Viridian: Viridian + fluoxetine - looking to end a dysfunctional relationship

[Viridian]

Hi all.

 

I'm Viridian, 28 y/o British male, and have been on fluoxetine most of my adult life. Was prescribed aged 10 to manage anxiety, but tapered pretty successfully after a couple of years. During college I had a severe anxiety episode and was prescribed fluoxetine 20mg again. Since then, I've attempted to CT several times, briefly had my dosage doubled, and switched to citalopram. Nothing stuck, and I'm still here chugging along with 20mg fluoxetine.

 

I want to taper soon for a couple of reasons, and would be interested in getting thoughts from those more experienced.

 

- I'm fairly sure the effects are wearing off - for the past year or so I've been experiencing regular, intense episodes of anxiety, and the past couple of months it's been especially pronounced. And yet I'm finding strategies to manage and carry on with life - in the past I've been knocked out by milder symptoms, if that makes sense. I'm thinking it's time to say goodbye to the meds and overhaul my diet and lifestyle. Does anyone have any advice on quitting while you're feeling good versus quitting while you're feeling crappy?

 

- In all likelihood I have a genetically transmitted neurodegenerative condition which my father and brother have both been diagnosed with. It's rare and no one knows much about it - basically it can kill you at 40 or it can kill you at 90, and no one's really sure what factors influence that. Either way, I'm not particularly keen to carry on messing with my neurobiology indefinitely when it could potentially piss something off. I'm sure 18 years' on-off usage has already done some kind of damage, but I don't feel like adding to that.

 

Let's see, other info. I'm currently finishing up a doctoral thesis which I'm submitting in April, and I have a fiance visa processing with my US-based partner. In short, it's not exactly a typical or stress-free year, and if I'm gonna taper, I want to be both informed and careful about it. My plan is to begin tapering around April when my thesis is wrapped up, but possibly sooner. I've switched to a high-fibre diet with plenty of probiotics. I also take Omega-3 and magnesium supplements, since I understand both are supposed to help with anxiety. Working on building exercise into my life, but it's a work-in-progress. Tips on building up a good base for a taper would be very gratefully received.

[Shep]

Hi, Viridian.

 

Welcome to Surviving Antidepressants.

 

Sounds like you've already done some reading on SA, but I'm going to post some links just in case so you have them here for easy referral on your thread.

 

Tips for tapering off Prozac (fluoxetine)

 

Why taper by 10% of my dosage?

 

What is withdrawal syndrome? 

 

The Windows and Waves Pattern of Stabilization

 

Healing from antidepressants. Patterns of recovery  video (4 minutes)

 

Coming off and on psych drugs, especially since your first exposure was from an early age, may leave you with a more sensitive nervous system and since you're in the midst of a more stressful time in your life, you may want to consider starting out with a micro-taper. Please note that a micro-taper does not involve reducing every day without holds. The holds are very important. For more, please see:

 

Micro-taper instead of 10% or 5% decreases

 

For more on why and how the nervous system becomes more sensitive with off and on use, please see:

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

For information on using a scale or liquid for your taper, please see:

 

• Using a digital scale to measure doses
• Making a liquid from a tablet or capsules

 

There are many ways of using non-drug coping techniques to not only aid you through your taper, but to set you up for success without drugs once you're off. For more, please see:

 

Non-drug techniques to cope with emotional symptoms

 

Please continue to use this thread to document your symptoms and to ask questions. 

 

[myndfull]

Viridian -- Read your intro and want to commend you for being so proactive. There's a lot going for you already, tapering-wise. You seem to know what's important in your life, and you have a plan to get you to a place where life might be better. That's positive and forward-thinking. So many folks on SA.org do some form of a cold turkey (that would include me at the very beginning of my taper) and then spiral out into withdrawal that isn't pleasant.

 

So, good for you! You're starting off on a very solid footing and though a positive disposition is not a requisite for an effective taper, it sure can help. 

 

Eating better, getting some exercise several times a week, losing negative perspectives on life and living, and meditating/mindfulness once or twice a day are all pursuits that a taper will push one toward. A taper teaches one patience, and gives one a perspective on the power of one's will. Instead of being numbed and dumbed down with a pill, one can take charge of one's health. A greater sense of personal happiness can be a by-product of those changes. SSRI's, in my view, estrange us from our selves. Knowing the self well is the foundation from which all positive change happens. A successful taper will teach you a lot about your self.

 

The moderators here are a great bunch of people, with a lot of wisdom to share. Let your self learn from them.

 

Myndfull

[Viridian]

Thank you for the links, Shep - that's really helpful.

 

Myndfull - thank you as well for your kind words. As you probably noticed, I've come to the idea of tapering fairly late in the game, having attempted to recklessly cold turkey several times in the past with disastrous effects. I think on some level I believed that the fluoxetine was nothing more than a placebo, and that I could afford to be fairly lax in how I took it - missing doses, taking it at varied times of day, continuing to drink alcohol etc. I now think I was wrong about this, and that I only created more problems for myself.

 

I'm actually really struggling with my symptoms right now, and have arranged to see a therapist next week. I plan on raising the topic of medication, but I imagine that she'll advise me to remain on my current dose, or even go up (which I'm not prepared to do). It's really frustrating - I've wanted to come off the SSRI for a while now, but it feels stupid to try and do it when I'm already feeling so awful every day.

[Shep]

Holding for now may be your best bet. Give your nervous system some time to stabilize. 

 

Before your visit to your therapist, you may want to have a read of these links:

 

How do you talk to a doctor about tapering and withdrawal?
 
What should I expect from my doctor about withdrawal symptoms?

 

Withdrawal dialogues & encouragement

 

A book that we highly recommend on this site is Robert Whitaker's Anatomy of an Epidemic . You may also like the podcasts on his website:

 

Mad in America - Podcasts

 

Please keep updating. 

[Viridian]

Thanks again. I also had a look at your "coping techniques" toolkit - there's some very helpful stuff in there for the type of anxiety I'm dealing with right now. 

 

The fluoxetine I'm taking is the kind that comes in 20mg hard capsules, so I'm guessing tapering would mean dissolving these in water, as suggested in the link? After so long on the same type of medication I feel like switching to a liquid solution might risk rocking the boat.

 

Right now what I'm struggling with - and this has always been my biggest problem when I've tried to cold turkey - is the shift in mood patterns from morning to evening. I'll wake up and have a moment of calm, then the anxiety hits me like a freight train. I feel awful all day till maybe 9pm, then my mood lifts to the point where I feel too wired to sleep. I've read some of the threads on this forum about cortisol and the waking response, but would appreciate any more tips anyone has on how to regulate this - supplements, timing of exercise, etc. Going to bed and waking up feeling like two different people isn't so much fun.

 

Symptom-wise, I already feel as though I'm cold turkeying, so maybe this will be good practice. I'm guessing what's happening is my body has decided 20mg isn't enough, and wants to go up a dose. But since these symptoms are forcing me to develop better coping strategies, it feels like a good time to be thinking about a taper. I'll hold off for the immediate future, though.

[Shep]

9 hours ago, Viridian said:

The fluoxetine I'm taking is the kind that comes in 20mg hard capsules, so I'm guessing tapering would mean dissolving these in water, as suggested in the link? After so long on the same type of medication I feel like switching to a liquid solution might risk rocking the boat.

 

Hi, Viridian.

 

We advocate switching from capsules to liquid gradually. So you could switch by 25% increments over several days as opposed to an abrupt switch. Or, if you feel your more sensitive, you could switch even more gradually. That is the easiest for your nervous system and is less likely to rock the boat, as you say. 

 

9 hours ago, Viridian said:

Right now what I'm struggling with - and this has always been my biggest problem when I've tried to cold turkey - is the shift in mood patterns from morning to evening. I'll wake up and have a moment of calm, then the anxiety hits me like a freight train. I feel awful all day till maybe 9pm, then my mood lifts to the point where I feel too wired to sleep. I've read some of the threads on this forum about cortisol and the waking response, but would appreciate any more tips anyone has on how to regulate this - supplements, timing of exercise, etc. Going to bed and waking up feeling like two different people isn't so much fun.

 

 

You may already read these links, but let me post just to be sure. They address some of what you're asking:

 

Tips to help sleep - so many of us have that awful withdrawal insomnia

 

Waking with panic or anxiety -- managing cortisol spikes 

 

Easing your way into meditation for a stressed-out nervous system

 

Non-drug techniques to cope with emotional symptoms

 

Do you have a sleep mask or black-out shades? Those can be very helpful. 

 

You may also find listening to guided meditations an hour or so before bed to be helpful.

 

Guided Meditations, Calming Videos, Sleep Hypnosis

 

Also, you may be experiencing a drop of blood sugar in the morning. So eating a healthy breakfast with protein can really help. Some of us find the low blood sugar diet to be especially helpful during withdrawal because withdrawal can cause erratic blood sugar drops. Eating small meals throughout the day will help maintain your blood sugar.

 

Diet Plans for Hypoglycemia (low blood sugar)

 

Suggested meal plan - hypoglycemia diet

 

Note that the symptoms of low blood sugar mimic withdrawal symptoms. 

 

Hypoglycemia - symptoms

 

9 hours ago, Viridian said:

Thanks again. I also had a look at your "coping techniques" toolkit - there's some very helpful stuff in there for the type of anxiety I'm dealing with right now. 

 

 

I'm glad you're finding coping techniques that are helpful. Feel free to link and post things in your thread that you find helpful so you have them here and accessible. 

 

As you are holding and later, as you taper, bringing these kinds of non-drug coping skills into your life daily will ensure you have the skills you need to cope during your taper and well into the future. 

 

[Viridian]

Thanks shep!

 

Met with new therapist for the first time today, and thought I'd share the parts of our discussion that touched on antidepressants. She visibly winced when I told her I was prescribed fluoxetine aged 11 - unsurprising, really - and said in her experience prescribing SSRIs to children/teens often damages the development of natural self-calming techniques. Makes sense to me on paper - was wondering if others here had heard the same? In truth I've tended to avoid information about the potential effects of giving SSRIs to adolescents, since I figure any damage has already been done.

 

She also said I ought to review with a doctor about whether to continue taking them, since a ) I'm not currently being monitored by a regular doctor, and b ) she thinks I'd be better off stopping (clearly not a pro-drugs person). I didn't get into tapering since medication wasn't the main focus of our conversation, but I plan to talk to her about it next time.

 

As regards coping techniques - I've been coping incredibly poorly the last few days. But some things that have been helping me, especially at night, are Michael Sealey's mindfulness/hypnosis recordings, which I first found in Shep's thread. Some highlights for me are:

• Sleep Hypnosis for Anxiety Reduction & Reversal
• Hypnosis for Clearing Subconscious Negativity
• Mindfulness Meditation for Deep Sleep: Recovery from Insomnia & Over-Thinking

I don't really know what my feelings are on the finer points of hypnosis, but the guy has the most relaxing voice ever and certainly puts a lot of thought and work into his material. So far I haven't managed to stay awake through one - and usually it takes a fair bit to get me to sleep.

[Shep]

6 minutes ago, Viridian said:

She visibly winced when I told her I was prescribed fluoxetine aged 11 - unsurprising, really - and said in her experience prescribing SSRIs to children/teens often damages the development of natural self-calming techniques. Makes sense to me on paper - was wondering if others here had heard the same? In truth I've tended to avoid information about the potential effects of giving SSRIs to adolescents, since I figure any damage has already been done.

 

Hi, Viridian.

 

Thanks for the update. 

 

Regarding your comment "any damage has been done" - the fact that you're working on a doctoral thesis is proof that you're not damaged and you're going to be fine. For many of us, it's not just about what the drugs do while we're on them, but more the damage that can be done if we come off too quickly. This is a great post about how these drugs work:

 

How psychiatric drugs remodel your brain

 

It looks like you're already started learning what you need to know as far as the natural self-calming techniques go. Since you'll need a very slow taper, you'll have plenty of time to learn these techniques and make them a daily part of your life. Many of us find we handle life so much better after coming off these drugs due to the process of learning how to manage our withdrawal experience. We come out with a bit of the Buddha in us.

[Viridian]

Thanks, that's an excellent post and has helped me to understand better. I'll be using it to explain to my partner as well.

 

Can I ask a little more about switching from capsules to liquid? You said:

 

On 04/02/2018 at 12:21 PM, Shep said:

We advocate switching from capsules to liquid gradually. So you could switch by 25% increments over several days as opposed to an abrupt switch. Or, if you feel your more sensitive, you could switch even more gradually. That is the easiest for your nervous system and is less likely to rock the boat, as you say. 

 

 

I'd appreciate clarification on this - how would 25% increments work? And would this be a switch from capsules to a prescribed liquid solution, or to dissolving the capsules in water? Sorry if I'm being slow or missing the point.

 

Thinking a lot about how to handle the doctor's appointment, which is Friday. In the past when I've talked to doctors about the SSRI, the only thing they've been interested in knowing is "are you still anxious/depressed?" and when my answer is inevitably "yes," they pretty much write me a repeat prescription and send me on my way. Am debating whether I should try to have the conversation about tapering this time, and/or ask for a prescription for liquid. I'm still concerned that "I'm feeling worse than ever, and also I'd like to quit the antidepressant" might not be the best strategy...

[Shep]

16 hours ago, Viridian said:

I'd appreciate clarification on this - how would 25% increments work? 

 

Hi, Viridian.

 

Sure, let's clarify this. Doing 25% increments means taking 25% in liquid and 75% by pill for several days. And then 50%/50% of each for a few days. And then 75% liquid and 25% tablets for a few days. And then transition over completely to 100% liquid. This gives your nervous system time to adjust gradually instead of one day tablets, the next day liquid.

 

And some people even prefer to switch over more gradually than 25%, depending on how severe your current symptoms are. As you mentioned previously, you don't want to rock the boat.

 

16 hours ago, Viridian said:

And would this be a switch from capsules to a prescribed liquid solution, or to dissolving the capsules in water? Sorry if I'm being slow or missing the point.

 

Please see the first post in the  Tips for tapering off Prozac (fluoxetine) thread, as it gives instructions for using the pre-made prescription liquid, as well as the make-your-own liquid. 

 

After you have a chance to read through that, please list any questions you have right here in your intro thread so a moderator can give you information specific to your own taper. 

 

 

16 hours ago, Viridian said:

Thinking a lot about how to handle the doctor's appointment, which is Friday. In the past when I've talked to doctors about the SSRI, the only thing they've been interested in knowing is "are you still anxious/depressed?" and when my answer is inevitably "yes," they pretty much write me a repeat prescription and send me on my way. Am debating whether I should try to have the conversation about tapering this time, and/or ask for a prescription for liquid. I'm still concerned that "I'm feeling worse than ever, and also I'd like to quit the antidepressant" might not be the best strategy...

 

You are right about that - it's very hard to convince not only doctors, but also friends and family members, that it's a good idea to come off these drugs when you're struggling and having loads of symptoms that could be seen as depression or anxiety. 

 

Unless you're going to need a prescription for a compounding pharmacy or to get a liquid formulation, it's really not a necessary conversation. So it really depends on how informed your doctor is and how comfortable you are having this discussion. 

 

You may want to frame it in the narrative of "I want to see how I do at a lower dose" as opposed to "I want to taper off my antidepressant". And then you can get a feel for how educated and informed your doctor really is. 

 

If you haven't already done so, please have a read of these links:

 

How do you talk to a doctor about tapering and withdrawal?
 
What should I expect from my doctor about withdrawal symptoms?

 

Withdrawal dialogues & encouragement

 

Unfortunately, we're left in a situation where the doctors who prescribe these drugs and believe 110% in them are the very doctors we have to go to in order to taper safely. It's kind of like playing a game, but with a calm and steady mindset, you'll be able to get what you need and take charge of your own health and healing.

 

Please let us know how it goes. 

[Viridian]

Had GP appointment for medication review this morning. Not much to report, other than my surprise when he said "non-pharmacological methods are generally better." In some ways it seems like a platitude, but I don't think I've ever heard that sentiment from a medical doctor before. I was a bit disheartened, though not surprised, when he suggested I might want to switch to a different medication - that would just so obviously be a patch-up solution. As usual, seeing a doctor has just left me feeling frustrated and powerless.

 

My partner, who has always been a sceptic when it comes to psychiatric drugs of any kind, now seems nervous about the idea of me coming off, even with a taper. My new therapist, however, thinks I'd be better off 'off' them - from which I'm inferring that she doesn't know much about tapering, and thinks I could just stop taking them at any time.

 

I don't really know what to do. I know how long a taper would take - especially for me, who's been on this drug for so long - and so I'm keen to get started. But I feel so terrible already and I'm afraid of getting worse still.

[Shep]

Hi, Viridian.

 

Have you had a chance to check out the below resources?

 

On 2/3/2018 at 10:38 AM, Shep said:

 

A book that we highly recommend on this site is Robert Whitaker's Anatomy of an Epidemic . You may also like the podcasts on his website:

 

Mad in America - Podcasts

 

You may also want to include your partner in reading Whitaker's book and listening to the podcasts. This is a short video about his book Anatomy of an Epidemic:

 

Robert Whitaker, author Anatomy of an Epidemic video (11.5 minutes)

 

If you read the book, you'll find the scientific sources documented.

 

You may also want to print out some of the information in the Journals section to share with your partner. 

 

From journals and scientific sources

 

You may want to start with this article in the Journals section:

 

Lacasse, 2005 Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature

 

 

 

[Viridian]

Hi Shep. Yes, I've had a look at Whitaker's stuff, and have spent quite a bit of time browsing this forum for more information on the long-term effects of psychiatric drugs. There are certain topics (potential neurological degeneration as a result of SSRI use) which are currently too much for me to handle, but in the long-term I would like to be more fully informed. I'll admit that in the past I've been a defender of psychiatric drugs, but I imagine that's true for many on this forum. I'm still on the fence in a lot of respects. What has tipped the balance for me is the obvious lack of knowledge about what these drugs do to us. I'll read Whitaker's book in full soon, but I'm concerned from what I've seen so far that he's making claims which outstrip his evidence. But then, when it comes to psych drugs, who isn't?

 

Apologies for the ramble. Part of this journey for me is figuring out my ethical stance on these pills I've been allowing to shape my behaviour and identity for years.

 

In other news, I've been starting to put together preliminary plans for a taper, using the resources on this forum. I'm thinking of following the method of tapering according to the serotonin transporter occupancy curve, and have put together a graph to visualise how that might work. I was thinking I'd go with 30-day reduction cycles, decreasing my dose to decrease occupancy by around 5% each time - until I get into the last few months, when I would reduce that to 2.5% to avoid a cliff edge.

 

 

This would mean that my first reduction would take me down to almost 10mg, which seems like a huge leap, but appears to make sense according to the data on occupancy. So my dosages for each stage would look something like this:

 

20mg (start) → 10.9 → 7.3 → 5.3 → 4 → 3.1 → 2.5 → 1.9 → 1.5 → 1.2 → 0.9 → 0.7 → 0.5 → 0.4 → 0.3 → 0.2 → 0.1 → 0.05 → 0 (finish)

 

Would be interested in getting your thoughts or the thoughts of others on whether this seems like a good strategy. Tapering this way would take me about a year and a half. Does that seem long enough? Should I be including more holds?

[myndfull]

Viridian -- Have to be honest: I don't see this working. Rather, I should say it this way: it might for you, but for me your rate of reduction could not have been viable. Your rate of reduction--to me--looks like a cold turkey. If I understand your graph correctly, your first drop is 55% of you total starting dose. That's far too precipitous a drop, even for the early stages of a taper when the side effects can be relatively minor (because the amount of the drug you're taking has not yet caused a drop in the occupancy rate). Your graph shows your occupancy totals to be much higher than your dosage totals. That usually indicates horrible side effects. 

 

I'm pretty sure the slow and steady rate of monthly 10% drops of previous dose is still the best method (some change that to 5%, or 8%, etc. as they work through their taper, basing their drops on how they feel). Many here drop regularly and occasionally hold when the symptoms become too severe. Again, we're all different. I've not held for longer than about 40 days and I think I only did that once. Even with my occasional lack of consistency per the 10% rule (my drops have often been "around 10%), my taper hasn't been easy.  

 

I've been tapering for three and half years now and most of my drops have been monthly, and most of them have been at or near 10%. When I've dropped more than 10% I've paid a price for it. As I've gotten closer to zero (which will hopefully happen sometime this year), I've begun making drops more frequently. I'm going to make my next drop this Wednesday, from 0.20mL to 0.19mL. My next drop after that will have to be determined by how severe my symptoms have been in the preceding ten days or so. My symptoms have been fairly bad with these lower-level drops--more physical than psychological (insomnia, headaches, diarrhea)--but, in a way that's hard to explain, they are easier to bear than the anhedonia, etc., from before.

 

One of the things I know now that I didn't when I started is that this CAN be done. 

 

Hope this helps/makes sense.

 

Myndfull

[Viridian]

4 hours ago, myndfull said:

Viridian -- Have to be honest: I don't see this working.

 

Hi myndfull - no problem, candour is what I was hoping for! Thanks for your reply.

 

Quote

If I understand your graph correctly, your first drop is 55% of you total starting dose. That's far too precipitous a drop, even for the early stages of a taper when the side effects can be relatively minor (because the amount of the drug you're taking has not yet caused a drop in the occupancy rate). Your graph shows your occupancy totals to be much higher than your dosage totals. That usually indicates horrible side effects.

 

I agree that it seems dramatic, which is why I wanted to get some experienced opinions on the matter. The method seems to have worked well for user ZK2015 with fluoxetine, if I'm understanding his thread correctly - my understanding was that tapering in this way might actually provide a steadier downhill slope for my brain to handle, in terms of the actual effects of the drug.

 

I'm not sure I fully understand your final point about occupancy > dosage = side effects, since the dosage field on that graph only represents the percentage of my starting dose (20mg). However, it's very probable that this is a misunderstanding of the science on my part.

 

Here's what the same occupancy graph would like with a more traditional taper (reducing by 10% of previous dose every 30 days):

 

 

This would take twice as long, and maybe that would be a good thing, but that could also be achieved by simply halving the % occupancy I decrease by each time.

 

Quote

I've been tapering for three and half years now and most of my drops have been monthly, and most of them have been at or near 10%. When I've dropped more than 10% I've paid a price for it. As I've gotten closer to zero (which will hopefully happen sometime this year), I've begun making drops more frequently. I'm going to make my next drop this Wednesday, from 0.20mL to 0.19mL. My next drop after that will have to be determined by how severe my symptoms have been in the preceding ten days or so. My symptoms have been fairly bad with these lower-level drops--more physical than psychological (insomnia, headaches, diarrhea)--but, in a way that's hard to explain, they are easier to bear than the anhedonia, etc., from before.

 

One of the things I know now that I didn't when I started is that this CAN be done. 

 

I really appreciate you sharing your experience on this. Were many of your difficulties with the 10+% drops in the early stages? If I'm understanding the data correctly, it seems as though there shouldn't be too much change in occupancy during the drop from 20mg to 10mg fluoxetine. But experiential accounts are a thousand times more valuable to me than data at this point. I really just want to find the method that is likely to be the least harmful (although I'll admit I'd love to be free of these things within two years).

 

EDIT: I see from the thread I linked to that perhaps a factor I hadn't considered was the variability of occupancy curves by individual. As tapering strategies go, I can see that there's a degree of risk to this one - I was just heartened by ZK2015's report of a successful and speedy taper from the same drug as me using this method.

[Shep]

11 hours ago, Viridian said:

EDIT: I see from the thread I linked to that perhaps a factor I hadn't considered was the variability of occupancy curves by individual. As tapering strategies go, I can see that there's a degree of risk to this one - I was just heartened by ZK2015's report of a successful and speedy taper from the same drug as me using this method.

 

Hi, Viridian. Yes, the "individual" rates do vary.

 

And there are other things to consider. You are looking at ZK2015's experience, which is good, it's good to research and learn. But I'm concerned about your experience as someone who went on these drugs at 12 years old while your young brain was still developing. Also, you have come on and off these drugs, so it's possible your nervous system is more fragile due to limbic kindling:

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

20 hours ago, Viridian said:

Apologies for the ramble. Part of this journey for me is figuring out my ethical stance on these pills I've been allowing to shape my behaviour and identity for years.

 

 

You're doing fine. There's a concept called "un-patienting" which is the process that we go through when we shed the psychiatric label that in many ways, attached us to our drugs, and in many ways, formed our identities. 

 

It's a process. Nothing that can be done in a day. 

 

A lot of times, as people spend time bringing in non-drug coping skills, the non-drug coping skills replace the medical label. For me, I let go of my manic-depression label. I brought in mindfulness, yoga, and music therapy. I replaced being "manic" with the understanding of "altered states". I replaced "depression" with learning to "go deep" and not let the dark thoughts control me. Mindfulness techniques taught me to view the unwelcoming thoughts as "uninvited guests" and I simply let them pass by without engaging in them. Very, very powerful techniques that put me in control over my symptoms. 

 

And as healing occurs and the symptoms subside a bit, I'm letting go of the remaining elements of the medicalized identity. 

 

You've already mentioned the guided meditation videos that are helping you relax. Please keep using those and also, finding other things - art therapy, music therapy, yoga, journaling, etc. 

 

As you taper and experience symptoms, the symptoms will be like teachers guiding you to more non-drug coping techniques. By the end of the journey, you'll be off the drugs and have the non-drug coping techniques already happening as an automatic response to whatever stressful event comes your way.

 

So please don't focus so much on the amount of time required to taper. One of the benefits of having a long journey off these drugs is it forces you to really learn and practice the non-drug techniques that you need not just for withdrawal, but for life in general. 

 

That's why many (if not most) long term users come off these drugs stronger than they were when they went on them. 

[myndfull]

Viridian -- My understanding of occupancy rates comes from a cursory look at this page and the links thereon:  

 

 

My understanding of your graph--to be very simplistic about it--is this: That the greater the degree of separation between the blue line and the orange line, the greater degree of suffering. Ideally, to mitigate suffering, one should try to keep the peaks of those two lines as close as possible. Slow and steady. Gradual decline. Ten percent is a general rule of thumb; but it's not set in stone. Since we're all different to some degree (different ages, temperaments, drugs, etc.), dropping more or less than 10% could also work. If I had to do my taper all over again (I shudder to think), I would drop at about 5% every three weeks or so. 

 

One thing I'm not sure I understand about your second graph is that the first month's drop (March 1, 2018) drops from 100% to 85%. That's a 15% drop, not 10%.

 

Quote

A lot of times, as people spend time bringing in non-drug coping skills, the non-drug coping skills replace the medical label. For me, I let go of my manic-depression label. I brought in mindfulness, yoga, and music therapy. I replaced being "manic" with the understanding of "altered states". I replaced "depression" with learning to "go deep" and not let the dark thoughts control me. Mindfulness techniques taught me to view the unwelcoming thoughts as "uninvited guests" and I simply let them pass by without engaging in them. Very, very powerful techniques that put me in control over my symptoms. 

 

And as healing occurs and the symptoms subside a bit, I'm letting go of the remaining elements of the medicalized identity. 

 

You've already mentioned the guided meditation videos that are helping you relax. Please keep using those and also, finding other things - art therapy, music therapy, yoga, journaling, etc. 

 

As you taper and experience symptoms, the symptoms will be like teachers guiding you to more non-drug coping techniques. By the end of the journey, you'll be off the drugs and have the non-drug coping techniques already happening as an automatic response to whatever stressful event comes your way.

 

So please don't focus so much on the amount of time required to taper. One of the benefits of having a long journey off these drugs is it forces you to really learn and practice the non-drug techniques that you need not just for withdrawal, but for life in general. 

 

That's why many (if not most) long term users come off these drugs stronger than they were when they went on them.

 

I like quite a lot what Shep wrote above, especially the idea that the experience of tapering can teach powerful lessons in how to cope. I'm not a Buddhist, but I do believe in the central tenant: that Life is Suffering. The better we're able to cope, the greater our chances for happiness.

 

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I really appreciate you sharing your experience on this. Were many of your difficulties with the 10+% drops in the early stages?

 

No, they were more difficult later, say at and below 5mL or so, but it's been difficult all along. I guess the early days were a bit easier (I wrote about this a bit in my journal). It's hard to explain why or how. I'll say it this way: In the early days, when I was still feeling the me that the SSRI created, someone not terribly emotional, a bit blunted, who didn't know where he was going, but was determined to get there, full speed ahead--I could rationalize away some of the pain. I said to myself: I'm not suffering because I'm me. I'm suffering because I'm not taking the drug. Whew! Okay, carry on then! You can do it! Being emotionally blunted because of the medication, I could take that stance fairly easily. I would power through.  

 

Now that I'm very low in dosage a lot of my old personality is coming back. Those two states--low dose + returning "me"--rub up against each other, cause some friction--what I would call existential angst, discordance. However, the questions I've always been asking myself along this journey remain the same. It's just that now I have a need for different answers. Answers to questions like "Who am I?" "Will this ever end?" "Where will I end up?" "Did I do the right thing?" etc. 

 

Since I've learned the lesson from the early days of my taper--it ain't me, it's the drug--I'm beginning to feel that finding the answers to these questions has become more complicated. For example, my earlier answer to "Who am I?" was "I'm not the drug or its affects." And to "Will this ever end?" the answer was "Yes." Now, as the drug has had less and less emotional effect on me, I feel I have a greater responsibility to myself to make myself better, so my answer have changed. I'm on the one hand less certain of my answers, and on the other certain that I'll be okay. 

 

Here's what I've been telling myself:  "As you drop more and more, how you feel is not because of the drug. It's because of you. It's what you do, what you eat, what you think, how you react, etc., etc., that matters. It's less the drug. It's more and more you." 

 

This is not a bad thing; just a meaningful difference. A bit scary. And it's existential, of course, because at the heart of this change is the realization that I'm responsible for the way I feel. That is ultimately empowering. Generative.

 

I will say this with absolute certainty: I'm in a better place now than I was earlier in my taper. I'm stronger. More serious. Less frivolous. More thoughtful. More empathetic. I'm a better me.

 

And, of course, I have hope that the trend continues.

 

Experience truly is the greatest teacher. 

 

Myndfull

 

[Viridian]

On 13/02/2018 at 10:38 AM, Shep said:

I replaced "depression" with learning to "go deep" and not let the dark thoughts control me.

 

Were there any resources that you found especially useful in learning to "go deep" that you could share? This is exactly the kind of strategy I'm currently working to develop.

 

Thanks to both for your inspiring posts. Will respond in full very soon - having a tough day today.

[Viridian]

On 13/02/2018 at 10:38 AM, Shep said:

And there are other things to consider. You are looking at ZK2015's experience, which is good, it's good to research and learn. But I'm concerned about your experience as someone who went on these drugs at 12 years old while your young brain was still developing. Also, you have come on and off these drugs, so it's possible your nervous system is more fragile due to limbic kindling:

 

This is a fair point. Looking around this site, I feel that my case is fairly unusual in that I took fluoxetine from about 12-13, and then was able to C/T off it and remain off for perhaps five years before withdrawal symptoms hit me hard. I don't know what my brain was doing during that time. Hopefully it managed to compensate a bit for any early damage done by the drug. As mentioned above, my therapist is convinced that the drug damaged my developing ability to 'self-calm' - I think that's likely accurate.

 

On 13/02/2018 at 10:38 AM, Shep said:

A lot of times, as people spend time bringing in non-drug coping skills, the non-drug coping skills replace the medical label. For me, I let go of my manic-depression label. I brought in mindfulness, yoga, and music therapy. I replaced being "manic" with the understanding of "altered states". I replaced "depression" with learning to "go deep" and not let the dark thoughts control me. Mindfulness techniques taught me to view the unwelcoming thoughts as "uninvited guests" and I simply let them pass by without engaging in them. Very, very powerful techniques that put me in control over my symptoms. 

 

And as healing occurs and the symptoms subside a bit, I'm letting go of the remaining elements of the medicalized identity. 

 

I've found what you say here, and reading about your own journey, very inspiring. Thanks for sharing.

 

I'm still looking around for techniques that help - so far, nothing has been half as powerful as the Sealey recordings. They're helping me to embrace mindfulness and focus in ways that I haven't succeeded in doing before, and I'm encouraged by that. I'm still nervous about beginning a taper as I just feel so awful already, but perhaps once I've built up a solid set of resources it won't seem so nerve-wracking.

[Shep]

8 hours ago, Viridian said:

Were there any resources that you found especially useful in learning to "go deep" that you could share? This is exactly the kind of strategy I'm currently working to develop.

 

Hi, Viridian.

 

I have this link in my signature and it's where I turn most often when I need help controlling symptoms: 

 

Shep's toolkit of non-drug coping techniques

 

My all time favorite is Mooji. I found that when I started developing looping thoughts, they were looping Mooji! So it was actually rather pleasant. 

 

Mooji is really good at teaching how to become The Observer, so you can simply watch your thoughts pass without engaging in them. Very, very good for intrusive thoughts, as well as learning acceptance.  

 

Nervousness, Anxiety & Fear ~ Spoken by Mooji

 

Mooji - Unbound Peace

 

And I really got into music therapy:

 

Music Therapy / Music for Wellness and Healing

 

If it seems to much, simply go back to basics, go back to the breath. 

 

4-7-8 Breathing Exercise by GoZen

 

But these are just my favorites. You'll find stuff you like even better. I see you already linked Michael Sealy's mediations in your signature. That's a GREAT resource. 

 

Other people really like Claire Weeks:

 

Claire Weekes - How To Recover From Anxiety

 

Loads of stuff to explore and bring into your daily life. 

 

On 2/13/2018 at 1:12 PM, myndfull said:

Since I've learned the lesson from the early days of my taper--it ain't me, it's the drug--I'm beginning to feel that finding the answers to these questions has become more complicated. For example, my earlier answer to "Who am I?" was "I'm not the drug or its affects." And to "Will this ever end?" the answer was "Yes." Now, as the drug has had less and less emotional effect on me, I feel I have a greater responsibility to myself to make myself better, so my answer have changed. I'm on the one hand less certain of my answers, and on the other certain that I'll be okay. 

 

Here's what I've been telling myself:  "As you drop more and more, how you feel is not because of the drug. It's because of you. It's what you do, what you eat, what you think, how you react, etc., etc., that matters. It's less the drug. It's more and more you." 

 

This is not a bad thing; just a meaningful difference. A bit scary. And it's existential, of course, because at the heart of this change is the realization that I'm responsible for the way I feel. That is ultimately empowering. Generative.

 

I will say this with absolute certainty: I'm in a better place now than I was earlier in my taper. I'm stronger. More serious. Less frivolous. More thoughtful. More empathetic. I'm a better me.

 

And, of course, I have hope that the trend continues.

 

Brilliant post, Myndfull. 

[Viridian]

On 13/02/2018 at 6:12 PM, myndfull said:

If I had to do my taper all over again (I shudder to think), I would drop at about 5% every three weeks or so. 

 

Hey myndfull. This is something like what I'm now thinking about doing - starting out with 5% drops as compromise between the standard 10% and a micro-taper. I'm fairly well persuaded by Shep's point about my early start on the drugs plus my failed CTs meaning that a slower taper would be better.

 

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One thing I'm not sure I understand about your second graph is that the first month's drop (March 1, 2018) drops from 100% to 85%. That's a 15% drop, not 10%.

 

Yes, I'm actually not quite sure how that happened! It seems as though there was an error in the formula I was using to calculate each percentage reduction. Here's the corrected graph with 10% drops:

 

 

There's still a pretty substantial gap between the percentages for most of the taper, but there seems to be no way to avoid that.

 

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No, they were more difficult later, say at and below 5mL or so, but it's been difficult all along. I guess the early days were a bit easier (I wrote about this a bit in my journal). It's hard to explain why or how. I'll say it this way: In the early days, when I was still feeling the me that the SSRI created, someone not terribly emotional, a bit blunted, who didn't know where he was going, but was determined to get there, full speed ahead--I could rationalize away some of the pain. I said to myself: I'm not suffering because I'm me. I'm suffering because I'm not taking the drug. Whew! Okay, carry on then! You can do it! Being emotionally blunted because of the medication, I could take that stance fairly easily. I would power through.  

 

Now that I'm very low in dosage a lot of my old personality is coming back. Those two states--low dose + returning "me"--rub up against each other, cause some friction--what I would call existential angst, discordance. However, the questions I've always been asking myself along this journey remain the same. It's just that now I have a need for different answers. Answers to questions like "Who am I?" "Will this ever end?" "Where will I end up?" "Did I do the right thing?" etc. 

 

Since I've learned the lesson from the early days of my taper--it ain't me, it's the drug--I'm beginning to feel that finding the answers to these questions has become more complicated. For example, my earlier answer to "Who am I?" was "I'm not the drug or its affects." And to "Will this ever end?" the answer was "Yes." Now, as the drug has had less and less emotional effect on me, I feel I have a greater responsibility to myself to make myself better, so my answer have changed. I'm on the one hand less certain of my answers, and on the other certain that I'll be okay. 

 

Here's what I've been telling myself:  "As you drop more and more, how you feel is not because of the drug. It's because of you. It's what you do, what you eat, what you think, how you react, etc., etc., that matters. It's less the drug. It's more and more you." 

 

This is not a bad thing; just a meaningful difference. A bit scary. And it's existential, of course, because at the heart of this change is the realization that I'm responsible for the way I feel. That is ultimately empowering. Generative.

 

I will say this with absolute certainty: I'm in a better place now than I was earlier in my taper. I'm stronger. More serious. Less frivolous. More thoughtful. More empathetic. I'm a better me.

 

And, of course, I have hope that the trend continues.

 

Experience truly is the greatest teacher. 

 

I found this whole section of your post pretty profound, and I feel fortunate that I can benefit from your experience.

 

More and more of late, I've been running up against the unavoidable fact that so much of my anxiety stems from a fear of taking responsibility for my own life and my own well-being. I see the drug as both a symptom and a cause of that: it was foisted on me when I was too young to give informed consent, at an age when I hadn't yet developed the capacity of self-soothing. Now, at 28, I still don't have that capacity, and in all probability, that is due to the drug. It's hard not to see the whole thing as a colossal screw-up.

 

I'm more than a little frightened to find out how different I might be without the drug, since it's so woven into the fabric of who I am, and all of my current meaningful adult relationships have been formed whilst taking it. But hopefully a slow taper will allow the 'real' me to emerge slowly over time.

 

This forum is a fascinating place. I feel like the recognition of a shared goal, and the fact that everyone here is at a different point on that journey, creates a sense of purpose that other depression/anxiety support groups tend to lack.

[myndfull]

Viridian -- Don't beat yourself up too much over the "colossal screw-up." Don't say it too often or you'll embed it in your psyche and it'll be hard to get rid of. It probably isn't a screw-up and even if it is, like in lot of life, you'll adapt and move on. What happens to us in life is never as bad as we think it is. And even while on an ssri one has to adapt and cope with the side effects of an ssri. One coping mechanism we come up with IS the decision to taper off the stuff. And if tapering teaches us anything, it's teaches us patience.

 

Isn't patience the ultimate coping strategy? I think it is, though some might say that's pessimistic.

 

I think the 5% plan is a good way to start. You can always adapt--go up or down--depending.

 

Stay optimistic, keep your smarts about you, and be patient. You'll do well.

 

I agree with you about this forum. The people here are all suffering to one degree or another, all for pretty much the same reason. So we all speak the same language.

 

You might want to check out Hudgens, AmyK, Brassmonkey, Aberdeen and some others. They've taken the slow route and seem to have done quite well overall.

 

Myndfull