trenace: is this serious withdrawal after a year?

[trenace]

Need some advice please. One of my symptoms is an increased addiction to smoking. I often have an extreme craving for cigarettes and smoke alot to the point that I become very agitated and anxious when I run out of cigs. I've noticed that in the mornings especially having a smoke makes my brainfog worse and im aware that the effects are not good but I crave it terribly. My surgeon has just told me that I must stop smoking for my abscess to have a better chance of healing so what can I do? It's literally my only coping mechanism at the moment and I'm getting very agitated and craving a cigarette just thinking about quitting.

[ChessieCat]

Hi trenace,

 

These suggestions are my personal thoughts on your situation.  I've been a smoker in the past.

 

Please be aware that there is a quit smoking drug called Zyban which is a psychiatric drug, aka Wellbutrin, common drug name buproprion.  I strongly suggest that you do not start taking it.

 

Please note that SA does not counsel members about quitting smoking.  If you do an internet search you will probably find forums and Facebook groups etc which support people who are giving up smoking.

 

I think you are caught up in an anxiety loop.  You are feeling anxious, possibly partly caused by withdrawal so you smoke.  Smoking is addictive both physical dependency on the chemicals in the cigarette (which creates withdrawal so you want another cigarette) as well as the action of smoking, a habit you are using to distract yourself.  Because you are addicted to them in different ways you end up smoking more.

 

You might find that Magnesium helps to ease the anxiety a bit.  However, you are going to have to find different ways to distract yourself when you feel like a cigarette.

 

One thing that I found was that there were particular situations which I connected with having a cigarette, which was unrelated to the chemical withdrawal.  For instance having a glass of wine or a coffee, or after a nice meal.  If you are working you might have a routine that you do at a certain time for going outside.  You could keep a note of when you have a smoke and what happened before it and then have a different activity prepared to do instead of having a smoke.  You need to try to differentiate between the physical addictive craving fo the chemicals and the act of smoking and/or the routine/habit you have formed.  For example do you reach for a cigarette immediately after getting up.  Another thing you could try is putting your cigarettes away somewhere so that you have to get up and physically move to get one instead of having them immediately available.  During the time of moving try to encourage yourself to not smoke or at least wait for another 15 minutes and go and do something else.  And when you are doing your activity to distract DO NOT smoke at the same time.  Only do the activity.  Otherwise you will only be introducing a new situation connected to smoking.

 

I'm sure that there would be plenty of ideas online for ways to distract yourself.

[ChessieCat]

On 12/24/2020 at 8:43 AM, ChessieCat said:

I'm sure that there would be plenty of ideas online for ways to distract yourself.

 

I've just done an internet search using a search engine and this search term and found lots of ideas:

 

things to do to distract instead of smoking

[trenace]

On 12/25/2020 at 9:49 PM, ChessieCat said:

 

I've just done an internet search using a search engine and this search term and found lots of ideas:

 

things to do to distract instead of smoking

Some days I've found it's easier not to smoke, very rare but I do have days like that maybe twice a month but I've realised that not smoking is sometimes impossible. The past two days I've had symptoms from a year ago where it feels as if my impulse control is totally broken. It feels as though my emotions are all numbed except irritation and anger and I can't sit still at all and I play video games all day and smoke. On days like that I've tried other tasks but my focus is terrible and I'm angry and can't do anything to a good standard at all and I have a crazy addiction to video games which makes me agitated and even more angry if I'm not playing. Then suddenly at some point during the day I'll become extremely exhausted and fall asleep where I sit. Today it isn't as bad, I woke up panicky as usual and have had one cigarette but I don't really have the desire to play video games or chain smoke. My emotions are numb and I'm irritable and have brainfog and derealization but I think I'll be able to smoke less today quite easily if i try. My friend who's been taking care of me has basically told me that he's getting bored of me now and isn't going to visit or look after me as much anymore so that's on my mind and I can see exactly wheres he's coming from. I'm not as bad as I was but I'm nowhere near recovered enough to keep him entertained. Probably functioning at about 30% on good days which arent very often, and non functional on very bad days.

[trenace]

Hi everyone, I hope everyone's doing okay. Yestrday was a little better but I slept badly. I was tired around 2 am so I went to bed and suddenly became wired me tally so couldn't sleep until about 5. Today I've woken with mild panic, brainfog and DR although not as severe as it can be. Obsessive depressive thoughts are mild today too almost nagging but not really consuming like they can be. I don't think it's going to be bad day if I'm being honest. Really worried about my upcoming surgery though so I'm trying to stay in the moment. Hope everyone else is doing well.

 

[DataGuy]

Hi @trenace, hope the rest of the day met your expectations. How is the quitting smoking going? Have you tried any gum or patches? These may help to lessen your desire to smoke. It is, after all, a powerful addiction and not simply a habit. I think quitting is a good thing to focus on. Do not let learned helplessness take you over. Do not tell yourself you have no impulse control. Exert your will. Control your behavior just a little and you will feel better. Sometimes this can help to make a bad day much better. 

 

I hope today goes well for you. Good luck with the surgery! When is it scheduled for?

[trenace]

3 hours ago, DataGuy said:

Hi @trenace, hope the rest of the day met your expectations. How is the quitting smoking going? Have you tried any gum or patches? These may help to lessen your desire to smoke. It is, after all, a powerful addiction and not simply a habit. I think quitting is a good thing to focus on. Do not let learned helplessness take you over. Do not tell yourself you have no impulse control. Exert your will. Control your behavior just a little and you will feel better. Sometimes this can help to make a bad day much better. 

 

I hope today goes well for you. Good luck with the surgery! When is it scheduled for?

Hey dataguy don't get me wrong, there's certain habits which I'm doing so well in quitting. Sugar I've cut down substantially and fizzy drinks I've eliminated totally. Just smoking in particular is extremely difficult for me. Some good days I'll have 3 or 4 sometimes less which is great for me and other days it's much more especially on bad days which is often. Yestrday was a good day overall and today's been fine too really just DR and brainfog. My surgeries on 21st and I'm so worried for reasons u can probably guess. I hope your doing well.

[trenace]

Hey everyone, hope your all okay. My surgeries tmrw and I'm pretty worried. One, because I don't sleep properly at all and wakeup many times during night and 2, I'm sensitive to most medications and worried about a reaction. Is there any advice people can give me before hand? I'm going to try to get to bed as early as possible and just rest, and do everything I can to avoid antibiotics.

[DataGuy]

Hi @trenace,

 

I don't have any tips, unfortunately, other than to try to relax and not worry about it too much. If you have a problem with the sedation it will probably only be short-lived.

 

Good luck! Hope to hear from you soon afterward : )

[trenace]

Hi, I've come to update. Im relieved to say I don't think I've had a huge setback from my surgery like the one I had to antibiotics. In fact being on morphine was probably the best time I've had for a good few years now. I've had some bad days since then some okay days and 1 or 2 good days. Sleep is pretty terrible, I don't sleep until 5/6 in the morning and always wake up panicking at about 12/1. Evening unusually feel a little better although not always. I seem to be recovering from my surgery okay although once the morphine wore off my psychological symptoms came back and were switching up on me all day whilst the pain was pretty severe so wasn't pretty. Yestrday wasn't so bad, I tried exercise again. A 15 minute jog and today I haven't felt so good. Mentally just felt totally anhedonic even though it's better than depression and panic. Hard to think of anything to do even because my mind feels totally blank. Can hardly hold a conversation. Anyway hope everyone's okay. I think I still have a good few years before I recover enough to live a better life. One thing however, my sex drive is consistently better which is pretty positive. It's still up and down but at one time it was totally gone.

[trenace]

Literally all I've felt today is rage. I've tried exercising but my ligaments and joints feel like they're going to pop and they feel so weak. Ive tried video games but I've actually just thrown my headset into my TV and smashed it. Made me feel much worse. I can't concentrate on a movie because I'm just angry. I'm gna have a cold shower. What a **** day and what a **** 5 years it's been.

[DataGuy]

Sorry to hear about your bad day, @trenace. I know it is pretty frustrating when symptoms drag on forever. Psychological symptoms might be a bit worse if you are having a rebound effect from the morphine? I'm not sure how long you were on it for or when you came off. Great that you tried jogging though. I think with exercise it's important to start slow and build yourself up. Have you been trying to go for walks at all? Sometimes your joints will loosen up as you walk longer, even if it is at a very slow pace. I know sometimes mine don't feel too great (especially when my nervous system is really ramped up), but a bit of walking or other exercise does seem to help things. Hope you are feeling better tomorrow, bud.

Edited February 27, 2021 by DataGuy

[trenace]

Should I be doing something to get better? Everything I've tried has made me worse. Diet changes, exercise anything i do sets me back but nothings getting better. Today I woke up panicking with palpitations spent the morning angry with bad brainfog and DR so I had a shower and then I was suddenly exhausted so I slept and woke panicking with DR exhaustion and anger. Now im just lying here again. I've had soooo many days just wasting away like this.

[Rosetta]

General anesthesia affected me a lot.  It took a long time to get over it.  It’s probably why I first tried an antidepressant and why I had a bad reaction.  I’m sorry to say you can only be patient with yourself.

 

How about the cigarettes?  Did you quit completely? Or reduce?  That’s also going to stress your system.  I hope your wound is healing well.

 

R

[DataGuy]

@trenace yes, I know it is very frustrating. If you have done everything you can and feel you aren't getting better, then maybe it would be a good idea to follow @Rosetta's suggestion: quit smoking (or switch to a patch or gum). It can definitely affect your healing and your health. It's not going to be easy, but if you feel you need to change something, that is a glaring candidate.

 

https://www.pnas.org/content/111/50/18031

 

"Tobacco smoking interferes with GABA_A receptor neuroadaptations during prolonged alcohol withdrawal"

 

"Significance

Alcohol dependence and tobacco smoking are highly comorbid. Although continued smoking during alcohol withdrawal may reduce relapse risk, most of the morbidity associated with alcohol dependence is due to tobacco smoking and many individuals in alcohol treatment express a desire to quit smoking. We conducted a parallel study in alcohol-dependent humans and nonhuman primates to identify the impact of tobacco smoke and nicotine on the neuroadaptations in the GABA-ergic system that occur during alcohol withdrawal. Our findings show that tobacco smoking, but not nicotine consumption, blocks the recovery of GABA_A receptors during extended alcohol withdrawal and that sustained elevations in GABA_A receptor levels in alcohol-dependent smokers are associated with alcohol and cigarette cravings, possibly contributing to continued smoking."

 

GABA is the primary inhibitory neurotransmitter in the brain, so for your nervous system to get back to normal, those inhibitory neurons are going to have to get back to doing their job properly. Quitting smoking may help with that. 

 

 

[trenace]

I've reduced my cigarettes to weaker ones and have some days where I smoke alot less and some days where I smoke more. Overall I'd say I've reduced but not quit. The last 3 days havent been as bad. It's just been DR and brainfog. I think the really bad days were triggered by aspartame because I drank soft drinks that I haven't in over two years. Smoking definitely isn't helping anything but it's my only coping mechanism other than exercise which I've done yestrday and two days prior and I haven't noticed any bad reaction this time so I'm going to try and keep that up every other day. And try and reduce cigarettes more. Certain foods are definitely a trigger and I'm avoiding foods that I'm certain cause issues and any ingredients that I find make things worse like aspartame.

[trenace]

In fact I think the main trigger is foods because certain foods cause terrible waves.

[trenace]

Okay so today and yesterday have been really bad with terrible anxiety and the only thing I've done different is exercise, which was 2 days ago. I don't know if it's possible to feel the effects a day or 2 after but I've not had anxiety this bad in a good while. Had a nightmare last night and woke with a terrible feeling again after a long time. 

[trenace]

I did push myself quite a lot at the gym so I can only think of that as the cause. I've not done anything else different.

[Fallensoul]

The brain of a smoker wants nicotine if that person is anxious or nervous. Its just programmed this way due the smoking habit.
I also smoke and in the end it make me more nervouss, stressed and anxious, esp. if I smoke to early on the day or to much.

But not smoking does the same at the beginning of the day, but it lessen over the day. I try to smoke only in the evening after dinner and if i managed that, I'm eventually far better of.

[DataGuy]

Great to hear you made some progress @trenace, keep it up!

 

So it was 2 days ago you worked out fairly hard? How did you feel yesterday? Did you do any exercise since? Walking or working out? 

 

I am kind of wondering if maybe your body wants more exercise? Sometimes I found that after I worked out particularly hard for a few days I would inadvertently give myself too much rest and my nervous system would jack itself up again. In withdrawal it seems like for me, if I sit too long without exercise, my system seems to build up a critical mass of excitatory neurotransmitters, which I then need to get rid of through exercise, otherwise I'm pretty uncomfortable. I particularly notice it in my stomach, which starts churning. Have you tried going for an easy walk? I know it is tough to tell what is happening sometimes. My system could be so messed up that I couldn't tell whether I was overly tired or needed more exercise - until I tried to exercise, that is, which would give me a clue as to what I needed. 

[Fallensoul]

29 minutes ago, DataGuy said:

Great to hear you made some progress @trenace, keep it up!

 

So it was 2 days ago you worked out fairly hard? How did you feel yesterday? Did you do any exercise since? Walking or working out? 

 

I am kind of wondering if maybe your body wants more exercise? Sometimes I found that after I worked out particularly hard for a few days I would inadvertently give myself too much rest and my nervous system would jack itself up again. In withdrawal it seems like for me, if I sit too long without exercise, my system seems to build up a critical mass of excitatory neurotransmitters, which I then need to get rid of through exercise, otherwise I'm pretty uncomfortable. I particularly notice it in my stomach, which starts churning. Have you tried going for an easy walk? I know it is tough to tell what is happening sometimes. My system could be so messed up that I couldn't tell whether I was overly tired or needed more exercise - until I tried to exercise, that is, which would give me a clue as to what I needed. 

Hmm, maybe I should also start exercising again.  I feel I'm allmost ready for it, if tiredness does not come back,  because here its a torn between tiredness and hypernervousness.

Prior to this 3 year hell I worked out 5 days/week, all most crying to think back at that time...lost more then 20 kg. This poison had allmost kill me completely...

[trenace]

2 hours ago, Fallensoul said:

The brain of a smoker wants nicotine if that person is anxious or nervous. Its just programmed this way due the smoking habit.
I also smoke and in the end it make me more nervouss, stressed and anxious, esp. if I smoke to early on the day or to much.

But not smoking does the same at the beginning of the day, but it lessen over the day. I try to smoke only in the evening after dinner and if i managed that, I'm eventually far better of.

I think that's the best advice I've gotten in regards to smoking as its very similar to me. A cigarette early on really kicks my ass but later in the day it just doesn't. But if I go without I feel alot worse some days.

[trenace]

2 hours ago, DataGuy said:

Great to hear you made some progress @trenace, keep it up!

 

So it was 2 days ago you worked out fairly hard? How did you feel yesterday? Did you do any exercise since? Walking or working out? 

 

I am kind of wondering if maybe your body wants more exercise? Sometimes I found that after I worked out particularly hard for a few days I would inadvertently give myself too much rest and my nervous system would jack itself up again. In withdrawal it seems like for me, if I sit too long without exercise, my system seems to build up a critical mass of excitatory neurotransmitters, which I then need to get rid of through exercise, otherwise I'm pretty uncomfortable. I particularly notice it in my stomach, which starts churning. Have you tried going for an easy walk? I know it is tough to tell what is happening sometimes. My system could be so messed up that I couldn't tell whether I was overly tired or needed more exercise - until I tried to exercise, that is, which would give me a clue as to what I needed. 

Doesn't feel like any progress has been made tbh, but I haven't had this kind of physical chemical anxiety for a while and the only thing I did was exercise fairly hard after 2 years. I exercised two days ago and yestrday was alot of anxiety and today was the disabling kind so I can only point to the exercise as a potential cause. I think I need to limit it to walking rather than heavy weights. Feel a tiny bit better this evening but it's been bad all day.

[trenace]

1 hour ago, Fallensoul said:

Hmm, maybe I should also start exercising again.  I feel I'm allmost ready for it, if tiredness does not come back,  because here its a torn between tiredness and hypernervousness.

Prior to this 3 year hell I worked out 5 days/week, all most crying to think back at that time...lost more then 20 kg. This poison had allmost kill me completely...

I miss weights and exercising too. I was basically a fitness freak lol. Lost three and a half stone now. If u feel ready I'd go really slow and see how u react to a gradual increase in weight or cardio.

[DataGuy]

3 minutes ago, trenace said:

Doesn't feel like any progress has been made tbh, but I haven't had this kind of physical chemical anxiety for a while and the only thing I did was exercise fairly hard after 2 years. I exercised two days ago and yestrday was alot of anxiety and today was the disabling kind so I can only point to the exercise as a potential cause. I think I need to limit it to walking rather than heavy weights. Feel a tiny bit better this evening but it's been bad all day.

 

Ok. Did you feel sort of shaky, like you've had too much caffeine? When I first started playing sports (before the pandemic) I would play at night and I found the stimulation was too much, too late at night. Sometimes I would have trouble getting my system to calm back down so I could sleep and I would often wake early and feel keyed up and kind of frayed the entire next day. Hasn't happened for quite awhile, so I'd forgotten about it. I wonder if this is what is happening? Felt like everything was geared up and I would often burn noticeably more calories the next day and could end up eating quite a bit more. The early awakening and shortened sleep was a very consistent feature. 

[trenace]

3 hours ago, DataGuy said:

 

Ok. Did you feel sort of shaky, like you've had too much caffeine? When I first started playing sports (before the pandemic) I would play at night and I found the stimulation was too much, too late at night. Sometimes I would have trouble getting my system to calm back down so I could sleep and I would often wake early and feel keyed up and kind of frayed the entire next day. Hasn't happened for quite awhile, so I'd forgotten about it. I wonder if this is what is happening? Felt like everything was geared up and I would often burn noticeably more calories the next day and could end up eating quite a bit more. The early awakening and shortened sleep was a very consistent feature. 

After my workout I just felt tired but struggled to sleep, and then the next day woke with racing thought and anxiety and worry which lasted all day. Today I woke from a nightmare with full on panic and dread from the pit of my stomach and have had racing thoughts and physical anxiety and dread all day leaving me non functional.

[Rosetta]

Exercise made things much worse for me.  I tried to jog up a hill when I woke up with cortisol spikes in the morning.  I did this for many days, and I did feel better immediately afterward for the first few days.  It seemed as if I had used up all the activating hormones in my body, and I felt more calm.  Over time, the anxiety became much worse.    I think that anything — drugs, our own hormones — can cause our balancing system to push back.  So, I switched to gentle walking.  That was better for me.  I have been jealous of the people who can exercise. (I also get this effect from female hormones, but there is nothing I can do about that.  It’s been a roller coaster for 4 years.  Fortunately, it’s slowing down now.)

[DataGuy]

That is tough, sorry to hear, @trenace. I think you said you had exercised a few days prior and hadn't noticed any ill effects? I would not get too discouraged from this bad reaction. You can always start slow as @Rosetta suggests, and try to slowly build up. If you have a bad reaction again, you can back off.

 

Congrats on lowering the cigarette consumption. Don't kid yourself, that is great progress. It could also be a source of symptom exacerbation due to withdrawal effects, but always hard to pinpoint exact causes. We usually recommend trying to only change one thing at once for that reason, but understandably that isn't always possible. Hope you can continue to make a bit of progress. Don't get too down, you were having bad reactions before that as well, after all.

[trenace]

On 4/21/2021 at 4:42 PM, Rosetta said:

Exercise made things much worse for me.  I tried to jog up a hill when I woke up with cortisol spikes in the morning.  I did this for many days, and I did feel better immediately afterward for the first few days.  It seemed as if I had used up all the activating hormones in my body, and I felt more calm.  Over time, the anxiety became much worse.    I think that anything — drugs, our own hormones — can cause our balancing system to push back.  So, I switched to gentle walking.  That was better for me.  I have been jealous of the people who can exercise. (I also get this effect from female hormones, but there is nothing I can do about that.  It’s been a roller coaster for 4 years.  Fortunately, it’s slowing down now.)

I think I'm just going to stick to walking too. Haven't had anxiety that bad for a while. I'll try more strenuous exercise if I feel more improvements at a later date. 

[trenace]

On 4/22/2021 at 7:58 PM, DataGuy said:

That is tough, sorry to hear, @trenace. I think you said you had exercised a few days prior and hadn't noticed any ill effects? I would not get too discouraged from this bad reaction. You can always start slow as @Rosetta suggests, and try to slowly build up. If you have a bad reaction again, you can back off.

 

Congrats on lowering the cigarette consumption. Don't kid yourself, that is great progress. It could also be a source of symptom exacerbation due to withdrawal effects, but always hard to pinpoint exact causes. We usually recommend trying to only change one thing at once for that reason, but understandably that isn't always possible. Hope you can continue to make a bit of progress. Don't get too down, you were having bad reactions before that as well, after all.

Yeah true I guess, yestrday wasn't so bad although I've woke today feeling off. Nothing major so far, cortisol spike and palpitations first thing and alot of brainfog but it's manageable. Going to just see how the day goes. The really severe anxiety I had for 4 or 5 days I think but it's died down now thankfully.

[trenace]

Okay hi everyone. So since my last update I think I've had a handful of bad days and some okay ones. Never symptoms free though. However my abscess has recurred and I'm almost definitely going to need another surgery. Pretty much just healed too. I'm stressing like you'd imagine and I'm wondering, is this going to set me back because I react to lidocaine in large amounts it can't be good for me going under general again. It's really causing me stress

[trenace]

And today I e got anxiety again quite bad after a week and I'm thinking it's because of my abscess. Both psychologically and Chemically because it's only just swollen up yestrday and that's when it started.

[DataGuy]

Glad you've only had a handful of bad days, @trenace. Sorry to hear about the abscess. No sense stressing about it, you gotta do what you gotta do, unless there is some alternative? I think it is always good to avoid general anesthetic if you can, but I believe you mentioned you did not want to be awake for that type of surgery? You can only control so much. Try not to catastrophize about it. You got through the surgery ok last time, after all.  Hope your bad days continue to give way to okay days : )

[trenace]

Thank you dataguy it's always good to hear a voice of reason. This condition makes everything seem ten times worse. I'm pretty sure I didn't react to the anesthetic too badly. Definitly not like I reacted to amoxicillin but im sure it's made my sleep worse. I'll have to just cross that bridge when I come to it. I do have some good days I have to realise that when things are bad. I'm mainly just dealing with DR, brainfog and milder neuro emotions and heavy fatigue on good days. Bad days can still be terrible but it's not everyday now like it used to be. For example today I don't feel too good but past 3 days it's only been DR and extreme sleepiness. When I feel that extreme sleepiness I have no anxiety or anger or depression, but I need to lay down because I can't do much else. Even though I'm really tired it's nice to just nap like that 

[DataGuy]

You are definitely not alone @trenace. I am 3+ years out and had a rough pandemic. Some people in my building used it as an excuse to smoke in their apartments and had a bunch of it (pot and tobacco smoke) float into my apartment on a near daily basis. I'm still very sensitive to psychotropic stuff and it seemed to really ruin my sleep and quality of life. Had some pretty bad stretches I didn't think were possible anymore. So it definitely isn't easy, just have to do our best.

 

I'm glad you are seeing a bit of improvement. Maybe once you feel stable enough you can make some progress on the smoking front and see even more improvement. Been a long haul for you.