success ☼ Ox123: 6 months on Mirtazapine. Reinstate?

[Ox123]

Hi all, in a bit of a dilema here. I was prescribed Mirtazapine in October 2017 for a severe bout of anxiety and depression. Within about 1 month I saw great progress. After 4 months i decided to taper. Im 28 and dont want to be on ADs longterm.

 

My taper:

15mg for 4 months

7.5mg for 40 days

3.7mg for 10 days

2mg for 7 days

(Smaller doses were innacurate)

 

Initially upon stopping i had bad stomach pains, this went after 4 days and I spent the next 3 weeks feeling great. Then boom! Something triggered me and I was sent straight back to feeling super anxious. 

 

Since then ive been having 2/3 week waves of sevre anxiety, insomnia, loss of appetite. Ill slowly recover, feel good for a few weeks then relapse again. 

 

Now its been 3 months off mirtazapine and im worried that I have caused permanent damage from the drug for tapering too fast. Would I benefit from reinstating this late on? I dont know how many more of these waves I can handle. Each time they rock me to the core and I consider hospitilisation. Im not suicidal like I was when I had my first anxiety episode but need some answers.

 

Im back doing CBT again with my therapist and starting exposure therapy to my triggers. Any advice welcome!

[Ox123]

May I also add that I experienced joint pain in one hand, chest pain and nosebleeds from mirtazapine. Also loss of libido and of course weight gain.

 

During each taper I had anxiety follow the taper roughly 3 weeks after each drop. I do not believe I allowed myself to stabalise after dropping under 7

5mg

[Altostrata]

Welcome, Ox.

 

18 hours ago, Ox123 said:

May I also add that I experienced joint pain in one hand, chest pain and nosebleeds from mirtazapine. Also loss of libido and of course weight gain.

 

During each taper I had anxiety follow the taper roughly 3 weeks after each drop. I do not believe I allowed myself to stabalise after dropping under 7

5mg

 

Yes, that does sound like you tapered too fast. We advise holding whenever withdrawal symptoms appear.

 

You might try 2mg mirtazapine and see what that does. Those side effects do not sound like mirtazapine and your body ever got along well.

 

Are your symptoms better or worse at any particular time of day? How's your sleep?

 

See this topic for how to titrate mirtazapine

 

Tips for tapering off Remeron (mirtazapine)

 

PS It might take a day for a moderator to approve a topic, we're not staffed 24 hours.

[Ox123]

Hey alto. Thanks for that. So is the idea to reinstate at the last dose you were stable at? As i was experiencing withdrawal as soon as i dropped below 15mg. Ive been told do NOT reinstate mirtazapine as its too late.. wondering what the risks are of a late reinstatement.

 

I know for certain the nosebleeds were from mirtazapine, as they stopped as soon as I stopped mirt. Probably due to drying of the mouth and inside my nose from the drug. Ive always been prone to nose bleeds/gum bleeding but mirt escalated that.

 

Symptoms.. Much much worse at the start of the day! I wake up, within seconds i feel panic and anxious, then the rest of the day is a rollercoaster until about 5/6pm. I can suddenly snap out of it by then, if im being positive and distracting myself. My sleep is hugely affected at the start of a wave, which slowly resets itself over the course of a few weeks until i reach a window. 

 

All my withdrawals seem to be psychological. Ive been drug free since march and my waves/windows seem stuck into patterns of 10-21 days for each. I really want to start experiencing shorter waves as i lose alot of weight each time! This site has some of the most motivational info and i really want to learn more and get support/support each other to become our pre mirtazapine selves again.

 

The burning question I have is whether Im now permanently going to dip into these severe waves for eternity or whether they are withdrawals and will slowly diminish. As patience isnt my strong point..

[mammaP]

Hi Ox123, welcome to SA.  I apologise for the delay,  all staff are volunteers and a few are away right now. 

It is possible that reinstating a very small dose of mirtazepine could alleviate your symptoms. Your last dose was 2mg, so you could try that to start. Often people become sensitive to the drug and react badly to the doses that had been tolerated previously. It is available in liquid form in the UK which makes it much easier to get the lower doses. It takes a few days to get a steady concentration in the blood but many people get some relief quite quickly. 

It is a good thing that you are having windows lasting 21 days,  many have windows that last just a few hours but that gives them a glimpse of what is ahead. 

 

4 hours ago, Ox123 said:

Symptoms.. Much much worse at the start of the day!

This is very common, and part of the healing process, accepting it and just keeping going helps a lot, feeling normal in the evening is normal too, I was at my best at midnight! 

5 hours ago, Ox123 said:

My sleep is hugely affected at the start of a wave, which slowly resets itself over the course of a few weeks until i reach a window. 

Again part of the process, insomnia can be very distressing, but again it is good that you get some good aleep when in a window. Good sleep hygeine is vitally important, especially with screens. No screens an hour before bed, the light from the screen tricks your brain into thinking it is daytime and stops it from producing melatonin, the sleep hormone. 

5 hours ago, Ox123 said:

Ive been told do NOT reinstate mirtazapine as its too late.. wondering what the risks are of a late reinstatement.

Reinstatement is best as soon as possible after quitting, and the longer it is left the less likely it is to work. 3 months is just within the timeline for reinstatement. Most doctors would not agree that such a low dose can be helpful, and I have to agree with a doctor who says not to reinstate a full dose. The tiny doses we recommend will test whether it can be tolerated without the nasty side effects. You could even try 0.5mg or 1mg. The link Alto left tells you how to get that tiny dose. It is available in liquid in the UK if you can get a doctor to prescribe it. When you are stable you can then start a slow taper off that tiny dose. 

5 hours ago, Ox123 said:

The burning question I have is whether Im now permanently going to dip into these severe waves for eternity

Absolutely not! You are actually doing really well with such long windows, it is a long process of healing but eventually you will recover fully. It is sad that a drug taken for such a short time can cause all this but you will get through it.  

 

Many people find that magnesium and fish oil help the withdrawal symptoms, these are the only supplements we recommend. Start with low doses and one at a time. Fish oil helps the brain fog and magnesium is calming. Most people are deficient in magnesium because of modern farming methods. There are many, many supplements out there but for the most part all they do is create very expensive pee, and many of them make things worse because we are very sensitive in withdrawal and have to be very careful.  Caffeine, alcohol, energy drinks etc can all have an adverse effect on a nervous system compromised by withdrawal, so take very good care of yourself. If you choose not to reinstate, just surf those waves, go with them and know that they will abate and a window will open. When there is a window take it all in,  remember the sights, sounds and smells. The feelings and experiences.  Then remember them when the waves roll. 

 

We require all our members to fill in their signature with their drug history. Your list in the topic is fine, if you can copy it into your signature that will be great.

This is the link to the signature box, fill it in and click save. 

https://www.survivingantidepressants.org/settings/signature/

 

About reinstating

https://www.survivingantidepressants.org/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

Windows and waves

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

Fish oil

https://www.survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/?view=findpost&p=100596&hl=magnesium

 

Magnesium

https://www.survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

[Ox123]

Thanks for the in depth reply mammap. It is reassuring to see this kind of advice, especially when my doctor (like most), told me that even taking half of 15mg Mirtazapine "wasn't going to do much". I've actually not been back to my doctor since October 2017 for this reason. I have no hatred towards my doctors, as I just don't think they're educated enough to know more about the strength of these drugs.

I'm currently taking a multivitamin called seven seas but it doesnt contain magnesium so i will look for this. I've stopped drinking my usual 1/2 coffees a day, even though I've not seen a correlation between these and onset of waves. I also don't drink or smoke now, I didnt much previously but cant risk that. As for diet, still consuming alot of sugar, lacking vegetables. Need to improve this.

I MAY have just evaded another fully blown wave, which started on Monday, this morning I woke at 3.30, but got back to sleep until 5am which is good for me. It's becoming more apparent that my wave severity depends on the trigger. This time there was no major trigger but past times if something really stressed me or shocked me it would trigger a much more length and strong wave. I've started back up my CBT sessions too. Although it's expensive I'm not concerned as it is somewhere I can go and vent everything going on in my head.

I read on here that someone experiences aches and pains when they're in a window, then the aches go during a wave. Exactly the same for me! Seems like during a wave my body is too stressed to think about the usual physical pains I'd get.

I would like to continue progressing without reinstating, but hopefully I dont leave it too late incase I really do need to reinstate and taper properly. I'm going off the goal that having more good weeks than bad weeks is a reason to continue how things are, even if it's scary as hell when another wave arrives.

I like that you're encouraging me to bask fully in the windows! I mean I kind of am anyway but I suppose if we are to re-programme our minds we want to embed this positive mindset so its cemented and we aren't just living in anticipation of the next wave.



 

[Ox123]

Well this week has been in the mild/moderate range. Mild anxiety upon waking. But usually waking at 4/5 am, unable to get back to sleep. Just a general feeling of uneasiness. Which progresses to anxious thoughts later in the day. Coming up to 100 days since my last mirtazapine dose. Ive been reading through the journals on here and its making me feel like i have really badly tapered. Im tempted to try a small dose again but part of me is saying just keep riding it out. I think i would only reinstate with liquid..

 

My windows havent improved this past 3 months, it seems they have reduced based on what ive recorded. Im not reaching as intense lows, but i dont seem to be lasting too long before things come crashing down again.

 

My gf is also strongly against me reinstating as she is worried we will go through this whole thing again which has been horrible for us both..

 

We are going on holiday in a week for 10 days and im not sure what decision to make about the reinstatement

[Ox123]

Had quite a relaxed weekend. Noticed the anxiety calm down significantly. What a relief!

 

This morning has been different however. Ive noticed since my trauma last year Ive had 1 or 2 spells of health anxiety. Specific to a none life threatening condition I have that flares up during periods of stress. Obviously when I see that its got worse I get anxious, which then makes the condition worse! 

 

I really hope these anxiety triggers start to calm down as i seem to have built up a series of them that can throw me back into a wave even if I spend even half an hour overthinking them.

 

Such triggers are: seeing mental health on the news, people commenting on my mental health (in person), any bad news that might relate to me, health scares. These triggers have been the onset of 2-3 week severe anxiety episodes. So im keen to understand them more.

 

Could these triggers be worse during this period of protracted withdrawal? When I was on my full mirtazapine dose these triggers were not occuring like they are now. Ive never had them in the past until my first major anxiety episode. I still worry on these bad days that I will be going through this cycle for life which feels like the main reason Im still suffering so much.

[Ox123]

Back again, hope Im not breaking any rules by posting on my own thread like this. Ive been reading about adverse reactions to SSRIs and forgot to mention That I took 1 sertraline pill in august 2017 and reacted adversely to it. Immediately felt my chest burning, was very restless, worsened anxiety, diarrhea, couldnt sleep on the night and had intrusive thoughts come over me for the first time. I switched to mirtazapine the night after.

 

So there are now 3 factors at play which could be the cause of my continued anxiety.

 

1. My original anxiety episode in 2017

2. The sertraline bad reaction shortly after

3. Withdrawing from mirtazapine too fast.

 

Ive not yet reinstated as im still researching but i was thinking to see if things get too hard to tolerate again before taking the gamble. Im still having windows where I feel normal so dont want to make these even worse. Any comments on this situation welcome!

[mammaP]

Hi Ox, we can be our own worst enemy with overthinking. I have a tendency to do that too and have to focus on positive things. Stress makes withdrawal worse, and can trigger a wave but most times waves just roll like the ocean and we have to ride them. 

 

I found this by Brassmonkey was very helpfiul for me, emotional spirals are something I am very experienced with! It takes a lot of practise but helps a lot. 

https://www.survivingantidepressants.org/topic/13492-dealing-with-emotional-spirals/

 

You can post here whenever you have something you want to log, it is your topic and we will answer questions but the forum is very busy and mods don't always see them but we do our best .  It is lovely to see that you are doing research, it is good to learn and understand what withdrawal and the drugs do, but I learned to be careful when trawling the net, finding lots of negative stuff that didn't help one bit!  Here we have research papers and studies in the current events section. 

 

Be aware that reinstating is more likely to help in the early days, after 3 months it could help but the chances are reduced as time goes by.  A very very tiny dose is best because the nervous system often becomes sentitive to the drug and higher doses can't be tolerated.  If you do decide to reinstate you can then taper off that tiny dose very slowly by diluting the liquid.  You are doing great, and have a good attitude, just need to work on the anxious thoughts. 

[Ox123]

Thanks for that mammap. That article is very familiar to me! 

 

Another one that is very similar to the Doom Cloud is Morning Dread. Waking up with an overpowering feeling of fear.  There is a lot more involved with it due to cortisol cycles, neuroemotions and the like, but the experience frequently acts as a trigger.  This sets off an Emotional Spiral that makes the situation a lot worse than it already is and prevents the dread from running its course and self-resolving over the rest of the morning.  It also sets up a fear response that can trigger insomnia and a self-fulfilling response that increases the likelihood of it happening again the next morning.

 

This describes my situation perfectly. Something I need to work on.

 

Had an appointment with my therapist yesterday and we worked on my triggers. He was confused though as he didnt know how i was experiencing panic and anxiety without any physical symptoms. Weird!

 

My days seem hugely dependant on my waking mood since stopping Mirtazapine. Kind of like being balanced on a knife edge. While I was on the drug I was sleeping very well and felt alot more stable.

 

This morning i seem to have woke up with anxiety again. I was watching a football game last night which got my heart racing, maybe that has been a trigger. Who knows..

 

I'd like to see some successful reinstatement of mirtazapine stories. I have seen people say they ended up with new severe symptoms when they reinstated! My only real lasting problem is anxiety but its the worst one, i just dont want to make things worse at this stage as i may have already come a long way in healing.

 

 

 

[Ox123]

Ok I've had a chat with my partner, done my research, and believe its probably time to at least try to reinstate a small dose of liquid mirtazapine (If i can get it). I'ts day 99 of ground zero (no mirt) and although yes I've had some very long windows, I can see these slowly reduce in length, and my waves become more frequent since i stopped. The waves are by no means as severe as they were before, but the frequency of them is hugely affecting my quality of life. It seems that its only really anxiety that is the issue here. I don't have physical symptoms that alot of people report from W/D apart from some minor heart palpatations. I believe I've 'toughed' it out for too long and don't what benefit this has done me at all over this past 3 months.

I'm aware that my window to reinstate is shrinking ever smaller, and seeing others post on here with regret that they did not reinstate is quite worrying. I will try and convince my doctor to prescribe me the liquid and ill maybe try 2 or 3mg introduction to see if things stabalise.

Wish me luck!

[Ox123]

Well that wasn't a successful doctors trip. I was told I could not have liquid mirtazapine, and instead was given 15mg tablets. So not really sure what to do. Spent most of yesterday feeling teary and had little sleep last night. So I'm back to thinking should I hold out and see if things improve at all..

[Ox123]

Well after my anxiety spiked on Wednesday after seeing the doctor, I started to calm down a bit. I still had terrible sleep that night and had to sleep with my partner next to me to allow me to drift off. This seems to help at the peak of a wave. Yesterday started with the usual high intensity anxiety, mainly due to the lack of sleep the night before. I managed to drag myself into work and flip it round. I've noticed during the more intense cortisol mornings, I can sometimes completely stop the anxiety if I really engage in something. I spent the rest of yesterday in a stable mood, before it starting to creep back in last night.

Surprisingly I still slept 5 or so hours last night. This mornings anxiety is in the moderate range, so I've been out for a run and now keeping busy for the next 4 hours until I start work. Since I have no way to reinstate 2mg I'm thinking about 1/4 of a 15mg pill of mirtazapine?

I also have a question about my CNS. Now I'm not sure if I blew this to smithereens when i had my first episode before the tablets, or whether the medication has messed this up. But can it be said that this would have been further damaged by the mirtazapine?  I mean in terms of emotional stability. I've noticed since my first 'attack', I have SO many triggers, as i previously mentioned. I can go 2/3 weeks without a single symptom, then someone could say something like "How is your mental health these days?" and throw me right back into a wave! I've noticed waves occur on their own but more often than not, theres usually a trigger. It feels like my ability to handle and process negative information is completely screwed. This problem only happened once while on mirtazapine, and started to get worse when i came off again.
 

 

[Peter]

Hi Ox123 - I am in a very similar situation to you - I am now 20 weeks since complete withdrawal from Mirtazapine and my main distress is bouts of severe anxiety especially at night and in the morning. I fall asleep seemingly OK and then 2-3 hours later suddenly awake with "anxiety" attack. I either lie there and try to just observe the symptoms waiting for them to calm down or I get up sit quietly and use my meditation app waiting for my system to calm down. I have not had a settled calm full night's sleep since I started reducing down from 3.75mg (1/4 tablet) and sometimes I feel quite desperate.

I would seriously think twice about reinstating to 3.75mg - I just know from my own experience that it was that final drop from 3.75mg to zero over 3 months was something you wouldn't want to wish on your worst enemy. I used to cut the tablets using a pill cutter and sharp knife to 1/16 about 1mg but it was a challenge to do it accurately.

To help me I often listen to a podcast called "The Anxiety Coaches Podcast" and I daily use my Headspace app for meditation.

Keep in touch

 

[mammaP]

Hi OX,  doctors can be so unco-operative, and they say we are non compliant!! 

 

You can make a liquid yourself with water.  You will need oral syringes, I have 20ml, 10ml, 5ml and 1ml. They are very cheap from Amazon or ebay, or you can sometimes get them free from a pharmacy or a vets clinic.  You would dissolve a tablet in water. I would use 15ml for 15mg tablet. 

You could use a pill crusher from the pharmacy or 2 teaspoons,  put the tablet in the bowl of one spoon and crush it with the other.  (You could experiment first by dropping one in water and waiting to see how long it takes to dissolve. )  When you have the solution, use a syringe to withdraw the dose. As more time has passed I would take just 1ml to start and see how you get on with it. It will take a few days to reach a steady level in the blood. 

 

This topic tells you how to make a liquid. I have told you how I do it, but I use capsules. 

https://www.survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

Tapering mirtazepine. 

https://www.survivingantidepressants.org/topic/5301-tips-for-tapering-off-mirtazapine-remeron/

 

[Ox123]

Thanks for the tapering advice. I have that here for as soon as I start. I'm leaving the country for 10 days on Tuesday so going to see how things are over the trip. 

 

I've just started to come out the last wave this weekend. Ive noticed as when I wake up at 4am. Im able to go back to sleep. Ive also just had a the best nap in about two weeks. Probably needed it as my 5 hours sleep per night was probably wearing me out.

 

Im still having moments during my windows where i question whether im feeling bad again, if u get me? But instead of getting anxiety i feel the negative though dissapate. I hope this is where to be in the future, a permanent window with only residual anxiety that doesnt slam into me like a truck. 

 

 

[Peter]

Sounds to me that your CNS is gradually getting back to normal so take heart in that.

Enjoy your trip - I am sure it will consolidate your progress 

[Ox123]

Thanks peter. I hope so!

 

Still having the morning anxiety which is weird. As i mentioned my waves/windows have changed significantly since i came off 3 months ago. Ive gone from having 3 weeks good/3 weeks bad, to now at a baseline where my symptoms change daily, but are less severe.

 

Example: tuesday anxiety most the day, 1 crying spell, wednesday high anxiety in the morning, gone by pm. Thursday low anxiety, friday low anxiety, saturday no anxiety, sunday no anxiety, monday low anxiety.

 

I think now that i dont have mirtazapine as a sleeping aid. My sleep is easily locked into an early waking pattern which is making the anxiety stay around. If i wasnt waking up with it in the morning id have mostly very stable days.  I hope this is a phase of recovery and not me locked in withdrawal. Anyone else have any theories for their recovery process with withdrawal?

[Ox123]

Ive been doing a graph of my mood since withdrawal of mirt. The bottom line is days passed, the top line is intensity of symptoms. So when the line is at the bottom thats when i feel best. See what you think, thoughts welcome.

[Peter]

You seemed to be OK for the first 3 weeks whereas I really struggled for nearly 7 weeks with waves of intense anxiety lasting a few days at a time - can’t quantify it as you have done. 8-14 weeks much the same but the bad episodes not as bad with a few days of feeling almost normal. 15-18 weeks again a general improvement and I think I can say that the bad episodes are precipitated by “doing too much” especially with such a poor sleep pattern and the nightly very early morning awakening (eg last night was 1:30am) with severe physical anxiety symptoms.

It does seem that anything that is over stimulating, even positive things, overtaxed the sensitised nervous system.

It makes me wonder whether your spikes in negative mood are associated with over stimulating events - for instance even strenuous sessions at the gym or running might have this affect.

I play a lot of golf and just recently had 7 competitive rounds in 6 days - this definitely had an adverse affect on my nervous system.

Might be worth looking back to see if you can see any correlation.

Anyway I think the old adage everything in moderation - at the moment perhaps we need to lower the bar as it were and be patient to build up our robustness again.

Hope his helps. Has PMR helped?

[Ox123]

Still yet to try PMR! Will this morning. Yes i agree with over stimulation, the England football game against Panama recently was enough to tip me over the edge again. Even an intense dream can put me in an anxious mood which is alarming.

 

Waking up religiously at 4.30am now. No matter what time I go to sleep. 3 months from stopping and Mirtazapine has still had an effect on me. Trying to get back to sleep these mornings is like holding a beach ball under water.

 

So I guess the question is can our brains rebuild that buffer so we dont have a mental breakdown when anything exciting/intense happens in our lives...

[Peter]

I am very much the same with this early morning waking. I find it best not to even try to get back to sleep. Getting up, sitting quietly, listening to the radio, meditating seems to be the best policy for me.

Regards to your question regarding our brains and nervous system rebuilding I think in the short term we need to try to avoid stressful situations but over time the resilience builds up. I think we also must remember that we have acquired very effective coping skills to deal with the stress symptoms. I have found that the meditation course I do has given me the ability to let things wash over me when I choose to do so.

I really now believe that by the meditation process and the in depth understanding of, for want of a better phrase “life, the universe and everything” one can look forward to becoming better and better over time.

Have a good day - when do you go away? 

[Poulesportive]

Ox have you tried magnesium yet for insomnia? I frequently wake up at 5 AM (or earlier - first light) even while on magnesium but this is actually an improvement in my insomnia - I used to wake up between 2:30 and 4 AM so I am really pleased that it's later now. Some days I can even sleep till 8:30 AM. 

 

Another thing I do that helps with insomnia/anxiety - smoothies in the morning with ghee or coconut oil - two sources of healthy fat that are supposed to be calming to the CNS according to holistic psychiatrist (who supports tapering) Kelly Brogan: https://kellybroganmd.com/heres-whats-breakfast-kb-smoothie/

 

I don't make her specific one, I use either ghee or coconut oil + chia seeds + frozen strawberries + bananas + OJ + kale or spinach + water. I use a Nutribullet, an inexpensive high speed blender. Very simple and relatively quick to make and if I'm running late to work I take it with me. 

 

For what it's worth!

[Ox123]

On 7/15/2018 at 3:39 PM, Poulesportive said:

Ox have you tried magnesium yet for insomnia? 

 

Hey, yes im taking magnesium and fish oil capsules. I really should try those smoothies ans clean up my diet. It seems everytime im in a window I get lazy and start eating sugar/coffee again.

 

Update:

Just been on holiday since 10th july. So ive had a 7 day window. Im now entering another wave which started yesterday morning. Woke up at 4am and stayed awake. Anxiety has crept back in again all of yesterday.

 

Struggled to sleep last night as the anxiety kept me feeling wired. Woke up at 4.30 this morning with low-moderate anxiety. Im still on holiday so ill trt and take it easy.

 

Im currently covered in mosquito bites/minor sunburn and a heat rash. So I doubt that has helped my window. These windows have been slowly getting shorter but not sure if its juat coincidence. Very hard to accept this is withdrawl at this point being like 110+ days mirt free..

[Peter]

I checked back on my notes and my symptoms were bad after 16-17 weeks. I am now on week 22 and although the symptoms are still there, especially during the night and upon awakening, they seem to be of less intensity and fizzle out after an hour or so.

I have found that just drinking a small amount of alcohol (1-2 pints of beer or lager) seem to trigger a really crap night and consequently crap following day - I hope this resolves itself in time for obvious reasons.

Yes I often wonder whether this can be withdrawal but I suspect what’s happening is that the brain chemistry does take many months to re-stabilise itself. Also perhaps as the nervous system has been so sensitised from the events that led us to medication in the first place and the withdrawal effects of quitting the medication this too takes many months to re- stabilise.

I like to think that everyday that passes it is one day nearer to complete recovery. 

I think my daily meditation using Headspace app really does help. Once you are familiar with the practice you can use the technique at any time in the day when you feel symptoms are building - you learn to just sit back and let them do their worst and “watch” them pass through.

[Skylark1980]

Hello, sorry to crash your thread. I'm about 16 weeks without sertraline and can empathise with a lot of what you both say.  Insomnia is my worst symptom and very easily triggered anxiety (from the footie too Ox!!).  After several bad nights sleep, I came back to this site to get info about reinstating.  I really don't want to but sometimes I just feel desperate, especially on nights where I get 2 hours sleep!  I'm also in waves although mine are shorter - maybe 3 or 4 good days then 3 or 4 bad (all relating to my quality of sleep).  I'm so worried I've damaged my nervous system.

 

I went back to the doctor yesterday who suggested that I could start back at a half dose (25mg) but that anything less wouldn't make a difference. (I was on 50mg which is the minimum dose for sertraline and it was for post-natal insomnia/anxiety).  

 

I also don't want to miss the reinstatement window, although part of me still wants to tough it out, but the bad sleep from the past 3 months is taking its toll and I have 2 little children who affect that too...

 

I'm following your reinstatement dilemma with empathy!

[Ox123]

So you arent experiencing waves as long peter? I get the night anxiety at the peak of a wave but the morning anxiety is there from start to finish. Very thoughtful points about recovery there.  It seems theres something very cyclic going on with what I have and little I can do to prevent it coming on.

 

I have been having 1 or 2 drinks while being on holiday. I didnt notice them as triggers but i cant imagine theyve helped. 

 

Skylark, not a problem. Yeah the insomnia thing is horrible as its not just being unable to sleep its more the panicky anxious feeling when shutting my eyes while everyone else is asleep thats hard to deal with. Well done on being off 16 weeks. Im not far off that myself. Its hard to see light when still having severe problems this far out. A friend of mine reinstated to full dose 7 months out and stabalised but im not taking any chances. Skylark are you keeping a mood diary?

[Peter]

Hi Ox

I know that feeling so well - that panicky anxious feeling when you go to bed to sleep. I don’t know whether it’s the meditation training I have been doing (every day for nearly a year now) but I am now quite calm about sleeping or not sleeping now. I sometimes challenge myself to see how long I can keep awake! Eventually the body will always fall asleep - it may not be the right time but it will sleep. For me the worst thing is falling asleep for 2-3 hours and then the sudden awakening with the nervous system going haywire - anxiety attack I guess.

Have you tried Melatonin - you need less than 1mg - I find this does help. I get mine from Biovea online.

I don’t want to reinstate now - I just don’t want to go through again what I have just been through - as I have said before I view each day as a day nearer to normality.

The anxiety now is much less severe now and tolerable.

 

Skylark it is a lot easier for me to tolerate - I have just retired - having two little ones is very demanding and challenging.

If you are going to tough it out have you tried a meditation program? Also progressive muscle relaxation is very effective - plenty of videos on YouTube. I have also heard that Yoga or Tai Chi can be very effective. Also learning these things gives a totally different perspective about life and a greater in depth understanding of the human condition.

Podcast - The Anxiety Coaches Podcast is brilliant - download the app on your phone 

Good Luck

Peter

[Poulesportive]

23 hours ago, Ox123 said:

Im currently covered in mosquito bites/minor sunburn and a heat rash. 

Lol! That does not sound optimal. Re: magnesium I wonder if you are getting the benefit? Altostrata has a post about different ways to ingest Mg to maximize absorption, don't know if you've seen. If not, search "magnesium" on this site to pull it up. Also, I joined a group on Facebook called Magnesium Advocacy Group where people are following something called the Root Cause Protocol. It frankly seems a bit hard core/possibly wacky IMO but the basic idea is to do mineral balancing to combat chronic inflammation-based illnesses/symptoms of all kinds - insomnia and anxiety are two biggies for that group. Remedies shared there tend to focus on (1) ways to absorb magnesium that maximize benefit (2) things you need to also take to facilitate Mg's functioning in the body (3) home remedies that are not part of the protocol but work for some, eg taking apple cider vinegar in warm water with honey in the evening and a zillion other suggestions of that kind.

 

 

 

[Poulesportive]

5 hours ago, Peter said:

I don’t know whether it’s the meditation training I have been doing (every day for nearly a year now)

 

Peter that seems like a really good thing to be doing. I just tonight got back from an introductory session on TM (transcendental meditation). It seemed like the next step as my insomnia is back this week with some lovely 4 AM wake ups.  If you can still drink alcohol more power to you! I had to give it up entirely. Drinking is basically like doing another SSRI switch now - it's the last thing I need. Have noticed significantly improved mood stability without it.

[Poulesportive]

10 hours ago, Skylark1980 said:

I also don't want to miss the reinstatement window, although part of me still wants to tough it out, but the bad sleep from the past 3 months is taking its toll and I have 2 little children who affect that too...

 

Skylark I am crashing too, Ox now has the party thread  I'm guessing Altostrata has a post on tapering from Zoloft and that it might contain info on how/if you can find a way to take less than 25 mg if you do reinstate? I would trust exactly zero doctors on whether a lower dose would "make a difference"....they mean well but have absolutely no clue. If I were considering reinstatement I would message the moderators and try to figure out a reasonable, quite low dose to go back to. The thought of you suffering while trying to parent two young kids is too much!

[Peter]

2 hours ago, Poulesportive said:

 

Peter that seems like a really good thing to be doing. I just tonight got back from an introductory session on TM (transcendental meditation). It seemed like the next step as my insomnia is back this week with some lovely 4 AM wake ups.  If you can still drink alcohol more power to you! I had to give it up entirely. Drinking is basically like doing another SSRI switch now - it's the last thing I need. Have noticed significantly improved mood stability without it.

TM is brilliant - I was taught it 30 years ago when I was going through a massive life crisis. Then they also had regular meetings which provided great insight into the more eastern philosophies of life. These were very comforting. I practised for about four years but gradually dropped it - why? - I guess I was feeling better and I was so involved with getting my business up and running. A shame really - I might have averted this recent life crisis reaction. Currently I use the Headspace app as I found I needed the  meditation to be guided at this point in time. There are many topics in the Headspace app as well as cartoon videos which clarify various aspects of meditation. TM used to be very expensive - about £300 in the 1980s so I guess a lot more now. The Headspace app cast about £80/year.

At the TM centre at a meeting I met my second wife to be. I don’t know whether it was the regular TM practice but our relationship has always been very harmonious and understanding. I am very lucky!

One of the great things about learning to meditate is that if you can’t sleep you can just get up sit quietly and meditate and it is amazing how even with little sleep you can still function quite well. You can also do it anywhere - it is always with you.

[Poulesportive]

On 7/19/2018 at 1:44 AM, Peter said:

 

At the TM centre at a meeting I met my second wife to be.

 

Peter, what a lovely story about TM - thank you for sharing it!  TM is still expensive to learn ($960 for four lessons + four months of as-needed follow up support). But I'm probably going to give it a try because I will need the follow up support - I find it very difficult to establish new habits. Apparently anyone who's completed TM training can attend group meditations at TM centers anywhere for free. They gave us a booklet summarizing data from studies published in peer-reviewed science journals and it's quite impressive. Reduced stress hormones, improved brain function, decreased blood pressure etc etc.

 

I can't schedule the 4 training sessions until mid August so I will check out the Headspace app. Thanks for this info too!

 

 

[Santino]

Hi friend..

for the anxiety at night... there are some good sleep hypnosis videos in Youtube. Just perform a search and try anyone of them. they were a big help for me during my night anxiety...

All the best Santino

 

[Ox123]

Hey all. Some cool info there. Peter - the fact youve had a crisis 30 years ago tells me you have returned to a normal functioning level for many years which is very promising. Im still yet to see a window longer than 22 days since I fully withdrew from mirt.

 

I will definitely get back into meditation. Im coming to the end of my 11 day holiday with my gf. Honestly shes been amazing. Ive had 2 or 3 days of anxiety since flying but nothing overly crippling. Shes always there to catch me when I start getting teary or super anxious. 

 

Anyway, i will soon be home and hopefully back to a routine where I can carry on my morning runs. Ive found the intensity of my morning anxiety + length of sleep = duration of anxiety over the day. Im still not sure if im stopping anxiety in its tracks on a morning to prevent a full on melt down, or wheter Im simply riding it, and it takes its own course. Hopefully today will be pleasurable and I can return home and enjoy a long window...