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Kernol: was doing well on my sertraline taper but now in hell and doc reinstated

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Kernol

Hi @Altostrata the company are adamant the formula is the same and it is only a name change but I have updosed anyway. If it is the same formulation and it is not due to that could it be that my system is just now registering the lack of vortioxetine and this has caused a bad turn in sertraline withdrawals? 
 

last night was probably the worst night I can ever remember in this whole journey. I fear even trying to sleep tonight if it happens again. Something is definitely very unstable and I am losing all hope. 
 

13/12

 

8.00am strong  electric head feeling and burning in my back. Get up and try and do a work email. Hear children outside on their way to school, strong surge of chemical anxiety comes over me and it goes right through burning into my skull. Tingling and burning all up my back. 
9.00am take 2mg diazepam and try and calm down from the strong surge

10.00am make a cup of tea. Have no appetite so have a smoothie

11.00am try and look at online shopping but I get strong anxiety every time I do so I give up 
12.00pm cannot eat so have a meal replacement drink

12.30pm have another strong chemical anxiety surge feel terror and it burns into my head and back 

1.30pm take 0.75mg diazepam 

2.30pm try some online quizzes

3.30pm do some deep breathing exercises 

4.00pm start browsing the SA site and find other people experiencing this awful chemical terror and random memories etc Almost identical to mine but they have been like that for a year and a half and are considering giving up. I have a massive panic attack after reading this 

5.00pm I am crying and feel so hopeless. I tell myself everyone’s journey is different and I shouldn’t compare but I have got myself in a state 

6.00pm try and put TV on for distraction but I get the chemical anxiety feeling so I turn it off 

6.45pm take 2mg diazepam 

7.45pm just laying in bed so scared and so depressed that I have no hope of recovery 

9.00pm take 17mg sertraline 

9.30pm fall asleep

11.30pm wake with an off the charts chemical panic attack, my brain is on fire, my back and front is intense sizzling burning nerves and my heart feels like it’s shaking about from side to side not like palpitations something quite different. Intense fear

12.00am-1.00am lay awake trying to calm my body and mind down 

1.30am -4.00am sleep but wake after the most horrific dream with dark awful emotions in it. So bad I can’t risk going back to sleep 

5.00am I fall asleep and it comes back the same dream the same awful chemical emotions and I awake to strong slamming down of the teeth 

5.00am-8.00am - I lay here with intense fear and burning all over my back and stomach And tingling on head and face and down both arms. I feel so depressed too because I feel I have no hope now and I will be in this chemical terror for years like the other people and I can’t face anymore. I tell myself people heal and I had a semi window a week ago but I can’t stop thinking that I have destabilised so badly now I face the same fate as them. 

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Altostrata

It doesn't seem like increasing the sertraline did anything good. I'm sorry. I would go back to 16mg.

 

How about adding the 0.25mg diazepam back in your 1:30 p.m. dose, making it 1mg again?

 

I cannot tell the source of this setback. It coincided with the brand change and vortioxetine reduction. It could be either, or something else.

 

You're doing everything right, being very careful with all your drugs. Your system should settle down. Please hang in there.

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Altostrata

Kernol, I might reinstate 0.20mg vortioxetine at 3 p.m. This is to cover possible vortioxetine withdrawal.

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Kernol

Hi @Altostrata I will try that. I have fallen into the darkest depression I have had throughout my whole withdrawal experience I haven’t even been able to write my notes I’m sorry. My teeth were slamming down so hard in the night and my mouth was twitching. I don’t know how I am going to make it through the day 

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Altostrata

Kernol, hang in there, it's hard but you can do it.

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Kernol

Hi @Altostrata I just wanted to check on taking the vortioxetine - is it just a couple of doses to see if it does anything? I don’t know if I can face having to come off it again. 
 

I am holding on by a thread the anxiety is so high but the depression is the worst. I guess my receptors are all over the place. I’m literally trying to get through hour by hour. I am scared and I hallucinated on waking this morning which hasn’t happened in months. My teeth were slamming down so I am guessing maybe it was the destabilisation of the sertraline all along 

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Cathy4

Hang in there, Kernol.  
You’re going to get through this.  Keep breathing, keep breathing and know this is the drugs, it isn’t you.  
HUG

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Altostrata

Kernol, I would try 0.05mg vortioxetine to start. A tiny amount might be enough. I know you don't want to go back on it. I fear you might be finally experiencing withdrawal from vortioxetine. Very hard to tell what's doing what, but the timing would be right. vortioxetine has a washout period of about 2 weeks. December 2 was when you stopped.

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Kernol

Thank you @Cathy4 ❤️

 

1 hour ago, Cathy4 said:

Hang in there, Kernol.  
You’re going to get through this.  Keep breathing, keep breathing and know this is the drugs, it isn’t you.  
HUG


 

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Kernol
1 hour ago, Altostrata said:

Kernol, I would try 0.05mg vortioxetine to start. A tiny amount might be enough. I know you don't want to go back on it. I fear you might be finally experiencing withdrawal from vortioxetine. Very hard to tell what's doing what, but the timing would be right. vortioxetine has a washout period of about 2 weeks. December 2 was when you stopped.


thank you @Altostrata I will take it now, it’s a bit late in the evening but I hope that’s ok. 

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Altostrata

You'll have to keep your excellent notes.

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Kernol

16/12

 

7.00am - pacing the bedroom in a terrible state of agitated depression. Feel so depressed yet so anxious too I can only pace and cry.

8.00am still pacing, tell my husband I don’t know how I will make it through the day. The depression feels different to the depression I have felt during year tapering sertraline. It’s all consuming and I feel totally disconnected from the world 

9.00am take 2mg diazepam

9.30am have a Bath 

10.00am still feel emotionally the same but Less pacing. Tell myself it’s just withdrawal and it won’t last forever

11.00am manage an oat smoothie

12.30pm pacing again and in despair

1.30pm take 1mg diazepam 

2.00pm do some hoovering still with thick cloak of depression 

3.00pm try and lay down to sleep as don’t want to be awake but every time I close my eyes I see images of the past random people place and wake instantly with jolt of fear and doom so get up

4.00pm decide to lay down again but just deep breathe

5.00pm still feel desperate but the breathing is at least stopping the restlessness

6.30pm take 1.75mg diazepam. 
7.00pm bit calmer, able to eat dinner in bed.

7.30pm able to do an online quiz, slightly less overwhelming depression, not sure if it is just because it is nearer to the day being over

8.00pm take 0.05mg vortioxetine 

8.30pm still feeling less depression 

9.00pm take 16mg sertraline

11.30pm - 4.00am sleep ok but have disgusting explicit dream

 

17/12

5.00am - teeth clenching moderate all night. Wake to v strong cortisol rushes 

7.00am - start to feel the depression filling me. Suicidal thoughts are there no plans just the despair of how long will I be able to cope with this pain. Feel v fatigued. Could be premenstrual fatigue as had it 3/4 days before last month 

8.00am have bath feel agitated depression like yesterday. Pacing 

9.00am take 2mg diazepam, pacing 

10,00am - diazepam not taking edge off this morning. Feel fear when I just see people walking outside. Tell myself to get a grip. Depression is strong 

11.00am husband comes in and tells me neighbour has died. I didn’t even know the woman. It feel like a knife through my heart. I feel intense grief and I sob whilst feeling so anxious I pace round the house. I feel like my own mother had just died x 10. I don’t remember feeling this intense pain when she died 3.5 years ago. I am so scared of these indescribably painful emotions. I breathe and tell myself it’s just the drugs and I won’t always react and feel like this 

12.00pm I don’t know what to do with myself. I can’t settle. Emotions are not my own I feel out of control

12:30pm force a piece of peanut butter on toast down 

1.00pm Thoughts of how long I will be like this are ever present. I try and tell myself my nervous system is just trying to readjust. So anxious I am restless but so depressed I can’t see the point in even doing the housework.  I desperately want to go to bed but I know sleep will not come. All I can think of is morbid thoughts, grief, people dying. I feel a complete emotional wreck. 

 

 

Hi @Altostrata here are my notes for yesterday and this morning so you can see them in case you want me to make any changes later today. Thank you 

 

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Altostrata

This was the first time you took 0.05mg vortioxetine this time around? Did you feel worse than usual the following morning?

 

If so, perhaps reinstating the vortioxetine is not necessary.In the evening of December 12, you were feeling a bit better before you took it. Could be your system is settling down from going off vortioxetine. What do you think?

 

I would  take 2mg diazepam at 9 a.m., 1mg diazepam at 1:30, and 2mg diazepam (do not reduce) at 8 p.m. in the evening.

 

Please be aware that depression and demotivation can be a side effect of the benzo. It's the trade-off for subduing some of the other symptoms. When you're a bit more settled, you might reduce the mid-afternoon dose again.

 

Please keep telling yourself this is a bad patch, you can get through it and come out the other side.

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Kernol

Hi @Altostrata I did feel worse today so I don’t think it is settling. It has been intense feelings of grief and dark depression with lots of intrusive weird morbid memories mixed with chemical anxiety relentlessly all day like I am reliving the past and I am just hoping tomorrow might be a little better. I have felt progressively worse each day since I started deteriorating last week so hard to say if last nights dose of vortioxetine had any impact. 
 

I do have this feeling this is due to vortioxetine withdrawal as opposed to diazepam, it’s just my gut feeling and I could be wrong but the intensity of it is worse than the depression I have felt during the sertraline tapers and I have never noticed depression linked with my diazepam up to this point. It just seems so brutal and fast to have come on and as you said the timing is right for the wash out for vortioxetine. 

 

I will take the diazepam as you suggest although I didn’t even notice any effect of it today. I had that dreadful episode of grief mid morning when I would normally be seeing some modicum of diazepam relief. 
 

Thank you, I keep telling myself this will pass and I won’t be stuck in a state of deep grief forever but when you are in it it’s hard to see out! 
 

 

 


 


 

 

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Altostrata

Then I would continue to take 0.05mg vortioxetine. It will take a week or so to ramp up.

 

You are doing beautifully, when you sink down, you bring yourself up. You are stronger than you know.

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Kernol

Hi @Altostrata I am still very destabilised I felt a tiny degree or two less of the overwhelming chemical depression yesterday evening so I didn’t take the vortioxetine I don’t know if I’ve done the right thing. The chemical anxiety was brutal today with some bouts of derealisation but slightly less of the consuming depression.

 

18/12

 

7.00am - got up with all consuming depression like I have never known. I tell myself it is withdrawal as you have never felt this before and it will pass

8.00am have bath

9.00am pacing agitated at the sheer overwhelming depression. Can’t even look outside. Tell myself my brain is just readjusting and it will lift. take 2mg diazepam and have oat smoothie

10.00am doesn’t seem to have had an effect. I am in a lot of emotional pain and distress only able to feel intense grief and depression. I am scared. 
11.00am psychologist visits. I sob. He tries to calm me down telling me it is withdrawal and I will inevitably get better and I must hold on

12.30pm pacing around telling myself my brain will heal and this is not me 

1.00pm take 1mg diazepam 

1.45pm able to sit down. Feel tiny bit calmer. Eat a sandwich 

2.30pm able to talk to my mother in law on phone 

4.00pm I can’t sit any longer as I feel the chemical anxiety every time I think about anything and especially my past for some unknown reason. It feels emotionally painful the anxiety. 
5.00pm I lie down and watch football match with husband, I am deep breathing through it and I can’t watch it 

6.45pm I can’t stand it anymore so I have go take the evening diazepam dose. 
7.30pm a lessening at last, a small bit of respite, even the depression seems slightly better. 
8.30pm able to eat something now and my past no longer causes me to feel grief when I think about it, still some chemical anxiety  in my stomach when I think about anything 

9.00pm take 16mg sertraline 

10.00pm - 3.00am slept ok in and out. Teeth clenching fairly strong 

4.00am wake to strong cortisol panics

5.00am - 7.00am in and out of Sleep waking with the panics 

7.00am get up. Monthly period has arrived. I hope and pray maybe this is why the depression was so severe 

 

19/12

8.00am have a bath. Feel marginally less overwhelming depression than yesterday 

8.30am have bath and notice weird de ja vu occurrences.
9.00amctake 2mg diazepam have oat smoothie

9.30am able to do two work emails 

10.00am notice I am restless and pacing and anxiety is high can’t settle too well but not sobbing like yesterday 

11.00am my dad visits. I make him a cup of tea. Him bringing in Xmas presents makes me cry a bit as I feel so sad to be like this for a second Xmas

12.30pm no appetite so have meal replacement drink 

 I feel the chemical anxiety rising and I have a strong surge when I think about the past. I have to walk around telling myself it won’t always be like this

1.00pm take 1mg diazepam, don’t notice much relief from this. Still getting some surges of chemical anxiety 

2.30pm starting to struggle more now. The anxiety when thinking about the past is upsetting me. Thoughts of whether I will ever be normal again if it wasn’t the vortioxetine causing it then it must be the other drugs and I Can’t continue this awful pain. I tell myself I had a brief semi window only 2 weeks ago and that I must hold on to that 

2.45pm try and lie down to sleep as I feel so anxious with the past constantly running through my mind with high chemical anxiety it feels so painful emotionally I can’t explain it 

3.30pm slept  a little but on waking feel totally disorientated and scared. 
4.00pm ring my mother in law as I’m so scared I just want to speak to someone. Speak to her for an hour. Chemical anxiety is spiking when she mentions anything that relates to the past or places or shops or anything. She tells me I must hold on and that I won’t be like this forever. 
5.15pm pacing waiting for my husband to come home. Feel chemical anxiety surges and general anxiety and restlessness. Some derealisation everything feels unfamiliar and it looks sinister outside. 
6.00pm I can’t eat dinner as in such a state. Have another de ja vu feeling. Pacing 

6.45pm I have to take the diazepam dose earlier. I can’t stand this emotional torture

7.25pm I am now a bit calmer and able to eat some dinner. I can think more clearly now about normal things not just torment going through my mind. 

8.00pm put tv on able to watch cooking programme with anxiety there but muted a bit 

9.00pm take 16mg sertraline 

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Altostrata

You can hold on and let your system settle down from going off vortioxetine, or you can continue to take 0.05mg vortioxetine. The improvement you felt might be from that dose you took 2 days ago.

 

Please remind yourself not to feel sad about being sad. One layer of sad is enough.

 

Good to hear your therapist is supportive. You have to remind yourself, you've been through bad patches, symptoms change, you'll get through this bad patch, too.

 

It's very possible that once you get through vortioxetine withdrawal, you'll feel better.

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Shep
On 12/13/2019 at 8:30 AM, Kernol said:

oh dear it feels like I have destabilised my nervous system again. I feel very bad and it just seems to be getting stronger each day which is really frightening. 

 

On 12/17/2019 at 3:18 PM, Kernol said:

I have felt progressively worse each day since I started deteriorating last week so hard to say if last nights dose of vortioxetine had any impact. 

 

On 12/19/2019 at 4:07 PM, Kernol said:

7.00am get up. Monthly period has arrived. I hope and pray maybe this is why the depression was so severe 

 

Kernol, looking over your thread for the past week, it's possible this recent wave was PMS, since you started to feel destabilized a week prior to your period. If you start feeling better over the coming days, these intense symptoms may have more to do with hormones than with the recent drug changes. If you haven't already seen this thread, it may help to have a read:

 

PMS, PMDD, and menstrual cycle issues during withdrawal and after

 

Knowing you're going to have these upticks in symptoms each month and that it's normal to have these upticks may help settle the worry, especially knowing you'll likely feel better in the coming week. 

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Kernol

Thank you @Shep it’s so strange the dark depression has been replaced by the most strong derealisation I have ever had in this withdrawal journey it has been with me all day so far and getting stronger. The diazepam this morning didn’t touch it at all and I am just pacing around feeling like I’m a stranger in my own house. Is this what they call rapid cycling when symptoms are changing like this? I have still got my monthly cycle and I do think the depression in the last week may have been heightened by hormones dipping but I think this has to be vortioxetine withdrawal as well as I haven’t had anything quite like this before. I am trying to breathe and tell myself it will pass but it’s the most peculiar feeling to be so disorientated in your own home. I can’t think about anything normal or put my mind to anything as I feel so odd like I’m losing my mind

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Shep

As long as you're in the safety of your own home, derealization won't hurt you. Find some relaxing things to do to calm your nervous system. Watching a favorite movie, listening to soft music, playing video games, drawing or coloring, etc. It's hard to enjoy things when you have dp/dr, but it's nothing painful, especially if you don't attach any thoughts or emotions to the feeling of dp/dr, such as fear. 

 

This will get better. 

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Kernol

20/12

 

8.00am got up with extreme anxiety, restless, pacing

9.00am have bath, take 2mg diazepam, have oatbran

10.00am Still feel very anxious, vision very blurred

11.00am can’t settle, lots of memories coming with emotional distress attached to them for no reason

12.30pm vision still blurred, have a strong chemical anxiety surge combined with memories, grief is still present 
1.00pm take 1mg diazepam, have smoothie as no appetite 

1.30pm try and do some online quizzes but I can’t focus

2.00pm pacing a bit

3.00pm trying to think about normal things but can’t focus my mind all I feel is strong restless anxiety 

5.00pm have strong Chemical anxiety reaction with skin burning when watching tv. Feel emotional pain and mental anguish 

6.00pm Take 2mg diazepam

7.00pm manage to eat small meal

8.00pm feel a bit calmer 

9.00pm take 16mg sertraline 

10.00pm - 4.00am restless sleep some burning and teeth clenching very strong 

5.00am high cortisol rushes, very strong. Not sure how I am going to get through the day

 

21/12

7.00am get up and feel strong derealisation and anxiety with strong past memory of a shop. All past memories i think of come with emotional pain for no reason. I feel so upset by this 

8.00am pacing 

9.00am take 2mg diazepam and Have oat bran 

10.00am diazepam not had any effect

11.00am derealisation is getting stronger doesn’t come in waves it’s a constant feeling everything feels so unfamiliar I am so scared

12.00pm try and calm myself but I am failing at even deep breathing 

1.00pm derealisation stronger still. I am trying not to get scared by it but it’s the strongest I’ve had all year. Take 1mg diazepam

2.00pm no effect from diazepam. No appetite so have smoothie

3.00pm try and lie down. As I get sleepy Derealisation gets even worse I look at houses outside the window and they look so unfamiliar 

I worry what if I get totally disconnected from everyone and everything

3.30pm I get up and try and do something. I put the laundry away. Mind going to the past the whole time and I just feel anxious of any memory

4.30pm the derealisation has come down a tiny bit

5.30pm watch football on tv whilst deep breathing. Still getting lots of memories flooding in

6.00pm take 2mg diazepam 

7.00pm manage to eat dinner 

8.00pm lie down totally freaked out and exhausted from the day. I tell myself I have nearly got through it

9.00pm take 16mg sertraline

10.00pm - 2.00am restless sleep 

2.00am-4.00am some night sweats and nightmares and strong teeth clenching 

4.00am get up to go to the bathroom and it’s dark and my vision is like strobe lighting flickering everywhere 

5.00am strong cortisol rushes and anxiety so strong, feel disconnected from the world and memories still coming with emotional pain, anything and everything

6.00am seeing visual hallucinations when opening my eyes 

 

@Altostrata tough 2 days the diazepam is doing nothing and it has changed to anxiety constant derealisation and emotional pain when thinking of past. The very deep depression from last week is not present. I have very strong teeth clenching, Hallucinations on waking. I am trying to tell myself it will pass but I feel very desperate. 

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Altostrata

Perhaps the diazepam is too much. Can you go back to 0.75mg diazepam for the 1 p.m. dose?

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Kernol

Hi @Altostrata I have just taken my evening dose of diazepam and it has calmed me a bit this time. I am pretty certain this is all connected to vortioxetine withdrawal and I’m not sure I could cope with lessening the diazepam dose as things today as usual got much worse from 4-6pm when the peak concentration of it has gone? If I lower the mid dose I am not sure I could cope with the intense emotional pain which has been with me continuously all day today if it is the same tomorrow. 
 

 

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Altostrata

The increased derealization might be from too much diazepam.

 

There's probably not much variation in your diazepam blood level. Generally, diazepam is dosed at once a day.

 

As the drug has a half-life of 3-10 days, you're feeling effects from the doses you took several days ago combined with what you're taking today. The increase of 0.25mg since December 14 has been ramping up every day. The increased diazepam may be responsible for the increased derealization you reported today.

 

You can overdose yourself. Please don't rely on more and more diazepam to settle your system. You may be taking too much already. You must balance the adverse effects (derealization, depression) against whatever benefit it might have. There's a point of declining return in dosage increase.

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Kernol

Thanks @Altostrata I don’t intend to take more. Would it be possible to take the 0.25mg off the evening dose instead of the middle dose as I think that would be easier for me at the moment in the midst of this. Perhaps the diazepam was responsible for the increase in derealisation although I have had less of that today and more intense emotional anxiety and inexplicable grief feelings like last week with me all day - every single minute my mind is on the past it’s like I can’t drag it away no matter what I try and do to distract myself. I also have an increase in burning skin, teeth clenching has got markedly worse, tingling head, vision issues etc so I am guessing this is more than just diazepam as it feels like an even more severe version of my sertraline destabilisation in September. It surely has to be also the removal of vortioxetine that has affected the underlying sertraline destabilisation do you think? It truly is awful and I am struggling to cope with the mental anguish. I just hope and pray it will lessen in intensity in the coming days 

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Altostrata

If the derealization is fluctuating, perhaps you should just keep everything the way it is to get through this patch. The fewer changes, the better.

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Kernol

22/12

 

8.00am got up very strong cortisol rushes and feeling of emotional pain when thinking avoid anything in the past

9.00am take 2mg diazepam, eat oatbran

10.00am feel restless still but emotional pain is slightly dampened

11.00am very scared that I will not be able to think about my life without feeling this inexplicable mental anguish 

12.00pm put some laundry away 

1.00pm have an intrusive memory of a tennis club where I grew up and it comes with the most intense emotional painful anxiety, mental anguish, grief all Together. Knocks me sideways

I can’t stand the pain. I’m so scared this is totally different to the electric anxiety I got when the intrusive memories came in the past weeks. Feel totally not present. Living in some warped emotional past. I’m in shock. I take deep breaths 

take 1mg diazepam 

2.00pm slightly muted the emotional anguish from the memory but I am still so shell shocked from it I can’t think straight 

3.00pm try and watch football on tv. Mind keeps going to the past. I’m checking every minute if I get the emotional pain when I think of the past 

4.00pm I am just deep breathing trying to tell myself that it is just the drugs but I am scared as I don’t know which one is doing this to me

5.00pm go to lay down I’m in such a state. I tell myself I’ve nearly got through another day but I don’t know how many more of this I can endure 

6.00pm take 2mg diazepam 

6..45pm the emotional anguish is muted. I can now think of memories without the pain

7.00pm manage a sandwich 

7.30pm play quiz with husband

8.00pm Lying down a bit calmer because I can think of my life without this awful grief weird anxiety feeling 

9.00pm take 16mg sertraline 

10.30pm - 4.00am sleep ok although teeth clenching is very strong all night

5.00am very strong cortisol rushes panic and fear. I have to lay awake as the minute I close my eyes the fear jolts me awake 

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Kernol

I had hoped that the intrusive memories were the vortioxetine but if they are still happening now I am scared it is in fact the sertraline. They started in August after all my changes. They always seem to come with great force at lunchtime and late afternoon. It’s when the anxiolytic effect of the diazepam has worn off. I didn’t have them when I had my short semi window the other week. The change is the emotion coming with them is no longer the electric anxiety feeling when I was still taking vortioxetine but this painful emotional agony for no reason whatsoever. My brain feels so messed up. This is so so hard. 

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Kernol

23/12

5.00am have to get up and walk around as the terror is too much. All the inocuous memories coming rapid fire but with emotional pAin instead of the electric feeling anxiety I had when still on vortioxetine. So strong. I try and tell myself I can cope but thoughts as to how long I can cope with this intensity fill my mind

7.30am go and have bath, feel totally disconnected don’t feel like Xmas one bit all I can think of is the past anything in the past constantly checking to see if it brings the same awful emotionally painful anxiety and it does. I fear I will be stuck like this for months now

9.00am try and have a cup of tea with family but I feel so removed from them as I am just in my own world of pain I have to leave the room. Took 2mg diaZepam - did not have any effect 

9.30am psychologist visits. He tries to comfort me that this won’t last longer than a few weeks at this intensity but I remind him I have been destabilised for 13 months now and kindled twice along the way so I have no evidence That any of this will improve in weeks. The flashbacks I have suffered for 5 months now. If only I could know this pain and grief mixed with anxiety would last only 2 weeks or so, I could cope with it. I only have a track record of a painful withdrawal behind me to go off and I am worse now than a year ago. I tell myself I must be positive that surely it will not be this intense for long.
11.00am reliving the strong flashback and time travelling incident from yesterday makes me feel the emotional pain and desperation even more intensely 

12.00pm totally disconnected feel like I’m a stranger in my house, freaky feeling. Can’t think of anything normal 

1.00pm take 1mg diazepam I lay on my bed in despair 

3.00pm I’m reliving the past all the time and the emotional pain anxiety is kicking up to intolerable levels 

4.00pm lie on my bed and weep. I weep for 2 hours. It is a release. I thought things were bad reducing the vortioxetine I never imagined they would get so much worse after stopping it. I should have been more prepared. I feel so angry at the doctors who put me in this mess and ruined my life. I feel like I’m fighting for my life, my sanity, fighting to not give up. Survival mode 
6.00pm take 2mg diazepam 

7.00pm Diazepam has not done much probably because the sheer intensity of today’s symptoms have been so high but enough that I can eat in bed I can’t sit with the family 

9.00pm take 16mg sertraline 

10.30pm - 5.00am ok sleep a couple of vivid dreams and woke with strong burning nerve pain on my back. Very strong teeth clenching all night 

5.20am was with strong cortisol rushes with fear and depression, so strong I have to get up and walk around. I feel like I’m in another world to everyone else. The emotional pain type anxiety is already here and strong. I tell myself I can get through another day of pain - survival mode.  I just need it to lessen even a little bit, that would be a relief. I pray for this today. 

 

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Kernol

24/12

 

8.00am get up have bath, feel strong disconnection with my surroundings and feel my mind pulled into the past every minute. Painful anxiety at every innocuous memory. Scared. Tell myself if will pass soon and my brain is just confused right now trying to heal 

9.00am take 2mg diazepam, feel tiny bit calmer - still feel like I’m in a parallel universe but able to converse with family. Have oat bran

10.00am wrap some presents. Still feel my mind going to the past like a checking thing every 2 minutes 

11.30am starting to struggle a bit more now, feeling like I’m in another world and struggling to be present. Feel emotional anxiety 

12.30pm Lay down in my room 
1.00pm take 1mg diazepam

1.30pm Manage to eat sandwich 

2.30pm still struggling to focus on anything or hold a conversation 

4.00pm try and watch tv but get intense random memories that come rapid fire one after another like a memory bank opening. I have to Leave the room, I feel disconnected and unfamiliar in my surroundings like I’m actually living 25 years ago. I truly feel like I’ve gone mad. I tell myself repeatedly others have had similar experiences and it has gone away and I won’t always have these. 

5.00pm lying on bed scared and feel like a vulnerable child. Try deep breathing but it isn’t helping with calming me as I feel brain damaged and keep thinking I will feel this emotional torture forever now. A permanent bad acid trip. Too much damage, too many destabilisations, no windows. I tell myself I can’t know what will happen and I will heal in time and I just have to keep holding on 

6.00pm take 2mg diazepam 
7.00pm able to eat a small meal

8.00pm tv is on Don’t feel as much weird emotional anxiety when thinking about past 

9.00pm take 16mg sertraline 

10.30pm - 4.00am sleep ok except for v strong teeth clenching 

5.00am wake with intense strong cortisol rushes 

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Altostrata

This actually looks more even than December 23?

 

On 12/23/2019 at 7:06 AM, Kernol said:

It’s when the anxiolytic effect of the diazepam has worn off.

 

Kernol, the diazepam is not wearing off in the afternoon, it's getting stronger from the 3mg diazepam you've taken earlier in the day. I am concerned that you might be getting derealization or a paradoxical reaction as a side effect in the afternoon.

 

I know you think of the diazepam as a safety net, but it's possible to take too much. Do you want to watch this pattern for week to see if it continues? @Shep

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Kernol

Hi @Altostrata when i spoke to @Shep a few weeks back she confirmed that peak effect is 1 -1.5 hours after dose and that is why I am getting the anxiolytic effect during this time and then it wears off. I am not sure it is a paradoxical effect as a few weeks ago when I was feeling a bit better I did not have any of this but was taking the same dose of diazepam and I was having to remind myself to take my dose. I think it has to be vortioxetine as things have changed dramatically over the last 2 weeks, a crash. 

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Kernol
On 11/27/2019 at 3:49 PM, Kernol said:

Thanks @Shep I will try and get more consistent with my eating. I note it says the peak concentration is between 1.25 hours - 2.5 hours depending on eating. That seems to correlate with the duration of anxiolytic effect I get from it - would that seem right? As I mentioned I have never had a long duration effect from it despite the long half life. 


 

On 11/28/2019 at 2:53 PM, Shep said:

 

Correct, yes, I think you're responding to the peak plasma concentration which is what's giving you the anxiolytic effect. 

 

It looks like you're putting too much meaning into the memory flashbacks and other reactive emotions to certain pictures. Please work on learning some mindfulness skills so you can detach your thoughts from the memories and images. You'll feel a lot more relaxed once you master these types of mindfulness techniques. 

 

In this post What is happening in your brain?, Altostrate is quoting an article by Parker who gives a really good description of the reason you're having these kinds of flashbacks due to the benzo (and people withdrawing from antidepressants also have similar experiences). I've quoted the parts on the amygdala and hippocampus in the quote box below, but when you're up to it, you may want to read the entire article. 

 

Basically, the fear center of your brain has gone on high alert and it's searching for anything in your memory center to match up to that level of fear. This can cause you to re-live very painful times in your life or simply feel intense fear for no reason at all. 

 

It's important to work on self care and learn some mindfulness skills, such as not attaching your thoughts to these flashbacks. Simply let them happen as if they are a disturbing tv show. It's not real, just your brain going in feedback loops.

 

Distraction can also be helpful, such as learning to "change the channel" so you don't go into an emotional spiral. Here's information on this on other related issues:

 

Change the channel" -- dealing with cognitive symptoms

 

Dealing With Emotional Spirals

 

Neuro-emotion

 

 

 

 

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Altostrata

The effect from a single isolated dose may peak in 1.5 hours but when you take a drug every day, there's still drug from the prior day in your nervous system. In your case, there are 3 overlaps every day from the prior day's dosing. Think of it as layers. When you wake up in the morning, you have about 63 layers of diazepam in you from the prior 21 days' dosing 3 times a day.

 

Since diazepam has such a long half-life -- It takes several weeks to go away -- the amount in your bloodstream increases as you dose throughout the day. Think of it as a bulge in the afternoon. Since you stop dosing at 6 p.m., overnight you might experience a lowering of plasma diazepam as the bulge wears off, but you start ramping it up again the next morning. You may feel a peak plasma effect as the first morning dose causes plasma diazepam to rise, but after that, it's not likely.

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Kernol

Thanks @Altostrata would I not notice a paradoxical effect after my evening dose if it was caused by diazepam build up over the day? I never do so I’m just struggling to work it out. I still do think the diazepam is just muting some of the effects of the AD issues but how can we possibly tell the difference? It’s so hard to know what is doing what but I have a feeling the vortioxetine withdrawal has to be involved in this somewhere. Given I took it for 6 months and I am only 3 weeks completely off it - I guess it is to be expected I may still be in the midst of acute withdrawal??

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