Mmmm: looking to reinstate cymbalta, would appreciate advice

[MMMM]

Hi everyone, I am looking to restart cymbalta and hopefully get myself back to a stable place. I would love input. My doctor (psychiatrist) seems to think I could start with my previous dosage of 20mg, but after a horrendous experience trying to get back on celexa starting with just 5mg, I am VERY hesitant and don't want to go through anything like that again.

 

Here is my history:

 

~12 years successfully on 20mg generic celexa --> successful switch over to ~2.5 years generic cymbalta --> slow-ish (I thought at the time) taper off over ~1.5 months (stopped 12/17) --> currently 8.5 months off and not doing well at all.

7/2018 Tried to go back on generic celexa starting at 5 mg. Stuck it out for ~9 days, never made it up past 5mg. Had a terrible reaction to it. Dr thinks maybe because it was a different brand from the 10 years before. He questioned whether it was just my anxiety in reaction to it, but it was entirely too physical to be just my thinking-- Gripping panic, terror, crazy thoughts, felt possessed, arms and hands suddenly dead and heavy like they stopped working, immediate emotional numbness, genital numbness, inability to cry, appetite zapped gone (had to force every bite I ate for those 10 days, got down to my lowest weight ever, and not in a good way), unable to work or think straight, agitation, thought I would need to be hospitalized.

8/2018 Tried Remeron. Wanted something that would not cause sexual side effects, so even though I had never taken it, dr recommended it. 7.5mg. First night bad restless legs. Got up to 15mg for ~2 weeks. Munchies. Slept. But neither in a nice way, more a zombie-ish way. Very tired and fatigued. Continued inability to think straight or work. Anxiety was sedated. Depression was sedated. More emotional numbness. Literally could not think. The depression did feel like it might have been starting to lift, but I needed to be able to think, and didn't want to keep experimenting with whether I could get to a dose that would not be so sedating, so I went down to 7.5mg/day then to 3.5 mg /day and have still been taking this just to try to stabilize. Having severe anxiety and depression though still.

Currently experiencing: panic, depersonalization, depression, and for the first time in my life pretty severe anhedonia (pleasurable feelings and other emotions feel offline and physically inaccessible... including 'tools' I would use before: gratitude, feelings of spirituality, humor, warmth of relating).

Looking to try reinstating generic cymbalta 9/2018.

Doc suggested starting at 20mg, we agreed on 10mg (since I had such a strong reaction to attempt to restart celexa at 5mg).

 

I would love to hear people's thoughts on slowly restarting cymbalta to try to get back to a stable place. I basically cannot go on in the panicked, anxious, depressed state that I am in. I have tried to white knuckle the panic the past months and it has only seemed to lead into a depression with anhedonia and my emotions shutting off in a way I have never experienced before and which is terrifying.

 

Restarting at 10 mg cymbalta seems ok... and I'm looking to make sure it's the same brand as before... but I did have an intense bad reaction to just 5mg of celexa, so I think I might be very sensitive at this point. Also my Dr. recommended I stop the 3.5 mg remeron the same day I restart the cymbalta.

 

Thoughts?

[MMMM]

I realize now that maybe this post will be a bit controversial, as it's asking about restarting vs getting off meds. I'm interested in doing a slow taper in the future, but right now, I did not anticipate the torture I would slowly slide into after going off them, and did not have any idea that the taper I did was on the fast side... so I am looking to do anything I can to get stable again.

 

The increasing anhedonia, depression, panic, inability to think straight, daily constant headaches, and waves of depersonalization feel like they are killing me. I don't have a job right now, and I need to be able to at least be stable enough to get one, so that I can try to get better (and get some health insurance)

 

Open to others thoughts on this.

 

Not being able to feel affection for my loved ones (or feel my spiritual connection) is probably the most disturbing part... paired with the fear that it will always be this way.

 

I am appreciating reading more on this site. I thought I was through withdrawal, even though I knew I had never been this bad pre-medication... it feels hard to know what is withdrawal/adjustment and what is relapse of depression/anxiety/OCD.

 

All I know is about 7 months ago (and for the many years before that) I was still vibrant, fun, quirky, energetic, loved life, spiritual, helped people in my 12 step program.... and now I am a complete wreck, can't feel, but alternately agitated/panicked/afraid I am going crazy, wanting to not continue, can't seem to think straight, and at times despairing of ever getting well vs determined to do so. And none of my normal tools feel available or helpful or make any sense to me now, which makes me panic even more.

 

I really relate to what I have read on here about the waves vs windows... I have been describing this to my coach and therapist all along... the cycles are soooo intense. Lately during the windows I don't feel great-- just times of being out of panicky/despairing mode at least... and during those, part of me feels like I can't imagine being back in it... until then I find myself spiraled in it again. The cycles seem to happen daily, or even multiple times a day. I was keeping a daily mood journal to try to keep track. I guess I should start doing that again.

 

I've been describing it as like being on a bad trip... or else just on a trip, where I am so sensitive to anything that will make it go bad... to the point of it feeling like intrusive thoughts-- like "oh I hope this doesn't make me spin off into panic/ a bad trip.... ooop, there we go"... I want off the roller coaster.

[Songbird]

Hi Mmmm, welcome to SA.  I don't think your post is controversial - your story is very similar to many we see here. 

 

Thanks for creating a signature.  Please can you edit your signature to add the Cymbalta dose, the date you stopped the Cymbalta, and the date you started the Remeron.

 

It is quite common for people to have an adverse reaction when reinstating a med, especially after considerable time has passed.  It seems that many people become very sensitive to meds and do not react well to the reintroduction of an AD - as you discovered when you reinstated Celexa.

 

For this reason, I would approach a Cymbalta reinstatement with caution.  The 10mg Cymbalta dose sounds rather high, considering you reacted badly to 5mg Celexa.  It may be better to reinstate a very tiny dose (e.g. 1 to 2 mg) to see how your system responds to it.  You also need to be aware that while reinstatement could potentially alleviate some symptoms, it is unlikely to be a complete cure for all your symptoms.  See this topic for more information: about reinstating and stabilizing to reduce withdrawal symptoms.  See this topic for how to create smaller doses of Cymbalta:  Tips for tapering off Cymbalta (duloxetine).

 

Please post all your updates and questions about your situation here in your introduction topic, and we will try to help you as best we can.

 

 

Edited September 8, 2018 by Songbird

[MMMM]

Hi Songbird, thank you for the welcome.

 

I've updated my signature with the info you mentioned.

 

I decided, like you said, to start with a lower dose in reinstating the cymbalta than what the dr. talked about.

 

So,

 

- 9/7, meds: took ~4mg cymbalta at night before going to bed + ~2mg remeron

 

- 9/8 mood: groggy in the morning, felt ok during the day, some light depression, but had a nice day with family. Could feel myself starting to go downhill a bit in the evening. Met a friend out, felt panicky and detached in the crowd. Listened to a concert. Couldn't feel the music the way I normally would. Got sort of panicky. Started having some thoughts if suicide, gathering my family, telling them I can't go on this way, etc. Told my friend. She came over with me and talked me down. Felt some numbness, but also reassured that this is depression and I will be ok.

 

9/8 meds: took ~4 mg cymbalta at 12:30am. No remeron. Woke up at 7am with some panicky feeling and what I think is maybe acid reflux. It feels like my heart is searing and I read into this as being the rest of the warmth being 'burned' out of my heart. I talk to my friend, she says when she has had periods of intense depression and has needed meds to help, the onboarding symptom she gets is bad acid reflux on them. I realize this might be what I am experiencing. We talk about it and laugh. I take some TUMs. Go to brunch with a friend, feel agitated but also more numb and detached than usual. Feel freaked out that I am having another bad reaction and won't be able to reinstate/treat my depression. We talk. Make a plan for later.

 

I call my boyfriend, cry a little, feel disconnected from him. Panicky about driving in the anhedonia further.

 

I bike home and think about how I don't even feel physically very capable these day, whereas I have usually been active. Not sure if it's just the depression.

 

Get email about having job interview tomorrow. Feel like I'm not sure I can think straight enough or have enough motivation to handle it or the other work I need to get done. Brain fog feels really crazy. I am usually smart, accomplished, motivated, etc. Again not sure if it's just because I am in a sever depression.

 

Feeling somewhat calmed down now and am going to try to watch TV (something I am trying to find to get back into even though I can't feel much and get triggered by that when I try to watch things)

 

My plan is to take another ~4mg tonight, and continue trying to get to a place where I can reach a therapeutic dose for the depression.

 

Thanks

[MMMM]

- 9/9, took ~4mg cymbalta, and 0 remeron.

 

It activated me, and I was awake throughout the night/multiple times (usually don't have any trouble sleeping through the night). Was still feeling crazy brain fog / complete inability to think straight, was very concerned about making it through my day today.

 

But then... today felt sort of miraculous...

 

I felt like I popped back into my "usual" self again after many crazy months of torture. I actually felt some warmth of feeling, like the first access to oxytocin in many months (thank god), tinges of the anhedonia lifting (connected with feeling a bit and felt some of my interests returning), and I think it was this that made it so I could then not feel depersonalized/on a bad trip as I was going about things during the day.

 

I'm not sure if it's because my system has been in withdrawal all this time, and it's getting some of what it has been deprived of, or if even at this low dose the medicine is already starting to treat the anxiety / depression... or placebo (I hope not, and don't think so).

 

I did feel myself going a bit downhill towards 6pm (as I was coming home from job interview), and things felt scary on the street where there are lots of people... like I was on the brink of going into a bad trip, but I got myself home, and then felt better, talked to my bf on the phone, ate some dinner.

 

I can feel that I am very fragile from so many months of being in a really bad state, and I could also feel that I have developed a pattern of tentativeness and concern around spinning out and not being able to feel that has become part of how I operate... hopefully will be able to keep getting stronger/back to my usual self and let this go.

 

Side effects seem to be mild so far: slight headache, some dry mouth, can feel my jaw is tighter/clenching a bit, some "upness" feeling from the medicine, can't quite breath as deeply as before starting.

 

The benefits I feel today are worth it.

 

I can also feel that as I calm down/feeling seems to be coming back online, can think, and feel "popped back into my normal self" that the psychological issues I face are sort of ready to come back in... which I am in a good position to deal with in therapy, and even welcome the chance to get back to working on issues and using tools like meditation, etc, but which have not really been able to help me in the terrible state my system has been in.

 

Hoping so much so that this is the start of getting back to normal. Something tells me that it is and to stick with this approach.

[MMMM]

I picked a horrible username in my bad state a few days ago when I signed on. Heh. Oops.

[Carmie]

Hi Mmmm, 

 

How are you doing after restarting a med and stopping another at the same time? I hope you’re doing okay.

 

Our poor brains take a battering with all these meds, don’t they? We will all be healed one day though, slow and steady does it. 

 

Wishing you all the best💚

[MMMM]

Thanks for checking in Carmie! ❤️

 

I think I'm ok with stopping the remeron (not sure if that made a difference), but adding the cymbalta I think has been the bigger change.

 

I think I took really quickly to the benefits I am already getting, so am focused a bit again on how far I have to go to get to feeling good/normal again.

 

I have been ramping up and last night I got to 10mg cymbalta. Maybe I will be able to hold out there. The thing is, I am not only in withdrawal, I am definitely in a major depressive episode.

 

The biggest issue I have been having is that I can feel pretty distinctly that the cymbalta alters my breathing. It feels like it makes me breath more shallowly. And oddly this seems related to how it makes me less anxious.

 

 

By way of keeping track:

 

- Monday 9/10/18: Stayed up too late enjoying feeling better, and also because I couldn't sleep from the medication.

 

- Tuesday 9/11/18: Appointment with psychiatrist. I mentioned suicidal thoughts from saturday, but also how I was feeling improved from the medication. He was upset that I am not ramping up more quickly. He said he has been trying to keep me out of the hospital but that he won't be able to if this doesn't work. He noted that the side effects i was complaining of are not fatal, whereas depression is/can be. It's a valid point. Had appointment with therapist. Was upset. Told him at the end that I would like to talk more strategy (I've been feeling like his expertise in depression leads him to do things like describing the nature of depression to me, whereas I am in a pretty acute situation and need more tactical help). 

 

Was very agitated from the medication. Went and got acupuncture. This really, really helped. I have decided to make it a point to do a lot of acupuncture. It was a bit triggering because I could compare it to how it used to make me feel when I was more well, and so I bumped into the numbness I am feeling, but at the same time, that was like a map, where I could try to get back to that/lose myself in it.

 

Took a bath to knock myself out (felt numb, triggering again) but it worked and I feel asleep.

 

Took 5 mg cymbalta

 

- Wednesday 9/12/18: Agitation from medication was somewhat back in the morning. Felt panicky/weak on the train. Made it through work meeting (doubting that a couple of times). Stayed up too late. Didn't sleep much (still agitation from the medication), but didn't have the terrible activation feeling.

 

Took 7 mg cymbalta

 

- Thursday 9/13/18: Therapy. Felt hard to get there. Was tearful about what's been going on. Went to work meeting. Felt bad, out of it. In the afternoon, did have some good moments, where I tried shifting to some affirmations. Made another acupuncture appointment and went to that. It helped again. This time though I became very fixated on how the cymbalta is affecting my breath. Got panicky about this, because I can't change it and I get obsessed with it. I think this is 'somatic OCD'. It's awful. It's true though that it is changing my breath. And I remember when I went off it completely, I had weird stuff with my breath.

 

Tried to watch a movie, and it was ok, but still triggering because I encounter the emotional numbness / ways in which I can't 'feel' the way I usually do. Went to bed early.

 

Took 10 mg cymbalta.

 

- Friday 9/14/18: Woke up early for a thing I had to do from home. Wouldn't have woken up anyway from the medication activation. Tried to tell myself to only stay in bed if I was actually sleeping, but to not agitatedly lay there ruminating. I think I achieved that. Ended up sleeping in pretty late, despite it being somewhat agitated /sweaty.

 

Have been kind of headachy. Wasn't at all productive, like I intended to be having gone to bed early like that. Felt like I couldn't think or concentrate. Watched some more TV. 

 

Went to yoga. Had some dark moments/thoughts. Had moments of feeling agitated about the cymbalta preventing me from breathing more deeply. Felt oddly strong in class. Again felt like it was from the cymbalta/breathing which felt weird. Feels weird to have that be this effect that I don't like (I was getting into deep breathing to calm myself before) but that also seems to be this thing that's contributing to reduced panic.

 

Feel good now. A little headachy, but can think.

 

My mood swings are so crazy. In the span of 2 hours in the later part of the day I had somewhat suicidal thoughts and then all of a sudden these hopeful thoughts.

 

I don't like realizing how the cymbalta was/is affecting me. I thought I felt normal before when I was on it, but now I don't know what normal is anymore.

 

I think I will try to stick with the 10mg and see if I can use that to get out of this depressive episode. I know my doctor will think it's totally crazy if I do that, get stable, and then try to go off it again.

 

I've decided to do acupuncture about 3 times a week. I think this is going to be a key part of helping my nervous system stabilize.

 

 

 

 

 

[MMMM]

Still very up and down.

 

I'm ambivalent about what to do:

 

Try to get off/stay on the lowest dose possible       vs.        Admit that I have depression and was doing much better on the meds and just try to go back on.

 

My biggest concerns are:

 

- The anxiety/panic bad-acid-trip feelings I was having before reinstating a some cymbalta

- the deep depression I am in (it's so physical and I don't feel very functional)

- the anhedonia/ numbness

 

I get so triggered and panicked by the numbness...

 

Not being able to feel love, gratitude, motivation, connection to my memories, humor, be moved by anything... even some physical numbness, like I can't really "feel" a hot bath, and I just went for a jog and I could not feel the usual tiredness/breathlessness/pain/desire to stop I would usually get.

 

It's all in god's hands I suppose, but this is awful.

[MMMM]

I was thinking about it, and the depersonalization / panicky bad-acid-trip feeling has gotten way worse, and I think it's because of / goes hand in hand with the numbness/anhedonia...

 

Because I can't feel enjoyment or warm or empathy really, it makes everything seem trippy and scary and sinister.

[MMMM]

Part of me thinks maybe if I can go back on 20 mg, get the depression in remission, get stable/happy again, then I can reach a point where my system can calm down, and the numbness can retreat and the emotions can come back online.

 

It scares me though, stories of people who are then constantly tweaking meds trying to get rid of anhedonia for years.

 

Of maybe the blunting of emotions from the meds would prevent the emotions from coming back online...

 

However, when I was on 20mg I felt I had a full range of emotions.

 

Ugh.

[MMMM]

Maybe the anhedonia is just part of the depression, like my psychiatrist has said... although I find that hard to believe, because it doesn't feel like a lack of pleasure, if feels like a complete physical inability to feel certain feelings.

[Carmie]

Hi Mmmm, 

 

Sorry your anhedonia is so bad, when mine gets bad I find it hard to enjoy anything but I still make myself do things that are fun even if I can’t feel the fun in them. 

 

I can still feel empathy though even when I’m anhedonic. I’m sorry you can’t. 

 

Wishing you all the best💚

 

[Songbird]

You keep talking about your depression rather than withdrawal - many doctors tell their patients they're having a relapse of depression, not acknowledging that the patient's problems are more likely from AD withdrawal.  This site exists because doctors don't understand anti-depressant withdrawal.  Doctors tend to believe what the pharma companies tell them about ADs and then parrot it to their patients.  Have a read around the site - here are some good topics to begin with:

 

What is withdrawal syndrome

how psychiatric drugs remodel your brain

 

Be very careful about making a lot of changes in a short amount of time.  In general, it's best to make any dose changes small (whether up or down) as your system will find small changes easier to adjust to.  It's usually best to stick with the same dose for a good long while, is because every change in dose causes instability in your system.  When you stick with one dose consistently, the body is better able to adapt and make the changes it needs to stabilise.

 

See these topics:

the rule of 3KIS - keep it simple keep it slow keep it stable

the windows and waves pattern of stabilization

 

 

[MMMM]

Thank you @Carmie for your kind words. You are very inspiring and I appreciate it.

 

Yeah, the numbness I have a big reaction to.

 

On most days I do believe and hold faith that time will heal it and my emotions will come back online.

 

I think the numbness is not just from the withdrawal, but from the trauma of the intense anxiety and depression that it has brought on. It's like I blew a fuse and the part of my system that can feel emotions shut down, as a protection mechanism I think.

 

@Songbird thank you very much for the info. I appreciate it. You're right that I keep talking about it as depression rather than withdrawal-- I guess I am still in the camp of believing that I am going through both-- or that part of withdrawal has brought on an intense episode of major depressive disorder. I have had MDD episodes in the past (both on and off medication), so it's a known thing for me, although this is indeed the worst one by far. In my mind, either way I slice it, I am definitely in a major depressive episode, and have been borderline functional in that regard.

 

I'm not someone who doubts that I struggle with depression. That's why I went on meds in the first place. and they actually seemed to help me and I did well on them for a long time. In fact, most people in my life don't understand why I don't just decide that I was doing better on them, go back on, and let that be that.

 

That being said, I have stabilized a bit at 10mg cymbalta after 3 weeks and wouldn't you know it... I want to come off it now. 😕  Part of me wants to see if I can try this soonish, because I feel like the damage has already been done, and it's only been 3 weeks back on it...

 

Pros of the reinstatement:

- It has calmed/ceased the panic attacks and the feeling of being on a scary, bad acid trip all the time

- It has calmed some of the intense physical anxiety/panic (which had been gone for years but then started coming back up strongly when reading aloud or speaking in groups while I was off it)

- I felt that at first it helped bring back some of my feelings of interest.

- I also had one night on it where I could feel feeling again, but I see now that was a very short, fleeting period.

 

Cons:

- It's affecting my ability to breath deeply (I was doing deeper ujjayi breathing to try to help with the panic before going back on, and now I can't access that deep breathing in the same way)

- I don't feel able to access the same subtly of feeling into

- I'm not sleeping well-- I feel like I can't get tired/sleepy even when I do sleep

 

I am meeting with a naturopath next week to have labs run and to look into amino acids and supplements that may be able to help my system replenish and stabilize more.

 

I know people can develop sensitivities to such things, so I plan to go pretty slowly and carefully with the help of a professional.

 

But all in all, right now I am wanting to hold or go slightly down on the 10mg of cymbalta for another week or two, swap in supplementing with amino acids, and then go back down on the cymbalta and try being off it but better treating the symptoms that come up through alternative methods. I think I might be someone who can greatly benefit from a supplementation regimen with amino acids, vitamins, and omega 3.

 

The panic attacks / constant bad acid trip feeling are the main symptoms that are not tolerable, and I don't think it's the self-care thing to try to white knuckle through those... that's what I think caused part of this flip over into numbness, was the trauma of that... so whatever I do, I think I need to do whatever allows me to not have those anymore.

 

 

 

 

[Poulesportive]

Hi MMM, I am fairly new on this site so take what I say with a grain of salt, but you might want to consider taking a magnesium supplement while you are stabilizing/tapering Cymbalta. I'm tapering from 20 mg of Cymbalta and I take 400 mg a day of magnesium glycinate. I have had one really minor bout of depression while taking magnesium, and it has a sedating effect which helps me deal with anxiety. Two very good resources, at least for me, are Cymbalta Hurts Worse - a Facebook group about tapering Cymbalta that you can search for many of the symptoms you are experiencing to see what others did for them, and the Magnesium Advocacy Group, which is about mineral balancing to counteract a wide range of health problems, most of them linked (like depression) to inflammation. 

 

Wishing you good luck getting stabilized - and for what it's worth, for me, 20 mg of Cymbalta is waaay too much Cymbalta. I'm probably at 18 mg now (world's slowest taper) and my side effects are less than they were at 20. If I could get off quicker, I would - but my anxiety skyrockets when I try, so I'm stuck right now tapering down at about 3 beads/month. 

[Lloyd]

Hi MMM,

 

Sounds like a similar situation to me. I am 9.5 months out from stopping Effexor XR which is a SNRI like Cymbalta. I've tried twice to reinstate with very tiny doses (around 2mg) but haven't been able to stick with it long enough. I also want to get back on it in the hope of stabilizing as the situation is becoming intolerable. I don't have extreme depression and anhedonia like others do but am worried that could change. I do know that when i reinstated the anxiety went down straight away but still had a ton of physical symptoms which i couldn't tell were from the meds or just because i am so destabilized. Like you i am tired of hearing medical professionals blatantly deny that discontinuation syndrome last any more than a week and is usually some mild cold symptoms. I suspect that's because they just shunt them onto another medication to solve the problem or blame it on anxiety or a pre-existing condition. Next time i see my Psychiatrist i might challenge them to start taking Effexor for a few months and then stop taking it. After all its totally safe, no permanent changes to the brain and coming off it is not that bad right? Might be a bit more careful about the advice they give out experiencing the joy of withdrawal for themselves... Then again i wouldn't wish this on anyone...

[Carmie]

Hi Mmmm, 

 

You are definitely right there, the numbness n anhedonia is like a protection. I remember someone writing a thread saying that it’s better to have anhedonia than severe anxiety. I don’t remember who wrote it though. 

 

Our emotions tend to go from anxiety to anhedonia though. It’s back n forth. Ahh, neuro emotions!

 

Hope youre coping okay today💚

[Songbird]

If you're beginning to stabilise after three weeks, that's good.  If you make more changes now, it's likely to destabilise things again.  Why not continue to keep things the same and see if you stabilise even more?

 

I would recommend being very cautious with supplements, especially amino acids, while your system is destabilised from withdrawal.  While your nervous system is so sensitive, supplements can have unpredictable effects.  Your naturopath may not be aware of this unless they have experience with AD withdrawal.   If you decide to try any supplements it's a good idea to try only one thing at a time and start at a very small dose, to see how your system reacts to it.

 

 

 

 

[MMMM]

I've been meaning to get on here and makes some updates for a while.

 

@Poulesportive thank you so much for your message. I checked out and joined the Magnesium advocacy group. Interesting stuff. And I have been starting to take some magnesium. I'm interested in their adrenal support stuff too. It's nice to meet another person on here coming off of Cymbalta. I think it has some of its own unique challenges (as do all the meds I'm sure). I hope we can keep in touch about how it goes for us.

 

@Lloyd good to hear from you, and from another SNRI medicated person. I love your idea of having a doctor start taking one of these for a while and then go off it if they are so sure that there is no harm.  Although like you said, I wouldn't even wish that one someone. Not sure if you saw this article in the NYTs, but there is one psychiatrist who is quoted who never thought it would be so hard, but ended up going through withdrawal for a year: https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html

 

Like you, reinstating also seemed to help right away with the anxiety for me. Haven't really had panic attacks since clearing the re-onboarding period.

 

That being said, since I was here last, I think a major thing has changed for me:

 

I have come around to the camp of seeing this as withdrawal.

 

I still believe I am in a severe depressive episode, however, I no longer see that as an indication that I am someone who at a baseline has suicidal depression... I now see it as something I ended up in as a perfect storm of circumstances and a psychiatrist-speed-taper I had no idea could land me in such a world of trouble. As well as a type of depression that was not typical to my diagnosis before, and that does seem to be typical to antidepressant withdrawal.

 

After reinstating, I do feel that I have stabilized... I'm sure it's from the medication, but I also like to think I am getting more skillful at managing my concern around all of this as I learn what is going on, and gain hope that I can heal.

 

I got up to 13 mg after reinstating... partially because my psychiatrist was urging me to get up to 20 and then 30... and I thought I should...

 

However, since in that time I started coming more around to seeing all this as withdrawal, I am now pretty firmly in the camp that I want to finish what I started when I unknowingly turned my life upside down by going off these meds after 14 years in Dec 2017. I've already put in months of 'healing' and since I don't really have access to my emotions, I feel that a lot of the damage has already been done, and that I need to just focus on getting back off and then doing the "letting time pass" type of healing.

 

I started going back down from the 13 mg, and from what I can see in my journals (getting much more disciplined about keeping this up) I was taking 7mg/night from around Oct 6th. I am now taking ~4.6mg/ night. So maybe I could have reinstated at like 2mg and have gotten the same stabilization. I know I'm going back down a little on the fast side, but after being off for so many months of 2018 I really don't want my brain chemistry to rebuild around this crap.

 

@Songbird I appreciate the suggestion about being slow and careful with any supplements, and I think I will reiterate to my new naturopath about the withdrawal.

 

I did a 2 hour intake with the naturopath and have started all the tests to see where there are any imbalances (either pre-existing, or since having my system so severely taxed).

 

Luckily, I don't think I have such extreme sensitivities as others experience, but I can see very much how important it is to be careful with any changes.

 

I've also realized that I need to be careful about what I am reading on here... I get really really scared by some of the stories, and I get quite obsessive about it, so I really need to lay off that. I have started admitting it to my AA sponsor and my boyfriend when I go down the rabbit hole of reading obsessively in a way that is more harmful for me than helpful.

 

Reading success stories however is what is giving me hope. I feel especially heartened when I read people who are totally fine now after:

 

- DP/DR

- Anhedonia

- Not feeling emotionally connected to memories

- Not being able to feel love for loved ones

- Cognitive impairment

 

I've made a document with success stories and it helps to read them.

 

I think the fact that such a small dose of cymbalta is stabilizing me makes me feel like I will be able to replace it (with the help of my naturopath) with supplemental support (have already been taking 50mg 5-HTP for a few weekly nightly, and L-theanine daily for anxiety which has been helping a lot) and then I can basically go back off and resume the process of healing from the protracted withdrawal.

 

I'm looking into making some sort of life plans that can basically support this-- sorting out where the money is coming from, dialing in support, getting an easy but structured schedule, and basically just getting into a position to allow time and space for healing for another year or however long.

 

I feel like I am strong and having a better attitude of looking at this spiritually and positively. I actually don't have it nearly as bad as some people... I've just had a lot of panic in response to my symptoms, fears of permanence, fears that I have lost the essence of who I am, etc. But today I do not believe that to be true. Today I see this as a very strange and unexpected spiritual journey that probably has some powerful lessons for me.

 

Thank everyone for being here.

 

 

 

 

 

 

 

 

Edited October 21, 2018 by MMMM
typos

[ChessieCat]

8 hours ago, MMMM said:

Reading success stories however is what is giving me hope. I feel especially heartened when I read people who are totally fine now

 

Here's one to check out:

  ☼-toulouse-my-paxil-withdrawal-journey

 

 

 

 

[MMMM]

Thanks @ChessieCat. 

 

Just a quick update.

 

I had a few days of really scary depression and withdrawal agitation when I went down to 3.5mg, so I am at 6mg the past few days and am going to try to hold there for a while.

 

Couldn't sleep the night before last, and then yesterday and today feel some warmth in my heart (it seems some feeling/pleasure came back online with the dosage change, not sure how long it will last) and like the inability to think has lifted enough for me to do some work.

 

• I really want off the cymbalta, wish I had never gone back on it.
• Called Dr. Shipko and might start working with him.
• Going to get honest with my psychiatrist that I do not want to go above the 6mg and still intend to come off it.
• Have a follow up appointment with the naturopath 11/13 to go over test results and come up with a plan.
• My main learning in the last week plus is that everything keeps changing, so hoping to have less fear around permanence. Roller coaster.
• I think I probably have healthy anxiety... or some thing where reading about symptoms makes me feel like I have them or possibly create them in myself.
• Definitely have lots of moments of being sad about who I was versus where I am now.
• Started making plans to go live with my parents for a while, but then felt that was extreme.
• Pretty aimless at the moment. Am planning on going to LA to stay with my boyfriend for a while, and hope to take it easy, get acupuncture, do yoga, try to eat enough, etc.
• Filed for disability.

[ChessieCat]

20 minutes ago, MMMM said:

get acupuncture,

 

Please see this topic:  Acupuncture - Posts #6 & #8 (not detox or stimulation)

[Songbird]

On 10/22/2018 at 9:54 AM, MMMM said:

... I need to just focus on getting back off and then doing the "letting time pass" type of healing.

 

I started going back down from the 13 mg, and from what I can see in my journals (getting much more disciplined about keeping this up) I was taking 7mg/night from around Oct 6th. I am now taking ~4.6mg/ night. So maybe I could have reinstated at like 2mg and have gotten the same stabilization. I know I'm going back down a little on the fast side, but after being off for so many months of 2018 I really don't want my brain chemistry to rebuild around this crap.

...

then I can basically go back off and resume the process of healing from the protracted withdrawal.

 

 

16 minutes ago, MMMM said:

I had a few days of really scary depression and withdrawal agitation when I went down to 3.5mg, so I am at 6mg the past few days and am going to try to hold there for a while.

 

Hi MMMM, I feel that you're not quite understanding how our slow taper is designed to work.  It's not about getting off the drug quickly, then waiting for recovery from protracted withdrawal.  Tapering quickly, or jumping up and down on dose like you've been doing causes more instability, more severe symptoms, and makes it hard for your system to stabilise.  The slow taper we recommend here requires spending time holding on one dose until your system stabilises, then reducing dose very slowly over time, with holds on doses as needed to stabilise.  This is the way that minimises symptoms, avoids major destabilisation and allows people to live a relatively normal life.

 

If 6mg is your current dose, then I would stick with that for several months, to allow your system time to stabilise.  Then when you taper again, we would recommend drops of no more than 10%, and then wait at least 4 weeks on the new dose before dropping dose again.  It doesn't really matter that it takes a long time, the important thing is that it is much easier on your system, and also allows better quality of life.

See these topics for more information:

 

the rule of 3KIS - keep it simple keep it slow keep it stable

 

why taper by 10% of my dosage?

[MMMM]

@Songbird re: acupuncture, yes, thank you. I had seen that topic before, and my acupuncturist had done exactly what it says not to: tried a stimulating approach since I complained of depression. I will make sure any future treatments are for calming the CNS.

 

You are totally right that I am wanting to go faster. I think it's because I was already completely off the meds for 7 months... so some part of me wants this to somehow count towards the potentially years of healing that it will take...

 

I also have to admit that I think because I have already lost so much of my feelings of joy and interests, etc from the initial 7 months of withdrawal, there is a part of me that is sort of wanting to go kamikaze... and also feels very resistant to having the drugs back in my system at all.

 

I can feel that some part of me doesn't want to have to continue the way things are, and so I almost welcome it being worse/bad. Maybe bad withdrawal is a distraction for me.

 

I think everything you pointed out is probably right though.

 

I have been so obsessed with this topic and what to do... I started trying to pray for guidance, and got some last night that I should hold at the 6. You are a voice of reason for the same thing. I have been feeling super willful around all of this (just because I am upset about all of it), but I am going to try to accept and be reasonable about this. Thank you. I will commit to holding and stabilizing for a while. This will give me a chance to end the internal debate for now too.

 

Thank you.

[MMMM]

Feeling obsessed and bad today. I'm so sad that I feel like a shell of my former self, and not much confidence that I will get my feelings and interests back.

 

I also wish I had never reinstated. I feel like even though I was not doing well in Sept. it even seems I had more drive then and could appreciate little things, like being able to sleep and having a bit of appetite.

[MMMM]

I remember a few months ago saying in my 12 steps meetings that it was like I had 'forgotten my lines'... no attachment really to anything to say. I feel like that still. Like nothing matters. And I fear it's getting worse. It seems that it is. It's like the life has just been draining out of me. Ughhhhh

[Gridley]

Anhedonia and apathy are very common withdrawal symptoms.  They do go away but it takes time.

[manymoretodays]

Hi MMMM,  Hey...another 12 stepper!  And we both have nice generic M avatars.  Take a look at all you've done since September.  Changewise.  I see a ton of changes and then an addition of 5HTP to boot!  Have you seen our thread on that.  It's in symptoms and self care.  We don't recommend it.  Have a look at the thread.  See what you think.   I expect the season change may be a factor too.  It's a lot of work....I know....to begin to practice some non drug coping......until you find some that helps and then continue with it.  What has helped?  And hugs.  L, P, H, and G.  mmt

[Peachy]

Hi there!

I think we are having a lot of the same issues. How are you now? What are your symptoms?

Are you still off the meds? I am still tapering, but  have been dealing with this for 2.5 years now. I'm also in the bay area

 

[MMMM]

Hi @Peachy! Yes, sounds similar. My main symptoms at the moment are depression, anhedonia, emotional numbness, head pressure, off and on agitation (feels at times like there are no feel good chemicals in my body and I can't get any relief), and anxiety about my situation. How are you getting on these days? Anything that you find helps you make it from day to day?

[MMMM]

Just making a note: I get afraid sometimes that I am going to die from this

 

I one time described it that it feels like the oxygen is being sucked out of my brain, and I found an account online of a girl who described the same thing, but I know that she didn’t make it.

 

I get confused and don’t know if it’s just fear or if I really won’t be able to heal from this.

 

I feel this pressure feeling all over, I’ve sometimes described it as like being underwater.

 

I can’t feel an ounce of pleasure or relief physically.

 

Like my body and mind are starving for some vital ingredient they don’t have right now.

 

Anyway, this really scares me.

[SkyBlue]

M, we do heal from this, even if it feels like we won't.

 

Were you able to try magnesium as suggested above? That can be very helpful and calming. 

[MMMM]

It's been a while, but thank you for this @SkyBlue.

 

I have struggled to get regular with the supplements. I do have some magnesium, but only take it occasionally.

 

That is actually part of why I signed on today...

 

I would love to get some advice, since my brain is not working so well:

 

I have fish oil supplements, 800 EPA / 600 DHA (https://www.amazon.com/Tobias-Strength-Burpless-Non-GMO-NSF-Certified/dp/B00CAZAU62/)

 

When would people suggest I take the fish oil? And how much?

 

 

 

 

 

[VincentV]

Hi M, just reading your post and I have to say I can relate to quite a lot of what you say.

 

I take 60g of magnesium daily along with a thousand 1000mg of "omega 3 fish oil". My magnesium is enmeshed with vitB6 which isn't ideal apparently, but its all i can get. My anxiety does seem helped by it, but I can't be sure as it might just have decreased anyway.

 

In your February post you talk about not being able to get good feelings or the feeling of the oxygen being sucked out of your brain. I have had something similar especially early on if I remember. I called it the 'thirsty feeling'  it was like my brain desperately need some kind of subtle thing that was suddenly missing, it was as if my throat was cut and I could no longer drink. I don't really think I feel that anymore, not at the moment at least (I have to think quite hard to figure out my current feelings, the dissociation and anhedonia make it really hard). Certainly recently I think there have been times where I've even  felt, very VERY subtle pleasure briefly. I don't think Ive ever felt the pressure feeling you describe though, for me its more like fog and a disconnection.

 

Can I ask if you've ever had akathisia?

 

 

 

 

[MMMM]

Hi @VincentV, thanks for writing. And for sharing what you do with the fish oil and the magnesium. I am going to try to get more regular about both of these.

 

I am feeling absolutely horrid. And I am not even all the way off the medication.

 

I still get that feeling-- like my body is starving for something. I find myself sometimes drinking orange juice, or eating various things hoping that some missing nutrient will provide some relief. I try to do self care, etc (last night I went to a yin yoga class), but I can't seem to get a moment's peace.

 

I have been describing it as "there are no feel good chemicals in my body", but I have started to wonder if it's more akin to akathisia... The thing is though, lately it doesn't make me pace the way it used to (partly I feel like because that part of me has just been shutting down), it's more of just an internalized, systems shutting down, nothing (nothing) can feel good even for a moment. Anhedonia to the point of painfulness?

 

I don't know but whatever it is, it feels unbearable. I am contemplating moving home with my parents as it feels so tenuous to be living on my own while feeling so unwell. But the thing is, sadly, I know they can't really do anything to help. I will feel just as miserable there.

 

I'm glad to know that some of your symptoms have gotten better. I hope that trend continues. You sound like you are doing a good job of staying the course. Best wishes.