Geezer2BNormal - Experiencing extreme depression and anxiety

[Geezer2BNormal]

I had read articles about the physical symptoms of SSRI withdrawal such as the brain zaps, etc but I was not ready for the absolute horrible depression and anxiety that has hit me. I had completed my taper and stopped my medication mid-July and then had two very tough weeks of extreme brain fog, fatigue, but no brain zaps.  I got through those two weeks OK and I thought I was in the clear.  Two weeks ago, I was going through a bunch of junk we had removed from our attic to sort through and I came upon some boxes of old college books, keepsakes, etc.  Then out of left field, the reality of being 63 years old hit me like a freight train.  I had NEVER had concerns about my age until this point.  I felt quite sad that day and the next and I "slipped" and took 10 mg of Citalopram on each of those two days but have not taken any since.  I I had to work the following week and managed to get through that week OK but I've been off this week because my son and his wife were having their first baby this week.  He was born 8/29 and is a beautiful healthy boy.  I was "happy" that he was OK and was doing fine but depression has hit me like a Mack truck this week.  I can't get over the fact of my age and I'm no obsessed with how little time I have left on this planet and I am overwhelmed with regret for so many things I have done in my life that in retrospect I wish I could do over.  The guilt and absolute overwhelming sadness that I didn't raise my kids to love Jesus and to take them to church has been just destroying me right now.  I can't get it out of my mind and I have this sense of abject sadness and guilt.  I have never ever felt so depressed and sad in my entire life.  I'm hoping this is just withdrawal depression and not something that I'm going to have to live with for some time.  I was on this poison for 12 years and I did not have any problems with it.  My doctor last spring suggested I get off of it and I thought why not.  I am so tempted to go back on it but am horrified of the thought of going through this again if it is indeed something that will get better.  I have tried taking 5-htp and it is not boosting my mood at all. In fact, it just seems to make me dopey.  I'm at my wit's end

Edited September 5, 2016 by scallywag
tags added

[SquirrellyGirl]

Hello Geezer2BNormal -welcome to SA!

 

Thank you for filling out your signature block, very helpful.

 

You came off Cit much faster than we advise on SA, and yes, this global depression with regrets about the past and fear about the future are quite common around here among folks in withdrawal.  I experienced the same when I was in protracted withdrawal from Effexor.  I never felt so terrified about my future as I did then.  I ended up reinstating.

 

When you have been on these meds for so long, the brain adapts to functioning with the drug built into the works:

 

One Theory of Antidepressant Withdrawal Syndrome

 

When doing a slow taper as we recommend here (Why taper by 10% of my dosage?), your nervous system is able to adapt very gradually to small dosage changes.  By the time you come all the way off, most of the healing has already occurred.  When you come off cold turkey or too fast, hardly any of the healing has happened yet and you are left with all the rest, with all the destabilization caused by yanking the drug away from your nervous system, like yanking a trellis out from under a vine that depends on it.  These strong emotions are one of the results, called Neuro Emotions.

 

You stopped mid-July so reinstatement is still a possibility, just 6 weeks or so.  About reinstating and stabilizing to reduce withdrawal symptoms

 

These drugs were never proven safe beyond 6 weeks so we long-timers have all been guinea pigs.  Your doctor may have suggested coming off because he has learned about the negative consequences of chronic AD use.  It is still your choice whether or not to be off the meds. We're just here to let you know that slow, careful tapering can help you get off while remaining functional along the way, without these extreme states of mind.

 

Please read up on the links I gave you and then come back with questions.  Your reinstatement dose will be smaller than the lowest dose the pills come in, likely, so this link will help in that regard:

 

Tips for tapering off Celexa (citalopram)

 

We can help you determine what that dosage should be.

 

SG

[Petunia]

Welcome from me too Geezer, I'm glad you found us.

 

SG has given you some good advice and the links you need to help you understand what you're going through. I don't have anything to add apart from suggesting you give reinstatement some serious consideration.

 

I was taking SSRIs for a similar length of time as you, stopped them too fast at the end of 2010 and was unable to reinstate because I left it too late. Six years later, I'm still recovering from protracted withdrawal, dealing with symptoms I never had before starting on the drugs including cycles of depression and other intense emotions. For some people, recovery can take a long time, but by tapering slowly, its possible to avoid all but the mildest of symptoms and so be able to remain healthy and functional in life while still becoming medication free.

[ChessieCat]

As Squirrellygirl mentioned:

 

"When you come off cold turkey or too fast, hardly any of the healing has happened yet and you are left with all the rest, with all the destabilization caused by yanking the drug away from your nervous system, like yanking a trellis out from under a vine that depends on it."

 

These helped me to understand SA's recommendations and have helped me to remain patient and taper slowly:

 

Brain Remodelling (Rhi's Description of Brain Healing)

Video:  Healing From Antidepressants - Patterns of Recovery

 

I'm nearly 58 and have been taking ADs for 25 years.  I updosed after discovering SA and now my taper is going well with minimal symptoms.  I'm also starting to feel more like my old self, being able to laugh at things and feel pleasure when I see something I like.

[Geezer2BNormal]

Thank you for your responses and for your concern and support.  These past two weeks have been hell on earth.  After seeing the responses, I've decided to reinstate at 5 mg.  I started yesterday and I'd say I feel slightly better today but I'm sure it's too early to tell.  I had tapered down to 5 mg. without problems so thought going to 0 would be OK.  It was a bit surprising to have the depression hit 3 weeks or so being off the med then bam!  I have to be able to function.  I don't have to go back to work until Wednesday and am going to go see my doctor tomorrow to inform him of the mess that he helped create.  He didn't give me any timeframe to taper and left it up to me.  I thought that once I hit 5 without an issue that going off would be fine......not.  I hope that I can reinstate at 5 mg. and get some help from this horrible anxiety and depression.  I just hope that I have not permanently damaged my brain beyond repair.  I will let you know if I get some relief.  My wife may not be happy to hear this but I have to stabilize this horrible mental state before I lose my job and/or my marriage.  Thanks!

[AliG]

Geezer.  As it's only been 6 weeks, it's probably wise to reinstate.  We probably would have advised starting lower but as it's done you may as well continue on that dose as it was what you were on before.

 

If you go back to the doctor you run the risk of him increasing the dose as he will probably tell you that it's not at a therapeutic level. 

These links might help you to discuss it with him : 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

 

As you get lower in dose , it becomes much more important to take it slower.

Why taper? Paper demonstrates importance of gradual change in plasma concentration

 

The symptoms have a way of hitting after a little " honeymoon " of feeling quite well. Unfortunately they can go on for a long while afterwards. Hopefully,with your reinstatement  symptoms will settle a bit. Give it a while though as it takes at least 4 days to reach steady state in the blood.

Ali

[Geezer2BNormal]

After two days at 5 mg., the extreme anxiety and depression is waning but the brain fog is back.  I had 20 mg. tablets so cutting into 1/4 is about as small as I could get.  Would it help to lessen what I'm taking now since I just started?  I got 10 mg pills today so I can go to 2.5 mg. or is that not a good idea?  

 

Thanks so much for your support and advice.  I came off that drug way to fast.  I went to my doctor today and of course he felt that this depression and anxiety was withdrawal-related.  He agreed that everyone is different and that the long you are on one of these drugs, the harder it is to get off of them.  I just wish I had some idea of what time it is going to take to get off this drug after 12 years.  Am in no hurry now. 

[Geezer2BNormal]

^{Correction.  My doctor did NOT think my depression and anxiety were due to the withdrawal from Citalopram.  I figured he say that.  I fortunately tolerated this medication well and had few issues with this med until I tried to get off of it.  Then and only then did I realize what a horrible drug this is.} 

Edited September 7, 2016 by ChessieCat
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[ChessieCat]

Hi Geezer,

 

Would you please add dates to the following information in your signature.  Thank you.

 

Tapered to 10 mg for 2-3 weeks

Tapered to 5 mg for 3-4 weeks

Stopped cold turkey after that...probable big mistake

 

It takes 4 days for the drug to get to a steady state in the blood, during which time you may start to feel improvement.  It may take between 7-10 days to feel the full effect.

 

AliG posted above:  "We probably would have advised starting lower but as it's done you may as well continue on that dose as it was what you were on before."

 

It would probably be best not to mess around with your dose at this time and to stay on 5 mg.  It is really important not to bounce around the doses:  Keep it Simple, Slow and Stable

 

Are you keeping daily notes on paper keeping track of symptoms which have improved, worsened or stayed the same?  Doing this helps us to know how the reinstatement is progressing.

[Geezer2BNormal]

Hi ChessieCat,

 

I will get my signature updated.  I'll have to estimate when my taper dates were since I wasn't really keeping track of the dates I started probably mid-June and pulled the plug in mid-July so it appears that I only tapered off for a month which in retrospect was far too short after reading information on this site.  I SO wish I had done more checking on the proper way to taper before I did what I did.  I was just following doctor orders and I'm finding that he is not well-informed on the risks of doing it the way he said.  Again, he was looking at just the physical "flushing" of the med out of your system and not the impact of mental problems due to withdrawal.  He even said he didn't think my depression/anxiety was due to withdrawal.  Sad that so many doctors are clueless on this. 

 

I'm into my third day or reinstatement and am definitely better but was still having having a few periods of anxiety but I went to work and am doing better.  Quick question.  During reinstatement, do you go through the same symptoms of when you first start taking this drug inintially?  I've had some serious brain fog the past two days and some stomach upset but I do recall that these symptoms went away after a while.  I think that since I'm not a weeping pile of emotions right now that the reinstatement is working.  There is absolutely now way I could have handled this going forward and still managed to keep my job and my marriage.  Last week was a descent into hell.  I cannot imagine what it must be like for people to suffer depression for long  extended periods.  God bless them and my prayers are for them to heal and to get peace.  That was truly one of the worse mental states I have ever been in.  Horrible.  

 

Thanks for everyone's comments and links.  They have been very informative, especially the studies that show the receptor occupation at low levels of the med.  I now see why pulling the plug at 5 mg. put me over the edge.  

[ChessieCat]

I would imagine that what you are getting are withdrawal symptoms because the drug is still building up in your system.  Several days after I dropped my dose by half (before I found SA) I had an upset tummy for about 3 days and thought I had a stomach bug.  It wasn't until I was informed of the withdrawal symptoms that I realised that it wasn't a bug.  Apparently about 90% of serotonin is in our gut!  Not long after I CTed my previous AD I had about 2.5 weeks where I was very sick with what I thought was the flu.  I had trouble eating and lost about 8 kgs.  With what I know now, I believe it was the withdrawal flu.

 

Here is the link to Dr Joseph Glenmullen's Symptoms Checklist

 

BTW I'm really pleased that the reinstatement is working.

[Geezer2BNormal]

When I went to my doctor on Tuesday, he gave me a prescription for 10 mg citalopram which I thought would be easier to cut up one in half then cutting one of my existing 20 mg pills into quarters.  I took half of one of the 10 mg tablets this AM and I now feel really out of it.  My blues are back and I just don'f feel well.  Should people be using brand-name drugs in this case to insure dosage?  I just think these new pills from a different prescriber are definitely a different dosage that what I had been taking.  Given that we need to be precise on dosage, I'm woindering if generics are just to iffy on actual dosage since they are allowed to be +- 10%.  

[SquirrellyGirl]

If you were on name brand before, reinstated on name brand, and now are on generic, that could definitely cause symptoms. Many have reported such.  The binders used between name brand and even between generics can be different, and this can affect how the drug is absorbed.  If you can get back on what you were on before (name brand?) then that would be ideal.

 

Dry cutting by splitting pills down is not at all accurate and could keep you having problems if the dose varies day to day.  If I were you, I would either get the jeweler's milligram scale (Using a digital scale to measure doses) or switch to the liquid (Using an oral syringe and other tapering techniques). The problem with the latter is that you aren't stable right now, so doing a switch to liquid would be even more destabilizing since, again, some folks have trouble with the liquid absorbing differently.  Never do a cut at the same time as switching between types, whether it is dry to liquid or generic to name brand, etc. I had to do a cross taper between dry and liquid mirtazapine because doing a direct switch caused symptoms.  Read the link on citalopram that you were given again; it includes info about the different ways to taper.

 

If you can't get the name brand, I would try to sit tight on this dosage of your current pill and see if the symptoms don't subside.  Right now you need stability, and monkeying around with what you are taking further will cause more destabilization.

 

SG

[Geezer2BNormal]

I switched to a liquid form today dissolving a 20 mg tablet and taking 5 ml via syringe. By the end of the day, I was really feeling depressed and seemed to be doing better cutting up pills. I don't know whether to stay on this regimin and hope I stabilize or go back to staying with pills. I did buy a Gemini-20 scale so I can measure the pill form so I'm not sure which way to go. Is it a good idea to split a dose and take half in the AM and when I get home from work? The anxiety and weeping stage has receded but I can't let go of my age and regretting so much of my life. I did not feel this way at all until I tried to get off this poison. Driving me nuts.

[Geezer2BNormal]

I went back to quartering a 20 mg. pill and used my scale to measure out 5 mg portion.  I was definitely down in the dumps this AM.  It seems that the liquid form wore off way to quick and I was depressed by the end of the day and was definitely in the mood dumper this AM.  I will see who I do today back on pill.  Is it common to see such a different reaction to liquid vs. pill inspite of each being the same dosage?  I sooo need to get stabilized.  It's been up and down and I'm wondering if I'm going to be able to stabilize.  How long should I continue on 5 mg. before I try to bump the dosage?  I seem to be so sensitive to the current dosage that if I vary, it has an impact.  Any insight anyone can bring is highly appreciated.

[scallywag]

Geezer - many people find that there is a an adjustment period after starting to use a solution/liquid of a medication, because the liquid is absorbed more quickly.  Sometimes we suggest that people transition to liquid in steps taking only part of their dose in liquid to start.

 

Would you put the date you reinstated citalopram in your signature?

[Geezer2BNormal]

Hi Scallywag,

 

I so appreciate your responses.  I updated my signature to include reinstatement date of 9/4.  At least today, I'm feeliing much better having switched back to a pill.  I think I want to stay put with this for the time being to get stable.  I'm using 1/4 of a 20 mg tablet so it's easy to weigh out and I don't have to worry about minute doses at this time.  Once I start to drop, then a liquid is going to have to be required.  

[scallywag]

Glad the switch back to the tablet worked for you. Enjoy the stability!

[Geezer2BNormal]

Beginning to wonder how long it's going to take me to stabilize and what does stabilized mean? I feel like I'm right on the edge of going over the cliff from an anxiety and depression standpoint. Should I expect to feel normal again before I try come off this drug or am I going to just be at a functioning level? It is really disheartening to read all the stories of folks who have been on these drugs for so many years and have been fighting these withdrawal symptoms for years and years. I can't help but wonder that that's what my future is going to be. I need to work as long as I can to at least 70 to be able to afford to be able to retire. I'm beginning to wonder how I'm going to be able to function in my job if I'm going through withdrawal. Is it feasible just to stay on this medication indefinitely? I was on this for 12 years and had no side effects and was living a normal life prior to my doctor suggesting I try to get off this medication. I am beginning to wonder whether I should have never tried given that I was functioning just fine while taking it. 20/20 hindsight. I know it will ultimately be better if I get off this drug once and for all but I can't help but be terrified of what is ahead. I don't know if I can handle years of depression without wanting to just end it. Those two weeks before reinstating we hell. How do people function like that?

[Geezer2BNormal]

Just feeling down today. Just learned that wife's nephew is in bad shape after kidney cancer surgery. He is only 56. Life is too short.

[Geezer2BNormal]

I have a quick question regarding using melatonin to aid in sleep.  I have been taking half of a 5 mg tab the past week to help me get to sleep, but last night was feeling on edge and took a full 5 mg. tablet.  I felt really down this morning and even after an hour after taking my 5 mg. citalopram, I was still feeling down and depressed. Also very drowsy on top of the A/D fog.  I feel a bit better now that I'm at work after a cup of coffee.  I read on the supplement forum that 2 mg or less should be the target that you try to use.  Would taking 5 mg of melatonin make me feel this way today?  I got really anxious that my reinstatement dosage was not working but I'm wondering if it's just the higher dose of melatonin that did it to me today.  

[AliG]

Hi Geezer.   I had the exact same thing happen to me. I felt " down & dopey" the next day as well as depressed. That's probably what it was with you . If you read through the thread , many others have experienced this. With Melatonin, less is best.  Small amounts can be very effective. Have a read through this link:

Melatonin for sleep

[Geezer2BNormal]

Hi AliG,

 

Thanks for the response.  I was taking 5 mg before I reinstated because of the withdrawal symptoms.  I will definitely back off on the amount taken.. I'm feeling better now so that's probably what it was.  The daily A/D dose usually kicks in in about an hour and it sure didn't do that today.  After I had a cup of coffee, I was feeling better so I will take it easy on the melatonin going forward. 

[AliG]

 Geezer.  Stabilized means low symptoms , where normal life carries on and you're not dysfunctional. Can you carry on in your job ? Yes. Is it feasible to stay on indefinitely? Only if you want to experience ever changing lows and more dysfunction leading to possible permanent disability.

 

12 years and no side effects ?  I think not . Maybe, if you're lucky for a while. It catches up with you though.

 

How do people function like that ?  They see through the smoke screen of Big Pharma lies and become determined not to become another victim. They take responsibility and move through the temporary pain to a healthy drug free future. 

[Geezer2BNormal]

Thanks AliG. I appreciate your honesty about getting off these things. I have been looking for anything about splitting a daily dosage so I don't feel irritable or down by the end of the day or is it best to take all at once?

[ChessieCat]

It might be worthwhile keeping a diary over a few days to a week noting dose times and when & what symptom/s you get.  This will give you an idea if there is a true pattern.

[doggiemama]

Hi Geezer so sorry you going through all these things at the moment but things do get better. I also was not aware of the implications of stopping Citalpram and went though hell after stopping ct and to late to start again after having a very bad reation after taking just 1 tab. I could not take any sort of vitamins or otc meds . All I did was epsom salt baths and smelling lavander oil. And what helped me a lot was seeing a phycologist and did CBT just to get things into prospective . I'm still not where I want to be mentally or phyically but a 100+ better than I was 2 years ago

[Geezer2BNormal]

Hi Doggiemama,

 

I do appreciate you words of encouragement.  I think I'm still stabilizing.  Yesterday I felt pretty good all day, but last night did not sleep well and the negative thoughts are back today.  I took my daily dose 2 hours ago but it doesn't seem to have made much of a difference in my mood.  I think I have grown so sensitive to this drug that even the slightest fluctuation seems to throw my brain and moods out of whack.  I am starting to keep a daily record of this so I can track where I'm at mentally.  It's a "brave new world" that I never envisioned would result from trying to get off this medication.  I had no idea.

[doggiemama]

Yes its good to make a record just don't become obsessed with symptoms as I did . The strange thing is we constantly looking out for them which makes it worse I think every little pain or twitch put me in stress mode . I've learnt to say ok this is just my head and carry on thinking of something else. I not alway succesful but it does help . Things do get better I promise GOD BLESS

[Geezer2BNormal]

I have a question on reinstatement. I have been back on a 5 mg daily dose and was back to feeling pretty normal last Thursday and Friday. However over the weekend I'm back to feeling depressed. Is this to be expected? I reinstated two weeks ago tonight so after two good days of feeling normal after two weeks, I thought I was ok. Can I still expect ups and downs or does stabilization after reinstatement take 6-8 weeks like I was just starting to take this drug before my moods quit going all over the place?

[ChessieCat]

Yes, it is absolutely normal.  The fact that you have had a couple of days of feeling "pretty normal" is a really good sign that reinstatement is working.  Healing is not linear it comes in windows and waves:  Windows and Waves Pattern of Stabilization

 

Did you check out brain and healing links in my post #4?  The brain has a lot of adjustments to make and it's important to be as stress free and patient as possible to allow the healing to happen.  I believe that when we become anxious and stressed that it takes the brain's focus off healing and its attention is directed towards keeping us alive - the fight or flight mode.

 

It's a good idea to learn non-drug coping techniques which can be helpful for all stages of this process and for once you are off drugs:

 

1. Non-drug techniques to cope with emotional symptoms
2. Acceptance
3. Acceptance and Mindfulness
4. Claire Weekes' Method of Recovering from a Sensitized Nervous System
5. "Change the channel" -- dealing with cognitive symptoms
6. Change cognitive framing - Redirect - Another Way
7. Cognitive Behavior Therapy (CBT) for anxiety, depression
8. Cognitive Behavior Therapy lessons
    

[Geezer2BNormal]

I woke again this AM feeling very depressed for the 3rd day in a row.  

 

I saw last night a link to the SSRI withdrawal article by James Heaney about reinstatement.  He mentioned that your brain adjusts to not having the daily SSRI dose at a rate of about 10% per month so to decide what dosage you should reinstate at was to start with your max dosage and reduce it by 10% per month starting at the time that you begin to taper.  In my case, it's been 3 months +- a week or two.  

 

If this is true, then it would seem that taking 5 mg/day when my max dosage was 20 mg/day is too low of a dosage.  That dose just doesn't seem to be enough to keep it from wearing off by the end of the day and given the weekend, I'm doubting that it's too low a dose to prevent depressive mood swings.  

 

At 10%/month, that would put my dose at 13 mg or so so I'm contemplating upping my dose to 10 mg and try to stabilize there.  His article recommended to not reinstate at too low of a dose just to speed up the timeframe of getting off the drug.  

 

I MUST keep stability in my mental state.  I cannot afford to lose my job over this.  I'm 63, have a good job that requires mental stability and clarity, and cannot afford to lose it.  My wife doesn't work so if I lose my job, I'm screwed.  

 

I would like others' opinion on updosing to this point.  I don't care at this point that it will take me that much longer to get off this medication.  

Edited September 19, 2016 by scallywag
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[scallywag]

When you say you are "feeling depressed," is it emotions you're referring to? Cognitive or physical symptoms or a combination?  Would you post what you are specifically experiencing and when these symptoms arise or change in intensity?

[Geezer2BNormal]

Primarily emotional.  I have not had physical symptoms other than some not feeling so hot stomach and intestinal-wise.  It's like waking up to a bad dream and I can't get my mind off the way I feel and I still am having depressing thoughts about being 63, having regrets for my actions in life, feeling old physically, etc.  It's like walking around inside a dark cloud.  My son and his wife came over yesterday with their two-week baby boy and you'd figure having a new grandchild would lift your spirits.  I just felt removed from it all and did not feel the joy that I should at holding my grandson.  I am also pretty hair-trigger from an agitation standpoint.  I have been waking up pretty much every day feeling this way but up until this weekend, I would feel better mentally after an hour or so from taking my medication.  On Saturday and Sunday, it really didn't make much of a change in my mood which alarmed me.  I was feeling pretty good on Friday at work and didn't think about this state of mind just about all day.  Yesterday was not good.  My wife went down to my daughter's to babysit our other new grandchild and I could not stay home by myself as depressed as I felt.  I had to have some company.  That is not like me at all to fear being alone with my thoughts and anxieties.  I don't know if this explains how I feel but I just feel that I'm having a nightmare that I can't wake up from.  My wife doesn't understand the way I feel physically and emotionally and I think she is afraid that I'm going to turn into my father who spent his last years in marginal health and made his focus in retirement his ill health and self-medication with narcotics to alleviate pain.  I am terrified of becoming that.  My dad had a history of depression as well and I'm a very emotional person so this sure as hell is a miserable experience like none that I have every had. 

[Altostrata]

Hello, Geezer.

 

Although you reinstated 5mg on 9/4, you've made a lot of changes in the way you take the 5mg. Some people do feel variations in manufacturer or when they take the liquid form.

 

Please take 5mg at the same time each day. If you're quartering a 20mg tablet, try to use the same lot of tablets consistently.

 

As ChessieCat pointed out, that you've gotten some windows is a sign the 5mg is helping. Sometimes it takes time for your nervous system to settle down from withdrawal.

 

The way you describe your symptoms sounds to me like you are confronting some normal existential issues that perhaps 20mg citalopram smothered. One common effect of SSRIs is that they make you emotionally numb. Some people interpret this as beneficial.

 

Please see Non-drug techniques to cope with emotional symptoms You may simply need to grieve whatever mistakes you've made in life, forgive yourself, and move on.

[ChessieCat]

You might find something helpful in these discussions:

 

shame-guilt-regret-and-self-criticism

 

grief-and-loss-of-capacity-from-adverse-drug-effects