CallMeSnake: Can't figure out this convoluted mess.

[CallMeSnake]

      I'll preface this by saying that I'm on here looking for answers. At this point, I don't know if I have discontinuation syndrome or if my depression/anxiety are returning. The reason why I have so much trouble discerning between the two is that before I went on antidepressants 8 years ago, I was in active addiction. I was a heavy porn user who would act out multiple times a day in addition to binge drinking. So in effect, I really don't know what my "normal" or "baseline" brain state is. I remember being anxious/depressed most of the time and feeling dread constantly, but at the same time, I feel that dumping large amounts of dopamine into your brain will cause anyone to feel that way. All I can say is the way that I feel now doesn't feel quite the same way I have ever felt (and I'll get into that) but you might make the argument that this is my true "unmedicated" brain state--without psych meds or drugs. Anyway.....

       8 years ago when I got sober from alcohol and pornography I was put on Lexapro as, I assume, standard operating procedure for a person with a history of anxiety/depression as well as a means of preventing relapse. I believe my dose was 75mg  but I have to check because I have since been off it. A few years into my recovery (maybe three or four years), I went to my psych and told her that I struggled with depression especially during the winter months so she prescribed lamotrigine at 100mg in addition to the 75mg lexapro I had been taking up to that point. Last september (September 2023) my therapist recommended that I go back to see my psych because although I had made progress in my recovery, it wasn't at a level I wanted and I still struggled with depression and an overall lack of motivation. We decided on Zoloft at 75mg. I rapidly tapered off of Lexapro while titrating up on Zoloft. I forget what mg at which intervals for the Lexapro but I believe I tapered off over the course of a month. The first two weeks on Zoloft felt amazing. I had lots of energy, I felt super confident about myself and I felt happy. However, after the two week period, things took an absolute nose-dive and I started to feel worse and worse each week. I felt horribly depressed as time went on and I assumed that it was my body just acclimating to the drug. After a month or so, I reached out to my pysch and told her what was going on and she upped the dose from 75mg to 100mg. This made everything worse. I felt miserable most of the time. I would wake up in the morning on certain days and feel like I was made out of concrete, like all the dopamine in my skull had just drained out through my ears. I felt like a zombie and didn't want to do anything. There were a number of days where I just sat and played videogames all day until I had to work in the evening. I should note that this is unprecedented. In retrospect, it gave me some of the worst depression that I have ever felt–or at the very least the worst I can remember. Zoloft gave me the spectrum of sexual dysfunction and made me emotionally numb. The height of this was november-december 2023.

 

 

In january of 2024 I changed doctors and told them what I was experiencing with Zoloft. Because my brain was in some sort of messed up state and I was dealing with a lot of out of control, racing thoughts, she put me on a dose of Straterra--the effects of which, were unknown. A month or two later when I showed up, I continued to complain about depression and lack of motivation and told her explicitly I wanted off of Zoloft. So she took me off (again, a rapid taper over the course of a month or so) and put me on a very low dose of Wellbutrin. So at that point I was on

100mg Lamotrigine
?mg of Straterra (Dont even remember, it was a low dose)
?mg of Wellbutrin (low dose) 
tapering off 100mg of Zoloft

From that point on I continued to feel irritated and depressed most of the time. But then I noticed that I started getting incredibly angry at times and eventually had rage attacks. At one point, I had to pull my car off to the side of the road and scream at the top of my lungs because I was so angry. This was absolutely unprecedented. I don't know if the addition of Wellbutrin or the subtraction of Zoloft caused this. Maybe both. Next time I went back to my doctor I told her this she pulled the plug on Wellbutrin and I made the decision to just go off all meds. So over the next few months I tapered rapidly off of wellbutrin and straterra, figuring that this couldn't hurt because the doses were so low. This was around Feburary-March 2024 . I decided to stay on my 100mg dose of lamotrigine because I didnt want to mess with too many things at once. I continued to have mood disturbances, bad anxiety depression and anger until about the end of May 2024. I had titrated off of all meds by that time and hadnt taken my last dosage in months. From about May to September I experieced a honeymoon period. I didnt feel depressed at all, and in fact, felt fairly motivated to pursue life tasks. However, there was some changes that I couldn't explain. For one, I felt this tiredness most of the time. This fatigue seemed to have started when I first started taking Zoloft and has persisted until today. At that time, it felt like I had almost limited brain stamina. I remember going out to buy a pair of shoes. I felt really good and had energy, but after a little while I would start to feel tired, almost as if it were in my brain. I noticed that my heart rate was randomly elevated at times and couldnt explain why. Also, bizarrely enough, a didn't have any self loathing like I always had and actually had a loving connection with myself. Finally, the sexual fantasies that I used to have before my addiction and during Lexapro simply vanished. I was no longer excited by the pornographic images in my head that were brought about by years of sex addiction. These were all incredibly weird and I couldnt explain them. 

[CallMeSnake]

As the summer went on, I noticed that this weird fatigue continued to seemingly morph and change shape. In July or August, I noticed that a lot of the tiredness felt like it was residing in my skull. The best way I can describe it was that I felt neurologically tired. At times, I would feel very lightly hungover. My face would be flushed, my heart rate slightly elevated, and I would be tired. I started to go to meet up events and I feel like the anxiety caused by them would create these symptoms. I remember going to one in which I was particularly nervous about, and by the time I got there, I felt so zoned out and tired, that I had to go home. I dont remember this ever happening in or outside of my addiction. I dont remember my anxiety ever feeling like that. Around september, it felt like this honeymoon phase was waning a bit and I went to see another pysch to see if I could get answers but she didn't know what to make of my symptoms. By this time, the only drug I was on was 100mg of lamotrigine. Around this time, the fatigue started to morph and I noticed that I would get almost uncontrollably tired after eating. For awhile it caused brain fog. I was also generally tired most of the time and had poor stamina when I would attempt to work out and exercise. After the psych appointment I decided to go off the lamotrigine as well and not learning my lesson, tried tapering in 25mg intervals. I got my doses mixed up and ended up going from 100mg down to 50 in a few weeks. I can't say that I immediately felt withdrawal symptoms, but I have noticed a steady decline in my mood from then until now. Realizing that I had tapered down that fast, I held at 50mg and have been there since. 

Since November started I noticed I have been in a quite bad depression that seemed to come out of nowhere but I have a few theories as to why it started. I feel tired almost all the time, have racing thoughts that won't go away and that elevated heart rate thing that seemed to go away for awhile and is now suddenly back. For awhile back in those spring/summer months, it felt like I was getting better but now it simply seems like my symptoms are changing or are actively getting worse. And for some reason, the creeping thought that keeps pervading in my anxiety riddled brain is "how do I not know that this is simply my brains normal state?" Sure, all those overlapping tapers probably messed something up, but what if what I'm experiencing now is just simply normal for me? I'm still on the 50mg of Lamotrigine and want to go off of that because I'm thinking maybe thats what causing the fatigue, but I simply dont know. I'm thinking of seeing a more reputable pysch, but I frankly dont know if thats going to help. I'm getting more used to the possibility of going back on meds, but if I have discontinuation syndrome, that could actively hurt the healing process. 

[Jane318]

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

 

So the moderators can best help you, please complete your drug signature by following these instructions. Adding a signature ensures your drug history appears at the bottom of every post, making it more efficient for those trying to assist. This link should go directly to your own signature: Account Settings – Create or Edit a signature.  Please include any other prescription drugs and supplements you currently take.  

 

From your narrative, it seems you are experiencing severe withdrawal from too-fast tapers off of multiple drugs.  I am sorry for all you are suffering right now.  I commend you for overcoming your prior addictions.  This demonstrates that you have courage and commitment to recovering from this challenge as well.

 

Antidepressants and other psychotropics are powerful drugs that profoundly affect our brains / bodies / central nervous systems.  You can read a bit about this here: How Psychiatric Drugs Remodel Your Brain.  

 

Further, even after only a few weeks, it can be very difficult to get off of these drugs without suffering withdrawal: What is withdrawal syndrome.   Things become even more complicated when there is history of multiple drugs and repeated too-fast stops.  Unfortunately, most psychiatrists and other doctors are ignorant of these risks.

 

The symptoms you describe are often associated with withdrawal.  Compare to the list here:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF)

 

If your desire is to get off all psychotropic drugs, we can help you craft a path forward, but we need to see your drug history / signature first.  In the meantime, I advise you to not make any more changes - maintain current dose of whatever you are taking right now and do not add any other drug.  Your CNS needs to stabilize, and this will likely take several months.  Once you are stable, you can begin to taper off the drugs you are taking now if that is what you choose to do.  

 

Here at SA, we recommend a slow hyperbolic taper, which you can read about here:  Why taper by 10% of my dosage?  In our experience, this is the best way to keep withdrawal manageable.  

 

During this period of holding to stabilize and later when you taper, it is very normal to have periods where you feel better, and periods where you feel terrible.  This is what we call the windows and waves pattern of stabilization. Read more about windows and waves here:   The Windows and Waves Pattern of Stabilization

 

You may want to watch: Video:  Healing From Antidepressants - Patterns of Recovery

 

It's important to track your symptoms - You can use the typical withdrawal symptoms checklist linked above to do so.  

 

You may choose to also track your foods and activities to identify things that trigger symptoms as well.  We do encourage people to avoid caffeine, alcohol, and recreational drugs.  Many prescription and OTC drugs can cause problems too and should be avoided as much as possible.   Eat a balanced, whole foods diet, stay well hydrated, engage in gentle exercise, and get adequate rest/sleep. 

 

We have many threads on how to cope with symptoms – I encourage you to check out the various forums / links on the SA.org home page.

 

 

We recommend only two supplements here - magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

If you decide to try a supplement, even those we recommend here, add in one at a time and at a low dose in case you do experience problems.  If you tolerate it well, you can increase the dosage slowly over time.  

 

This is your introduction topic.  Each member gets one intro topic- please post updates and questions here, in this thread.

 

Hope this helps - we can advise further once we see your drug signature.  Best wishes.

[Jane318]

9 hours ago, CallMeSnake said:

I can't say that I immediately felt withdrawal symptoms, but I have noticed a steady decline in my mood from then until now. Realizing that I had tapered down that fast, I held at 50mg and have been there since. 

The fatigue and other symptoms you describe are common withdrawal symptoms.  Onset of symptoms can be delayed somewhat depending on the half-life of the drug and other factors.  You are wise to hold at 50 mg foor now.

 

9 hours ago, CallMeSnake said:

And for some reason, the creeping thought that keeps pervading in my anxiety riddled brain is "how do I not know that this is simply my brains normal state?" Sure, all those overlapping tapers probably messed something up, but what if what I'm experiencing now is just simply normal for me?

You have made a lot of changes in the last 15 months or so.  Your brain / CNS is struggling to adjust.  This is not your brain's normal state.  You need to stabilize.  This will take some time.

 

9 hours ago, CallMeSnake said:

I'm thinking of seeing a more reputable pysch, but I frankly dont know if thats going to help. I'm getting more used to the possibility of going back on meds, but if I have discontinuation syndrome, that could actively hurt the healing process. 

As you have seen, a psychiatrist will prescribe more drugs.  After all the changes you have made, it is certainly possible, probably likely, that adding another drug could make things worse for you.

 

Antidepressants and other psychotropic drugs numb our emotions / mask our symptoms.  So we may feel better for a time.  However, the evidence is clear that over time, they do more harm than good.  In Anatomy of an Epidemic, author Robert Whitaker presented the data that show that over the long term, people who do not take drugs fare better than those that do.  

[CallMeSnake]

I don't know if I've said this in the previous post, but the main reason why lately I feel I have been particularly disturbed is because of the very rapid onset of the depression I've been having for about a month now. From about June to October, I dont remember having any real depressive symptoms, but then all of a sudden when November came around WHAM. I've been in a bad state lately, with very low moods, energy levels, constant rumination, emotional numbness. Back in August, I would have told you that something else was going on. Definitely didn't feel like anxiety or depression. I thought I was deficient in some sort of electrolyte of vitamin but my blood work has been coming back consistently healthy. However, this feels way more like typical depression, which is why I'm worried. 

Plus why such a bizarre psychological shift after coming off those meds? Why do I no longer self loathe like I did when I was on them? No longer have sexual fantasies related to my addiction? Sometimes I can't tell if my libido is lower or simply different. One way that I use to describe what happened while coming off these meds is that some switches were flipped on while others were flipped off. I have a much more intimate and loving relationship with myself now, but at the same time, I feel like I can't feel as deeply in certain situations. Numb to some things while unnumbed to others, except lately now, with these depressive symptoms, I seem to be numb to most stuff. 

[CallMeSnake]

Right now I'm currently dealing with near constant rumination and severe depression that seems to come in waves. I still am thinking that this is just the return/relapse of depression but I can't remember feeling this depressed before. I made an appointment with a reputable psych that's in a few weeks, but I'm skeptical as to what they'll say.

[Jane318]

Greetings @CallMeSnake -

On 12/1/2024 at 7:48 AM, CallMeSnake said:

I've been in a bad state lately, with very low moods, energy levels, constant rumination, emotional numbness.

On 12/7/2024 at 8:17 AM, CallMeSnake said:

Right now I'm currently dealing with near constant rumination and severe depression that seems to come in waves. I still am thinking that this is just the return/relapse of depression but I can't remember feeling this depressed before

I am so sorry you are dealing with severe depression and related issues right.  All are common withdrawal symptoms.  Compare with: This Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) .  That they are due to withdrawal, not relapse, is indicated by the fact that they appear soon after tapering / quitting.   I can relate and assure you that this will get better with time, as your CNS stabilizes.

 

On 12/7/2024 at 8:17 AM, CallMeSnake said:

I made an appointment with a reputable psych that's in a few weeks, but I'm skeptical as to what they'll say.

I can pretty much guarantee you that they will want to give you another drug, which could well make things worse for you.  May be of interest:  https://www.psychologytoday.com/us/blog/side-effects/202412/the-costs-of-mistaking-antidepressant-withdrawal-for-relapse

[CallMeSnake]

The thing is, I'm constantly gaslighting myself. Each day, I flip flop between thinking that its discontinuation and that its relapse. The amount of thought and rumination is absolutely bonkers.  I feel like my mind is coming apart at the seams sometimes. You can make some pretty good arguments (especially now, with this current depressive episode) that its depression/anxiety. However, if you look at the bigger picture, things just don't add up. June-September I felt really good and had a lot of motivation, but I still had this weird malaise and unexplainable fatigue. It felt like my brain was tired a lot of the time. I was vehement during that time that it wasn't depression/anxiety and I was almost convinced that I had some sort of vitamin/electrolyte imbalance. 

The reason why I'm going to see a psych is that this one was recommended by my therapist whom I have a lot of faith in. I'm not expecting a lot and I'm definitely not going to make any on-the-spot decisions about medication. And secondly, I think I'm reaching a point of panic with all of this. This past year has been absolutely hell on earth and I'm just afraid of this continuing on indefinitely. It doesn't seem like my symptoms are getting better, they just seem to be changing in subtle ways. Whatever I have seems to be amorphous and continues to progress but not get any better. 

[Jane318]

I grieve for all you are enduring right now.  I can only repeat that with all the drug changes / fast tapers, you central nervous system is highly de-stabilized.  Be sure to take your drug history with you to your psych apptment.  Hopefully,  (s)he will be one of the rare ones that understand AD withdrawal syndrome.

 

You might consider a small updose of the lamotrigine - perhaps to 55 mg.   Reinstatement (updose) of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  It isn’t a guarantee of diminished symptoms but it’s the best tactic available. The only alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement predictably works up to 3 months after last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and if you take too much it may be too much and can be even harder to regain stability after this happens.  Then, once you've stabilized on that dosage, which can take several months, you can begin a 10% per month taper down to zero.   Please read:

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

How long does it take to stabilize after reinstating or updosing?

Hypersensitivity and kindling

 

If you decide to try this, wait a few days at least to test the effect.  It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.

[Jane318]

How are you doing @CallMeSnake?  Wishing you the best for the holidays.