ChargingBull: Very afraid.

[Chargingbull]

Hello,

 

Thank you in advance for any help or perspective any may be able to offer. It is greatly appreciated.

 

First, a slightly more detailed version of my signature to put more into context.

 

16-21yrs: St John's wort for unipolar depression (caused by 3 months intense cannabis use), ended up with cyclothymia from ages 17 onwards, on withdrawal became psychotic for a week (also meditation retreat and sleep deprivation)

 

21-23yrs: initially fluoxetine (1yr), then venlafaxine when pooped out (1yr). Intense anxiety on withdrawing from venlafaxine. 2yrs without medication then, perpetually existentially challenged, many struggles. Maintained function as a low intensity mental health worker. Good days and bad days.

 

25-27yrs: severe mental breakdown (obsessive self doubt, mood swings and anxiety). 3 months off work. Worst time of my life. Unabated horror. Tried existential therapy to no avail. The only thing that worked was eventually getting past my Peter Breggin induced fear of medication and going back onto fluoxetine,but only after psychiatrist first trying quetiapine and Abilify. Eventually added lamotrigene at my request to help stabilise swinging.

 

Oct 2015: discontinued fluoxetine as I wanted to be med free. 40mg for a few weeks, then 20mg for few weeks, then off. Was worried about withdrawal so I took St John's wort for two months and then stopped in 2 weeks.

 

It was a difficult, but manageable Christmas.

 

Its now end of Jan 2016, just returned from a meditation retreat, as part of my ongoing hope that leaning into my fears and sadness will help me process them. I am also an ACT practitioner so I try to help people without medication. I am currently off work after experiencing intense anxiety at and after the retreat.

 

Main symptom is overwhelming anxiety. Obsessive doubts, attempts to fix, constant rumination about my life and mind and what to do or not do about it. I exercise, eat well, sleep well, take various supplements. I practice as much mindfulness as possible, sometimes very successfully. Before this crisis, I could have days or even a week feeling fine, and then there would be either very low moods or anxiety.

 

I have some respite, but then it's back.

 

I am afraid for my life. Afraid to stay off meds, afraid to go back on them. I don't want to cause long term damage to my brain, and fear I already have. I truly hope someone on this site will be able to help me recognise whether this looks like withdrawal or just my original problematic self. I have always had a vacillating self esteem.

 

I should add that I've played with a lot of supplements in the past and recently, but of late mostly only vitamins and minerals (D, mag, high potency B, omega 3). I haven't had any for a few days as I'm completely losing perspective on what might be effecting me in what way. I tend to make aggressive changes. I realise this is stupid and will stop.

 

Thank you again.

[Chargingbull]

I wanted to add that, after reading the guide sticky on this site, I am basically doing everything as advised, apart from my aggressive drug changes last year. This has probably screwed things up.

 

I guess I need to know what might be the best way forward - reinstatement, and then GRADUAL withdrawal, or just stay off and hope for the best. I am very scared (and motivated) by the second option, as in my previous 2yr break, I ended up having the worst breakdown of my life. I would say I take better care of myself now though (no alcohol, no caffeine, compassion focused therapy etc)

[AliG]

Hi ChargingBull.  Welcome. I'm sorry for what you have gone through.

What date in October did you quit Fluoxetine ?   It seems you  essentially C/T 'ed ,  but perhaps with a small reinstatement, you can stabilize somewhat. Starting off at 1 - 5 mg.  It  might  help to alleviate withdrawal symptoms . There is no guarantee, as everyone is different. Some , do become sensitized. However, as it has been only 3 months or thereabouts, it might be  something to think about.  ACT  - Acceptance and commitment therapy ?  You should be in a good place to deal with this. I'm sure it will help , enormously. Thanks for adding your drug history signature.

There is a lot of support and information here, for you. This is your thread/ journal to ask questions , and record your progress. Please come back with more questions and other concerns. These links might help.

http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

We advise a  10 %. taper method.  Possibly, if you reinstate a small amount , and then taper off slowly, you might be able to minimize any further withdrawal symptoms.  Have a read , and see what you think .

Ali

[Chargingbull]

I'll ask my doctor if I can get access to liquid fluoxetine, as otherwise I'll have to eyeball the pellets inside...sounds too variable.

 

I reduced from 40mg early October, then down off 20mg 9th November. I'd forgotten that I actually started taking fluoxetine again for a week in December after freaking out about withdrawal...

 

Ive also considered the possibility of reinstating 20mg,healing for a few months, and then beginning taper from there. Does that sound reasonable?

[apace41]

Hi, Chargingbull,

 

Welcome to SA.  First off, it does sound like you have done a lot of the things we recommend in terms of self-soothing techniques and lifestyle so that is a positive.  In looking at your supplement regime, I would suggest you drop the B complex as B can be very excitatory for a lot of people (me included).   You have had a fair number of changes in your AD history, including going on and off the meds, which will have had an impact on your CNS and will take some time of being gentle and careful to get over.  Thinking in terms of brain damage is not particularly helpful as it is our general experience that any damage is transient and reversible as a result of neuroplastic change in the brain.  Adopting a more positive attitude that healing is possible and happening will be more beneficial to the extent you can.

 

 

I'll ask my doctor if I can get access to liquid fluoxetine, as otherwise I'll have to eyeball the pellets inside...sounds too variable.

 

An alternative to liquid if you can't get it is to weigh the capsules with a high quality jeweler's scale you can purchase on Amazon for $30 US which would be about 20 pounds (assuming exchange rates are about where I last left them  ).

 

I reduced from 40mg early October, then down off 20mg 9th November. I'd forgotten that I actually started taking fluoxetine again for a week in December after freaking out about withdrawal

 

As AliG said, for all intents and purposes that is tantamount to a c/t off the med since you went from 40mg to 0 in a month and then had a week reinstatement which you abandoned (presumably further destabilizing the CNS).  Thus, your choice is to reinstate or not. 

 

Ive also considered the possibility of reinstating 20mg,healing for a few months, and then beginning taper from there. Does that sound reasonable?

 

Our general advice is to reinstate at the lowest level necessary to quell symptoms.  Two reasons for this: 

 

• First, your CNS is sensitive and 20mg may be too activating to calm your symptoms so we would suggest somewhere in the 2-5mg range.  You can give that a good 4-5 days and titrate up slightly if needed to get the symptom reduction. 

• Second, the lower you are when you stabilize, the less you have to taper to get off.

 

So, I would suggest you start on a small dose and see how you do after 4-5 days (it takes at least 4 to fully metabolize and take effect in your body).

 

We can reassess after you see how you are feeling.

 

Best,

 

Andy

[Chargingbull]

Thank you both, very helpful.

 

I had read years back the B-vits could he over stimulating, so I will keep going with that.

 

The 'brain damage' negation is very reassuring indeed. Brain plasticity has strong backing and it's good to know it mirrors the anecdotal bank of experience here.

 

I am very doubtful a UK doctor will prescribe liquid fluoxetine for the purposes of withdrawal; I'm not sure they would even acknowledge this as withdrawal. On that, I have to conceded, they could be right. I could just be screwed up. I'm hanging onto the possibility that I can exist with relative freedom without medication. It's the swing of symptoms that makes me think it's physiological/neurological - for 2hrs today I was at extremely high anxiety. All the mindfulness in the did not influence the storm, despite total surrender. Calm since then. Happy, even. Does this mirror anyone's experiences?

 

Certainly when I eventually decide to come off lamotrigine, it will be at the 10% taper, or 25mg every 2 months.

 

I'll stay focused on exercise, meditation, healthy food, love, and substance free living. If that's not worth recovery, then nothing will ever be.

[apace41]

I'm not sure they would even acknowledge this as withdrawal. On that, I have to conceded, they could be right. I could just be screwed up. I'm hanging onto the possibility that I can exist with relative freedom without medication. It's the swing of symptoms that makes me think it's physiological/neurological - for 2hrs today I was at extremely high anxiety. All the mindfulness in the did not influence the storm, despite total surrender. Calm since then. Happy, even. Does this mirror anyone's experiences?

 

CB,

 

I think that the VAST majority of people on the site can relate to what you are describing.  You are going along just fine and, seemingly out of the blue, you get hit with a wave of anxiety that you can't alleviate with the best of coping mechanisms.  That does not, in and of itself, mean you have an underlying condition that needs medication.  Read through the site and understand the science a little.  The great majority of the benefit of these medicines has been demonstrated by greater minds than mine to be placebo in any event.  The level of anxiety that you get from withdrawal is greater in volume and nature than what most people had prior to going on meds.  The stuff you had prior to the meds would be more likely to respond to coping tools than the stuff being generated by chemical imbalances CREATED by the meds.

 

There is every reason to believe that if you come off the meds slowly and carefully over time you will be able to live med free using the coping tools as the way you deal with periodic anxiety -- MUCH THE WAY MOST OF US SHOULD HAVE BEEN COUNSELED TO BEGIN WITH!

 

Best,

 

Andy

[Chargingbull]

Then I will live in hope of that, Andy. To be honest, it is the main reason for my existence.

 

Ive decided to stay off the fluoxetine for the time being. To be honest I just don't want to fk with it any more. Both the drug and my CNX.

[KarenB]

Hello ChargingBull,

 

Just picking up on your last comment.  The way these drugs change our brains, and the length of time required for healing, means that whether you reinstate or not, the fluoxetine is still messing with you.  So it may well be that a small reinstatement and subsequent gentle taper is the route of least messiness for your CNS.

 

Not sure if I'm explaining this very well.  To use your phrase:  either way, fluoxetine is still '*****' with you, so it may be best to choose the lesser type of '*****' (which could be the reinstatement).  

 

Well, at least you have all the info at hand for making an informed decision.  

 

Wishing you well,

Karen