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Dealing With Emotional Spirals


brassmonkey
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Not sure if this thread is still active but I am in a major emotional spiral right now about akathisia. I don't think I have it yet (this week I've felt rather restless in the morning and not been able to sleep through the night. Nothing during the day though) 

 

I learned about it early on in my withdrawal and it's just stuck in my mind - I am terrified of it. I feel I am doomed to go through it bc of the crazy taper that my doctor made me do and the length of time I took sertraline. 

 

Any tips on how to diffuse this with some logic? 

 

13 years of Sertraline - 100mg. Started at age 16. I was also on Risperdal for a year around this time (don't remember the dose but I went off it and don't remember having any WD) Have had attempts at decreasing in the past but inevitably go back up to 100mg but never experienced WD symptoms.

 

Dumb AF taper went as follows over the course of 1 year in 2020 : april/may alternating 100/50mg, june 75mg, july/august 75/50mg, sep/october 50 mg, november/dec 50/25mg, january/feb 2021: 25mg (dizzyness starts here) 

April 11 2021: last dose (drop to 0) (symptoms of dizzyness and heart palpitations)

June/July: started experiencing some windows and waves. window from dizzyness starts.

August: window from dizzyness, overall good but some numbness in arm and leg and so inevitably health anxiety. 

September: breakdown over fear of the future. had to move home. dizzyness comes back for a few days and then goes away. sleep issues

October: sleep issues, severe anxiety over future, twitching and jerking. insomnia but had a few good days of sleep. some amazing moments like windsurfing and an almost euphoric bikeride.

 

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2 hours ago, Seb1992 said:

Not sure if this thread is still active but I am in a major emotional spiral right now about akathisia. I don't think I have it yet (this week I've felt rather restless in the morning and not been able to sleep through the night. Nothing during the day though) 

 

I learned about it early on in my withdrawal and it's just stuck in my mind - I am terrified of it. I feel I am doomed to go through it bc of the crazy taper that my doctor made me do and the length of time I took sertraline. 

 

Any tips on how to diffuse this with some logic? 

 

Hi Seb, 

I am sorry you are going through an emotional spiral. Those are really difficult! 

However, it is highly unlikely that you are going to get akathisia at this point. 

 

What you are experiencing seems like a morning cortisol spike - these are very common. I have terrors in the morning. Taking magnesium when these happen should help. Having light blocking curtains and and eye mask may also be helpful. 

 

Early-morning waking - managing the morning cortisol spike - Symptoms and self-care - Surviving Antidepressants

 

This symptom has been my companion throughout my taper but may not be for you. But it is definitely not akathisia. 

 

Have you tried using some of the non-drug techniques to manage emotional symptoms? They may help with anxiety. 

 

Hope this gets better soon, 

OMW

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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Hi @Onmyway

 

Thank you for your message. Could you clarify what you mean by highly unlikely that I would experience it? I thought it was a symptom that many people get down the line after stabilising? Maybe I'm totally wrong. Very welcome news if the odds look better. 

I watched a video with Stuart Shipko and he made it seem like most people experience this a while after their last dose, particularly after 6-9 months. I'm 4 months out since dropping to 0. 

 

Very likely that it is a morning cortisol spike. I toss and turn for a few hours and then have a sense of restlessness that is super uncomfortable but am still able to lie in bed for example. Normally if i turn my focus to my phone it calms down (ironic since the blue light is probably not helping the insomnia.) 

 

For sure there's a health anxiety component to all this as well. 

13 years of Sertraline - 100mg. Started at age 16. I was also on Risperdal for a year around this time (don't remember the dose but I went off it and don't remember having any WD) Have had attempts at decreasing in the past but inevitably go back up to 100mg but never experienced WD symptoms.

 

Dumb AF taper went as follows over the course of 1 year in 2020 : april/may alternating 100/50mg, june 75mg, july/august 75/50mg, sep/october 50 mg, november/dec 50/25mg, january/feb 2021: 25mg (dizzyness starts here) 

April 11 2021: last dose (drop to 0) (symptoms of dizzyness and heart palpitations)

June/July: started experiencing some windows and waves. window from dizzyness starts.

August: window from dizzyness, overall good but some numbness in arm and leg and so inevitably health anxiety. 

September: breakdown over fear of the future. had to move home. dizzyness comes back for a few days and then goes away. sleep issues

October: sleep issues, severe anxiety over future, twitching and jerking. insomnia but had a few good days of sleep. some amazing moments like windsurfing and an almost euphoric bikeride.

 

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4 minutes ago, Seb1992 said:

Hi @Onmyway

 

Thank you for your message. Could you clarify what you mean by highly unlikely that I would experience it? I thought it was a symptom that many people get down the line after stabilising? Maybe I'm totally wrong. Very welcome news if the odds look better. 

I watched a video with Stuart Shipko and he made it seem like most people experience this a while after their last dose, particularly after 6-9 months. I'm 4 months out since dropping to 0. 

 

Very likely that it is a morning cortisol spike. I toss and turn for a few hours and then have a sense of restlessness that is super uncomfortable but am still able to lie in bed for example. Normally if i turn my focus to my phone it calms down (ironic since the blue light is probably not helping the insomnia.) 

 

For sure there's a health anxiety component to all this as well. 

 

Hi Seb, 

from my reading here, akathisia is not actually all that common. It does happen and it can be severe in some cases but I don't think it happens that often. I had a mild version of it for a month going from 5 to 0 in the very beginning - mine was just restlessness though, not movement. Reinstatement of 2.5mg and slowly tapering sorted it out fairly quickly. 

 

Yours seems very clearly to be a cortisol spike and health anxiety/ruminations. 

The thing is thinking about it ahead of time will not actually fix akathisia or prevent it. If by a very tiny chance you do get it, then you will deal with it then. 

 

Your questions lead me to believe that you are looking for reassurance (a common OCD symptom). This doesn't mean that you have OCD, withdrawal just makes people get OCD-like symptoms of obsessions where you are looking for relief by trying to get others to reassure you that it won't happen. However, it doesn't usually work. The best, maybe not easiest, way for me to deal with this is to accept that if it does happen I can deal with it then and worrying now is not going to prepare me for it when it happens. 

 

 

 

 

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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Thank you @Onmyway - your message made me feel better. I think I've been frightened by what i've read about it - I saw a video of someone going through it and they were just in such horrible pain. My personal story (having taken Sertraline for years, starting early and dropping to 0 at 25mg) just made me believe that it was a certainty. 

 

Knowing that its a possibility is both a blessing and a curse i think. It can prepare me a little but it's also made me so fearful. 


The reassurance thing is awful. Living in uncertainty is the only way I know but so incredibly painful and scary. 

 

 

13 years of Sertraline - 100mg. Started at age 16. I was also on Risperdal for a year around this time (don't remember the dose but I went off it and don't remember having any WD) Have had attempts at decreasing in the past but inevitably go back up to 100mg but never experienced WD symptoms.

 

Dumb AF taper went as follows over the course of 1 year in 2020 : april/may alternating 100/50mg, june 75mg, july/august 75/50mg, sep/october 50 mg, november/dec 50/25mg, january/feb 2021: 25mg (dizzyness starts here) 

April 11 2021: last dose (drop to 0) (symptoms of dizzyness and heart palpitations)

June/July: started experiencing some windows and waves. window from dizzyness starts.

August: window from dizzyness, overall good but some numbness in arm and leg and so inevitably health anxiety. 

September: breakdown over fear of the future. had to move home. dizzyness comes back for a few days and then goes away. sleep issues

October: sleep issues, severe anxiety over future, twitching and jerking. insomnia but had a few good days of sleep. some amazing moments like windsurfing and an almost euphoric bikeride.

 

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  • 2 weeks later...

To anyone who has done trauma therapy, it is clear that these emotional spirals are often old pain on the rise. You may use whatever technique you can to ease these spirals, but I find that dealing with the trauma is the best way. You can't keep avoiding old trauma if it comes up to be addressed. The key is getting help from a good therapist who can lead you through this painful process and integrate those old feelings.

In my experience, it is a much more effective way to deal with these symptoms than the cognitive methods outlined here. Otherwise, they can last for years if you don't recognize them for what they are. They are not just a brain out of whack. They are a brain out of whack that's trying to deal with emotions that have been repressed for years. That's why many of us went on these drugs to begin with -- to deaden that old pain. 

Bruce 

1980s: First diagnosed with depression. Treated with a tricyclic. 1988: Switched to Prozac 20 mg.  1990s to 2010: On and off Prozac. Increased dose led to side effects. 2011: Put on Zyprexa. 2011: Work burnout and breakdown. Hospitalized for suicidal depression. Switched to Seroquel. Switched to Celexa 40 mg and lithium 300 mg. 2019: Stopped Seroquel. 

2020 July: Decreased Celexa to 30 mg in attempt to alleviate sexual dysfunction. Worked somewhat.

2020 August: Decreased Celexa to 20 mg. Sexual function improved but w/d effects started. 

2020 September: Maintaining Celexa at 20 mg. Experiencing w/d effects - fatigue, dysphoria, mood instability

2020 September 13: Increased Celexa to 30 mg due to w/d effects. Still on lithium 300 mg/day.

2020 October 3: Reduced Celexa to 27 mg. Started taper. 10% per month as recommended.

2020 October 18: Reduced to 24 mg.

2020 December 4: Reduced to 21 mg.

2020 December 23: Reduced to 20 mg (spacing out taper intervals due to persistent w/d effects)

2021 September 23: Several reductions over the past 9 months to 7.0 mg. Stressful life circumstances led me to feeling very depressed with suicidal feelings, so upped to the dose to 10 mg until I feel better. 

 

 

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@BruciI hear what you are saying.  I believe that it is a combination of both - a brain that is out of whack, plus old emotions that need to be addressed.  At least, that is how it is for me.  

 

When people are in the throes of withdrawal, often all they can do is try to survive, and get through the WD.  They are usually in too much pain to address the further pain of old emotions from the past.  That is why we suggest the cognitive methods to stay out of an emotional spiral.  Not only that, doing intense techniques like EMDR can be too activating and upsetting for an already upset nervous system, and hence worsen the WD symptoms, so we at SA suggest that people don't do trauma therapy while in WD.  

 

However, as withdrawal starts to ease, then it becomes feasible to start to address some of the old emotions using gentle techniques.  At least that is how it is for me.  

 

On 9/6/2021 at 4:27 AM, Bruci said:

They are a brain out of whack that's trying to deal with emotions that have been repressed for years. That's why many of us went on these drugs to begin with -- to deaden that old pain. 

I fully agree with this.  I think it is a matter of first things first - I needed to get through the worse of the withdrawal, before I had the bandwidth to address the pain from the past.  

Please do not tag me, unless it is an urgent question about tapering or reinstatement. 

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

Ibuprofen 800 mg, or Tylenol 1000 mg as needed

other meds: Levothyroxine 75 mg

Trazodone on occasion, stopped in late 2019

Xanax on occasion, stopped in late 2019

magnesium in small amounts at 4 AM, breakfast, 3 PM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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  • 2 months later...
  • Moderator
On 9/6/2021 at 10:27 AM, Bruci said:

To anyone who has done trauma therapy, it is clear that these emotional spirals are often old pain on the rise. You may use whatever technique you can to ease these spirals, but I find that dealing with the trauma is the best way. You can't keep avoiding old trauma if it comes up to be addressed. The key is getting help from a good therapist who can lead you through this painful process and integrate those old feelings.

In my experience, it is a much more effective way to deal with these symptoms than the cognitive methods outlined here. Otherwise, they can last for years if you don't recognize them for what they are. They are not just a brain out of whack. They are a brain out of whack that's trying to deal with emotions that have been repressed for years. That's why many of us went on these drugs to begin with -- to deaden that old pain. 

Bruce 

Hi @Bruci

I was just checking this thread and saw your post here. I absolutely agree with you and therapy has been helping me get through these spirals. I have been doing EMDR and IFS. For me the trauma is activated in emotional spirals and there is no amount of cognitive restructuring or distraction that can take me away from it. Trauma informed therapists will do whatever technique they use in a safe way - EMDR or IFS in my case - and can often get one out of a spiral.

 

I wouldn't advise digging for trauma unless it's activated but in a spiral it is activated and there is no way around it. Might as well do the work. I know @haydukehas done a lot of EMDR as well during withdrawal. Are you considering any of these?

 

OMW

 

 

 

 

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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