SkyStreamer: tapering off Cipralex / escitalopram safely

[SkyStreamer]

Thanks for sharing @eymen23.

 

I am aware that I have more anxiety and sometimes panic attacks after certain exercise workouts. However, I am not persisting in this practice without some rhyme to my reason. Like yourself, during your 20s, I'm testing and trying out various exercise routines and intensity levels to determine both the cause of my anxiety/panic during these times AND what kinds of exercises I am capable of tolerating. I don't want to prematurely stop all of my exercises, and settle for just walking lightly for 30 minutes, when I may be able to do more without jeopardizing my CNS and possibly improve my situation. I guess you can say that I'm approaching exercise, presently, on a kind of trial and error basis. 

 

To be completely honest, I don't find the issue of exercise and anxiety/panic very clear-cut. Instead, I find it much more complicated and nuanced. Take, the experiences of different members on SA for example. There a lot of people that experience an agitated CNS when they exercise more intensely or for longer periods of time. But, there are also others on the site that say that, not only are they unaffected by such exercise, but also that it allows them to better cope with WD symptoms. If this was a clear-cut issue, then you wouldn't have these differences in experiences, even if they are less common among members. 

 

Then, there's the issue of the complicated associative links between anxiety/panic and exercise. It's an easy assumption to make that exercise causes anxiety/panic when you experience it immediately after exercising. However, sometimes there may be an associative link between the anxiety/panic and exercise that is created simply by memory and fear. For example, when you experience a panic attack in the shower one or two times, whenever you enter the shower again thereafter you begin to feel anxiety/panic and fear not so much because showering is an inherently stressful event, but because you 'remember' having anxiety/panic when showering two times in the very recent past.

 

This is something that Dr. Claire Weekes discusses in a lot of detail in some of her talks. Specifically, she says that memory is one of the biggest causes of anxiety/ panic because it makes it possible for you to relive, and thereby become fearful again of, a situation in which you once experienced a lot of anxiety/panic, but which, in itself, is not anxiety/panic inducing. She says that when the cause of the anxiety/panic is the associative memory and fear, then you should try and confront the situation, push through it and proceed anyways. In her estimation, this pushing through and proceeding onwards, in spite of the anxiety/panic, will help you break the associative link between the actual experience and the anxiety/panic. However, if you begin to retreat in these situations whenever the anxiety/panic arise, then, in her words, you are making the associative links all the more strong and difficult to break. When I look back over the panic attacks I've experienced, I can see that some of them have been caused by this associative link of memory and fear, while others may have been caused by situations or events that were inherently very stressful. 

 

Another thing that makes me a little uncertain about the causal assumptions between exercise and anxiety/panic is Dr. John Sarno's non-drug based teachings for overcoming chronic physical pain. Dr. Sarno categorizes a majority of chronic physical pain under what he calls TMS. His solution for overcoming these problems is to stop being afraid, stop worrying about them, stop giving them attention, and, most importantly, to begin resuming all physical activity, including high intensity exercise (i.e. all those things that you thought would aggravate the pain!). In approaching chronic pain in these ways, Dr. Sarno reports that many people actually begin to break the false associative links they created between their pain and their memory, fear and worry. In confronting the situation, pushing through and proceeding, many of his patients experience not only huge reductions in their pain, but also complete healing. The point, here, is that many patients assumed, at the beginning, that their activity was both causing and aggravating their pain. But, Dr. Sarno discovered that the exact opposite was true. Their inactivity (along with their fear & worry) was aggravating their pain and making both healing and a possible future return to activity impossible. 

 

This is all to say that I am not trying to be stubborn about this whole issue of exercise and anxiety/panic. I am just trying to do my best to honestly discern the actual state of things  and the truth about my experiences both during and after exercise. And, this seems, to me, to take some time, patience, and some unfortunate, but necessary, trial and error. 

 

I hope you continue to provide feedback on my posts. I find your comments very insightful and supportive. But, just know that I also have to do my best to discern things by filtering them through my own heart, mind, and personal experience. 

 

 

 

 

[SkyStreamer]

After trying out medium intensity walking yesterday, and having two panic attacks, I've decided to just settle with light walking for the next while until my system recovers. I think I've done enough trial and error for the time being (😉@eymen23 ).

 

I hope I stabilize in the near future, because I really love doing higher intensity exercise. 

[SkyStreamer]

Day Summary: 02/08/2019

 

- Took a break from exercise today (after experiencing 2 panic attacks post exercise yesterday)

- Felt tired, exhausted & anxious the first two thirds of the day

- Felt less anxious by the end of the day (some glimmers of calm)

 

NIGHT: slept 7.5 hours; woke at 3am with anxiety (7.5/10); fell back asleep at 4am

8am: woke; high anxiety (7/10); tired & exhausted; disoriented; lacking hope; pessimistic; feelings of unreality

9am: took 7.5mg of Cipralex (pill form)

10am-12noon: work; high anxiety (7/10); very tired; lacking mental sharpness & focus

12noon: 20 relaxation meditation; less anxiety (4.5/10); moments of calm

12:30-3pm: work; medium anxiety (5/10); slower mind momentum; a little more focused and mentally sharp

3pm: 15 mins fresh air outdoors; bitterly cold; unenjoyable

3:30pm-6pm: work; lower anxiety (4/10); glimmers of hope; mildly relaxed and calm at times

6:30-7pm: 30 mins downtime; TV

7pm: family dinner; family time

8:30pm: 45 mins prayer

9:30pm: BEDTIME

[Steve61]

12 hours ago, SkyStreamer said:

After trying out medium intensity walking yesterday, and having two panic attacks, I've decided to just settle with light walking for the next while until my system recovers. I think I've done enough trial and error for the time being (😉@eymen23 ).

 

I hope I stabilize in the near future, because I really love doing higher intensity exercise. 

It is one of the hardest things for me (in withdrawal )to stop lifting weights. It’s something that I have done nearly all my life. I suppose that I am addicted to the feel good factor afterwards. I am experimenting. I try to stay away from it altogether but after a week or so, I give in and. do some. I am finding that after a session I still get the good feeling afterwards. Raised mood, relaxed etc but the next day my withdrawals are heightened. This is especially true if I deadlift. I think that this taxes my CNS too much. I suffer extreme anxiety the day after and perhaps  the day after thst. So like you it is trial and error. I don’t want to make my withdrawals worse but I don’t want to give up either. I don’t suppose being 62 helps much either lol.

Steve

[SkyStreamer]

Day Summary: 02/09/2019

 

- Woke up extremely tired & exhausted

- Less anxiety throughout the day

- Some glimmers of hope and motivation

 

NIGHT: 7.5 hrs sleep; woke at 3am; fell back asleep at around 3:20am; restless sleep

7:30am: woke; tired & exhausted; disoriented; brain fog

9am: took 7.5mg of Cipralex (pill form)

10am-12:30pm: work; low anxiety (3/10); unmotivated; uninterested in work; pessimistic

12:30pm: 30 mins downtime; TV; low anxiety (4/10)

1:15pm: 1 hours exercise (light weights); medium anxiety (5.5/10)

2:30pm-4:30pm: work; medium anxiety 5.5/10

4:30pm: 20 mins breathing exercise; low anxiety (4/10)

5pm-5:30pm: work; low anxiety (4/10)

6:15pm-7:15pm: family dinner; medium anxiety (6/10)

8pm: 45 mins prayer; low anxiety (3/10)

9:30pm: BEDTIME

[SkyStreamer]

Day Summary: 02/10/2019

 

- Family Day (always a challenge)

- Took more consistent breaks throughout day

- Struggled with anxiety at times

 

NIGHT: 9 hours of sleep; woke up once for 20 mins; went back to sleep

7am: woke; medium anxiety (5/10); a little tired; lethargic; unmotivated

7:15am: 30 mins prayer

8am: got ready for church; drove to church (1st time in three weeks that I drove by myself); medium anxiety (5/10)

9am: took 7.5mg dose (pill form)

9am-10am: church service; medium anxiety (5.5/10)

10am-11am: left mass; picked up a few things at grocery store; drove back home; high anxiety (7/10)

11am: 20 mins breathing exercise; low anxiety (4.5/10)

11:20am-1:30pm: family time; higher anxiety (6.5/10)

1:30pm-2:30pm: personal downtime; tv; medium anxiety (5.5/10)

2:30pm: 35 mins light walking; medium anxiety (5/10)

3:45pm: 10 mins personal downtime; silent break ( 6/10);

4pm-6pm: family time; high anxiety (7/10); sad & lonely; pessimistic; lacking hope about stabilizing

6pm: 15 mins breathing exercise; medium anxiety (5.5/10); sad & pessimistic; lacking hope

6:30pm-8pm: family dinner; family time; low anxiety (4.5/10)

8:30pm: 45 minds prayer; low anxiety 4/10

9:40pm: BEDTIME

[SkyStreamer]

On 2/9/2019 at 9:47 AM, Steve61 said:

It is one of the hardest things for me (in withdrawal )to stop lifting weights. It’s something that I have done nearly all my life. I suppose that I am addicted to the feel good factor afterwards. I am experimenting. I try to stay away from it altogether but after a week or so, I give in and. do some. I am finding that after a session I still get the good feeling afterwards. Raised mood, relaxed etc but the next day my withdrawals are heightened. This is especially true if I deadlift. I think that this taxes my CNS too much. I suffer extreme anxiety the day after and perhaps  the day after thst. So like you it is trial and error. I don’t want to make my withdrawals worse but I don’t want to give up either. I don’t suppose being 62 helps much either lol.

Steve

 

Hi @Steve61 - thanks for your comments! As much as I'm sorry you're in the same boat as myself, its nice to know that struggling with exercise during WD is not uncommon.

 

62 years old and still working out - that's amazing & very inspiring! Congrats!!! 

 

I know what you mean about the high. It's such a nice feeling and boost after a good weight workout. In addition to the high, I find that exercise in general has always made me feel less anxious, more in control of my thoughts, and gives me greater motivation to eat healthier, to meditate, and to just take better care of myself in so many other ways. I can't overemphasize how much good it's brought to my life. 

 

Through a bit of trial and error, I've figured out now that I can safely do about 30-45 mins of walking for cardio and about 80-85% intensity weight workouts. I had to cut out the stair-running, skipping, hill running, and boxing for now. It hurts to take a break from these exercises. But, I figure it's only temporary until I stabilize again. And, all things considered, being able to still walk and do a bit less intense weight workouts is still good, and definitely something to be grateful for.

 

I've never tried deadlifting before. I've seen tons of people do it in the gyms and studios, but I've always considered it a bit too intense and scary for myself.  

 

My biggest struggle is trying trying to determine what causes my anxiety and panic attacks during certain workouts. Is it the physical stress and increased heart-rate or is it my memory of having experienced these things during a previous workout? Sometimes, I think it's a bit of both. Other times, it's probably one more than the other. Right now, though, I'm just going to take it easier on the cardio and stick with the walking. But, I'll continue with the weights that I can handle. I know I'll improve soon enough if I just keep prioritizing self-care, relaxation and downtime, and continue to get good sleep (which I am presently, thankfully!).

 

Hope you're able to get some good workouts in without having to endure any collateral damage!

[SkyStreamer]

Day Summary: 02/11/2019

 

- Much less anxiety today

- Had glimmers of hope, joy & peace

 

NIGHT: slept for 9.5 hours; woke up once for 20 mins; went back to sleep

7:30am: woke; a little tired and lethargic; low anxiety (3.5/10)

8am: 30 mins prayer; low anxiety (3/10)

9am: took 7.5mg of Cipralex (pill form)

9am-11:30am: spent time with one of my children; my wife spent time with the rest; very nice and relaxing time; medium anxiety (4.5/10)

11:30: 20 mins breathing meditation; low anxiety (2.5/10); felt peaceful and calm

12noon: lunch

1pm: 1 hour downtime; reviewed SA; TV; medium anxiety (5/10)

3pm: did 50 mins of light weights; medium anxiety (5/10)

5pm: family time with entire family; higher anxiety (6/10)

6pm: family dinner; family time; medium anxiety (5/.5/10)

7:30: 45 mins prayer

9:40pm: BEDTIME

[SkyStreamer]

I came across a post on SA a few days ago, where someone said they found a particular mantra very helpful to say to themselves during difficult withdrawal times. It went something along the lines of: 'This is an opportunity to earn my freedom.' I don't know who mentioned this, but I have found it helpful lately for myself. Whoever you are: thank-you!

 

I'd be interested in hearing about other mantras, or statements, people find helpful to say during WD periods?

 

Usually, my two go-to mantra are: 'I don't have to be afraid of this' & 'I don't have to worry about this.'

[Gracee]

My mantra which I use during WD and during many difficult situations:

"This WILL empower you"

[SkyStreamer]

21 hours ago, Gracee said:

My mantra which I use during WD and during many difficult situations:

"This WILL empower you"

 

Thanks for sharing, Gracee! That's a good one!

[SkyStreamer]

Day Summary: 02/12/2019

 

- Felt rested for first time in a while (10 hrs sleep!)

- My wife has become an external stressor (she's a bit depressed & negative today)

 

NIGHT: 10 hrs sleep; woke up at 3am for 20 mins; went back to sleep; woke up at 6:30am for 30 mins; went back to sleep

9am: woke;  took 7.5mg of Cipralex pill; felt well rested and refreshed; medium anxiety (5/10); likely had more anxiety b/c I was 'behind schedule'

9:15am: 30 mins prayer; lower anxiety (4/10); very bored and disinterested

11am-1pm: work; medium anxiety (5.5/10); lethargic and unmotivated; extremely bored; very uninterested in work

1pm-2:30pm: 20 mins of breathing exercises; low anxiety (3/10); downtime; tv

2:30pm: 35 mins of light walking; medium anxiety (6/10)

6pm-7pm: work; decrease in hope; pessimistic; extremely bored; disinterested in life; tired of routine and horrible cold weather!

7pm: family dinner; wife feeling depressed & pessimistic; tension with wife; medium anxiety (6/10)

8pm: 45 mins prayer; low anxiety (4/10)

9:45pm: BEDTIME

[Carmie]

Wow! Ten hours of sleep SkyStreamer, 

 

That’s wonderful. Thank you for dropping around to my thread, much appreciated. Hope you get lots more sleep.

 

Sending hugs🤗

[SkyStreamer]

10 hours ago, Carmie said:

Wow! Ten hours of sleep SkyStreamer . . .

 

Yes, getting 10 hours of sleep was amazing. I'm so thankful!

 

For me, I find trying to get to bed at the same time is crucial. If I do it consistently, I can feel my body slowly preparing for sleep mode just before bedtime.

 

Thanks so much for the hugs!

 

Hope you're coping ok with the passing of your father. I know it must be a bit of an emotional roller coaster. At, least it was for me when my father passed.

 

 I'll keep you in my prayers. 

[Carmie]

Hi SkyStreamer, 

 

I’m not doing too badly now, thanks again for all your kind words. I’m so glad to hear that going to bed at the same time each night is helping you with your sleep patterns. It’s 4am here in Australia, I’m not usually awake this early in the morning, I’ll probably have a bit more shut eye soon. I usually wake up around 6am or so. 

 

The medication I’m on usually puts me to sleep, but I will probably get bad rebound insomnia from it eventually. When I forgot to take it one night I didn’t sleep whatsoever. I try not to focus on what might happen though. We can only live in the moment.

 

I like how you say to yourself: “I don’t have to be afraid of this.” That’s a very positive thought, I’m glad that you try to keep your focus on the positive. It’s kind of what Claire Weekes says about not heaping fear upon fear. We can become so fearful in this journey, but fear doesn’t serve a purpose, it just ramps up our symptoms. 

 

Take care, we will win this fight one day and heal.💚

[SkyStreamer]

Day Summary: 02/13/2019

 

- A day out with my wife (2pm onwards)

- We got along

- Much less anxiety

 

NIGHT: 7.5 hrs sleep; woke up once for about 15 mins; went back to sleep

5:30am: woke (haven't woke this early in a while; maybe b/c of 10 hrs sleep previous night); low anxiety (4/10); tired; but motivated & a little optimistic

6am: 30 mins prayer; low anxiety (4/10)

8am: 1 hr exercise (light weights); medium anxiety 5.5/10

10:15am: 20 mins breathing exercises; low anxiety (3/10); peace and calm

10:45am-12noon: work; medium anxiety  (5/10); a bit of racing thoughts and desire to do more activity; 

1pm: 1 hr psychotherapy session; low anxiety (3/10); feeling of relief and inner satisfaction

2pm & onwards: rest of day out with my wife

2:30-4pm: lunch at restaurant with my wife; low anxiety (3/10); very fun, enjoyable, and bonding time; lots of laughing

4:30pm: 20 mins prayer; low anxiety (2/10); very tired and exhausted; fell asleep briefly one or two times

6pm-8pm: watched move with my wife at theatre; low anxiety (1/10); very relaxing and enjoyable

9:30pm: back home; 20 mins prayer; low anxiety (3/10)

10pm: BEDTIME

[SkyStreamer]

8 hours ago, Carmie said:

Hi SkyStreamer, 

 

I’m not doing too badly now, thanks again for all your kind words . . . 

 

Wow - Australia!! I'm envious! Beautiful weather and gorgeous beaches. My favourite things in life.

 

Yes, so important to try not to focus on what 'might happen.' It can cause so much anxiety. But, it's a continual struggle for me. I just keep trying, though. I like to tell myself that all I have to do is 'just try.' You can never go wrong with doing that. 

 

I find that saying "I don't have to be afraid of this" is much better for me than saying 'don't be afraid of this.' The second one tends to increase anxiety by putting pressure on myself. Whereas the first one takes away the pressure by reminding myself that it is ultimately my choice. I find that whenever I tell myself 'not' to do something, my brain seems to want to do it all the more. My brain is a bit more calm and cooperative when I let it work within the context of choice. 

 

Nice chatting with you! Hope you have a nice sleep for rest of the night!

[Steve61]

@SkyStreamer Yes, it’s interesting that we have both used exercise to cope with our depression/anxiety etc throughout our lives , to make us feel more relaxed, more upbeat, more focused  etc and yet here we are in withdrawals and it is having the opposite effect !  For me, I don’t think that doing the actual workout  gives me the panic/ anxiety. I feel it the next day. I think that it is the extra stress that I put on my body. I suppose that our bodies are coping with lots of stress from the withdrawals and any extra stress just pushes me over the top. I’m not ready to give it up completely though. I will modify it, cut down etc and monitor it. Good luck with your journey through this ever changing mine field.

Steve

[SkyStreamer]

Day Summary: 02/14/2019

 

- Great sleep at night (10 hrs)

- Lower anxiety

- Boredom & restlessness off and on

 

NIGHT: 10 hours sleep; woke up once for 15mins with high anxiety; went back to sleep; woke again at 5:30am for 15 mins; went back to sleep

8am: woke; felt rested; bit more energy; medium anxiety (4.5/10)

8:30am: 30 mins prayer; very bored, restless and disinterested; low anxiety (4/10)

9am: took 7.5 mg of Cipralex dose

10am-12noon: work; medium anxiety (5.5./10); drop in energy; lethargic; unmotivated

12noon: 20 relaxation & breathing exercises; low anxiety (2.5/10)

12:30pm: 30 mins downtime; tv; low anxiety (4/10)

1:30pm: 40 mins exercise (light walking); low anxiety (4.5/10); lowest anxiety during exercise for a long time; a bit more energy

3pm-5:30pm: work; medium anxiety (5/10); bored; disinterested; restless; tired of routine

5:30pm: 30 mins downtime: tv

6:30pm-8:30pm: family dinner; family time; a bit higher anxiety (6/10); low attention span; racing thoughts; having trouble listening to family members; 

8:30pm: 45 mins prayer

9:30pm: BEDTIME

[SkyStreamer]

Day Summary: 02/15/2019

 

- Glimmers of calm, hope & optimism

- Lower anxiety

- Feeling more stable everyday 

 

NIGHT: slept 9 hrs; woke up once for 5 mins; went back to sleep

7:15am: woke; a little tired; low energy; lethargic

7:30am: 30 mins prayer; low anxiety (4/10); a bit of calm; lethargic; disinterested

9am: took 7.5mg of Cipralex

9:30am-12noon: work; low anxiety (3.5/10); increase in energy; a bit of hope & optimism

12noon: 15 mins outside fresh air; low anxiety (3/10); enjoyable; relaxing; glimmers of calm; a bit of hope

1pm: 20 mins downtime; tv; medium anxiety (4.5/10)

1:30pm: 1 hr of exercise (weights - 90% intensity); medium to higher anxiety (6/10)

3pm-5:45pm: work; medium anxiety (4.5/10); higher energy; motivated

5:45pm: 20 mins downtime; tv; low anxiety (4/10)

6:15pm-7:30pm: family dinner; family time; medium anxiety (5/10)

8:15pm: 45 mins prayer

9:30pm: BEDTIME

[SkyStreamer]

I feel like I'm beginning to stabilize, slowly - from my large taper in November & my one-day missed dose a few weeks ago. 

During the last few weeks, while stabilizing, I think I've noticed a pattern with my moods, from morning to evening. 

 

• 7am-9am: low energy; lethargic; unmotivated and bored
• 9am: AD dose
• 9:30-4:30pm: high energy; more motivated and focused
• 2pm onwards: return to low energy; lethargic; unmotivated and bored

I haven't really noticed a pattern with anxiety (except for that it is sometimes higher during certain exercises and family time).

 

I'm beginning to wonder whether this down, up and down again in mood pattern  is related to my AD dose and the length of time it is working in my system. For example, I'm low in the early morning because this is when my AD is less potent in my body (i take my dose every morning at 9am). Then, I start to feel better shortly after taking my AD. And, then later on in the evening, I begin to feel low again because my AD is losing it potency.

 

Does this make sense to anyone? And, has anyone ever experienced something similar to this?

[SkyStreamer]

Day Summary: 02/18/2019

 

- Low anxiety

- Off and on boredom & restlessness

- Moments of higher energy

 

NIGHT: 8.5 hours sleep; woke up once or twice briefly; went back to sleep

7am: woke; low anxiety (3/10); tired & lethargic

7:30am: 30 mins prayer; lethargic; unmotivated

9am: 7.5mg Cipralex dose

9am-12noon: work; low anxiety (4.5/10); higher energy; little more motivated

12:15pm: 20 mins relaxation exercises; low anxiety (2.5/10); calm and peaceful

1:30pm-2pm: downtime; tv

2:15pm: 1 hr exercise (weights - 95% intensity); low anxiety (4/10)

3:30pm-5pm: family time; medium anxiety (5.5./10); feeling a bit tired, lethargic & bored

5pm: 15 mins relaxation exercise; low anxiety (3/10)

5:30pm: 30 mins very light stroll outside; some boredom & restlessness; a bit higher energy

6:15pm-8:15pm: family time; medium anxiety (4.5/10); higher energy

8:45pm: 45 mins prayer; low anxiety (3.5/10)

[SkyStreamer]

I would love to get some feedback about this from anyone who is willing . . . .

 

I feel like I'm beginning to stabilize, slowly - from my large taper in November & my one-day missed dose a few weeks ago. 

During the last few weeks, while stabilizing, I think I've noticed a pattern with my moods, from morning to evening. 

 

• 7am-9am: low energy; lethargic; unmotivated and bored
• 9am: AD dose
• 9:30-4:30pm: high energy; more motivated and focused
• 2pm onwards: return to low energy; lethargic; unmotivated and bored

I haven't really noticed a pattern with anxiety (except for that it is sometimes higher during certain exercises and family time).

 

I'm beginning to wonder whether this down, up and down again in mood pattern  is related to my AD dose and the length of time it is working in my system. For example, I'm low in the early morning because this is when my AD is less potent in my body (i take my dose every morning at 9am). Then, I start to feel better shortly after taking my AD. And, then later on in the evening, I begin to feel low again because my AD is losing it potency.

 

Does this make sense to anyone? And, has anyone ever experienced something similar to this?

[ChessieCat]

16 minutes ago, SkyStreamer said:

• 7am-9am: low energy; lethargic; unmotivated and bored
• 9am: AD dose
• 9:30-4:30pm: high energy; more motivated and focused
• 2pm onwards: return to low energy; lethargic; unmotivated and bored

 

I think you've made an error here.  9.30am to 4.30pm but 2pm onwards

[ChessieCat]

Q:  Was this happening before the missed dose?

 

If not, then it's probably just going to take more time to stabilise.

 

Cipralex has a long half life so I doubt that you are getting interdose withdrawal.

 

It is more likely that during the morning the dose in the body is at a lower level and during the afternoon it is starting to get higher again (trough in the morning a peak in the afternoon).  So opposite to what you are thinking (peak in the morning and trough in the afternoon).  Tiredness is a common side effect.

 

From wiki: 

Common side effects include trouble sleeping, nausea, sexual problems, and feeling tired.

 

Elimination half-life      27–32 hours

[SkyStreamer]

9 hours ago, ChessieCat said:

 

I think you've made an error here.  9.30am to 4.30pm but 2pm onwards

 

Yes, you're right @ChessieCat - that was a mistake. Good catch!

 

It should read: 

 

• 7am-9am: low energy; lethargic; unmotivated & bored
• 9am: AD dose
• 9:30am-4:30pm: high energy; more motivated & focused
• 4:30pm onwards: return to low energy; lethargic; unmotivated & bored

[SkyStreamer]

9 hours ago, ChessieCat said:

Q:  Was this happening before the missed dose?

 

If not, then it's probably just going to take more time to stabilise.

 

Cipralex has a long half life so I doubt that you are getting interdose withdrawal.

 

It is more likely that during the morning the dose in the body is at a lower level and during the afternoon it is starting to get higher again (trough in the morning a peak in the afternoon).  So opposite to what you are thinking (peak in the morning and trough in the afternoon).  Tiredness is a common side effect.

 

From wiki: 

Common side effects include trouble sleeping, nausea, sexual problems, and feeling tired.

 

I wasn't as aware of my moods and patterns throughout my day before my missed dose as I am now. So, I'm not entirely sure whether this was happening then. But, my hunch is that I suspect it was. And, I suspect it's been happening for the last 4 or 5 years or so. 

 

Maybe I didn't explain the pattern well enough, but you have described it as I meant to. You're right - my low mood in the morning could parallel the low level of AD in my system in the morning. My bump in mood in the afternoon could parallel the high level of AD in my system. And, then later in the evening, my drop in mood (though less intense than the morning) could parallel the lowering levels of AD in my system. 

 

It definitely seems like an ongoing pattern every day, since I've been recording my symptoms. And, there must be an underlying cause. This is the only cause (the varying levels of my AD throughout each day) that seems to make sense. I find it extremely helpful to be aware of this. It should help me just accept my low moods during these times, knowing that they are related to my AD levels, not necessarily to something I've done or failed to do throughout my day. It's just part of the physiological effects of the AD. 

[SkyStreamer]

Day Summary: 02/19/2019

 

- Less anxiety

- Sudden extreme tiredness & exhaustion in early afternoon

 

NIGHT: 8.5 hrs sleep; woke up briefly one or two times; went back to sleep

7am: woke; low anxiety (3/10); very tired & exhausted; lethargic; unmotivated; low energy

7:15am: 30 mins prayer

9am: 7.5 Cipralex dose

11am: counselling appointment;; low anxiety (2/10)

12pm-2pm: extremely tired & exhausted; very lethargic; maybe b/c I had a little more decaf coffee & sugar than usual; low anxiety (2/10)

3pm: slept for 1 hour; felt so nice to sleep!

4:30pm: 45 mins exercise (walking); low anxiety (4/10)

7pm-9pm: family dinner; family time; low anxiety towards beginning (3/10); higher anxiety towards end (6/10)

9:30pm: 25 mins prayer

10:20pm: BEDTIME

[ChessieCat]

I think it could be a side effect of the drug especially if it has always been there.   As you reduce your dose the side effects generally lessen.  It could be that the missed dose ramped it up a bit and/or you noticed it more because you were checking your symptoms more and/or you were stressed because of the missed dose.

[SkyStreamer]

5 hours ago, ChessieCat said:

I think it could be a side effect of the drug especially if it has always been there.   As you reduce your dose the side effects generally lessen.  It could be that the missed dose ramped it up a bit and/or you noticed it more because you were checking your symptoms more and/or you were stressed because of the missed dose.

 

ok- thanks for the feedback! Much appreciated!

[SkyStreamer]

Day Summary: 02/20/2019

 

- Low anxiety

- Tiredness off & on

 

NIGHT: 8 hrs sleep; woke up briefly one or two times; went back to sleep

7am: woke; low anxiety (4/10); tired; lethargic; unmotivated

7:15am: 30 mins prayer

9am: 7.5mg of Cipralex dose

9:15am: 1 hr of exercise (weights); higher anxiety (6/10); felt pressured to finish quickly b/c had to leave at 10:50am for an 11;45am appointment; looking back, I shouldn't have worked out until later in day

11:45am:1 hr  psychotherapy appointment; low anxiety (4/10); a bit tired

1pm: lower anxiety (3/10); high energy; motivated; optimistic

3pm: 15 mins silent downtime; low anxiety (3/10); a bit tired

6pm: 45 mins prayer; low anxiety (2.5/10); getting more tired

7:15pm: dinner; tired; a little bored; feeling sad and a bit pessimistic; a little irritable

9:30pm-10:45pm: Downtime with my wife; tv; low anxiety (3/10)

11pm: BEDTIME

[SkyStreamer]

I seem to have been stabilizing over the last few weeks. My anxiety, as well as other WD symptoms, have been much slower; and I feel like my life is very manageable at this point.

 

Under the assumption that I continue to stabilize, how long do you think I should wait before I begin my 10% taper? One, Two or Three months? 

[Gridley]

It's difficult to predict at this point.  I suggest 3 months at a minimum, so you have a strong foundation.  See how it goes over the next three months and revise if necessary.  It will be clearer once the three month period draws to a close.

[SkyStreamer]

@Gridley - thanks for responding! Seems like sound advice.

 

I always feel overly eager to just get on with the taper. But, I need to check this urge and make sure I'm fully stable first. I think you're probably right that I need to give myself a good amount of time to recalibrate. 

[SkyStreamer]

Day Summary: 02/21/2019

 

- Felt rested when woke (not common)

- Took less breaks than usual

 

NIGHT: 8 hrs sleep; don't recall waking up at all throughout the night

7am: woke; low anxiety (3/10); felt rested (very uncommon!); good mood; a bit of energy; and some optimism

7:15am: 30 mins prayer

9am: 7.5mg of Cipralex dose

10am-1pm: work; low anxiety (4/10); motivated; optimistic

1:15pm: 20 mins relaxation exercises; low anxiety (3/10)

2pm: 50 mins of exercise (walking); medium anxiety (5/10)

3pm: 30 mins downtime; tv; felt higher anxiety at beginning (8/10); lots of commotion going on around me; felt lower anxiety towards end (5/10); commotion ended

4:30pm-6pm: work; low anxiety (4/10); glimmers of calm

6:30pm-8pm: family dinner; family time; medium anxiety (6/10); lower energy; less optimistic

8:30pm: 45 mins of prayer; lower anxiety (4/10)

9:45pm: BEDTIME

[SkyStreamer]

Day Summary: 02/22/2019

 

- Feeling a bit rested in the morning lately

- Still lower anxiety

 

NIGHT: 8 hrs sleep; didn't wake up during night

7am: woke; low anxiety (2/10); felt rested; a little motivated; some optimism; bad eczema on lips

7:15am: 30 mins prayer

9am: took 7.5mg of Cipralex

9:30am-11:15am: work; low anxiety (3/10); a bit bored; restless; less motivated

11:15am: 15 mins outside fresh air

12:30pm: 1 hr exercise (weights - 100% intensity); medium anxiety (5/10)

1:45pm: 15 mins of relaxation exercises; low anxiety (3/10); 

2:30pm-5:30pm: work; medium anxiety (4.5/10); high energy; a bit motivated

5:30pm: 30 mins downtime; tv; medium anxiety (4.5/10)

6:15pm-8pm: family dinner; family time; got really bad sinuses; constant sneezing and runny nose; higher anxiety (6/10)

8:30pm: 45 mins prayer; continuing sneezing & runny nose; higher anxiety (6/10); difficult time concentrating

9:45pm: BEDTIME