sashiko: New here, introduction

[sashiko]

Hi, I've been lurking for a while and decided to finally create an account. First of all, I'm not a native English speaker and I live in a country outside of the EU or North America. Hopefully you forgive any odd phrasing or mistakes.

 

I'm 25 years old and have been on some kind of psychiatric medication since I was around 13 or 14. I had a fairly tumultuous childhood so by that point I had been mentally unwell for a while. I was later institutionalized at 16 years old for an attempt on my life. So, really, most of my formative years have been marked by being a psychiatric patient. My extremely summarized timeline goes something like this:

 

2013-2016: Teenage hell, institutionalized, was put on benzos and an ever-changing cocktail of SSRI + antipsychotic + mood stabilizer. 

 

2016-2018: Multiple attempts at reducing clonazepam dosage. The tapering was done in a haphazard way. Doctor was extremely unhelpful so I tapered in a disorganized, intuitive manner over the course of a few months. My memory is better after this.

 

2019: Diagnosed with bipolar disorder. I was on lithium, lamotrigine, olanzapine and sertraline. I didn't feel well mentally, but I believed I was on the right track.

 

2020: I started to feel very physically ill: fatigue, horrible cystic acne, weight gain. I was switched from sertraline to venlafaxine, no taper. I began to experience excessive sweating. Doctor suggested some blood tests; my thyroid hormones were low. I was told it was probably the lithium, so I quit lithium cold turkey. At this point I believe I also quit lamotrigine. 

 

2021: Acne and excessive sweating persisted. Fatigue was a little better, mentally I felt very unstable. Struggling through college and the pandemic. I switched from venlafaxine to desvenlafaxine in an attempt to reduce side effects. I believe venlafaxine also gave me bruxism.

 

2022: Switched doctors, and this one gave me a new cocktail with mirtazapine, valproate, olanzapine and duloxetine. This doctor also gave me random things like bupropion or pregabaline when I complained of fatigue and continued depression. Did a few sessions of TMS after the doctor told me I was a "tough case" and "treatment-resistant". I don't think it did anything. Dropped out of college.

 

2023: Seeked treatment for my acne, discovered I have Hashimoto's disease after a few blood tests. If the lithium triggered it or it was pre-existing, it's hard to say for sure. I felt like my health was in the gutter: pre-diabetic, PCOS, bruxism, mystery excessive sweating. Was put on levothyroxine, and my energy and mood improved so much I did some quick tapers off mirtazapine, valproate and olanzapine which I now believed to not be helping anything at all. Duloxetine was harder. I did some research and cross-tapered to escitalopram.

 

2024: Have been trying to get off escitalopram. I'm on 10mg. I feel better than ever, honestly. Not perfect, but I feel like I'm finally living my life, present and clear-headed. No longer in the pre-diabetic stage, PCOS is controlled. In school again and I'm able to do some freelance work to support myself. Excessive sweating and bruxism are still major problems I deal with on a daily basis.

 

I feel like I've been relatively lucky in terms of being able to easily go on and off and cross-taper meds. So when I tried quitting escitalopram cold turkey, I didn't think it would be hard, since I'd done it before for other SSRIs. This time though, I got really severe withdrawal symptoms and I quickly realized it wasn't going to be an easy taper. I tried halfing the tablet, so 5mg daily and even though the withdrawal wasn't as bad, it was still untolerable and disabling. Here I am now, with these stubborn 10mg clinging to my body.

 

After all of this, I just feel lied to, neglected and outright harmed by psychiatry. I have long-term health problems that I believe were directly caused by some of the meds that were supposed to help. It's also hard to relate to most people and I feel generally stunted due to my early life experiences. I was misdiagnosed as a child and sent on a pipeline from which I'm just emerging. A lot of this is very upsetting, but right now I'm genuinely looking forward to the future. The escitalopram is just this last piece, and then I will leave psychiatry behind, probably forever. I will start with some of the suggestions I've read here for my next tapering attempt.

[Catwoman73]

Hi @sashiko, 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.   And I am so incredibly sorry for all you have been through.  Unfortunately, like everyone here, you HAVE been harmed by psychiatry- perhaps more accurately, the pharmaceutical companies.  Psychiatrists are just parroting what they've been told by the pharmaceutical companies, and perhaps more importantly, most have not listened to their patients when they have complained of difficulties stopping these medications.  It's a terrible situation. 

 

I'm very glad you've found us, and I can hear a lot of optimism in the final paragraph of your post.  That will carry you far on this journey!

 

I know you've been lurking around for a while, but I'm going to point out some very important information found on this site so that I'm certain that you have all the information you need as you start your taper!

 

Here at SA, we recommend tapering by no more than 10% of your CURRENT dose, no more often than every four weeks (so, in your case- 10mg, 9mg, 8.1mg, 7.29mg and so on).  This is known as hyperbolic tapering, and as a general rule, it does a fine job of keeping withdrawal effects to a minimum.  This method takes into account the fact that these medications have much larger effects on the brain at lower doses than it does at higher doses.  Dropping from 10mg to 9mg is often very well tolerated, but dropping from 2mg to 1mg can be catastrophic.  You may wish to taper at an even slower rate, of say, 5% per four week period, because of your lengthy history.  Or even consider a micro tapering method, which I can help you with, if you wish.  Read more here on hyperbolic tapering:

 

Why taper by 10% of my dosage?

 

I am happy to help you decide on a tapering method, and with any math required to calculate dosages, if math isn't your thing.

 

As you taper, you will find that you have periods where you feel pretty good, and periods where you feel terrible.  This is an absolutely normal part of the recovery process- we refer to it as the windows and waves pattern of stabilization.  This is actually a very good sign that your brain is making adaptations, and healing nicely.  Read more about windows and waves here:

 

The Windows and Waves Pattern of Stabilization

 

There are a variety of things you can do to help your body and brain heal as you proceed.  Most are intuitive- eat a balanced, whole foods diet, stay hydrated, get enough rest/sleep, and engage in gentle exercise.  Avoid neurologically active substances, such as caffeine, nicotine, alcohol and recreational drugs- all of these can be like pouring gasoline on the fire of your withdrawal symptoms, making things much worse.  And I don't think I necessarily have to say this to you, but I will anyway- avoid taking other psychiatric medications to deal with the withdrawal symptoms from psychiatric medications.  The effects of these medications are not predictable on a nervous system trying to stay stable during a taper, and they could make you feel much worse.  

 

Here at SA, we only recommend two supplements- magnesium, and omega-3 fatty acids.   Do be mindful though- it is very common for those tapering/experiencing withdrawal to develop hypersensitivities to all sorts of things- medications, supplements, and even foods!  So if you choose to start taking anything, even supplements that we recommend, start at a very low dose to see how you fare.  You can increase slowly over time if you tolerate them.  I am a fine example of hypersensitivity- magnesium is supposed to be calming, but it gives me brain zaps and insomnia!

 

It is a good idea to start keeping a symptom journal as you begin your taper.  Keep a daily record of your symptoms, rating them on a scale of 1-10 for severity, along with tracking your dosage, foods, supplements and activities.  This can help you identify your windows and waves, and can help you identify things that make your symptoms worse.  For me- that list includes coffee (even decaf) chamomile, magnesium, stress of any sort, and intense exercise.  Here is a list of typical withdrawal symptoms that could serve as a template for a journal, if you wish:

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

In terms of coping with emotional and cognitive symptoms  as you proceed, we have many, many threads on these topics here.  I will link some below.  It's very important to start developing some solid non-drug coping mechanisms as early as possible in your journey.  For me, I practice mindfulness every minute of every day, I use guided meditations/yoga Nidra and nature sound recordings on YouTube to assist with sleep at night, and I use CBT techniques like box breathing and challenging my negative thoughts to help with daily anxiety.  I stay as active as I can (though I also suffer from long covid, so I have minimal ability to exercise), and I love distracting myself with fun activities.  I love to swim (I feel normal in the water!), cook, and tackle artistic projects.  I'm currently taking a drawing course.  Distraction is a wonderful tool!

 

Non-drug techniques to cope with emotional symptoms

 Easing your way into meditation for a stressed-out nervous system

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

Ways to cope with daily anxiety

"Change the channel" - dealing with cognitive symptoms

Dealing With Emotional Spirals

Symptoms and self-care

 

In summary, proceeding with a hyperbolic taper would help you to minimize your withdrawal symptoms as you proceed.  You may wish to also consider a micro tapering method with your history, as it is much more gentle than making the larger cuts all at once.  Take very good care of yourself as you proceed, and keep a journal to help you identify your windows and waves, and your triggers.  

 

Most of all, keep the hope alive, even when you are experiencing symptoms!  We are all healing, all the time, even on those days when it doesn't feel like it.  You already have optimism regarding the future, and that will carry you a long way.  We're here to support you in any way we can!

 

This is your introduction topic- each member gets ONE intro topic.  Please post updates and question here, on this thread.  But do keep exploring the rest of the forum- there is tons of good info here!  And, if you are feeling up to it, do read the intro threads of other members, and drop a comment or word of support.  Tapering and withdrawal can be a lonely journey.  I have found it very helpful to have built this community around me- everyone here fully understands the challenges you are facing, and will support you unconditionally along the way.  That makes the journey easier. 

 

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

[sashiko]

On 9/13/2024 at 10:27 AM, Catwoman73 said:

Here at SA, we recommend tapering by no more than 10% of your CURRENT dose, no more often than every four weeks (so, in your case- 10mg, 9mg, 8.1mg, 7.29mg and so on).  This is known as hyperbolic tapering, and as a general rule, it does a fine job of keeping withdrawal effects to a minimum.  This method takes into account the fact that these medications have much larger effects on the brain at lower doses than it does at higher doses.  Dropping from 10mg to 9mg is often very well tolerated, but dropping from 2mg to 1mg can be catastrophic.  You may wish to taper at an even slower rate, of say, 5% per four week period, because of your lengthy history.  Or even consider a micro tapering method, which I can help you with, if you wish.  Read more here on hyperbolic tapering:

 

Why taper by 10% of my dosage?

I am happy to help you decide on a tapering method, and with any math required to calculate dosages, if math isn't your thing.

Hi! Thanks for your thoughtful response. I've been learning a lot about withdrawal and what actually is going on in the body. Makes me wonder if the fast med changes I've gone through have done more damage than I thought, or if some things that I thought were adverse effects were actually WD symptoms. Ultimately, I want to approach my escitalopram taper with the utmost care and patience.

 

I was also somewhat disappointed to read that caffeine and other psychoactive drugs can make the healing harder. It makes sense but in the past I've managed a lot of side effects through CBD and edibles, and I'm a complete coffee lover/addict. Weed I can live without, but as of right now I'm not planning on quitting coffee. I've made of it something of a hobby, and enjoy grinding the beans and carefully brewing a nice cup through whatever method I fancy. As of recent years I've restricted myself to 2 cups a day at most, but in the past I've unfortunately gone way past that in an effort to cope with med sedation and hypothyroidism.

 

I'd say the genuine joy it gives me outweights the possible harmful effects of caffeine, but if it comes to it I'll make the changes. We'll see. I've found a lot of strenght in realizing that YES, I can change and my body can adapt. One of the lies I bought into for a long time is that I'm broken or irreparably flawed in some way, but I see now that it's not true. Recently I taught myself how to ride a bike -something many people learn in childhood and I thought I'd never learn- and I've been loving going out and doing some relaxed cycling through the neighborhood. Better than coffee sometimes. 

 

Back on the tapering topic, my last haphazard attempt at tapering by halfing the tablet ocurred about a month ago. In a desperate attempt to ease symptoms I returned to the 10 mg dose last week. For now I feel a lot of relief but I've realized that rapid cycling like that is far from ideal. Now I'm wondering if I should wait for a while to stabilize again in the 10mg, or if I can start tapering right away. Caution tells me to wait but I don't know what the peer consensus on this situation is, considering my last dose change was quite recent.

 

I'm looking forward to sharing my journey as well. 

[Catwoman73]

21 hours ago, sashiko said:

Hi! Thanks for your thoughtful response. I've been learning a lot about withdrawal and what actually is going on in the body. Makes me wonder if the fast med changes I've gone through have done more damage than I thought, or if some things that I thought were adverse effects were actually WD symptoms. Ultimately, I want to approach my escitalopram taper with the utmost care and patience.

 

 

Rapid med changes are extremely destabilizing for many people, and they do make subsequent tapers more challenging.  But nothing is impossible- I have a very lengthy history with these drugs, and am currently tapering hyperbolically for the first time, and it's going relatively well.  Self-care and acceptance of every step of the journey really helps!

 

21 hours ago, sashiko said:

I was also somewhat disappointed to read that caffeine and other psychoactive drugs can make the healing harder. It makes sense but in the past I've managed a lot of side effects through CBD and edibles, and I'm a complete coffee lover/addict. Weed I can live without, but as of right now I'm not planning on quitting coffee. I've made of it something of a hobby, and enjoy grinding the beans and carefully brewing a nice cup through whatever method I fancy. As of recent years I've restricted myself to 2 cups a day at most, but in the past I've unfortunately gone way past that in an effort to cope with med sedation and hypothyroidism.

 

I'd say the genuine joy it gives me outweights the possible harmful effects of caffeine, but if it comes to it I'll make the changes. We'll see. I've found a lot of strenght in realizing that YES, I can change and my body can adapt. One of the lies I bought into for a long time is that I'm broken or irreparably flawed in some way, but I see now that it's not true. Recently I taught myself how to ride a bike -something many people learn in childhood and I thought I'd never learn- and I've been loving going out and doing some relaxed cycling through the neighborhood. Better than coffee sometimes. 

 

Everyone is different!  If you love your coffee, keep it for now!  Track how you feel in a journal, and watch for signs that you are not tolerating it anymore.  I drank coffee religiously until about four months ago.  I was having daily severe stomach pain and nausea at 2pm every day, like clockwork.  When I figured out that it was exactly three hours after I drank my daily coffee, I tried cutting it to see what happened.  And dropping the coffee completely fixed the problem.  Though I had nasty withdrawal from that too lol... I'm still glad I gave it up.  

 

Keep up that bike riding!  That's the perfect gentle form of exercise for withdrawal.  Added bonus- it gets you out in nature, which is so good for all of us, whether in withdrawal or not! 

 

21 hours ago, sashiko said:

Back on the tapering topic, my last haphazard attempt at tapering by halfing the tablet ocurred about a month ago. In a desperate attempt to ease symptoms I returned to the 10 mg dose last week. For now I feel a lot of relief but I've realized that rapid cycling like that is far from ideal. Now I'm wondering if I should wait for a while to stabilize again in the 10mg, or if I can start tapering right away. Caution tells me to wait but I don't know what the peer consensus on this situation is, considering my last dose change was quite recent.

 

Yes, if you've just made an increase, following a large decrease, a hold of 1-2 months minimum (some people need longer) is probably in order to give your brain and body a chance to settle.  This is a great time to start that symptom diary, and get in the habit of keeping it updated, and work on your non-drug coping mechanisms.  Then you'll be 100% ready to get the ball rolling! 

[Franco12]

I'm so glad you quickly identified the signs of discontinuation, @sashiko Best wishes for the medication reduction process!!!! Are you also a Spanish speaker?