed me to recognize "Okay, I'm in a bad wave again" rather than freaking out thinking something's irreparably wrong with me and I need drugs to fix it.

 

I also can't help but notice the beginnings of a pattern, maybe? My first crash happened around the 8 week mark of stopping my med, and now I'm having a second crash 8 weeks after that. I think... THINK... maybe this one isn't quite as bad as the first time around... But I second guess myself moment-to-moment.

 

So now I just keep reminding myself that things got better before, and they will again. But god do I hate these feelings inside me. This level of anxiety and dread is pure torture