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Altostrata

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

 

Please do not add Klonopin to your problems. If you want to increase Abilify to cope with your lifestyle, either you need to change your lifestyle or your reaction to it -- not increase Abilify. That is the opposite of tapering.

 

Grief, by the way, is normal. You have to allow yourself to go through it.

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marconyc

@Altostrata The reason I even considered using Klonopin is that I’ve used it in the past, and one of the moderators here even suggested using a little bit at one point to ease some of the withdrawal. During this whole 2-year ordeal, I have tried to resist using Klonopin even when I was having panic attacks. My pdoc has been telling me that using it will help break the cycle of anxiety, but I have tried to follow the advice on SA instead and avoid it. As you can see from my drug signature, I tapered off of it during 2018.

 

It’s not easy to change my lifestyle when I’m the main breadwinner. I can’t just quit my job. I wish I could leave and get something less stressful, but my wife doesn’t make much money. 

 

I’ll keep trying to hold where I am with the Abilify and avoid the Klonopin. I guess I was thinking that I might try increasing the Abilify from 0.4 to 0.5mg during this difficult time, but I’ll keep trying to soldier on without increasing. Hopefully the grief will ease over time. It's just hard because we've been trying for more than 5 years to start a family. I have wanted to be a father for a very long time. 

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marconyc

Just went for a 4-mile run in spite of a torn calf that isn’t fully healed. Feeling a bit better emotionally. Going to try holding at 0.4 mg Abilify and resist using Klonopin. Grief is coming in waves and I’m trying to ride it out. 

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manymoretodays

Oh shoot.  I'm sorry marconyc.......on the IVF.  2nd time too.  Hugs to both you and your wife.

I agree with Alto of course!

I did see I suggested possibly a bit of benzo awhile back.......naw, don't do that.

 

And wow.  You have done well with your aripiprazole reductions.  You may want to just decrease from 10% of your previous dosage when you next reduce.

.40 mg X .90= .36 mg  for your next 10 % drop.

I know you don't want to reduce again so soon, but just a reminder that each percentage drop is based on the previous dose.

Your January drops may be just catching up with you now too.

 

Again, so sorry marconyc and yes......grieve.  Take some family leave time if you can.   Try and spend some extra time with your wife too.  Her poor hormones are probably all over the place right now.

 

Love, peace, healing, and growth,

mmt

Edited by manymoretodays

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marconyc

Thanks @manymoretodays. Yeah, my wife's hormones are all over the place. I feel really bad for her because she's not only dealing with the emotional fallout, but the cycle and embryo transfer were hard on her body. She had to have hormone injections every night, get blood tests every week, etc. 

 

I wish I could take some time off but my job won't allow it. I'm trying to take care of myself by taking frequent breaks. It's been hard to drag myself out of bed these past few days, and it's still hard to eat. I felt a little better yesterday as the day went on, and then I went for a run last night and felt pretty normal for a few hours. Unfortunately, I had pretty bad insomnia, and today I feel bad again. I probably need to cry. If I'm up to it, I'll take a Bikram yoga class later. And tomorrow I  have my weekly therapy appointment.

 

I hadn't thought about the last reduction catching up with me now, but it's been a little over 2 weeks, so that's certainly possible. From what I understand, it can take a couple of weeks for a drug like aripiprazole to cause withdrawal because of the amount of time it stays in the body. 

 

How are you feeling these days?

 

 

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marconyc

@manymoretodays Just wanted to give an update. I'm still holding at 0.4mg of aripiprazole and no clonazepam. I'm feeling a little less fatigued each day since the IVF news, and a little less anxious, although I still generally feel like garbage, and work is super stressful as always. At least my insomnia wasn't as bad last night as it has been for the past few days. I forgot that my wife and I are going away to visit family in California this weekend. I'm hoping that a week away from work will be good for me. Trying to recover from withdrawal while working a stressful job has been like trying to heal a torn hamstring while running a race every day. 

 

The IVF doc called my wife and said that she is in great health and the embryo looked good and that it was just luck of the draw that it didn't implant. That made my wife feel better. I'm still not sure if we'll do another round (for emotional and financial reasons), but it made me feel a little better that my wife doesn't feel like it's her fault now that she spoke to the doctor.

 

Sometimes I can't believe that I have felt so crummy since the start of 2017. It's been a long road, and on top of it I'm back on the drug I tried to taper off of--and at a higher dose. I'm trying so hard to get better.

 

I hope that you are doing well, and I appreciate your words of encouragement and advice.

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marconyc

Wow, the insomnia lately is relentless. I try to fall asleep around 11:30pm and end up tossing and turning until 2-3am. It's so frustrating. 

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marconyc

@manymoretodays Hi, I wanted to give you an update. I am down to about 0.10 mg/day of aripiprazole--the smallest amount that I seem to be able to break the 2mg pill into. I went on vacation with my wife last week and felt pretty good. I'm still having some trouble falling asleep but have resisted taking clonazepam to help with the insomnia.

 

I am considering stopping the aripiprazole at this point. I don't feel totally free of depression or anxiety symptoms, but I do feel "baseline normal." 

 

As I have reduced the aripiprazole and continued in talk therapy over the past 2 years, I am feeling more of the emotions and stressors that are underneath the depression and anxiety, including intense job stress and dissatisfaction, loss of meaning because I don't have the time and energy to do my own writing, grief and shame and frustration over not being able to start a family, fear that my brother's cancer will return, sadness over loved ones getting sick and old, and a few others. The antidepressant withdrawal has coincided with one of the most difficult periods of my life. I'm doing my best to manage these emotions and stresses with therapy, meditation, and exercise--and while reducing my meds--but it's really hard. Some days I still worry that I'll never get back to the person I was before the withdrawal started in Jan 2017. I could use some encouragement, to be honest. Two years is a long time to not feel like myself, and I worry that I'm never going to heal--that by taking sertraline and then trying to come off of it, I damaged my brain and nervous system irreparably. I also feel so discouraged at times because I was only on 150mg of sertraline and now I'm on 200; it's like my effort to come off of it backfired. 

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Gridley

The fact that you are down to 0.1 and are feeling baseline normal is a very good sign you will get back to being the person you were before.  I know two years is a long time not to feel like yourself, and it will likely be a bit longer after you do finally drop off to zero.  But our experience here is that the brain has remarkable abilities to heal itself (neuroplasticity) and I would say that your fears of having damaged your brain and CNS irreparably are unfounded.  

 

 

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marconyc

@Gridley Thank you. That's very reassuring. At the very least, I would like to get back to normal and reduce back to what I was on before: 150mg of sertraline, without clonazepam or aripiprazole. Of course, I would love to be off of these meds completely, which is why I tried to taper off of sertraline in the first place. But this experience has been awful at times. When the withdrawal first hit, I was absolutely terrified. 

 

 

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marconyc

Insomnia has been awful since reducing the aripiprazole to 0mg on Feb 16. I'm getting anywhere from 2 to 6 hours of sleep a night. Anyone else had this experience? If so, how long did it last, and can you suggest any nondrug ways to falling asleep?

 

Also, I'm starting to think that I'm not really experiencing that much depersonalization. What I seem to be experiencing is this kind if "hyperawareness" of my own consciousness and obsessions about whether something is wrong with my consciousness, my sense of being in my body, my ability to think and function cognitively, etc. Maybe it was triggered by some DP but has taken on a life of its own. I recently saw an article online about "hyperawareness" obsessions that seemed to jibe with what I'm experiencing. Apparently these types of obsessions can be about anything from breathing to blinking to the way a particular body part feels to the process of thinking itself. Anyone else familiar with this? I have experienced it before during an episode of bad depression/anxiety before I was on sertraline, and then another time when I tried to stop taking sertraline, and now I'm experiencing it again as I deal with this withdrawal.

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marconyc

Thanks @ChessieCat. I think I could do a much better job of not using any devices in the hour or so before I turn in. I do use a white noise machine. I'm kind of hesitant to use melatonin because I don't want to rattle the boat any more than it's rattled. Might try warm milk. 

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marconyc

2 weeks without any Abilify. I’m feeling pretty bad, but I don’t know how big a role WD from Abilify is playing and how much is job stress. I was having terrible insomnia, and assumed it was from reducing/stopping Abilify, but I realize the insomnia only happens during the week. On the weekends, I have no insomnia and in fact can barely stay awake. This makes me think it’s my job. I think I am truly burned out because I’m so exhausted I can barely function. I’m on my way out of town for another business trip and all I want is to be home with my wife and dogs. Before I left, I cried my eyes out and told my wife how overwhelmed and burned out I feel. I feel like I have lost touch with who I am. I know I need to look for another job but I’m so exhausted that the thought of starting a new job is incredibly intimidating. I wish I could just take a few months off to heal. The past 2 years have taxed my nervous system to the hilt. Between the drug WD, work burnout, failed rounds of IVF, and my brother’s stomach cancer, I feel like I’ll need an extended period of time to feel normal again.

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marconyc

@Altostrata How long did it take you to fully recover from withdrawal? And what advice would you give your younger self—the person going through withdrawal—if you could go back in time?

 

I’m feeling despondent, and at times like this the stories of people like you keep me going. Sometimes I wish I hadn’t reinstated the Zoloft but I guess I wasn’t strong enough to endure the withdrawal. It was a nightmare, as you know. I was terrified that I would become suicidal and end up hospitalized.

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Altostrata
1 hour ago, marconyc said:

2 weeks without any Abilify. I’m feeling pretty bad, but I don’t know how big a role WD from Abilify is playing and how much is job stress. I was having terrible insomnia, and assumed it was from reducing/stopping Abilify, but I realize the insomnia only happens during the week. On the weekends, I have no insomnia and in fact can barely stay awake. This makes me think it’s my job. I think I am truly burned out because I’m so exhausted I can barely function. I’m on my way out of town for another business trip and all I want is to be home with my wife and dogs. Before I left, I cried my eyes out and told my wife how overwhelmed and burned out I feel. I feel like I have lost touch with who I am. I know I need to look for another job but I’m so exhausted that the thought of starting a new job is incredibly intimidating. I wish I could just take a few months off to heal. The past 2 years have taxed my nervous system to the hilt. Between the drug WD, work burnout, failed rounds of IVF, and my brother’s stomach cancer, I feel like I’ll need an extended period of time to feel normal again.

 

You need to learn stress reduction techniques to lower the stimulation from your job. Also, you need to stop thinking about it when you're home. If you have a tendency to brood, you need to manage that, too. These are all habits of mind you can change. See

 

Non-drug techniques to cope with emotional symptoms

 

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

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

2-5 hours of sleep is not terrible for withdrawal syndrome. Read this

 

The Windows and Waves Pattern of Stabilization

 

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

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

Melatonin is fairly harmless in small doses and may help you get to sleep -- if you can quiet your mind with non-drug techniques.

 

If I went back in time, I'd tell myself to quit that job instead of taking Paxil.

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marconyc

Thanks @Altostrata 

 

I was meditating daily at a local Zen center but stopped recently because it’s been hard to wake up in the morning. I know I should resume my meditation practice.

 

I have an excellent therapist whom I see weekly, and I do my “homework.”

 

One of the problems with my job is that I work from home. 

 

I’m not the only person at my job who is struggling. A coworker just told me she is having terrible insomnia and panic attacks—which she’s never had before—because of the workload and pressure.

 

So your job was a major reason you took an AD?

 

 

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Altostrata

Yes, I had a terrible job and was too dumb to quit it. But what I did or didn't do is only about me, it may not have anything to do with you.

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marconyc
44 minutes ago, Altostrata said:

Yes, I had a terrible job and was too dumb to quit it. But what I did or didn't do is only about me, it may not have anything to do with you.

Thanks @Altostrata I realize everyone’s situation is different in some way, but it’s also very helpful to hear that other people have gone through a similar experience. Looking back, my taper went really well until my job changed. I hadn’t thought that job stress could be so powerful.

 

 

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Altostrata

 

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marconyc

I tapered the Abilify too quickly from 0.5mg to 0, especially given the amount of stress I’ve been under and the long hours I’m working. So I updosed to 0.2 for a week or so, stabilized, and today I haven’t taken any. We’ll see how it goes. 

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marconyc

By the way, I had a very powerful therapy session on Thursday, and I felt pretty close to normal on Fri followed by one of the best windows I’ve had in 2 years yesterday. It lasted for several hours and was so wonderful. I felt like myself. Not even any of my most recalcitrant symptoms such as low-level DP or obsessive rumination. I felt like myself before this horrible withdrawal started. I was disappointed that when I woke up today, I wasn’t quite symptom-free, but those few hours last night are helping to give me hope. Mind you, I’m still on a high dose of Zoloft and don’t know when or if I’ll be able to taper off that. But still, a window is a window.

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marconyc

When I said I had a window where I felt “normal” I did not mean “WD normal.” I meant “normal normal.”

 

Also, some of the WD symptoms I have experienced while tapering Abilify have been anxiety, depression, nausea, loss of appetite, dizziness, insomnia, a feeling of agitation (especially in my legs) while trying to fall asleep that made me have to get up and move, and lightheadedness. While some of these symptoms could conceivably be attributed to “recurrence,” many of them—such as nausea, dizziness, and lightheadedness—are symptoms I never experienced before meds, even when my anxiety and depression were at their worst.

 

The fact that my anxiety and depression increased after each cut of the Abilify but then returned to WD normal makes me think that if I had been able to withstand the original WD symptoms from tapering off Zoloft, I might have similarly stabilized. In other words, maybe I was not experiencing recurrence, maybe it really was WD and would have resolved. It’s like the Abilify taper is a mini-version of the original Zoloft taper. And I only have been tapering off of 1mg of Abilify. That’s a tiny dose. But clearly my body reacts strongly to even small med changes. I feel like I’m learning a lot about my nervous system and how it reacts to these drugs as the result of this nightmare.

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manymoretodays
Posted (edited)
17 hours ago, marconyc said:

And I only have been tapering off of 1mg of Abilify. That’s a tiny dose. But clearly my body reacts strongly to even small med changes. I feel like I’m learning a lot about my nervous system and how it reacts to these drugs as the result of this nightmare.

 

19 hours ago, marconyc said:

I tapered the Abilify too quickly from 0.5mg to 0, especially given the amount of stress I’ve been under and the long hours I’m working. So I updosed to 0.2 for a week or so, stabilized, and today I haven’t taken any. We’ll see how it goes. 

 

Hi Marconyc,

Your changes in Abilify/aripiprazole are going to take awhile to feel.  Possibly a week or two, or more.  Due to it's longer halflife.

Aripiprazole has a really long half life, compared to most of the drugs we work with here.  Meaning that it takes longer than most of the medications/drugs,  to work it's way completely out of your body.  Hence, it takes much longer for any change in dose to register in your system. 

Maybe these links will help:

Tips for tapering off Abilify(aripiprazole)

On 3/11/2012 at 5:34 PM, Altostrata said:

Abilify has a very long half-life -- estimated at 4-7 days -- but still needs tapering. From http://www.drugs.com/pro/Abilify.html

 

Washout/and what does half life mean?

 

Thus, the full effects of Abilify, taken regularly, may not be apparent, for 14 days or even longer.  Same with dose changes or discontinuing it completely.

 

I think if I were you, I would stick with any change in the Abilify, for at least a month, perhaps longer.  And meanwhile HOLD on making any changes in sertraline for the immediate future.  No need to rush.

Work, work, work the non-drug coping as well(Alto gave you a nice slew of links to look at and experiment with). 

 

You've had a lot of life happenings to deal with too.  That all takes time.

 

Love, peace, healing, and growth,

manymoretodays

 

Edited by manymoretodays
spelling!

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marconyc

Thank you @manymoretodays Today is the second day of 0mg, so I'll keep in mind that it might take a couple of weeks to fully feel the effects. And if I do end up updosing, I'll hold for at least a month when making any further changes. I'll also wait on making any changes to the sertraline.

 

I've been reading through all the links and working on stress management. 

 

How are you?

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manymoretodays

Good, good.

I'm okay marconyc, and thanks for asking. 

Pushing through some probable tardive dysphoria........the kind of depression, that's iatrogenically caused I think.  I'm determined not to be a statistic.  Off everything now for 2 years plus.  Longing to be more than just a survivor of all those years and drugs. 

Feeling hopeful as the sun comes over the nearby peaks in the East.

It does help to try and be helpful.

 

This is your thread though, your story!!!

Rooting for us all!

 

Love, peace, healing, and growth,

manymoretodays

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marconyc

@manymoretodays Sorry to hear you're experiencing some lingering symptoms. I don't know if you have used exercise as part of your recovery, but my experience has been that moderately intense cardiovascular exercise is very beneficial for mood. For me, running 3 to 5 miles almost every day has been an indispensable part of getting through this. There's good research backing up the benefits of exercise for anxiety and depression. 

 

It's really inspiring to hear that you've been off all meds for 2 years. 

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manymoretodays

Hey thanks. 

Yes, indeed........I got sloppy with exercise, meditation, and diet!

I need to get disciplined again for sure. 

 

You're an inspiration too!

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Altostrata
On 3/10/2019 at 3:22 PM, marconyc said:

When I said I had a window where I felt “normal” I did not mean “WD normal.” I meant “normal normal.”

 

Also, some of the WD symptoms I have experienced while tapering Abilify have been anxiety, depression, nausea, loss of appetite, dizziness, insomnia, a feeling of agitation (especially in my legs) while trying to fall asleep that made me have to get up and move, and lightheadedness. While some of these symptoms could conceivably be attributed to “recurrence,” many of them—such as nausea, dizziness, and lightheadedness—are symptoms I never experienced before meds, even when my anxiety and depression were at their worst.

 

The fact that my anxiety and depression increased after each cut of the Abilify but then returned to WD normal makes me think that if I had been able to withstand the original WD symptoms from tapering off Zoloft, I might have similarly stabilized. In other words, maybe I was not experiencing recurrence, maybe it really was WD and would have resolved. It’s like the Abilify taper is a mini-version of the original Zoloft taper. And I only have been tapering off of 1mg of Abilify. That’s a tiny dose. But clearly my body reacts strongly to even small med changes. I feel like I’m learning a lot about my nervous system and how it reacts to these drugs as the result of this nightmare.

 

Valuable observations! So many people think their adverse drug reactions are relapse or psychiatric disorders.

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marconyc

Thanks @Altostrata this has certainly been a learning experience, painful as it is

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marconyc

@manymoretodays I went too fast by stopping the Abilify completely. I think I need to stay at at least 0.2mg for a bit. I’m so anxious to get off this drug, but even the slightest cuts affect me. I’m freaked out about the possibility of tardive dyskinesia, so I’m pushing really hard to discontinue.

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manymoretodays
Posted (edited)

Hi marconyc,

I'm seeing the following.  From your narratives.

7 Febr. you were on .4 mg aripiprazole

19 Febr.- all the way down to .1 mg (and a whopping 25 % decrease from the .4 mg above)

16 Febr.- 0 mg

.......and then some time after that back to .2 mg

Which you then jumped off of again, less than a week ago.

 

Yes, you've made it tough for your CNS to stabilize.  I think a reasonable hold time, with ANY change in your apipr. dose, would be at least 6 weeks.  Before any further jumps down or up.  Or longer.  It's your decision, if you do reinstate.  Personally,  I don't think it's a bad idea.

 

10% of .2 mg

.2 X .90 = .18 mg

 

.18 mg is what you would go down, for a 10% decrease from the .2 mg...........after holding  for........I think, if I were you, I would hold for at least 2 months.  If you decide to reinstate today or tomorrow.

All those other changes you made in Febr., might just be being felt now.  That whole long half life thing again, marco.

 

You might consider a careful crossover to liquid or even making your own liquid during this time, if you reinstate, for more accuracy of measurement. Or figuring out a way, with your scale for accuracy too.  I'll just add the link here again with general Tips for tapering off Abilify. Right in the first post.......you'll find more links, so you can consider further options for accuracy.  I can't recall if you are already working with a scale.   I followed a link from that topic too.......that took me to some more reading from the professional journals on tardive dyskinesia.

 

If you do switch to liquid......homemade or pharmaceutical grade........do consider a cross over of some type.  We usually promote the following:

3/4 old formulation and 1/4 new  (no change in dose, hold for 3-7 days with this)

then 1/2 old and 1/2 new (same as above)

then 1/4 old and 3/4 new (^ same)

then go to the new formulation completely

 

This helps minimize any bumps that could be felt from changing formulations.

 

As far as the tardive dyskinesia goes.......from what I just found, it's more likely to occur with prolonged usage of these nasty neuroleptics/antipsychotics/dumb adjuncts to A/D's, and possibly at the higher dosages.   My comprehension is just teensy weensy, a little slow lately.

So try and rest easy.  You've only been on this class of drug, and at a lower dose(as far as the range prescribed goes), since 2017- April.

 

What kind of symptoms are you having today or recently, that are making you question your previous decisions?

Do let yourself just feel marconyc.  I know it's hard, if your the man of the house and the breadwinner and all........or it just is for males sometimes.  I'd do the tears for you, if that's it.......I'm a weeping widow type......lol.  I can almost weep on demand, for a few minutes, whenever I'm disheartened.  No biggie.  I don't wear a ton of make-up or pretend to be a big professional anymore.    If it's the anxiety stuff........go look around in S and S, for ideas.  Try some Claire Weekes.  Acknowledge, Accept, and Float, if you will.

 

Okie doke.  And hugs buddy.  Hope you are AOK soon again.

Love, peace, healing, and growth,

mmt

 

Edited by manymoretodays

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marconyc

@manymoretodays Thank you. Hugs to you as well. You’re very kind, and your advice has been so helpful.

 

I think I need to get a digital scale. It’s too difficult to estimate the dosages at this point with the Abilify.

 

The symptoms I’ve been experiencing lately are mostly anxiety-related. Thankfully no panic attacks or DP/DR, but last night I had fairly intense anxiety. I know that it’s mostly due to work, but I think the reduction in Abilify is also a factor. Also some insomnia and a little reduced appetite.

 

Although it has often difficult for me to express emotions like grief or anger, I’m getting better at it. My therapist has been a huge help in that regard. I grew up in a family where strong emotions, especially negative ones, were taboo, so I’ve had to essentially learn on my own that it’s okay to feel. And I’m a naturally sensitive person. I’m learning that it’s okay to cry and it actually makes you feel better. Some of my withdrawal symptoms over the past couple of years have been depression-related. At times I’ve wondered if what I’m experiencing is recurrence, but lately I’m thinking it’s more withdrawal.

 

Okay, so my plan is to reinstate to 0.2mg of Abilify and hold for 2 months. I’m going to consider the risk of TD a very minor one given the dose I’m on and length of time and just try to be patient. The Abilify was added because Zoloft wasn’t working as well for my depression/anxiety after I reinstated. Mind you, my pdoc never told me how to  taper, nor did he tell me anything about the possibility of WD.

 

Thank you again. The support I’ve received here has been wonderful.

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marconyc

@manymoretodays An update: I'm holding at 0.2mg of aripiprazole and feeling decent. I delegated some projects at work, purchased a digital scale, replenished my bottles of fish oil, magnesium, and vitamin D, and started meditating again. Yesterday evening I went for a 7-mile run and was able to get a pretty good night's sleep. Going to soccer practice tonight. Trying my best to accept that I'm not recovered yet but am moving in the right direction.

 

Hope you're doing well. 

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manymoretodays

Oh Wow!  Yes.  You ARE.  Moving in the right direction, marconyc.

 

My family of origin wasn't much for being sensitive either.  A lot of chaos at times.  Anger outbursts by others.  I never learned anger expression due to that.  I've always turned it inward.  My Mum still says those dreaded words......."you're too sensitive".  I'd prefer....."you are sensitive and that's wonderful".  Oh well......my internal Mommy says the second phrase to me all the time.  And I've got lot's of care and Love from my Mum in other ways.  Very fortunate that she is going strong at 91 now!  She's a saint of sorts.  B)

 

I'm making progress.  Walked.  I've got to walk before a run, swim, or yoga.  Getting more sun and outside time.  Nature.

You've been keeping up with the motion/exercise, much better than I have.  So you should fare okay with the higher intensity now.  Listen to your body though.  Adapt, if need be.

 

Thanks for the update and warm wishes.

 

Love, peace, healing, and growth,

manymoretodays

 

 

 

 

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