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

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Kernol

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. 

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Kernol

26/11

 

8.00am got up, feel more panicky heart racing and some chemical anxiety feeling in stomach, teeth are sore from clenching, vision blurred when reading 

9.00am take 2mg diazepam

9.30am have veg smoothie

10.00am do some work emails, feel a bit calmer now

11.00am do some housework 

12.30pm chemical anxiety starts to rise on looking at photo online of an outdoor scene in summer - I have no idea why sunny scenes are setting off this bizarre reaction. Feel worried this is still happening 

1.30pm have sandwich

2.00pm do some work emails, still feel chemical anxiety. Take 0.75mg

3.00pm take 0.35mg vortioxetine 

4.00pm do some online quizzes 

5.00pm getting quite a few memories which is causing anxiety

6.00pm have Dinner

7.00pm take 2mg diazepam

8.00pm able to do some online shopping which was unthinkable earlier 

9.00pm take 16mg sertraline 

11.00pm can’t sleep

12.00am - 4.00am horrible dreams and anxiety 

5.00am teeth clenching starts and strong cortisol rushes that feel more burning in stomach than usual

7.00am get up feel a bit panicky also with the chemical anxiety feeling and tingling in head 

 

27/11

 

8.00am got up had shower, again feel more heart racing with a chemical anxiety burning feeling in my heart / stomach, vision blurred when reading 

9.00am take 2mg diazepam, have a cereal bar 

10.00am do some work emails, feel a bit calmer 

11.00am do some quizzes 

12.00pm doing some work emails

1.00pm have sandwich 

2.00pm take 0.75mg diazepam 

2.30pm still able to work ok despite anxiety 

3.00pm take 0.3mg vortioxetine
4.00pm still able to do work and have a work call

5.30pm have dinner

6.00pm notice chemical anxiety rising. I look at an innocuous brochure of a golf club and the photos of the greens in it make me feel this bizarre anxiety. Feel crazy that a photo of a golf course could do this.

6.30pm try and watch Big Bang theory bit get very strong chemical anxiety feeling and strong doom. Get upset I can’t even watch a comedy without this happening.

7.00pm take 2mg diazepam 

7.40pm watch football on tv with husband, feel a bit calmer

9.00pm looking online at bathroom furniture 

take 16mg sertraline 

10.30pm feeling the chemical anxiety in stomach rising again. 
12.00am - 3.00am - awful nightmares and wake with strong teeth clenching at 3am. vision is a bit flickering in the dark 

3.00am-6.00am - horrible emotive dreams of death feel very real. Wake up with teeth clenching and panicky with strong emotions from the dream 

 

 

 

 

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Shep
22 hours ago, 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. 

 

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

 

On 12/26/2015 at 2:37 PM, Altostrata said:

BRAIN STRUCTURES
amygdala  - This is the FEAR center in the brain. It's a tiny part in the middle of your brain. Fear is protective and it's GREAT if you need to assess something that is dangerous and to ACT  - like if a rabid dog were chasing you. - but it's hard in recovery when it's all you feel for months! But the FEAR is not truly in your MIND. It's in your BRAIN.  There is too much glutamate acting here in the amygdala and not enough GABA. So the nerves are firing off in the fear center when nothing scary is really there in your environment.  It is normal for that to happen given the circumstance physiologically. But it feels awful, doesn't it?  I know.  But it's just a brain structure. This can account for fear, agoraphobia, fear of water, fear of anything.  It's not that you're really "scared" of the moon - it's that you're in almost constant fear because this brain structure is healing. The glutamate is pruning back. The GABA receptors are opening back up.  It may or may not continue for awhile. It will abate. Then come back. But eventually, the brain will get it right.  smiley.gif

Hippocampus - This is the "memory" center of the brain. It ties in old memories to emotions.  The same thing is happening here that is happening in the amygdala with GABA and Glutamate. So - voila. You get intrusive memories from ALL times in your [...].  It's wild and wicked and wooly. But it can't hurt you. And if you can learn to visualize this as what is happening - then you can learn to be objective and realize it's normal.  And like the amygdala - it will come and go and frustrate you, but it will go away when the physiology is restored.

 

 

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Kernol

Thank you @Shep I found these quotes incredibly helpful and reassuring and I read the entire article - it’s amazing!! and even mentions visual disturbances which I have been having too. Thank you for sharing.

 

i am working on acceptance and mindfulness - I will keep practicing. 
 

 

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Shep
4 minutes ago, Kernol said:

i am working on acceptance and mindfulness - I will keep practicing. 

 

Yes, exactly - it is a "practice." Just like you hear those who teach yoga or mindfulness and call it "my practice." 

 

If you can look at these intense fear experiences with gratitude for giving you the opportunity to practice, it's transformative because it give these experiences meaning and purpose. 

 

Eventually, you'll no longer fear them, but welcome these experiences. This is when your symptoms become your Teachers. 

 

And by keeping in mind that this is a practice, you won't beat yourself up during times when you aren't successful. It's a process that when practiced over the years that it takes to recover, you can master in time. 

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Altostrata
On 11/26/2019 at 1:26 PM, Kernol said:

It is just coming up to 9.30pm I took 2mg diazepam 2 and a half hours ago and I don’t have any of the chemical anxiety stuff I get at lunchtime so I don’t know why I would only get a paradoxical reaction to the morning dose but maybe it has to do with the fact it’s nearing bed time as opposed to morning. Also why some mornings the diazepam dose doesn’t seem to do anything is also strange.

 

The diazepam you take in the morning overlaps with the diazepam dose you took the previous evening, most of it is still in your bloodstream. This may be too big of a diazepam load in the morning, which affects you several hours later after the morning dose peaks.

 

Please do eat more regularly, as @Shep has observed, low blood sugar may be confounding your symptom pattern. Put some undenatured whey protein powder in your smoothie, or have complex carbohydrates with it. Protein and complex carbs help keep your blood sugar steady.

 

Not sure what's causing the teeth clenching. Is it the same as when you were taking 3.75mg vortioxetine? It seemed the bruxism was decreasing.

 

At any rate, it does not appear that reducing vortioxetine is making your symptom pattern any worse, which is good, at least it will be out of the mix. As it has a very long half-life, benefit from going off may take weeks to gradually appear.

 

I think the eye focus issues might be a side effect of diazepam. Please hang in there through the side effects.

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Kernol

Hi @Altostrata thank you I will add the complex carbs and protein in. 
 

the bruxism was decreasing yes. It is not as bad as it has been when I could feel myself slamming my jaw down, that seemed to be happening when I was on 2.5mg vortioxetine and 2mg vortioxetine.  Prior to that when I was on 3.75mg it was probably about the same level as it is now. I recall the bruxism first started at the beginning of August after reducing to 5mg vortioxetine but this was also when I had made a big cut in sertraline from 16mg to 8mg so I suppose it’s possible it might be sertraline and not vortioxetine causing it but I really hope not!! Incidentally this is when I also first noticed some visual disturbances like the pattern on the rug moving. 
 

I definitely feel that things are changing in terms of some of my symptoms. The chemical anxiety is still very high but each day it feels just a little bit different in the way it manifests physically and emotionally not better but not worse either just different so I’m hoping this might be a good sign. 
 

The depression has not been present the last few days so think that may have been hormonal and the head vice feeling and fatigue have also improved. I have not noticed as intense skin burning sensations in the last few days or head burning/ tingling which have always been my hallmark sertraline withdrawal symptoms so I am hoping in the background maybe the sertraline might be settling. But as with all these things - I am hesitant to say something has improved as it may return the next day! 
 

I am glad you said it may take weeks for the gradual improvements to appear after stopping Vortioxetine - as I was starting to wonder whether I should have seen more improvement by now so I feel better knowing it may take some more time.

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Altostrata

Did we talk about a bite guard to protect your teeth against the bruxism? That would be a good idea.

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Kernol

Hi @Altostrata yes I am wearing the flexible rubbery type mouth guard. I think you said this was the best type. Happy Thanksgiving by the way! 

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Altostrata

Happy Thanksgiving to you!

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Kernol

28/11

 

8.00am got up felt quite panicky, different to yesterday subtle change to feeling 

9.00am took 2mg diazepam and had oat bran 

10.00am still feeling quite panicky slightly wired but manageable 

11.00am still feel a bit wired, trying to do some online quizzes 
12.00pm have sandwich for lunch 

1.00pm do some housework 

2.00pm take 0.75mg diazepam 

2.30pm do some deep breathing 

3.00pm take 0.25mg vortioxetine 

4.00pm do some work still feeling background wired feeling but haven’t noticed as many of the bizarre reactions to things 

5.00pm still feel edgy, have a bath

6.00pm have dinner 

7.00pm take 2mg diazepam 

8.00pm calm down a bit 

9.00pm manage to watch a tv programme 

take 16mg sertraline 

10.00pm-4.00am sleep ok notice some teeth clenching and wake with night sweats

4.30am cortisol panic rushes start and get stronger until I have to get up

 

29/11

 

8.00am get up have shower, feel panicky edgy but again slightly different to yesterday 

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

10.00am do some work emails, feel panicky but not overwhelming

11.00am do some housework, feel a bit wired

12.00pm have tuna salad for lunch 

1.00pm do some work emails, not noticed any bizarre reactions yet

2.00pm take 0.75mg diazepam 

3.00pm still feeling amped up but able to Carry on working. Take 0.2mg vortioxetine 

4.00pm start looking at Xmas presents to buy online 

5.00pm have a bath 

6.00pm eat dinner 

7.00pm take 2mg diazepam. Looking on internet for bathroom fittings, a few reactions but not as strong as previous days 

8.00pm manage to watch tv, some reactions but not as overwhelming 

9.00pm take 16mg sertraline 

10.00pm still watching TV

10.30pm-4.00am sleep ok some waking with teeth clenching and night sweats

5.00am onwards waking with strong panicky cortisol rushes and some disorientation 

 

 

 

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Altostrata

That looks a little better? I wonder if we are seeing vortioxetine reduction in slow motion, with accompanying readjusting effect of all the other drugs. What appeared to be paradoxical reaction to diazepam has gone away?

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Kernol

I am hesitant to say but yes definitely noticed a  lessening in some of the more bizarre reactions and random memories over the last 2 days!

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Kernol

30/11

 

9.00am had porridge and took 2mg diazepam, feel a bit panicky but ok

10.00am did some online shopping - no bizarre reactions 

11.00am dealt with washing machine repair man - able to hold conversation ok

12.00pm - online shopping for new washing machine 

1.00pm have lunch

2.00pm watch football match on tv take 0.75mg diazepam. No bizarre reactions to anything yet. House feels like my house and it feels like a Saturday which is a nice feeling.

3.00pm take 0.15mg vortioxetine 

4.00pm more online shopping, no random memories yet today 

6.00pm have dinner 

7.00pm am watching tv without strong reactions. Take 2mg diazepam 

8.00pm still watching tv ok 

9.00pm take 16mg sertraline 

10.30pm go to sleep

11.00am-2.00am restless panicky sleep and woke with some teeth clenching 

2.00am - 7.00am more panicky waking but I am sleeping some. Teeth are clenching same intensity as last few nights so not worst I’ve had but has been milder 
 

1/12

 

9.00am have croissant and take 2mg diazepam, feel a bit more edgy this morning 

10.00am doing some online shopping ok

11.00am have a bath 

12.00pm notice a bit of rising chemical feeling anxiety. Feel a bit of derealisation and had some random memories of old dreams come in 

1.00pm have Tuna salad lunch

2.00pm take 0.75mg diazepam 
3.00pm watching football on tv but notice not as calm as yesterday and getting a few reactions to adverts. Also a few more random memories. take 0.10mg vortioxetine 

5.00pm go to do some deep breathing and try not to get disappointed that today some of the more chemical stuff has returned. Remind myself this is a non linear process

6.00pm have dinner

7.00pm lay down and take 2mg diazepam 

8.00pm am able to watch tv for 2 hours ok with some anxiety and a couple of more chemically feeling reactions but I accept them

9.00pm take 16mg sertraline 

10.30pm - 2.00am - sleep ok bit panicky restless and wake with teeth clenching 

2.00am - 6.00am more restless feels like cortisol rushes but coming much earlier so in and out of panicky sleep and some teeth clenching 

 

 

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Kernol

2/12

8.00am get up , high cortisol panicky feeling, notice my vision is blurred again find it difficult to read my phone  

9.00am take 2mg diazepam and have Oat bran

10.00am do some work emails, calmed down a bit

11.00am do some online quizzes and ring my dad

12.00pm still feeling ok although a bit more anxious and a some random memories of old dreams 

12.45pm make lunch for myself and my husband 

1.00pm eat lunch

2.00pm take 0.75mg diazepam 

2.30pm do some work emails

3.00pm do some online shopping, get some stronger anxiety rising just looking at bathrooms online, feels chemical but not as strong as a week ago. Take 0.05mg vortioxetine

4.00pm do some online quizzes

5.00pm a couple of random memories

6.00pm make dinner 

7.00pm take 2mg diazepam 

8.00pm have some anxious reactions to places on tv but try and breathe through them 

9.00pm take 16mg sertraline, still watching tv although a bit of anxiety is there I don’t have to turn it off 

10.30pm -12.00am - slept with lots of panicky wakings

12.30am-6.00am - feel like I havent slept as my sleep has been so anxious and continuous waking but must have slept some bits. Almost like morning cortisol rushes but from the middle of the night. Teeth clenching same as previous couple of nights 

 

hi @Altostrata I think yesterday was my last dose of vortioxetine? I am glad to be off it. 

 

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Altostrata
4 hours ago, Kernol said:

 I think yesterday was my last dose of vortioxetine? I am glad to be off it. 

 

Whew, that was a slog. Let's see what happens. You may be feeling effects of reductions in October, the half-life is that long. You may have symptoms irregularly from the changes, but I hope they gradually fade.

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Kernol

Thanks @Altostrata for all your help in seeing me through getting off the stuff! I do hope to see some lessening of the symptoms in the coming weeks too! Do you still want me to write a daily journal? 

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Altostrata

Yes, please continue to note your symptom pattern.

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Kernol

3/12

 

8.00am got up had bath, feel lots of stomach sinking sensations of dread, strong but feels more like my own anxiety not so Chemical but very strong. Vision blurred when reading 

9.00am take 2mg diazepam have oat bran 

10.00am -12.00pm - doing online quizzes and some online shopping - feel a bit calmer 

12.30pm have lunch 

2.00pm start to feel a bit of a rise in reactions to things - bit of a chemical feel. Take 0.75mg Diazepam

3.00pm play some more quizzes and tidy house

4.00pm some chemical anxiety feelings but not overwhelming 

5.30pm have dinner

6.30pm watch football on tv

7.00pm take 2mg diazepam

8.00pm watch tv - a couple of strong reactions but able to keep watching 

9.00pm take 16mg sertraline

10.30pm - 6.00am - very anxious restless sleep. Less Chemical feeling, no nightmares more panicky stomach churning waking continuously in a startled state.Teeth clenching same as before. 
 

4/12

 

8.00am get up have shower, feel a bit of chemical anxiety, vision blurred when trying to read. 

9.00am - take 2mg diazepam and have 2 pieces of peanut butter on toast

10.00am - 12.00pm - researching bathrooms online looking at ideas, some anxiety but not too bad

12.30pm have sandwich for lunch and smoothie

2.00pm take 0.75mg diazepam 

3.00pm still online researching new Bathroom

4.00pm notice a stronger anxiety reaction when looking at bathrooms now and a feeling of chemical anxiety when I look at my own bathroom 

5.00pm - watching the news on tv. Notice a big spike in stomach churning dread feeling whilst watching fairly benign news item. The places look depressing and I feel my stomach sinking it’s very strong.

6.00pm have dinner

7.00pm have to go to bed as the stomach sinking is intense and I feel dread when I imagine myself going anywhere or doing anything. Take 2mg diazepam

8.00pm feel a bit calmer 

9.00pm take 16mg sertraline 

11.00pm - 6.00am - exactly as night before - continual waking with strong anxiety / panic -,feels less chemical more organic but v intense

 

 

 

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Kernol

5/12

 

8.30am got up had bath, felt some chemical anxiety but not too strong

9.00am take 2mg diazepam and have oat bran

10.00am dad visits, able to have normal conversations 

12.00pm make us both lunch

1.00pm do some online Xmas shopping almost feel like Xmas won’t be as bad this year so not dreading it today 

2.00pm take 0.75mg diazepam 

3.00pm do some work emails, not feeling too bad 

4.30pm start to feel a little up kick in anxiety

5.30pm tv is on and start getting v strong anxiety feelings in my stomach to inocuous places on tv - reaction shocked me so much with the intensity of it I had to go upstairs 

6.30pm lying down with no tv and no phone - every time I look at phone, photos are setting me off so I decide to just deep breathe and tell myself this is not linear just because I have had a stronger reaction today than the last couple Of days it doesn’t mean it’s not going to get better again 

7.00pm take 2mg diazepam and have dinner

8.30pm feel a bit calmer and can look at online content again so decide to turn tv on. Able to watch reality show ok some anxiety but nowhere near as strong as earlier in the evening 

9.00pm take 16mg sertraline 

10.30pm - 6.00am restless sleep with anxiety waking - teeth clenching a bit but maybe slightly less 


 

 

6/12

 

8.30am get up have Bath, feel a bit of stomach sinking dread, vision blurry when reading 

9.00am Take 2mg diazepam and have peanut butter on toast

10.00am do my hair and actually straighten it and make it look nice 

11.00am man comes to install washing machine - able to deal with him okay

12.00pm make lunch for husband and myself 

1.00pm make a dinner for later from scratch, some anxiety but able to do it

2.00pm take 0.75mg diazepam 

3.00pm do some online quizzes 

4.00pm looking at online pics of new bathrooms and notice suddenly I am getting a bizarre anxiety reaction to them like I did earlier this week. Start to feel strong dread and stomach churning and has a bit of a chemical feel. I notice some intrusive memories of old dreams coming in 

5.00pm husband puts tv on and it’s golf in the Bahamas and I can’t bear looking at it as it all looks unreal and strange. I feel upset the bizarre reactions are still there but tell myself it’s to be expected for a while 
6.00pm having difficulty watching tv so turn it off and eat dinner I made earlier

7.00pm take 2mg diazepam and lay down

8.00pm able to watch some tv with some anxiety but not so overwhelming that I can’t continue 

9.00pm take 16mg sertraline 

10.30pm - 6.00am restless panicky sleep with some vivid disturbing dreams and some teeth clenching but not too strong 

6.00am - 8.00am - stomach is wrenching with anxiety almost like I can feel the stress hormones flooding through me - the whole world seems disturbing it is so strong, I cannot find a comforting thought to self soothe so I just lie and deep breathe. 

 

 

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Kernol

7/12

 

8.00am Wake up with strong anxiety have oatbran and try and watch cooking programme on tv but gives strong anxiety reaction and feels a bit chemical so turn it off. Vision is still blurry when trying to read 

9.00am take 2mg diazepam, takes edge off a bit . Turn programme back on and able to watch it with some anxiety but not overwhelming. 

11.00am have bath, background anxiety is stronger than this time last week

12.00pm prepare lunch, eat lunch but feel very anxious at the table my mind is going all over the place. Random memories and my stomach is churning over very intensely. I lose my appetite.

1.00pm notice a couple more random memories  and anxiety is building. Every thought I have is giving rise to an anxious reaction

2.00pm take 0.75mg diazepam 

3.00pm watch football on tv. Anxiety is still strong my stomach is wrenching with it like yesterday 

4.00pm I notice a strong de ja vu feeling whilst watching football

5.00pm anxiety is now becoming overwhelming. I am trying not to despair or think about why it is worse than a week ago but I can’t help it. 

6.00pm try and eat a small dinner

6.45pm go up to lay down as it’s so relentless 
7.00pm take 2mg diazepam 

8.00pm tiny bit of edge taken off but not much - still can’t think of anything without an Intense anxious reaction. 
9.00pm try and watch the reality show I have been watching recently. I watch it but I notice some strong anxiety and chemical reactions to the scenery. take 16mg sertraline 

10.30pm trying to get off to sleepy lots of old memories coming that feel so real I can remember the smells and sounds of my grandmother house - so surreal it causes strong anxiety 

11.30pm - 6.00am - restless sleep waking with very strong anxiety feels like my own anxiety not so chemical but much more intense. Some teeth clenching 

6.00am woke up with a strong chemical anxiety feeling with an image of a field on a sunny day - so random it scares me these are still happening 

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