Lakelander82: Sertraline general query and tapering info

[Skeeter]

Lakelander,
In our very first post here, you said you were doing just fine on 50 mg of Sertraline, you were able to do all of the normal things in life, you mentioned no problems at all, and you were able to socialize with no issue.  This was May 28th.

 

It appears from your notes that you reinstated to 50mg on May 29th.

 

I only mention this because the longer we feel crappy sometimes our memory of past events change, so it is REALLY helpful to go back and read the old notes to see if we are recalling things correctly.  In WD our brains do not work the same sometimes.  I found that even I recall things differently myself, so I am glad I keep notes on how I am feeling every day.  I will swear things were one way, but will read the notes and find the they were actually totally different.  

 

Not quite 4 weeks later, you reinstated, you were anxious to start tapering, so then it reads that your best day before you dropped your dose, you only felt like a 5 out of 10 while on your normal dose of this med, but some days would be a 7/10.  June 17 Squirrleygirl said she would like to see you wait at least 4 weeks, preferably longer before you start to taper, and to start your first taper at 5%, but you were really chomping at the bit to get started (which I understand), and you only waited until June 23,which is only 26 days, then started at the full 10%. 

 

Well under 4 weeks of reinstatement was not quite what she meant...lol.  Only under 4 weeks of reinstatement after 6 days at 25mg instead of 50 is not a long time to let your brain get used to things. IMHO (and Squirrleygirl's).  It also FEELS like a long time it you truly want to be tapering already, and of course, we all hold out hope that we will feel good as we taper. 

 

Now if you truly did not tell the entire story on your first post  (maybe did not realize that you were not fine every day despite saying so on your first post for some reason, maybe did not realize when you left that first post that the med truly was not working THAT well for you despite your words- that can and does happen.  Now you were warned again about your taper on July 16 by Petunia, warning you that your heart palpitations and other symptoms could be a sign you were tapering too fast for your system. The only way to really tell the difference is to hold until...  Until you start to feel better, or until you continue to feel the same, and you may not know that for a few months. 

 

You, IMHO may not have waited long enough for your brain to reset after dropping 50% of your dose then reinstating.  I suggest a hold, but obviously you can do what you like.  You know that what you are doing now is not working well for you, so only you can decide if a hold is right for you. Now on August 25, Scallywag, suggested that you may need to wait more than 30 days between each taper.  This is common,  4 weeks is not how everyone's system works the best with.  Some people find 5 weeks works better, some 6, and others find, like you are trying, to lower the amount you taper, but you may have to let go of the 30 day thing, and find out what works for your system, IMO 

 

My obvious guess is that you really, REALLY want off of this med, and will not wish to hold, as no one wants to hold, but it is now when you figure out how well you know yourself.  Are you the type able to stick it out a few months just in case you can feel better or are you the type to suffer through when suffering may not be necessary.  There are some people who can only decrease 1% a month (sometimes less), but if you have the strength to allow yourself to see if you can wait this out, you may do much better (even on a 30 day taper if you let your system catch up with your taper.  The brain is working very hard to right itself. 

 

You may either have to choose between playing with percentages and different amounts of weeks between each taper, doing a hold for a few months, or continue to suffer as you have been. Holding for a few months should not hurt anything at any rate. Here is where the danger comes in if you do not start listening to your body, and QUICKLY, you can end up with protracted symptoms after coming off of the med, if you come off too fast for your brain, so we have a VERY good reason in suggesting what we do.  I see in September you decided on your own to do a 5% taper, good for you!  Flexibility in this process MUST be learned. 

 

Now as for side effects from going too fast, just to mention it, some drugs, like Lexapro, for one, causes hypersomnia when you are tapering too quickly, this could be an issue for you personally with your unique metabolism, as every person is very different in how we react.  However, you seem to have always been a night owl, like myself, and if this is YOUR normal pattern, that is fine, but if it is more severe than you usually encounter, then you should listen to your body for sure.  If it does not let up, and is more severe than you are used to, you may want to have your blood tested to make sure nothing else is going on, just to be safe.  I AM NOT saying anything is wrong!!  Now a for a long hold, if you choose to try it-  your body is already used to the med, all you are doing in a hold is waiting to see if your brain can get used to the new lower dose, so your side effects of tapering do go away or at least lessen. 

 

If you feel fine in a few months, you should be able to find your own perfect taper schedule, whether that be every 8 weeks, or every 5 weeks, or whatever works for you, including finding the right percentage.  It is a precarious balancing act!!!  You are having some big issues right now.  Will you maybe consider a hold of perhaps 6 weeks FROM NOW (not your last taper, I mean), then reassess?  Some people do really well with a hold.  From reading all of your posts, I think asking you to do 3 months would drive you up a wall, for sure.  How about holding 6 weeks.  I will be happy to revisit with you then, and we can discuss how you are doing?

 

I wish you the best of luck.  I am happy to chat now and then here on your thread to discuss how things are, when I am available, for sure.  I a struggling a bit myself right now, but I still check on people!!

 

I am a new mod here (not new to the medical field), but I am not aware of any suicides being deleted personally.  Are you having suicidal ideations, is that why you ask?  If anyone tells us they are thinking of suicide, we refer them to resources right away.  I know from my work on the ambulance that people do not generally warn people when they actually do it, but that is my experience, and the experience of the police officers I spoke to on scene about such things said the same.

 

I am proud of how physically active you remain.  I see that your recent run did not go so well.  If you are going through a rough patch, better off walking than doing no exercise at all.  Sometimes in WD, we do not always feel pain from an injury right away, so if you DO notice an injury, proper care is indicated RIGHT THEN, do not exercise on an injured limb.  I have seen that time and time again here.

 

Happy Holidays LL!!!

Skeeter

Edited December 25, 2016 by JanCarol
white space by poster request, added bold

[Lakelander82]

I have no problem with long holds, I will hold as long as it takes Skeeter....that said if my symptom don't abate in the next number of weeks I'll probably updose. I probably was going slightly too quickly...but I don't believe it was shockingly quick.

 

No I'm not suicidal, never have been in my entire life, I was just curious after I read an article taking issue with this website. Here's the article if you're interested.

 

 

http://m.ripoffreport.com/r/surviving-antidepressants/internet/surviving-antidepressants-advice-given-out-like-candy-internet-1015295you

[Skeeter]

LL,
Thanks for the article, I will take a look!

Am happy to talk when you are ready to taper, or if you are not sure you are ready, happy to be an ear!!! I agree with you that you did not do anything severe, but we (the mods at SA) know both about how much change the CNS can take, and are quite good at seeing the signs that one is going too fast for their own brain/system to handle. Have seen it before over and over and over again, is all.

I am so glad you can be patient. I am very proud of you!!!

Skeeter

[Lakelander82]

Woke up with little to no anxiety today Skeeter ....haven't changed my thoughts, attitude, activity level nothing, which illustrates clearly that it's an involuntary thing we have no control over. Feeling pretty decent...

 

 

Nollaig shona dhuit everyone.....

 

[Skeeter]

LL,
I am so glad you are feeling decent today, but this thing is sneaky, as I know that you know. We can get lulled into a place of feeling good for a few days which makes us think we can taper, but then all hell can let loose, as you well know. Healing is not linear. I am pleased that you are going to stick this out without changing doses for sure for a while. I would love nothing more than for you to go for several weeks without bad days. You just cannot let yourself forget what the bad times feel like. I have a hard time with that myself. If you forget, or start to think, "It isn't so bad." I want you to go back and read your notes on your bad days and remember how truly awful it was. I want you to be able to run again without that awful feeling. You need to wait for a while first, do walking, powerwalking if you can, then try to add short bursts of jogging to see how that feels I want you to do a of the things you love, swimming as well, and your deep tissue massages, etc. Your resting heart rate tells me that you are quite fit. Thank you for the beautiful music!!

YOU CAN DO THIS!!!

And a Merry Christmas to you, Lakelander! Trying to get me with the Irish Gaelic, hmmm? LOVED IT!
Skeeter

[Lakelander82]

Believe me Skeeter. I'll be holding for a long time this time, maybe even as long as 2 months. Lesson learned. Thanks for your valuable contribution on my thread. :-)

[Lakelander82]

I'm strongly contemplating updosing again to my previous dose where I was stable. Things have not settled at all since my last cut and I'm suffering mush head syndrome anytime I get stressed or depressed. Had a problem with my car again today, remote locking wasn't working, had to insert key into door which then got jammed in the lock for an hour and then when I did get it free, the car wouldn't start because the there was a problem with the electrics which is linked to the locking problem. Had to go to a local leisure centre and make a phone call or two to get the problem sorted, as I hadn't got my mobile phone. All in all it was stressful and an upheaval for me but I know it shouldn't be. When I'm forced out of my comfort zone I automatically get stressed. My brain just seems to shut down when I'm stressed, my memory becomes poor and it's almost as if I don't know what to do next. You can hear the nervousness in my voice when I'm in a situation like this and I'm forced to interact with strangers when a mishap occurs. Trying to settle down and concentrate or do anything after this is very tough, even reading is a tough task. I never used to be like this at all, I used to take everything in my stride.

Anybody else suffer from this mush brain thing when they're stressed or anxious? Another thing that causes me this is when I'm contemplating going far from home as in a trip to the airport followed by a flight abroad.

[JanCarol]

Hey LL, if you read carefully in the "complaint" article you posted (from 2013, rebutted by Alto), you will see it says

Some sites "helping" people wean off  meds (all run by lay people) have had long term members commit suicide. Their posts are quickly deleted.

 

There are veiled references to a site which has since closed (PaxilProgress), and I think he is talking about that site, which had a "delete" policy in reference to suicides.  If you consider that SA has been around helping people since 2011, and tens of thousands of people have used our site - one complaint is a very small thing.  There's always someone, right?

 

We have had and do grieve suicides here.  I won't point you any links, because we also don't advertise them.  It is because we have experienced suicides that we are extremely cautious, and tend to suggest the safest course of action.

 

Making changes to your drugs is like bouncing a basketball in Mars gravity - that basketball can continue to bounce for 3-6 months or more.  This is why we caution against frequent changes.  Delayed Onset of Withdrawal Symptoms

 

If you look at the calendar - this current mushy funk could be from your major bounce in July.  That's why Petunia asked you to hold for awhile before starting to taper, preferably 3 months.  It's why Skeeter is asking you to hold, now.

 

If you updose, it is another bounce.  You can do it - but please be prepared to hold for at least 2-3 months.  

 

If you taper while having symptoms, you are making the situation worse and not healing.  If you broke your arm, would you continue to hit it with a hammer to see it if was better?  If you had a broken leg, would you go out and play football?  Tapering while having symptoms is a similar thing.

 

Adjusting your dose according to symptoms, will continue to play out in delayed symptoms.  It is normal to have a windows and waves pattern of symptoms.  This is a wave, and a result of previous changes.  

 

I don't know what links you've seen so far - please re-read your thread, and re-read the links that moderators have given you.

 

It is, of course, your body, your life, and your choice.   We are not doctors or medical professionals, we are only making suggestions based on our experience here.   At least I have told you my reasoning behind why I wouldn't updose.  So you can make an informed decision.  It is a small updose, so if you are completely miserable and have been for more than 7 days, perhaps an updose to halfway between where you are now, and your last dose, is a thing to try.

 

Otherwise, if you can, it would be best to hold for a long while, until your symptoms have settled down.

[Lakelander82]

Thanks for your input Jancarol. I have to disagree however that holding for threee months at 50mg instead of 1 month before beginning my taper would have made any difference to how I'm feeling now. My rationale for this is that I was completely stable for that month and for the first three cuts after that I had no withdrawal effects, so why would it effect me further on down the line?

[Skeeter]

Hey Lakelander,

I think all JanCarol is pointing out is that you want to start tapering from the most stable place you possibly can be when you start a taper, because it is a really long, draining process.  Since we have seen many people do all sorts of things with the meds they were prescribed, we can see how the big and little things can add up as you continue to taper.  Remember those awful days when you cut 50%?  Really hard, right?  Well, just because we feel better after we go back to our full dose, it does not mean that all is well.  The brain still needs time to right itself.  With all the cases we have seen/read and responded to here, we have seen over and over again how something one does comes back to bite them between about 5-6 months later.  I first noticed this when I was reading large number of peoples stories here and on other forums.  It most often happens at the 5 month mark, but there is a sweet spot of a couple of months around that.  I have not yet figured out why this happens, I need to contact a neurologist to figure that out.  I am actually just starting to track cases where this has happened on SA.  I personally most often notice that it happens with people that go cold turkey off of their AD (and do not go back on), and they feel great for a few months, then month 5 hits, and they are suddenly so sick they are bedridden.  I have started noticing now that more minor events are seeming to have this effect too.  Perhaps I will start to monitor this as well.  I am NOT saying this is what happened to you, I am just giving you information.

 

I am pretty sure you will not agree with me, but that is okay.  I was kind of hoping you would hold out another few days to a week and see if things would settle down a bit, but I do understand if you do not wish to. This is all your choice.  I am just telling you what I have gone through and what so many on this site have, and many times updosing, even a little upset in that can cause worse side effects like agitation and anxiety.  That is my fear for you. I hate that you are feeling this way, but yo have had such good coping skills thus far, I was hoping that things would calm down for you first.  If you updose, you may need to hold a it longer, because it is another dose change, and I do not want to see things get worse.  You can always consult your physician, if your doc knows about antidepressant withdrawal,  It is rare from what I have seen, but there is always the possibility

 

Not being able to function as well when you are frustrated is a very common symptom, and will fade as you hold.  I have not yet seen this symptom not fade yet in situations like yours which came on by your body sending warnings that you were going too fast for your system.  Again you did not go too fast on paper percentage wise, you system just did not like the speed in which you went over time, everyone is different. 30 days is just a guide, many people need a bit more time, it is not a one size fits all.  If you think you cannot possibly wait it out and HAVE to updose because your symptoms are excruciating, maybe going up a tiny amount is all you need.  Your brain chemistry is always changing, so it is getting used to your last dose on a constant basis. Your last decrease was about 5%, if I remember right, so you could try to reinstate maybe 1/5th of your last taper.  Know that things do not get better in a couple of days. According to the information I have learned on AD's, it takes about 4 days for your body to start to react to the new dose, and a bit longer for your system to fully get used to the new dose (you would know this better than I, perhaps!!!), so you might want to wait a couple of weeks to see if it works before you updose again, if you feel it is not working. I know that seems like such a small amount, but your brain is already working to get used to the last "new" dose, so upsetting that balance too much can actually have severe consequences.  This I have seen over and over, and I do not want to see you there.

 

Could you name all of the symptoms that make you want to updose, just so we have a record, as I am sure it is more than that awfully frustrating time you had recently with the car.  It generally involves more symptoms than just one or two.  Forgive me if I missed you listing every one, just point me to the message number (top right corner of the post) if you did list them all.  Now if you already did updose, please say by how much, what day, and any changes you have noticed thus far, and update your signature.

 

Are you keeping a journal on paper that includes the date, any meds/supplements you took, and the signs and symptoms you feel that day.  You might also work out a system t number each day with how severe your symptoms, such a 0-5 or 0-10 with zero being no symptoms at all.  Bow with your recent symptoms being brought on by major stress, you would note that under the day it happened, so you know what set off which s/sx.  During withdrawal, our memories are not generally as perfect as we wish, and this takes the guesswork out of it.  I am having a bad day myself in the brain department, so please forgive any mistakes in fact I made, they were not intentional.

 

Have you ben able to exercise at all?  How about swimming?  I hope that is going okay, as I know how you love to do it!! Have you tried jogging or walking since our running incident, I am wondering if you have had any mad experiences again. I love how you say swimming feels like a massage to you!!

 

Please ask any questions!!  I am happy to help if I can.

 

Athbhliain faoi mhaise duit!

Skeeter

[Lakelander82]

Hi Skeeter, good to hear from you again. I'm not updosing even though I feel like shite warmed up at various times through the day, that's about as eloquently as I can put it! :-D My decision not to updose is more borne out of my innate stubbornness and an unwillingness to give in. This thing is bewildering at time, you can go to bed at night on top of the world and then wake up 8 hours later a gibbering, anxious, crying wreck. Literally nothing has changed in my life in the space of those 8 hours and yet physiologically you wake up a different person, surely there must be a more sophisticated explanation than changing cortisol levels?? Movement first thing in the mornings is such a strange feeling for me, it's almost as if you're too nervous to move, its very hard to articulate in words. Generally I'm better in every aspect, both emotionally and cognitively in the second half of the day (from 5 - 6pm onwards).

 

I hear you're not doing too well yourself at the minute? Hopefully things improve for us soon. Happy new year to yourself.

[Skeeter]

Dia dhuit, LL!

 

At the end of the day, this is your decision on updosing.  I have talked to other mods regarding this and do not want you to suffer needlessly.  JanCarol suggested that the updose you suggested was not unreasonable.  I get nervous when talking about updosing, as I have seen it go wrong, but that is usually with higher dose increases than you are suggesting, so I will follow the other mods suggestion.  My worry was that you would get worse, and I would feel really guilty. JC is very experienced, so I totally trust her judgement.  If you want to updose to your last stable dose, you certainly can.  If may slow your taper overall, as after your updose, you really should hold for a while after updosing.  She stated as much in one of her posts to you.

 

It may slow everything down by a bit, because you should really hold for a few months after this before you continue to taper, even if you feel 100% after 30 days, just to be safe, but if this leads to you feeling better, it may be worth it. You can start to feel it in as little as 4 days, or it can take u to a week to notice any difference, unless it is not enough, then you may need to try a bit more, but it seems safer, from what I have seen to stat small first.  You CAN do it all in one fell swoop, and go up to your last dose, or do what I would prefer if it was me, and go up by half, as your system has already started getting used to the new dose you are on currently.  If it does not work, generally yo will start to feel anxiety, r the urge to keep moving, so if that happens, drop back to your current dose, you will generally feel this within a few days if it is going to happen.

 

If you do updose,  update your signature (and, if you choose to, leave a note here if you like, so we know what is going on, and please ask any questions that come up, okay?

 

I am sorry to change my mind, but I had to weigh all of the info carefully, as I did not want to advise you to do the wrong thing.

 

Good luck/ádh mór!

Skeeter

[Lakelander82]

Skeeter the really frustrating thing is that for a number of weeks before my lost cut I was feeling good - look through my posts and you will see I didn't post anything from 13th Nov to 1st Dec. This shows you I was in a good way of being and had nothing to moan about!

 

It's a dilemma for me, go on feeling like crap in the hope of eventually stabilising out or cut your losses and give in to the updose. What if you never really stabilise out...It's five weeks today after all.

[Skeeter]

LL,

I have not yet had to agonize this hard over a case that seems so simple on the surface. On one hand you are 5 weeks into only a 5% into this particular taper, but on the other hand you are feeling like crapola.  Healing is NOT LINEAR in any way shape or form.  This we know.

 

Did the holidays themselves stress you?  All of your kids/relatives/friends over, and your  precious grandbaby? It is wonderful to see all of those people, but I often see stress as a start to a wave, even if someone has not really had one previous to this, and then you had that day running where you felt terrible after, and then the car issues (which was a total stressor)!  Perhaps this al added up to the perfect storm, and it will just take your system time to settle down.  This is where my personal worries come in with updosing, and why I want you to try a week of 1/2 of the total amount first for a week perhaps, and if that at all IS activating, you can stop, hopefully without too much damage done,  IF it is gong t happen (your body will tell you for sure, no worries there).  Then after a week, see how you do, ad if you like to go back up to your last dose in full (the other half), the try it, or try staying where you are.  I do not think you will have issues, but some people do have them, and luckily with a low dose the issues tend to be short lived because we try to be very cautious.  It is all up to you what you wish to do or not do. 

 

I hope this helps a little. 

Skeeter

[Lakelander82]

Grandbaby Skeeter? I'm only 34, don't have any kids never mind grandkids! :-D

 

Christmas is neither here nor there for me, I don't get too stressed or excited about it. I'm not remotely materialistic, neither are my father or mother so running about like a headless chicken looking for expensive presents isn't an issue. My brother who lives in England would be materialistic alright!

 

I've decided to up dose, to 32mg for convenience sake. It's not quite half way but it's not far off. Will let you know how I get on.

[Skeeter]

Lakelander,

I have another person in Ireland please forgive me. YIKES! I am still sleeping about 15 hours a day, and have some groggy times. GRR, missing Lexapro is a BAD thing!!

 

At least Christmas does not have bad connotations for you, that is surely a good thing.

 

Great on the small updose, please keep us apprised of any changes, good or bad, if you feel up to it. I have my fingers crossed. You even updated your signature, wow, color me impressed!

 

You are a young one, at 34, aren't you!! I am only 9 years your senior...lol!

 

Good luck!!

S.

[JanCarol]

Hey Lakelander:

so why would it effect me further on down the line? 

 

see Delayed Onset of Withdrawal Symptoms.

 

We have had people who were doing fine for a year or more, but then a stressor hit, and all the waves came crashing down.  It doesn't happen with everyone, I'm just recommending caution, slow down.  Listen to your symptoms and your body.

 

I got a quote from someone who was doing a benzo withdrawal - slightly different from sertraline - but so many of these "adjustments" to neurotransmitters are so similar:

I had been fooled by the symptom free taper and the six months time lag. 

from:  https://nevertrustadoctor.wordpress.com/2015/07/31/a-terrible-experience/

 

 

I saw those words, and thought of you - and so many others here who seem to think that this is like quitting caffeine or even tobacco.  It's not.

 

Our own Rhi said it like this:

 

You can't get off the drug (without major instability) faster than your brain can re-adapt itself to the absence of the drug. 

 

and:

Each time the drugs are switched around--whether they are cut, or increased, or changed to other meds, et cetera--whatever processes have already been happening have to try to stop and go the other direction. (Or maybe a couple of other directions.) 

 

This is not simple. This causes more trauma, more chemical chaos, more damage. Processes that cannot be quickly halted and are already out of control, try to counteract themselves using other processes that are very imperfect as well. (Imagine the LA freeway system if all of a sudden everyone had to stop and go the other direction, but there were no lights and no traffic cops. And everybody's brakes and steering were already kind of busted and unstable to begin with.)

 

You have done a nice, gentle, slow taper.

 

You are now having symptoms.

 

In SA, that means it is time to go even slower.  Skeeter has explained really well how that lag time can "catch" you, and I still hold that you may still be feeling your changes from July.

 

Additionally, it is vitally important that you now learn more about managing your mood on your own, without drugs.  This can take the form of sunlight (or SAD lamp - did I see that you got one of those?), exercise (weightlifting, walking, yoga, tai chi - gentle on the nervous system is best), meditation (mindfulness, guided YouTube meditations, music (playing, listening, dancing), art.  Moods are clouds, they come and go.  Sometimes they are persistent, and a storm can last a month (or three!).  Just wait it out, it will change - and the more active you are in managing your mood, the better you will thrive.

 

Non Drug Techniques for Coping with Emotional Symptoms

 

Oh heck!  I'm not done, but I have an appointment - I'll check back later today.

[JanCarol]

Hey Lakelander,

 

 you can go to bed at night on top of the world and then wake up 8 hours later a gibbering, anxious, crying wreck. 

 

 

Ah!  The Cortisol spike!  This is very very common in withdrawal, as your adrenal / endocrine system tries to adjust to what the drug has been doing, and is no longer doing.  It's a major re-adjustment.  http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

 

Cortisol, or adrenaline, has a natural cycle, and it tends to spike just before time to get up and start your day.  In withdrawal, these spikes are more extreme, and are often interpreted as "panic attacks."  Your doc would love to give you a benzo for that....(egads)

 

I believe that the drugs rob the endocrine system in order to make you work (when you - or your body - don't want to) - and so - that you are having cortisol spikes is a sign that you are healing this system.

 

This statement confirms for me that it is likely your cortisol cycle:

 Generally I'm better in every aspect, both emotionally and cognitively in the second half of the day (from 5 - 6pm onwards).

 

After you've settled from this one, I recommend that you try smaller drops, or micro-tapers, or even the Brass Monkey Slide - these are all different ways to fool your nervous system into not noticing the drop.  Have a look at these, and see if they appeal to you, to prevent symptoms as you get down to the wire.

http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

The BrassMonkey Slide

 

Oh yes, down to the wire - the lower your dose goes, the higher percentage neurotransmitter occupancy you have.  I'm not a scientist, but if you can read science at all, you may be able to understand this:  The importance of tapering on plasma concentration  Basically, in simple terms, it means we have to be more careful, the lower the dose we are on.  We want you to succeed, and the last bit has a sting in the tail, but can be avoided.  I think you've been careful and probably caught it in time, that if you slow down, you can continue to control your taper to suit your lifestyle.

 

You said:

Skeeter the really frustrating thing is that for a number of weeks before my lost cut I was feeling good - look through my posts and you will see I didn't post anything from 13th Nov to 1st Dec. This shows you I was in a good way of being and had nothing to moan about! 

 

This, too, is a normal pattern for withdrawals.  Waves and Windows.  As your different systems heal, your symptoms will ebb and flow and change over time.  Right now, it looks like your cortisol system is going through some adjustments.  Maybe later it will be about sleep and circadian rhythm.  Maybe another time it will be more of an emotional symptom, or maybe you are going through that, now.  

 

Sorry about all the links, but other people have said it better than I could hope to.

 

Waves are a sign that you are healing, and windows are a sign of what "healed" will feel like.  It's hard to remember the windows when you are in the wave - but after you have been through them a few times, you recognize them, and will be able to say with confidence:  this is temporary.  This too will pass.  It's only symptoms.  It's temporary.  It gets better.

 

Let us know how that updose goes, and keep notes on paper to observe your response to that tiny updose.  I think halfway between where you were and where you are - after 5 weeks - is a safe amount to try.  Fingers crossed that this does the job!

 

I hope you see the Sun today.

[Lakelander82]

Thanks Jancarol, I needed that injection of confidence as I wasn't exactly feeling sanguine about the whole situation. The first part of the day continues to be a struggle, mainly characterised by poor concentration, irritability, depression, not wanting to be around anybody or communicate with people and an unwillingness to leave the house. Brain just doesn't operate early in the day, but a walk does seem to light it up a bit.

Sleep is generally unaffected, slept around 10 hours last night. Sometimes wake up in a panic half an hour after falling asleep, yet I'm not dreaming at all, its just a case of waking up highly agitated. Movement feels strange and peculiar at times, it's as if your system shocked or surprised by the fact you're moving your limbs. Even turning your neck to look at something seems to surprise your system, I can't adequately articulate it because it's so strange.

In relation to the waves and windows, I assumed the few weeks before I cut in late November was just all windows and the period after I cut was just all waves and it would continue to follow this pattern i.e. the longer I held after a cut it just became exclusively windows.

[JanCarol]

I know, it's difficult letting your nervous system be in control of your life.

 

But it has been injured, and wants to heal, and the best, fastest, gentlest way to do that - is let it.

 

If it needs to thrash around in the mornings - but settles later in the day - can you structure your life around that?

 

You've found that a walk first thing helps the initial cortisol spike.  That's actually an impressive insight!  Follow the things which help, avoid the things which harm.

 

Are you taking Magnesium and Omega-3 fish oil ?

 

There are some who say that Ashwaganda for Anxiety, Stress and Toxic Overload helps them.

 

Magnesium sometimes is more effective with Taurine as a co-factor.

 

If I were you, I'd try the fish oil first.  It "lubricates" the systems for smoother functioning, and provides EFA's for brain and nervous system function, and is a mild anti-inflammatory.

 

When trying supplements, only ever try single supplements (no complexes or compounds), and gradually build up to a desirable dose.

 

For example, if you are not taking any of these,

try 1 fish oil capsule daily.  If it "feels okay" gradually build up over 2 weeks until you are taking 3-4 fish oil capsules per day (read the fish oil topic for more information).

After the 2 weeks on the fish oil, if things are going smoothly, add in 1/2 tablet of magnesium.  After a week, crush the other 1/2 tablet of magnesium and dissolve in water to sip when you feel anxious or restless.  After another week, you can take 1/2 tablet in the afternoon, 1/2 tablet in the evening.  Build up to 1 tablet afternoon and evening.  (read the magnesium topic for dosages and types).  You may wish to keep a crushed tablet in water in the fridge, if you like sipping mag water.

 

Over a month, you will get up to speed in mag and fish oil.  This is just a sample schedule - your results may vary.  It's a thing you can try, and if, at the end of the month, the cortisol spikes are still horrible (read the cortisol spike thread, I gave you above) - you might consider the ashwaganda.

 

Try not to judge yourself by the numbers.  This is now no longer a numbers game, it is an intuition game.  Listening to your body is more important than a certain % taper, or a schedule, or a "finish line."  I think it's harder for men who measure their lives, and are measured, in quantifiable terms.  How much money, how much production, quantity quantity quantity. 

 

It will help you to shift from the numbers, the quantities (though, as always in tapering, precision is vital!) - and focus on the qualities.  How good is my sleep?  My diet?  Did I enjoy the walk?  Did it help?  What else helps improve this quality?

 

I hope you feel better soon. 

[Skeeter]

LL,

I replied to your post on the 6th, but I had a computer lock up.  So sorry.  I did not forget ya!!

 

When I came off of this AD many years ago, I would have the oddest sensation if I either moved my eyes from one side to the other quickly without movng my head, or moved my head, as if to look at something quickly (my job MADE me do that, as I crossed streets, and I was in a hurry due to emergencies), so when I looked both ways to cross the street, I had the oddest feeling of my brain "shifting" in my head.  It did go away after a while, but It was AWFUL while it lasted.  I could not stop moving my head that way, so I had to deal with it.  No fun.

 

I am hoping that as soon as your CNS stabilizes a bit that thins will be much better, then you will hold for a while longer until things really normalize for you.  Remember, anything you have read on not healing until the med is totally out of your system is NOT true.  You do heal while you hold even, if not, you cold not stabilize when you slow down or hold as commonly happens here at SA.

 

Are you able to do any exercise right now, or are you having to take a break while all of this settles down?

Best Wishes!

Skeeter

[Lakelander82]

Thanks for the input guys. Yes Jancarol I'm taking 200 - 400 mg of Magnesium citrate every night, and 1780mg of EPA and DHA daily as well as vitamins D, E and C. I just haven't included it in my signature. To my my knowledge, there's nothing stimulating about any of these supplements. I avoid all B vitamins like the plague, apart from what I get in my diet, they're far too stimulating for me.

 

Skeeter I'm not able to run at the minute, I have no energy for it so I just walk instead, as well as gentle stretching. Being too weak to run is new symptom which has literally only started this last two weeks. I'm sleeping on average about 8 -9 hours a day, I have never had a problem sleeping, it's the waking up I have a problem with! :-)) Sometimes go for a nap around 6 or 7pm when I'm feeling fatigued or weak.

 

Visited the supermarket today for the first time in a few weeks as I wasn't feeling up to being among crowds of people this last few weeks. Felt ok but sweating under the armpits quite a bit which is nothing new. Feeling quite drowsy now typing this, might go for a nap.

[AliG]

So sorry that you're feeling this LL but it's pretty normal at this point.  Hang in there.

 

Ali

[Lakelander82]

Thanks Ali. Maybe the weather has something to do with it, January here in Ireland, as I'm sure is the case in lots of the Northern hemisphere, is very bleak and cold. The one saving grace is the that the daylight hours are getting that wee bit longer as each day goes on!

[Skeeter]

LL,

I wrote up this large post nd lost it.  All of the vitamins you are on may be activating.  Now if you have a KNOWN, MD verified vitamin deficiency, that is one thing. Depending on what vitamin B you are taking it can be VERY activating to the CNS. I do not want you to have one more moment of being uncomfortable than you need.  The only 2 vitamins that we have found to be helpful during AD withdrawal for the majority to be most helpful are Magnesium (the link advises which form is tolerated and absorbed the best (Mag Citrate is memory serves), and fish oil.  Most if not all of the vitamins you take now are also on this page and explain the issues most have.  You can always try a vitamin holiday, then add them back one by one, and see if you feel better or worse.  it does not matter if you have been taking them for years for certain people.  They can increase the activity in the CNS, and that is NOT what you want right now, I assume.  you can resume the vitamins either after the taper, or you can try when you have stabilized. You can also get the vitamins out of your food, so do not feel like you cannot get those vitamins!  Some people feel a ton better when sopping vitaminsm quite a few actually,  Your body responds differently now to many things (like exercise, etc).  Here is the link: http://survivingantidepressants.org/index.php?/topic/606-important-topics-about-tests-supplements-treatments-diet/

 

Please let me know if you have any questions!

Skeeter

[Lakelander82]

It's truly bizarre having a nervous system with a mind of it's own. A hyperactive nervous system as I have found, dictates your thoughts and behaviour not the other way round as students of Psychology would have you believe. I am no more negative or cynical than any of my family members, in fact I'm probably more postive in a lot of respects and yet I suffer with this and they don't. Sometimes forcing myself to go and out about and mix in public ie taking "positive" action only exacerbates my condition, when staying at home would have been more calming for my system.

 

First part of the day is still a disaster for me characterised by excessive sweating under the armpits esp in public, jitteriness, muscles that are on the verge of trembling but I don't allow to tremble, jumpiness, teariness and poor concentration/forgetfulness. These are all peripheral things I have no control over, they are going to occur anyway regardless of my attitude. Even getting things ready to go out to the gym or swmming pool seems overwhelming and stressful for my system. Did I pack this and did I pack that are recurrent questions you keep asking yourself over and over and you only do this because your systems on edge, your hearts beating hard and you're stressed to put it simply. Come out of the gym and for 10 seconds forget where you parked the car, panic and then quickly remember where you parked it again - all because your systems on edge. Ask yourself what the frig has happens your once excellent brain??

[Flowers]

Hi LL

 

Your last 2 posts could have been written by me about me.

 

Sorry you are going through the mill too.

 

It can only get better.

 

Flowers xxx

[Skeeter]

LL,

I may have mentioned this before, but for normal agoraphobia, exposure therapy may be suggested, making yourself go out and do the things that you are fearful of. Not good in WD. Now it does not necessarily hurt you to go out and do things, but perhaps do a few things on the days that you DO fee well enough to go out. Then you can rest your CNS the other days. You don't have to do nothing at home, you can do pushups, crunches, still do exercise *great yoga for free on you tube!

 

To make yourself not go crazy on the days you leave the house. Make yourself a list of where yo are going, what you are getting. For the gym, make a list on your phone with everything you need, and check each one by putting it in th bag in the sequence of the list, then no worrying that you have forgotten anything. I have a list that I say out loud before I leave the house to make sure I have everything. You could put a list next to the door on the wall. I will say it how I do you know "purse" will mean wallet, unless yo would like to carry a purse, your choice! Mine is "Sunglasses, meds, purse, phone, keys, sunscreen (as in did I remember to put it on/make sure I have with me), dogs (have food and water and toys?), lock door" I touch or look at each thing as I say it, or do it (as in "lock door"). For me it is a series of rituals that nor my roomie does before leaving for work- since he started doing my thing, we say it together and both look if I am awake (for fun), he has not forgotten one thing for work. Until you have it as your mantra (lol), put the list in your phone or by the door and look at it EVERY SINGLE TIME until you can recite it without looking at the list. Must touch or look for everything, ad I have said keys, and still locked myself out of the house with the knobset (whoops-y) Meds for me are my PRN meds, which I am famous for forgetting! Any tip you can think of for bringing down that anxiety- USE IT! Until your brain fog wears off, and all of the distractions your body is throwing at you for now, tools are a great thing.

 

I am a little stressed myself personally right now, so again if I repeat myself, please forgive me. Please consider not touch your dose until at least 2-4 weeks AFTER you are asymptomatic AT LEAST. This long process of healing, which I hope you are journaling, rating how you are feeling each day, what s/sx you have, what vitamins/meds you took (if your fog is really bad, you can put what you ate & the times),and what you did that day (walked, swam, shopped, etc), will remind you when you are feeling well and all that badness is behind you WHY you are going so slowly, and not rushing in to taper until some normalcy and return to your full activities is achieved! For me I have to even journal in Word when the dogs last did their business, because if I do not, I don't remember!

 

tóg(a'í) go réidh é!

(Is this right/proper?)I learned you do not go with the American "Have a Nice Day", so I went with the above, which fit better. We used to do this a tiny bit before, and I quite liked it, but I will stop if you do not enjoy it any longer. I love translating what you have said!

 

I do hope you have gotten something helpful out of this!

Skeeter

[Lakelander82]

LL,I may have mentioned this before, but for normal agoraphobia, exposure therapy may be suggested, making yourself go out and do the things that you are fearful of. Not good in WD. Now it does not necessarily hurt you to go out and do things, but perhaps do a few things on the days that you DO fee well enough to go out. Then you can rest your CNS the other days. You don't have to do nothing at home, you can do pushups, crunches, still do exercise *great yoga for free on you tube!To make yourself not go crazy on the days you leave the house. Make yourself a list of where yo are going, what you are getting. For the gym, make a list on your phone with everything you need, and check each one by putting it in th bag in the sequence of the list, then no worrying that you have forgotten anything. I have a list that I say out loud before I leave the house to make sure I have everything. You could put a list next to the door on the wall. I will say it how I do you know "purse" will mean wallet, unless yo would like to carry a purse, your choice! Mine is "Sunglasses, meds, purse, phone, keys, sunscreen (as in did I remember to put it on/make sure I have with me), dogs (have food and water and toys?), lock door" I touch or look at each thing as I say it, or do it (as in "lock door"). For me it is a series of rituals that nor my roomie does before leaving for work- since he started doing my thing, we say it together and both look if I am awake (for fun), he has not forgotten one thing for work. Until you have it as your mantra (lol), put the list in your phone or by the door and look at it EVERY SINGLE TIME until you can recite it without looking at the list. Must touch or look for everything, ad I have said keys, and still locked myself out of the house with the knobset (whoops-y) Meds for me are my PRN meds, which I am famous for forgetting! Any tip you can think of for bringing down that anxiety- USE IT! Until your brain fog wears off, and all of the distractions your body is throwing at you for now, tools are a great thing.I am a little stressed myself personally right now, so again if I repeat myself, please forgive me. Please consider not touch your dose until at least 2-4 weeks AFTER you are asymptomatic AT LEAST. This long process of healing, which I hope you are journaling, rating how you are feeling each day, what s/sx you have, what vitamins/meds you took (if your fog is really bad, you can put what you ate & the times),and what you did that day (walked, swam, shopped, etc), will remind you when you are feeling well and all that badness is behind you WHY you are going so slowly, and not rushing in to taper until some normalcy and return to your full activities is achieved! For me I have to even journal in Word when the dogs last did their business, because if I do not, I don't remember!tóg(a'í) go réidh é!(Is this right/proper?)I learned you do not go with the American "Have a Nice Day", so I went with the above, which fit better. We used to do this a tiny bit before, and I quite liked it, but I will stop if you do not enjoy it any longer. I love translating what you have said!I do hope you have gotten something helpful out of this!Skeeter

Tbh Skeeter, I don't know if I'm improving at all, I seem to be getting worse in almost every respect. The first two to three cuts were relatively simple, very little problems but as I have progressed with the taper I am seeing the same old problems return with a vengeance. I carry out the tapering in the hope of getting better more than expectation of getting better...I don't fully buy into the logic of healing espoused on here, but that said I sincerely hope that I am wrong and the theory is correct. The reason for my cynicism as I said is seeing the return of old symptoms... symptoms that were in no doubt ameliorated by the medication.

 

The first half of the day continues to be bad, they can be Depression filled or anxiety filled or sometimes both. Teariness but not weeping, weakness/ fatigue and jumpiness. I have noticed an interesting correlation that when I am jumpy and on edge my cognition is really poor. My brain is full of useless trivial facts (I'm a quizzer), but when I'm like this I can't retrieve the damn facts, or if I can, it's a hell of a lot slower. My logic and maths ability is away to the dogs as well. It's other simplier things as well, like forgetting where I parked the car briefly after I get out of the swimming pool or have been shopping , and I'm only doing this because my nervous systems in overdrive, no other reason. My central locking is buggered in my car at the minute, which means I can only lock and unlock the car manually via the drivers side door yet when I come back from my walk and go to put the dog in the passengers side, I keep putting the key in the passenger door to unlock it even though this doesn't work. The thing is I keep doing this over, and over and over and over again no matter how many times I tell myself this isn't correct and I won't do it next time. It's as if my brain can't take this piece of simple information on board and apply it.

 

I'm sleeping well as usual, but sometimes shout in my sleep or wake up in a panic about half an hour after going to sleep.....it's an arbitrary panic about nothing in particular. It all down to cortisol levels apparently.

[Skeeter]

LL,

 

Every single person, almost without fail thinks that their same issues are returning, esp when you hit a huge snag, like you have currently. I have not heard yet of anyone who has not gotten past this, but every day is very, VERY hard. Your brain is telling you that you will not get through this.

 

What would you like to do? You have a couple of choices- either updosing, or staying where you are and waiting it out. As severe as your symptoms are, I do not have to wonder much which you will choose. This is your body and your decision. I think updosing slowly to find a comfortable point, staying there for many months, & then, if you choose, taper slowly from the beginning, no bouncing around at all, and hopefully listening to your body very carefully. you may want to start, if you want to taper, is that you want to start at even 2% reduction, then allowing at least 6 weeks before attempting again.

 

I hear you, you have told me the same thing a few times, I understand you not wanting to hear the tips and tricks. I am going to ask for reinforcements on this.

 

So, what do YOU want to do? Last time you chose the dose to updose, if that is indeed what you want to do, do you have a dose in mind?

 

Thanks for the update,

Skeeter

[scallywag]

Lakelander, some of those cognitive issues happen to everyone.  We all forget where we parked the car from time to time. Under stress, it seems that some brain functions get shunted to the slow track. I saw a dramatic decrease in my father's memory and cognitive processing when my mother was ill at home in her last months. Looking back at times of stress in my own life, I see that I experienced the same thing.

 

The passenger door to the car thing --  It seems that after having done something a different/wrong way once the brain goes back to the most recent way rather than the right way which we've done hundreds of times before.

I'm having this happen ALL THE TIME now with keying certain words, one of them being words ending in "ation". I've also had this problem previously and well before I started taking an anti-depressant, so I'm inclined to think this is one of those things that happen withdrawal or not.

Previously after having intentionally taken a different longer way to home, I would find myself on the longer route even though I didn't have the same need to stop along it instead of taking my usual faster, more direct route.

 

We can get caught in a bind with such things especially now when we're challenging the CNS: we want to observe symptoms but not get overly concerned about them. I find cognitive symptoms are the hardest to observe because the thing we use to detect problems is the very thing that is having the problems, including the problem of being overly concerned.

[JanCarol]

Hey LL - sorry you are still struggling (but glad to hear you are on the fish oil!)

 

muscles that are on the verge of trembling but I don't allow to tremble, jumpiness, teariness and poor concentration/forgetfulness.

 

What happens if you exaggerate that?  Shake and tremble and thrash and dance?  

 

Sometimes the suppression of a symptom takes more energy than the symptom itself.

 

http://survivingantidepressants.org/index.php?/topic/3533-acceptance

 

Let your body be what it is to be.  Surrender, don't fight the symptoms.  Rest when you are tired, rattle when you are shaking, eat when you are hungry, cry when you are lonely, walk when you are restless.  Think about the immediacy of a child.  If the candy is taken away, the child cries.  Right away, no thinking.

 

As we become adults, we put in "delays" and "socially acceptable faces" on all of that.  

 

And I'm not suggesting that your adult face will never return, it will.  But for while you are healing, your nerves are raw and almost childlike, and you may have to learn new ways of being. 

 

The only way to learn new ways of being, is to let go of old ways of being.  Sounds horribly simple, and it can be - but "unlearning" is a challenge.  

 

So I would suggest - you do a scientific trial of exaggerating symptoms, for just 3 days..  If you are sweaty, do some star jumps or take a hot shower.  If you are shaky, do some dancing.  If you can't sleep, then don't sleep.  Yell if you are angry.   If you are tired in the daytime, take a nap.  Walk if you are restless.  Let your body do what it wants, and it will help speed the healing process.  At the end of 3 days - see how you feel.  Is it slightly better?  Or slightly worse?  Adjust your practice to your body, because there's really no way you're going to adjust your body to your practice until this is over.

 

The only caveat to this experiment is the other people in your lives - you don't want to hurt or frighten others - so if you can bring them into the experiment, that would be helpful - let them know what you are trying to do.

 

I feel (as much as I can from 14,000 miles away) that it is your resistance to the symptoms that is causing you more grief than the symptoms themselves. 

 

But while you are healing, learn to accept the process, let it happen.  Don't try to control it.  

 

Brassmonkey said it like this:

One very effective technique to use is referred to as AAF. Acknowledge, Accept, Float. 

 

First the situation/symptoms need to be Acknowledged.  Through no fault of your own you are now very sick and there are going to be a lot of very unpleasant symptoms to deal with, and like any major illness getting better will now be your primary focus.  Mentally explore the situation, feelings or lack there of, symptoms etc. and get to know them.

 

Secondly you have to truly accept that is happening.  The symptoms and feeling or lack there of are going to happen no matter what you say about it, there is nothing you can do about them or the situation.

 

Lastly, let the symptoms and unpleasantness float off as you go on about your life as best as you can, believing that it will get better in time.

 

 All of your symptoms, as you've expressed them, are quite "normal" in withdrawal.  It is unusual that you are getting them this late into your taper.

 

Have you seen this?

The importance of tapering on plasma concentration

 

This is scientific evidence that the "pointy end" - the finish line - is the most difficult part of a taper, and slowing down (or being forced to slow down, as in your case) is perfectly normal.

 

I hope there is something here to help you.

 

And that you see the sun today!

[Altostrata]

Lakelander, do you have a longstanding tendency to health anxiety? Worrying that little things are signs of big problems?

 

It sounds like you might stop tapering for the time being and let your nervous system settle down. Meditative breathing would be a very good thing for you to practice, particularly when you're about to go out or finding a situation stressful.

[Lakelander82]

Jan carol, surely you mean that it's unusual I'm getting these symptoms this early in the taper and not late, I've 32 mgs to go after all and am nowhere near the finish line. Is it beyond comprehension that's ones original condition would start to rear it's head when approaching half the original dosage? Maybe I'm just an anomaly in every respect.

 

I'm actually reading Claire weekes book "Essential help for your nerves" for the third time. Her advice is quite old fashioned and if you could distill her message down to a few sentences, she just advises people to willingly accept their symptoms and float past them. Problem is, when you're coming off this crap, having a brain that's just dead (ie dead head syndrome)and having no energy, you can't float anywhere only to the bed!

 

Anyway, I can only stick it out at the dose for a long time, I'm not updosing come hell or high water. Alto, I probably have some health anxiety to a degree but not to the point where if I get a headache I'm having a brain haemorrhage or if I have chest pain I'm having an myocardial infarction.

 

Btw I'm still mixing my liquid up consistently and being as precise as I can. I take exactly 32ml via a syringe and measure what's left in the jar and it's always exactly the same -slightly over 17mls. The left over liquid does seem to vary in particulate matter but it's the very best I can do as I'm mixing the whole thing up properly after the tablet dissolves.

[RachelSusan]

Hi Lakelander,

I wanted to introduce myself since I've been following your posts.  I'm following because I am also trying to taper off of Sertraline (Zoloft). My symptoms are mostly physical symptoms (nausea, headaches, tremors, etc..) however there were some times that I could barely put two words together to form a sentence. I really feel for the agony that you are going through, and I am hoping that you are able to stabilize quickly. This really is h*ll, isn't it?

Rachel

[JanCarol]

Hey Lakelander:

 

Jan carol, surely you mean that it's unusual I'm getting these symptoms this early in the taper and not late, I've 32 mgs to go after all and am nowhere near the finish line. Is it beyond comprehension that's ones original condition would start to rear it's head when approaching half the original dosage? Maybe I'm just an anomaly in every respect.

 

No, if you read the article, it talks about the "ut-oh" point, the point where small changes in dose create greater changes in plasma.  This is where it becomes harder, and more important to slow down.

 

I'm guessing that 32 mg might be your ut-oh point, and that it is now time to slow down.

 

I hope you see the sun today!