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

[Altostrata]

It's possible you're experiencing some withdrawal effect from vortioxetine, but a symptom that occurs regularly every day is more likely due to something else you do regularly every day.

 

Except for early morning cortisol hypersensitivity, which you've had consistently throughout, withdrawal symptoms are more random.

 

Removing the vortioxetine may have caused a shift in the effect of the other drugs. Since we didn't know exactly how the vortioxetine was interacting with diazepam or sertraline, it's hard to say what's going on. Are you feeling more of an effect from sertraline or diazepam? Are you metabolizing sertraline faster now? We don't know.

 

At one point, at my suggestion, you had reduced diazepam by 0.25mg and felt better for a period. (I broke my own rule, you were tapering vortioxetine at the same time.) Again at my suggestion you recently increased it. These changes may have caused changes in symptoms too.

 

My intuition is the 1mg diazepam at 1 p.m. might be contributing to paradoxical reaction -- feeling dazed and scrambled -- in the afternoon, which coincides with peak plasma from the 1 p.m. dose. I would like @Shep to look at this.

[Shep]

Before making any changes, I want to ask - Kernol, are you seeing any relief from symptoms that you think were caused or made worse by PMS?  I would hate for you to make changes to anything that resolves on its own. 

 

Please post your thoughts on this. 

[Kernol]

Hi @Shep the extreme severe depression that I believe was vortioxetine withdrawal exacerbated by hormones has lessened somewhat but random memories, high anxiety all day has got worse. Appetite has gone. Morning cortisol spikes much stronger. Obsessive thoughts. Derealisation. Today I have not noticed any anxiolytic effect from morning dose of diazepam. It is relentless with no relief from the minute I wake up. Teeth clenching has been bad for at least a week maybe more

[Kernol]

25/12

 

8.00am got up felt very strong anxiety, mind immediately going to old memories to check if they cause extreme emotionally painful anxiety. They do so I despair. 

8.30am try and participate in conversation but mind is continually checking past memories or whatever in conversation reminds me of past is triggering me. Feel like I have a severe form of OCD, I only have one train of thought at moment. I feel deeply disturbed like I am being emotionally tortured. 

9.00am take 2mg diazepam, have smoothie

10.00am manage to open presents with family 

10.30am the Xmas carols on radio cause an extreme anxiety reaction and I get an intrusive memory of childhood. Feel grief and chemical anxiety at same time. This is so hard. I try and compose myself upstairs breathing on bed re-reading the excerpt about why the brain produces random memories and why they come with intense fear for no reason. I tell myself I will  surely heal in time 

12.00pm still continuously obsessing over past. How does this memory make me feel? etc Feel like I’m stuck in a loop. The intensity of the reaction from the memories is extreme and distressing. I tell myself I have to accept this for now. Until the extreme reaction lessens I will need to accept it.

1.00pm take 1mg diazepam 

2.00pm able to eat dinner with family 

4.00pm Go go bed tired - sleep for one hour 

5.30pm feel some strong anxiety coming with only half formed memories that I think are intrusive flashbacks but my head is so much in the past now sometimes I don’t know which ones are flashbacks and and which ones aren’t. The anxiety is gut wrenching and so painful emotionally. When I was taking vortioxetine I had same intense random flashbacks but coming with this electrical chemical anxiety now it seems to be replaced by this emotionally painful anxiety. Both awful but I think this one is even more distressing.

6.00pm take 2mg diazepam 

7.00pm able to watch a bit of TV but still checking memories every 2 or 3 minutes. It is obsessive rumination. I can’t seem to stop doing it

9.00pm take 16mg sertraline

10.30pm -4.00am - sleep ok bit restless but not too bad. Teeth clenching very strong.

4.30am strong cortisol rushes, flashbacks and painful emotional anxiety waking me every 10 minutes until 7.00am. Feel depressed at thought of fighting my way through another day of this. I just wish for a slight lessening of the anxiety then maybe the obsession would lessen

 

[Shep]

14 hours ago, Kernol said:

8.00am got up felt very strong anxiety, mind immediately going to old memories to check if they cause extreme emotionally painful anxiety. They do so I despair. 

8.30am try and participate in conversation but mind is continually checking past memories or whatever in conversation reminds me of past is triggering me. Feel like I have a severe form of OCD, I only have one train of thought at moment. I feel deeply disturbed like I am being emotionally tortured. 

 

Kernol, these thoughts and memories are just a TV set playing. They aren't directed at you unless you engage with them. Why would you do that? 

 

Find something else to do. 

 

"Change the channel" - dealing with cognitive symptoms

 

Dealing With Emotional Spirals

 

You are going to exhaust yourself until you learn to go about your day with these thoughts and memories playing in the background. 

 

Find 5 distractions. Write them down. When you first get up, eat breakfast and then go to one of your distractions. 

 

When this becomes habit, those thoughts and memories will just be background noise. 

 

I also think the holiday season may be in play here, which can be an emotional time filled with memories, especially if you are around relatives who've known you all your life and make you think of the past. 

 

But the holidays are coming to an end and life as normal will return, or as normal as it can be for folks in withdrawal. 

 

14 hours ago, Kernol said:

10.30pm -4.00am - sleep ok bit restless but not too bad.

 

From reading over several days of your journal, it looks like sleep is improving overall. Do you think this is true? 

 

On 12/25/2019 at 3:58 PM, Altostrata said:

At one point, at my suggestion, you had reduced diazepam by 0.25mg and felt better for a period. (I broke my own rule, you were tapering vortioxetine at the same time.) Again at my suggestion you recently increased it. These changes may have caused changes in symptoms too.

 

My intuition is the 1mg diazepam at 1 p.m. might be contributing to paradoxical reaction -- feeling dazed and scrambled -- in the afternoon, which coincides with peak plasma from the 1 p.m. dose. I would like @Shep to look at this.

 

If reducing the diazepam is helpful, Kernol, it may be worth a try to take another small reduction. It appears to be overly sedating when you first take it, as you mention needing to lie down after that afternoon dose in several of your recent journals. 

 

I would go very slowly because it does look like your sleep is better now.

 

Please post your thoughts. 

 

 

[Kernol]

Hi @Shep thank you for your help. I am trying to distract myself as much as possible. I will keep going with that. I think I have just been blindsided by the change in the feelings and emotions that have come over the last 2 weeks and I am scared by their strength. I tell myself they won’t always be like this. I hold on to the hope that this will settle soon and tell myself i can get through another hour and another day.

 

I do sometimes lie down in the afternoon but I think that is more because I just want to escape than the diazepam. 
 

my sleep is ok apart from the teeth clenching which does wake me and I’m waking with early cortisol rushes but I am grateful I can get to sleep easily. 
 

I still think that the vortioxetine withdrawal is at play here because of the intense change in emotions and it may have destabilised the underlying sertraline destabilisation which is also why the teeth clenching has become very strong again? 
 

What would you suggest I reduce diazepam to?

One thing I thought might be worth mentioning is that for many weeks in fact maybe months I could almost set my clock when I get these extreme explosions of anxiety and random memories. It is always at around 1pm usually before my second dose and then later again around 4 or 5pm. The anxiety and memories are there at other times but there seems to be an escalation to extreme levels at these two times. What do you think this could mean? 

 

[Kernol]

@Shep as an example. Had an extreme episode of brutal chemical anxiety at 1.00pm today that left me in utter despair it was so strong and off the scale chemical feeling. Took 1mg at 1.15pm. It is now 2.50pm and it has calmed down. 

[Kernol]

And now at 4pm the chemical anxiety is rising to unbearable levels with head and back burning and tingling. I could set my watch by it. 

 

question is whether it is the Diazepam anxiolytic effect wearing off laying bare the AD withdrawals underneath or whether it is some kind of rebound/paradoxical reaction to the diazepam itself. 
 

I don’t want to reduce the diazepam if it is muting the strong AD withdrawal at the moment but if it is the cause then I obviously would like to. How can I test it without messing things up? 

[Kernol]

26/12

 

8.00am get up feel weird like I’m living in the past and every sound or image reminds me of the past and I feel this chemical anxiety. Head in tingling and down arms 

9.00am have bath, take 2mg diazepam, have peanut butter on toast

10.00am try and busy myself doing housework continuously reassuring myself these feelings will go and one day thinking will be normal again 

11.00am try and engage in conversation with family and ignore the constant wandering of the mind to the past 

12.00pm have to lie down as I get horrible feeling of doom in my stomach so strong 

1.00pm deep breathing on bed. World feels warped and distorted I feel like I can’t think about anything normally. My head starts to burn and tingle. Take 1mg diazepam. 
2.00pm able to get up and watch some Tv and eat sandwich

3.00pm do laundry 

4.00pm watching TV and feel the anxiety rising. Horse racing on tv reminds me of my aunt and uncle and feel deep intense fear for no reason. Tell myself this will pass and one day I will be able to think of them normally again. head starts to burn 

5.00pm sit in my bedroom to deep breathe. 
6.00pm take 2mg diazepam. Manage to eat dinner but in my room as emotions are dark and intense and I cant sit with them

7.00pm tiny bit calmer 

8.00pm watch football match with husband in bed

9.00pm take 16mg sertraline 

10.30pm sleep

11.30pm wake with strong panic attack 

12.00am -4.00am sleep but with strong teeth clenching 

4.30am strong cortisol rushes but with dark deep doom and rapid fire memories until 7.00am

 

27/12

 

8.00am get up and pace a bit as memories are coming thick and fast. Decide to have bath 

9.00am take 2mg diazepam 

10.00am do laundry and vacuum

11.00am sit and do crossword. Still feeling anxious

12.30pm eat sandwich 

1.00pm just sitting in living room and TV is on. Man on tv looks a bit like someone I knew at school. The anxiety goes crazy, deep emotional pain, reminds me of childhood, road where I lived, my mum, there is grief, doom, dread it’s chemical it’s alien. My head burns. I leave room

1.15pm take 1mg diazepam 

2.00pm bit calmer, can think of the memory still with some of that feeling but muted slightly so I can cope

3.00pm able to carry on watching tv

4.00pm another chemical explosion of anxiety. Again about the past. Awful strong painful emotions. Head burns back burns 

4.45pm somehow manage to calm down or maybe it just passed

5.00pm do some deep breathing 

6.00pm take 2mg diazepam 

7.00pm able to eat dinner at table 

8.00pm watch football match on tv. Anxiety and past memories are muted 

9.00pm take 16mg sertraline 

10.30pm fall asleep

12.00am have nightmare and wake disorientated in terror and in a cold sweat

1.00am -4.00am restless sleep with Very strong teeth clenching 

5.00am strong cortisol rushes but again with a deep doom feeling. 
6.00am wake with despair 

[Shep]

3 hours ago, Kernol said:

4.00pm watching TV and feel the anxiety rising. Horse racing on tv reminds me of my aunt and uncle and feel deep intense fear for no reason. Tell myself this will pass and one day I will be able to think of them normally again.

 

I think this is a key insight - you noticed that your feelings of fear had no reason, especially within the context of your aunt and uncle, and you will be able to think of them clearly once you're recovered. 

 

But if possible, try to avoid thinking of people or events even when you've healed. Don't engage even in this way because you're still giving these memories and thoughts attention and importance, and this gives them power.

 

Instead, completely disengage with these thoughts and memories. There's no reason you need to rationalize them. 

 

They are like a TV show or annoying neighbors making noise. Once you can relegate the memories and intrusive thoughts to noise, you lose some of the intense emotions, such as fear. If you can do this, you'll be able to put down this heavy emotional baggage you're carrying. Trying to deal with these intrusive thoughts and memories is exhausting. Make them noise and then, as best as you can, tune out the noise. 

 

This is a very advanced mindfulness practice, but if you can do this, you'll come out of this journey with some stellar non-drug coping skills. Also, be grateful for the intrusive thoughts and memories because they are giving you an opportunity to practice these mindfulness skills. Showing gratitude for these intense symptoms is another way of reducing their power over you. 

 

On 12/27/2019 at 11:11 AM, Kernol said:

I don’t want to reduce the diazepam if it is muting the strong AD withdrawal at the moment but if it is the cause then I obviously would like to. How can I test it without messing things up? 

 

On 12/25/2019 at 3:58 PM, Altostrata said:

At one point, at my suggestion, you had reduced diazepam by 0.25mg and felt better for a period. (I broke my own rule, you were tapering vortioxetine at the same time.) Again at my suggestion you recently increased it. These changes may have caused changes in symptoms too.

 

Kernol, is your signature up to date? I don't think it includes your most recent benzo changes. Please go ahead and update it:

 

Account Settings - Create or Update Your Signature

 

It depends on when you've made these changes as to what you'll want to reduce it to, if you decide to do so. 

 

Once you post this information, we can better guide you in a dose. 

[Altostrata]

6 hours ago, Kernol said:

12.00pm have to lie down as I get horrible feeling of doom in my stomach so strong 

....

4.00pm watching TV and feel the anxiety rising.

 

I am seeing this repeated pattern 3 hours after the 9 a.m. and 1 p.m. diazepam dose, respectively. I interpret these as paradoxical reactions to the 2 diazepam doses.

 

(Other stuff happens after the nighttime diazepam dose, but the sertraline at 9 p.m. is a confound.)

 

Reducing the 1p.m. dose to 0.75mg diazepam as before will slightly lower the plasma blood level of the drug overall.

 

Kernol, please do detail the benzo changes over the last 2 weeks, that will be helpful for @Shep and me.

[Kernol]

Hi @Shep I have updated it now. Thank you for you insights into how to deal with these intense symptoms. I am trying my best to disengage with the strong emotions they bring. It is hard as the feelings are so strong and have a chemical feeling like a bad acid trip not me or like any emotion I have ever felt before but I continue to practice and try and find a way through. I practice acceptance meditations daily. I am struggling though I’ve got to be honest, it is a brutal journey at the moment. 

[Shep]

20 minutes ago, Altostrata said:

Reducing the 1p.m. dose to 0.75mg diazepam as before will slightly lower the plasma blood level of the drug overall.

 

@Kernol Thank you for updating your signature. Alto mentioned that with the vortioxetine removed (which is a stimulating drug), you may now not need as much benzo, and I agree. 

 

Since your last diazepam change was December 15, you're within a safe timeframe to make an adjustment. 

 

Alto's suggestion of .75 mg diazepam at  1 pm sounds like a good path forward. 

 

Please post your thoughts. 

 

26 minutes ago, Kernol said:

I practice acceptance meditations daily.

 

That's another great coping technique. I know it may not seem to be helping right now, but once you catch a break from these severe symptoms and have less to deal with, I know you'll appreciate the skills your learning. 

 

[Kernol]

Hi @Shep sure I’m happy to try the reduction from tomorrow. Thank you for your help 

[Kernol]

28/12

 

8.00am Very strong cortisol rushes - I wonder why they are getting stronger these days? 
wake with strong memory and guilt for something I did as a teenager. Try and dismiss it

9.00am have bath take 2mg diazepam. Quite restless possibly because I know I am going to be on my own for 2 days. Eat some fruit as no appetite at all I feel nauseous 

10.00am mind checking the past all the time to see if it makes me feel weird. I tell myself not to but it seems compulsive. I let it happen and tell myself to just refocus on the present. 
11.00am starting to feel very restless now. I know my husband is leaving for 2 days in an hour. I am beginning to panic. I feel like a helpless child and berate myself and the drugs for this. I used to be a competent woman before this reduced me to a shell

12.00pm they leave and I pace. I do vacuuming and tidy around. Can’t sit down have to keep moving 

12.30pm text my psychologist tell him I’m struggling. Have protein drink as no appetite 

1.00pm call my husband in car and do crossword over the phone anything to try and distract myself. Take 1mg diazepam 

1.30pm minutes seem like hours. Why can’t I just find some way of self soothing? I try deep breathing but I have to keep moving so it’s not really helping too well. Try some affirmations that I will heal

2.30pm chemical anxiety feeling starts and the past comes to my mind and I feel sick with anxiety. My brain starts to burn and skin pain starts. I walk around telling myself I am ok these emotions can’t hurt me they are just drug related and not me I try not to engage in second fear

3.00pm I try and lay down maybe sleep will help. I manage to lay still and breathe. I put big bang theory on tv

3.30pm the Big Bang theory is giving me the chemical anxiety feeling and random memories of the past. I turn it off. My stomach and back are burning my head is tingling 

4.00pm I lie still in bed telling myself over and over that I will heal I won’t be like this forever. That All I need to do is get through each day at the moment. That I am safe. I am at home it’s a Saturday even if it doesn’t feel familiar. I try and conjure up the feelings of peace.

5.00pm my psychologist calls. He suggests I try an exercise video. I ask him for reassurance again that people heal from this. He reassures me but it means nothing to me. I have read too many horror stories and I fear I am one of them. I stop myself. I tell myself I must believe. The other part of me says I am doomed to be like this forever as I am not even off the drugs. How can healing even be happening whilst still on them? I think of suicide a lot as a way our if I don’t improve even though I don’t want to die. 

6.00pm took 2mg diazepam. Feel a bit calmer. I manage a sandwich. 
7.00pm I lie still and listen to healing acceptance meditation 

8.00pm notice electric shock feelings on stomach 

9.00pm take 16mg sertraline 

9.30pm - 3.30am - sleep ok no nightmares. Teeth clenching very strong and slamming down 

4.00am cortisol rushes start and get stronger and stronger with teeth clenching until 7am

 

[Kernol]

29/12

 

8.00am lay in bed with strong cortisol rushes more getting stronger these last few days

9.00am take 2mg diazepam. Want to go back to sleep

10.30am sleep in and out of random memories and wake with strong panic attack 

11.00am have Bath. Feel anxious and a bit disorientated but ok

12.00pm have sandwich 

1.00pm call my husband to Chat as I m restless take 0.75mg diazepam 

1.30pm sit with a cup of tea and do some deep breathing 

2.20pm feel chemical anxiety kicking up a bit When I think of anything. Head tingling 

3.00pm speak to husband on phone again - chemical feeling not as bad

4.00pm watch football on TV. 

5.30pm make myself dinner 

6.00pm take 2mg diazepam 

7.00pm go to bed and watch some tv. Look at floor tiles online 

9.00pm take 16mg sertraline 

11.00pm still awake. 
12.00am - 4.00am sleep ok but wake with night sweats and burning skin on back and leg

4.30am wake with my teeth SLAMMING down in my mouth 

5.00am wake with extremely strong cortisol rushes - repeated waking each one getting stronger 

 

30/12

8.00am get up and have Bath. Feel a bit depressed more than yesterday and very fatigued I look ill in the mirror 

9.00am take 2mg diazepam. Notice tiredness is increasing. Have smoothie. Cannot read anything on my phone so blurred 

10.30am eyes are getting heavy - what is wrong with me? I notice I have breast tenderness and pelvic pain too a mid cycle. Oh gosh I do hope this doesn’t mean I am going to be affected at mid cycle as well as pre menstrual 

11.30am fatigue and depression getting stronger like I have no energy at all

12.30pm eat some toast 

1.00pm take 0.75mg diazepam. Fall asleep on sofa. Horrible toxic sleep of random old dreams, cortisol rushes, in and out of sleep and then disorientated on waking 

2.20pm. Get up and splash water on my face. I am so tired but I can feel the anxiety rising 

4.00pm lay on bed. Can’t stand the tv all the programmes make me feel doom and anxiety. I lay still and try and tell myself it is just a bad day. I feel haunted by the place I grew up, can’t think of anywhere there without feeling overwhelming anxiety, depression - makes me feel nauseated. My mind plays over people that have died. My stomach and back is burning intensely 
5.00pm so overcome with this horrific grief type anxiety and doom and depression I actually vomit. I tell my husband I can’t go on like this. The emotional pain and suffering is too great. 
5.30pm try and listen to a withdrawal meditation on YouTube which I have found comfort in before but I have to switch it off after one minute as it just intensified the anxiety and doom. I think it’s because of the reality of the withdrawal process is too much for me to even think about in this state. 
6.00pm take 2mg diazepam. 
6.35pm - it’s like I have returned to the world and I can think a bit better and the extreme overwhelming darkness has gone. I know it won’t last but I take the respite. 
 

@Altostrata @Shep a truly awful day today. I don’t understand what is happening to me. Teeth slamming down again, very high cortisol rushes in morning and then this awful fatigue and intense emotional pain and terror. Do you think this could be a mid cycle hormonal thing? Or am I just very destabilised? I got some relief the only relief of the day from my evening diazepam dose.  I am losing hope that I will ever recover especially whilst I am still taking sertraline I have never stabilised and 13 months of deterioration and fighting through every day just to survive is so hard when I see no progress I just have more symptoms. I’m sorry to be so negative I’m just finding it hard to hold onto hope. I had really wanted the chemical terror to be due to the vortioxetine but I now guess it wasn’t. 

[Altostrata]

Your symptoms got better in the evening. Hold onto that.

 

It will take some time for the diazepam reduction to take effect.

 

Did we talk about moving sertraline earlier in the day? That might be causing the jaw tension.

[Kernol]

Hi @Altostrata I am a bit scared to move the sertraline earlier as I have always taken it at night over the 11 years I was on it and if I every forgot a dose I would have terrible nightmares and night sweats and be unable to sleep until I took it and my fear is I would not be able to sleep if I take it earlier? 
 

I hope the diazepam reduction will help although I’m worried it is actually the sertraline destabilisation that has been causing this chemical terror, flashbacks all along as it all started with my down dosing to 8mg in August. I hope I am wrong and it is a paradoxical reaction to diazepam. 
 

thank you for helping me 

[Altostrata]

Hard to tell what's going on when you're taking multiple drugs. Moving the sertraline earlier would allow us to see what symptoms travel with the sertraline. You'd have to remember to take it, of course.

[Kernol]

Ok thanks @Altostrata I suppose if I took it earlier and I couldn’t sleep I could always move it back again? Should I wait to do this or go ahead tonight and move it an hour earlier? 

[Altostrata]

It would be best to see the effect of the diazepam reduction over a week before making a change in the sertraline.

[Kernol]

Ok thank you @Altostrata I also wanted to ask if I should be trying fish oil to try and aid the healing process or is that too risky for me? I just want to do anything I can to help my brain. I know you are so busy so no rush to answer sorry for all the questions. 

[Altostrata]

Yes, you might find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Try a little bit of one at a time to see how it affects you.

 

Also, what is your vitamin B12 blood level? And vitamin D? Has your doctor checked those?

 

[Kernol]

Thanks @Altostrata I will read through and try some fish oil. I had my bloods checked at the beginning of the year and vitamin d and b12 were okay then. I am not well enough to leave the house to go to the doctors or anywhere at the moment to have it tested again. 
 

I did wonder about evening primrose oil as I clearly have a strong uptick in withdrawal connected to hormones, I believe I am peri-menopausal but maybe fish oil is best to try first. 

[Kernol]

30/12

 

7.00pm manage some dinner 

8.30pm the temporary relief from the diazepam has worn off and can feel the doom dark dread feelings getting a bit stronger again and intrusive memories get stronger. Lie still in bed breathing. Try and watch TV and the reaction is so Incredibly intense I turn it off straightaway. Utter terror and grief feeling like someone had just died. So extreme so powerful. I feel like my nervous system must be soo broken to produce that.

9.00pm take 16mg sertraline. Past dreams come at me rapid fire some feel very old some recent as I try and drop off to sleep. There are scary images too - horror movie faces when I close my eyes 

10.00pm -4.00am hardly sleeping keep waking with depression and terror feelings. I can usually sleep some but not tonight. I feel deeply disturbed lying awake wanting so much to be better to be different just a bit better even 

4.00am fell asleep but woke with strong teeth clenching at 5.30am with my back stinging and burning like it has been burnt by a fire and my head is tingling. I have pain under surface of my stomach - had it before with sertraline destabilisation 

 

31/12

6.00am very very strong cortisol panics so get up and feel depressed and strong feeling of dread in my stomach 

7.00am lay down again and so drowsy I fall asleep. Have dark dreams about a friend who died some years ago. Strong cortisol panics waking me but I can’t get out of the dream even though I’m awake. This is so scary. I am hallucinating when I am waking seeing people in my room. As I wake fully they are gone. My head is sizzling and tingling all over.  I am so tired so drowsy

8.00am get up still feeling like I’m in the dream totally and utterly disorientated trying to ground myself. This is like a new hell. Intrusive memories are coming one after another 

9.00am take 2mg diazepam have bath have meal replacement drink as no appetite and feel nauseous. I keep heaving with the emotion. 

10.00am able to think a bit calmer now only a touch but I try my best to do things I need to do like laundry and ordering a gift online Although my vision is blurry it is hard to focus but I do it

11.30am the darkness is starting to descend again. I start heaving with the emotion. I don’t vomit but almost wish I could perhaps it would be a release. Random memories of the past come intrusively over and over and over and then All I can think of is the past and where I grew up places people fill me with doom and dread so strong and emotionally painful in my stomach. I tell myself I won’t always be like this but the pain is so great I can’t bear it. I feel utterly broken

12.00pm I start to pace. I repeat over and over that I will get better and heal but not one part of Me can feel it as all I feel is this dark depressing anxiety. I think of going to a hospital - but what can they do? They can’t help me repair the damage. still dry wretching and want to vomit because the emotions are so strong 

12.30pm manage to drink meal replacement drink. Can’t eat at all 

1.00pm take 0.75mg diazepam 

1.30pm try and watch tv with husband but I can’t it’s all too dark. 
2.00pm I lie down as if I keep still I might be calmer. My stomach starts to burn like I’ve Been scorched and I start to feel the flank pains under the skin again. I am a bit calmer as long as I don’t move and I don’t fall asleep as I know the sleep will be toxic and I will wake disorientated. I keep my eyes open

3.00pm my husband lays on the bed with me he reads a book and I just watch him and wonder if I will ever have the peace to read a book again. I feel sad for him that he has been lumbered With this. 
4.00pm I Lie still but feelings of terror are still there. I start to have suicidal thoughts. There is only so long one can go on in this emotional hell. I tell myself surely things will get better soon I have fought so hard for 13 months I can’t give up now. I start to think about whether I would be better on more sertraline less sertraline no sertraline- if I hang on in the hope of stabilisation and it doesn’t come - then what? I am trapped With no respite. I am envious of everyone celebrating tonight. I tell myself not to feel self pity it won’t help. 
5.30pm still laying still trying not to move even. Shock like pains on stomach are there again. I recognise them from previous sertraline destabilisation.  Scorching Skin pain on back is also present. 

5.45pm strong emotions depression anxiety grief all together making me want to vomit again. I try and calm myself with breathing but it’s not helping today or yesterday. I dare not even try the meditation as that gave me terror when I started to play it yesterday. 
6.00pm take 2mg diazepam 
6.25pm the mind is a tiny bit calmer the strong emotions in the stomach now muted but only very slightly. Still distressed still nauseous with emotion just laying still. Memories still coming in. 

 

hi @Altostrata @Shep I seem to be getting worse. I fear this is AD withdrawal and whether there is a paradoxical reaction to diazepam as well I am not sure but it feels like earlier destabilisations I have experienced except this time even more severe. 
 

has anyone ever got better that has destabilised so many times as me? I am so scared this is it for me now and too much damage has been done. I can’t remain in this state for weeks or months hoping to stabilise. I am a strong person but this has broken me.  I don’t know what my chances are for stabilising on the sertraline now after all that has happened over the last 13 months. Sometimes I think should I go up or go down if I am so ill now but I know you say holding is the best but when you get worse  it’s so hard to just wait and pray that my brain will heal at least to a manageable wd level whilst on it. 

 

 

[Shep]

17 hours ago, Kernol said:

has anyone ever got better that has destabilised so many times as me? I am so scared this is it for me now and too much damage has been done. I can’t remain in this state for weeks or months hoping to stabilise. I am a strong person but this has broken me.  I don’t know what my chances are for stabilising on the sertraline now after all that has happened over the last 13 months. Sometimes I think should I go up or go down if I am so ill now but I know you say holding is the best but when you get worse  it’s so hard to just wait and pray that my brain will heal at least to a manageable wd level whilst on it. 

 

Most people come into these forums destabilized. It's not until most of realize our doctors have no answers that we wake up from being mystified by doctors and medicine and hit the internet in search of answers. So many of the success stories here are from people who've recovered from massive amounts of destabilization. There's no reason to think you won't heal, Kernol. Please push those thoughts aside. 

 

Regarding what to do next, you'll have to weigh the pros and cons of tapering or holding. This involves weighing the increase in symptoms from tapering against the increase in symptoms due to battle fatigue from holding while being sick for months at a time. 

 

You have made progress already and you are now completely off Vortioxetine. This is good progress. 

 

Some people have large upticks in symptoms over the holidays due to change in diet due to holidays foods and / or the stress of being around people or the stress of being isolated, depending on your own individual circumstances. So perhaps giving yourself a week or two now that the holidays have passed before making any changes may be helpful. 

 

[Shep]

Kernol, what is the name of the meal replacement drink you're using?

 

Many of these types of drinks contain MSG and / or other additives that can ramp up symptoms. Before making any other changes, let's take a look and see if that may be a problem for you. 

[Kernol]

Thanks @Shep I checked the box it doesn’t have MSg in it and I have only had a few of them and none over the last two days. I think I am maybe just dealing with my brain trying to acclimatise to not having vortioxetine and it has just ramped up the underlying sertraline withdrawal symptoms and added a few more. I guess this is to be expected as I’ve taken away a serotogenic drug it had for 5 months and maybe it is just trying to acclimatise itself again? It has only been 4 weeks since I stopped? This is what I am hoping and that maybe this will even out to at least a more bearable level soon. Of course the diazepam could also be playing a part. plus I have extreme breast tenderness since day 12 of my cycle so my hormones are a bit messed up too. I’m now on day 16 and still very painful. 
 

symptoms that have increased over the last few weeks are:

grief like depression/anxiety/terror 

bizarre strong chemical feeling anxiety reaction when thinking about anything to do with the past 

Toxic sleep with scary images and dark emotions in my dreams and dreaming even when I’ve woken up 

stronger teeth clenching so slamming together especially from 4am onwards 

burning nerve pain on back and stomach worse

Burning on leg and shoulder blades like I’ve been scolded more frequent 

pains like electric shocks that come and go on my stomach 
tingling face and head 

hypnagogic hallucinations every morning for the last 5 days

Much stronger early morning cortisol rushes

blurred vision
derealisation (on and off) 

Fatigue (on and off)
 

 

 

 

 

[Altostrata]

Please hang in, Kernol. Your hormonal cycle may be affecting your symptom pattern.

[Erell]

Holding your hand from France Kernol, you can do this  ❤

[Kernol]

7 hours ago, Erell said:

Holding your hand from France Kernol, you can do this  ❤

bless you @Erell that made me cry but they were good tears that you would be thinking of me - it makes the world of difference to have the support - thank you and I hope you had a good day today ❤️

[Erell]

Of course I'm thinking of you ! I know too well the chemical anxiety you're going through, and I know how hard it is to cope.

But I also know that it decrease eventually : you will go through this ❤️

[Altostrata]

Kernol, how are you doing?

[Kernol]

Hi @Altostrata thank you for checking in on me. I’m sorry I haven’t been writing my daily notes - I have been finding it a real struggle. Everything remains the same - all the above symptoms are still raging. I am just patiently waiting, doing my best to accept and hoping for some stabilisation soon. 

[sunnysideup69]

@Kernol, hello, have been reading your thread and was really struck by your comment....

On 12/31/2019 at 6:15 PM, Kernol said:

 

has anyone ever got better that has destabilised so many times as me? I am so scared this is it for me now and too much damage has been done. I can’t remain in this state for weeks or months hoping to stabilise. I am a strong person but this has broken me.  I don’t know what my chances are for stabilising on the sertraline now after all that has happened over the last 13 months. Sometimes I think should I go up or go down if I am so ill now but I know you say holding is the best but when you get worse  it’s so hard to just wait and pray that my brain will heal at least to a manageable wd level whilst on it. 

 

 

 

Yes, I recognise those thoughts. I've destabilised my system a fair bit, too, as have many other people here, who have still gone on to recover. I really do believe it's possible to achieve at least a manageable WD normal....not perfect, but okay. And we can then begin to taper. I'm sending you virtual support.

 

 

On 1/1/2020 at 11:56 AM, Shep said:

 

Most people come into these forums destabilized. It's not until most of realize our doctors have no answers that we wake up from being mystified by doctors and medicine and hit the internet in search of answers. So many of the success stories here are from people who've recovered from massive amounts of destabilization. There's no reason to think you won't heal, Kernol. Please push those thoughts aside. 

 

 

I agree. I noticed you've been holding the Sertraline dosage consistent since September, which in WD terms is not very long...you're a couple of weeks ahead of me. The stabilisation process is maddeningly slow and frustrating, especially if you're suffering badly, but honestly I think it's a question of letting a bit more time pass.

Just a quick hello and to say, I'm thinking of you and sending you well wishes  

[jozeff]

Hi kernol,

I'm sorry to hear you are struggling so much.

What sunny said is true unfortunately. A couple of months is not very long in wd country..

 

Until recently you have been changing your sertraline dosage quite a lot. You have to keep faith! Eventually you will stabilize. I've tapered citalopram too fast and it took me 8 months before I felt like tapering again. I wasn't symptom free, no way. But the dark room that you describe was way less than when I'd crashed.

 

The anxiety that this will last forever is the worst. You have been feeling quite well for years so this doom is not going to last the rest of your life.

 

This thoughts are very recognisable. I keep diving into the past and horrible things come up. I feel like I had a terrible youth sometimes although in fact my youth has been pretty good and problem-free. I think about dead people, lost friendships, my career that went not as I expected....these thoughts just keep popping up. Someone wrote not to let these thoughts take over your mind. That is very true. Distraction is key although you have very little energy to do anything at the moment.

 

Try to distract your mind. Thinking about how awful our lives are makes it worse.

 

Hope you are feeling better very soon. Keep us posted and write as much as you can. That can be a therapy on its own.

 

Cheer

Jozeff