ForMyGirls: introduction

[ForMyGirls]

Hi all,

 

My name is Joel, and first of all I want to say I really appreciate the resource of this site. I never realized how insane things could get on starting or stopping antidepressants. I knew about withdrawal syndrome, but I didn't realize it could be 100 times worse than the worst of my anxiety. I'm currently seeking support for a tapering schedule I'm on.

 

A bit of my history. After a whirlwind year in 2013 of getting married and losing a job, I had my first panic attack. At the end of the year, I started having more pronounced anxiety episodes – instead of 30 minute attacks, overwhelming anxiety that would come for hours at a time. My doctor at the time prescribed 50mg sertraline. After reading a bit about antidepressants, I decided to start with 25mg, and it worked for me. My life changed. I felt like myself again. Even on that low dose, my panic went away, I felt more confident, and I was able to not only survive but thrive through getting a new job, two babies, two dogs, and a house in a matter of 3 years.

 

In mid-2016, I talked with my doctor again about going off the sertraline. My largest complaint was it made me sleepy at night and occasionally I'd feel mild brain zaps. I tapered over a week and had no issues. Fast forward to the end of 2017. On a business trip, I felt anxious one night, and I had brought my old Xanax/sertraline bottles as a safeguard, which I've always done when traveling. Knowing how addictive Xanax can be, and because sertraline helps me sleep, I took the sertraline. The next month, I felt anxious again while traveling, but didn't take anything. Then, in March 2018, I was traveling for work in Ethiopia and had a major anxiety episode. I had taken a sertraline the first night there, again ignorant that I probably shouldn't be popping them for the occasional time I want to fall asleep. About 6 days in, while traveling back from the south of the country, I felt a panic attack hit. It wasn't your typical panic attack: I had no overwhelming feeling of doom or fast heart rate, just an extreme urgency to urinate and a sick stomach. When I got back to my hotel, I took Xanax and started on the old script of sertraline. Within two days, I felt better, was able to travel home without incident, and was fine through April. The old prescription ran out after a few weeks, and I did a few-day taper, and wanted to see if I could survive without the drug, scheduling an appointment with a new doctor in July.

 

I was feeling more anxious in July. Not every day, just occasional evenings. Mostly, my gut was sometimes a mess — I had a lot of IBS symptoms. When I saw my doctor, I asked to be put back on 25mg sertraline. It worked, and then it didn't. In late September, I began getting chronic, all-day headaches that lasted from early morning to the time I went to bed. I thought it was some kind of sinus infection, and to save money, did a teledoc appointment where a nurse practitioner wrote me a script for antibiotics. The antibiotics didn't work, and over the course of a month, I felt sicker. It was then I began to worry about some serious ailment, and after going to a walk-in clinic when I was feeling rather sick, I was sent to the ER with 160/100 blood pressure. They did a CT scan and tested my blood and everything was normal. The next day, my doctor's PA upped my sertraline to 50mg, convinced it was anxiety.

 

Within 12 hours, I knew something was wrong. My whole body was shaking, I felt like my heart was beating through my chest, I had to urinate every 30 minutes. It was crazy. At first, I told myself it was just the anxiety, but it was always bad after taking the pill and got better in the evening. After 5 days of this hell, my doctor said to taper over a week. I didn't listen, but went cold turkey. At first, I was shaky but fine. Then I experienced a week of near-black depression. I've never struggled with that before, but they only way I can describe it is like staring at a black wall. You can't even see or think about anything. By Thanksgiving, I was stabilizing, and doing better and better. In early December, I then had an episode of anxiety that hit in the evening. My heart was pounding and I felt sick to my stomach. Angry, I decided to try taking 12.5mg of the sertraline again. Within an hour, it felt like my brain was on speed. My wife woke up and found me running around our basement because I felt I had to move. She suggested, actually demanded, going to see a psychiatrist. She works with moms who suffer from anxiety/PPD. I put it off, thinking I would stabilize, but I didn't. By the next week, I felt like all my nerves were on fire, I had no patience, noises were making me jump, and I began to have the complete inability to sleep. Every time I would drift to the edge of sleep, I'd wake up with a racing heart. My doctor saw me and prescribed buspirone and Ambien. I tried the Ambien twice — both days after were hellish and painful beyond belief. I had to take Xanax to get rid of the horrible fiery pain they caused me. 

 

As Christmas approached, I was desperate. I had been so normal just a few weeks prior. I had my girls and pregnant wife to think about. I couldn't fall apart, but I was. I ended up in a day program at a psychiatric hospital for 3 days where I was diagnosed with generalized anxiety and given 100mg of trazodone. It helped me sleep, and boy was I happy for it! At a followup the next week, I was then prescribed 5mg escitalopram. I began to stabilize. I was sleeping, I wasn't jumping at sounds, my anxiety was slowly resolving, but I still felt off. My body still felt out of sync. I learned about autosomatic dysfunction. I also tried to taper the trazodone because it made me feel zonked all day every day, but within two days felt like someone had poured battery acid in my veins. I was fine again within 24 hours of taking the 100mg again. In early February, I began researching something I'd thought of way back in October — the effects of different generics. For years, I had been on the generic sertraline manufactured by Pfizer's subsidiary Greenstone. Last July, I was started on a brand from the Indian company Aurobindo. As I researched, I began finding testimonies of people saying the Aurobindo brand make them feel like they were on speed. I asked my psychiatrist about it and talked to my pharmacist who used to work for Pfizer and had heard of similar situations. My psychiatrist then had me stop the escitalopram and trazodone (he said cold turkey, but I tapered to 25mg of trazodone in a week) while restarting the sertraline at 25mg. Within a few days, most of my symptoms went away. I learned more about post acute withdrawal and generic switches. I was angry no one had thought of that except my pharmacist.

 

Stopping the escitalopram had to effects, but the trazodone nearly killed me. I learned about trazodone's short half-life and was, again, angry no one had explained this to me. I came home from work one day in horrible, burning pain and felt panic setting in. I couldn't even play with my girls – I had lost the ability to sit still. I called my doctor who said to take .75mg of Xanax and that stopped the pain. He then met with me and prescribed .5mg Klonopin as needed and planned a 6 week taper of the trazodone. I am currently 3 weeks in and at 37.5mg. Every little step has come with pain and a few restless/sleepless nights, but I've been in a good mood and have been very productive the past few weeks. The most recent taper had me switch to 50mg pills that are made by Tiva, a different generic, so I am concerned that this might exacerbate withdrawal symptoms.

 

Overall, I am very angry with the way these medications are offered without talking about the risks. I'd pay everything in my bank account to be able to deal with the occasional anxious nights I had last summer as opposed to the painful misery of today. I am grateful to now know, however, that it wasn't me going crazy and that I don't have major generalized anxiety disorder – that 90% of my symptoms have been medically induced.

My questions in coming to the forums are as follows:
1) Has anyone ever experienced such pronounced withdrawal symptoms after less than 3 months on an antidepressant?

2) Has anyone had a similar experience tapering from trazodone? 
3) One of the major symptoms I had on the Aurobindo brand of sertraline was chronic all-day headaches. I've been getting them again more again now that I'm back on the sertraline (but on the Greenstone brand). I have no idea if the headaches are simply being caused by the fluctuations in my serotogenic systems or by the drug itself. Has anyone else experienced dull, constant headaches that last all day? My research into it has turned up nothing.

4) Has anyone experienced changes switching from one generic to another?

Thanks for being a resource!

- Joel

 

_____

Current medications: 37.5mg trazodone, 25mg sertraline, .5mg Klonopin as needed during taper

(I should mention I also completed 3 months of CBT which was far more helpful than the meds)

[manymoretodays]

Hi ForMyGirls and welcome aboard,

 

I think you've definitely come to the right place for more information, and support for tapering.

So......you've been on at least one psychotropic medication/drug now since 2013?  Or on and off them it appears. 

 

What we often see is that, that can, and often does dysregulate the  CNS(central nervous System) and ANS(autonomic nervous system). When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.

 

I'm seeing that you came off the sertraline in 2016.......but then began using some Xanax, as well as some dosing with some left over sertraline.  And then tried some other medications more recently too........settling back on the sertraline again.

 

And thanks so much for doing your signature. If you could add a few more details, with dates.......that would be great.  I'll include a bit from the signature topic for you here that will hopefully make that go a bit easier.

 

Your signature appears under all your posts.  It acts as a quick reference for us too, as far as your history goes, and what you are presently on.

 

If your drug history is very long, the last few years will do. FOR READABILITY, SHORT LINES ARE BEST.

 

• A list is easier to understand than one or multiple paragraphs
• Include ALL drugs, doses, and dates (starting and stopping)
• Any drugs prior to 24 months ago can just be listed with start and stop years
• Please use actual dates or approximate dates (e.g. mid-June) rather than relative time frames (e.g. 3 months ago)
• Spell out months (e.g. "January" or "Jan" as 9/1/2016 can be interpreted as 9 Jan 2016 or 1 Sept 2016)
• Please leave out symptoms and diagnoses

 

I think if you could just get more dates and years in with your drug history.......that would be really helpful. 

 

How have you been tapering the trazodone so far?

And how often have you been taking the .5 mg of Klonopin?

 

I'm glad that the CBT worked really well for you and that you can still practice that.  The more non-drug coping you can learn and practice now........the better.   Do feel free to look around at our different forums especially Symptoms and Self Care.  I'll go ahead and link you up with some important information for you to take a look at too, in the next post.

 

On 3/18/2019 at 8:27 AM, ForMyGirls said:

My questions in coming to the forums are as follows:
1) Has anyone ever experienced such pronounced withdrawal symptoms after less than 3 months on an antidepressant?

2) Has anyone had a similar experience tapering from trazodone? 
3) One of the major symptoms I had on the Aurobindo brand of sertraline was chronic all-day headaches. I've been getting them again more again now that I'm back on the sertraline (but on the Greenstone brand). I have no idea if the headaches are simply being caused by the fluctuations in my serotogenic systems or by the drug itself. Has anyone else experienced dull, constant headaches that last all day? My research into it has turned up nothing.

4) Has anyone experienced changes switching from one generic to another?

 1.  Yes.  And I think that some of your symptoms are due not only to W/D(withdrawal), from a drug on for just 3 months,  but also to the on and off again nature of your medication/drug usage to date, since 2013.  The CNS really craves stability.

2.  I never was on trazodone for long myself or tapered it, but you will find other members here who have.   And it does have an "evil" metabolite that can result in adverse symptoms as well.  I'll link you to the information that we have on it, in my next post.......so you can read more about it.

3.  I've had headaches but not constant during W/D and before.  Mine are usually resolved with occasional ibuprofen.

4.  Yes, we see this a lot.  That changes in drug formulation may result in W/D symptoms. 

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

 

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

Edited March 21, 2019 by manymoretodays

[manymoretodays]

Helpful topics and links:

The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

**Why taper by 10% of my dosage?

    

*Tips for tapering off trazodone
^ and more about trazodone can be found here

 

Brain Remodelling

 

*What is withdrawal syndrome?

 

The windows and waves pattern of withdrawal and stabilization

 

Dr.Glenmullen’s withdrawal symptom list

 

*If you would also plug your current medications into this drug interaction checker that should prove helpful too.

Go ahead and copy and paste the results here,  on your intro/journal page for us too.  Thanks.

 

Welcome again,

L, P, H, and G,

mmt

 

Edited March 21, 2019 by manymoretodays
*'s added

[ForMyGirls]

Topic title:  the final push to be off meds

 

Hi all,

 

I'm relatively new here, but I've appreciated the information this site has to offer. I posted an intro over a month back when I was halfway through a taper from Trazodone that I'd been on for 2 months. Just being on the Trazodone for 2 months required a month of tapering and now nearly a month off before I can say the withdrawal symptoms are 90% better.

 

Long story short, I was free from antidepressants until last year. I'd tapered off 25mg sertraline for panic attacks in late 2016 and was doing well until a work trip to Africa. I'd brought my old Xanax and sertraline prescriptions in case I felt anxious, and the first night I took a sertraline pill because I thought it was far better than taking a benzo. Five days later, I had what I now know are withdrawal symptoms and immediately went back on the prescription till it ran out a month later. Fast forward to July, and I was feeling anxious/sick (partially because of actual anxiety, but I'm sure there were also WD symptoms there) and my new doc put me back on 25mg sertraline. It was a different brand and made me feel weird. I injured my back in August and started to get headaches. In late October, I was feeling more anxious and sick from the headaches. My doctor thought it was just anxiety and upped me to 50mg sertraline. I had a massive reaction to the new pill and came off cold turkey 4 days later. I spent 4 weeks being depressed and sick from WD when I had never experienced acute depression before. Stupidly, I tried taking 12.5mg in early December and that destabilized me. I went from being a person with the occasional anxiety episode to losing my mind.

 

A well meaning psychiatrist diagnosed me with anxiety disorder (such a fun label) and gave me Trazodone for sleep. It helped me sleep, but it gave me horrible nerve pain. He then prescribed Lexapro to further help my anxiety. The Lexapro did nothing and the Trazodone was so horrible that I kept trying to reduce the dose. In February, he told me I could quit it cold turkey. I stopped the Lexapro with no WD and tapered Trazodone over a week, thinking I'd only been on it for 2 months, and then realized it was going to take longer. The mCPP metabolite in Trazodone exacerbated feelings of anxiety I'd never had so strongly, so with my doctor I weaned off a bit faster than planned (4 weeks) and I've been off the Trazodone for almost 4 weeks. I feel better than I have in nearly 6 months. Over this period, I was prescribed Klonopin as it was the only thing that controlled the hellish nerve pain and electric shocks the withdrawal caused. I also decided with my primary doctor to reinstate the generic of sertraline (Greenstone) I had been on for several years and that did help curb the WD/somatic symptoms I'd had since taking that fatal 12.5mg dose of the other generic (Aurobindo) in December.

 

I haven't had to take a Klonopin in 8 days, and don't plan to, but I have noticed over the past few days that I've had random waves of tinnitus, nervousness for no reason, and insomnia that I'm wondering is a WD symptom from the Klonopin. I was only taking it every 2-3 days, and mostly only .25mg-.5mg, but I know how quickly benzos can establish dependency.

 

I'm now faced with a question of whether and when to come off the Greenstone sertraline. The headaches I got when I started the Aurobindo generic in July have, unfortunately, come back. I'm seeing a chiropractor and naturopath to explore alternate treatment, but if the headache is not mechanical, but caused by the sertraline, the logical conclusion would be to quit it. However, after finally having general stability (I am finally feeling like a productive parent, husband, and worker and really enjoying things again after months of hell), I'm worried about this last step. I DO have anxiety, and while I have learned SO much about myself and healing through CBT sessions, CBD oil, supplements (especially B12), medication, and chiropractic care, I'm creating panic and anxiety in myself by worrying about what the sertraline is doing to me. I'd like to try going down to 12.5mg for two weeks and see how I do, but I'm in this guessing game of what symptoms are being caused by the sertraline, what by the trazodone WD, and what now from the Klonopin WD. I also have a new baby arriving in two weeks, so timing is a crucial decision here! I don't want to destabilize myself — really, this constant headache is my only massive complaint — but I also don't want to become further "hooked" on the sertraline. I'm curious to hear anyone's thoughts on how to proceed in this case. I've found having a plan is the best at reducing any anxiety over guesswork.

 

Edited April 24, 2019 by ChessieCat
added topic title

[ForMyGirls]

Topic title:  Anyone Else Have a Constant Headache?

 

Hey all,

 

Anyone else have a constant headache and neck tension — not just the electrical ones caused by withdrawal, but just a constant, dull headache? I restarted a different generic of sertraline 25mg last summer (made by the Indian company Aurobindo) and after having a bad reaction when my doctor tried to up the dose, began my journey of getting off the med for good. My doctor upped the dose because I was having trouble with a constant headache and mild lethargy, and thought the problem might be latent anxiety (one of my final lessons in taking a doctor's advice at face value). It wasn't until I had the reaction that I thought my month-long headache might have to do with the sertraline itself. After coming off the sertraline, my headache did go away within a few weeks, but then a mild anxiety episode prompted me to be stupid and take a 12.5mg dose one night, which led to 3 weeks of further, insane nervous destabilization (insomnia, headaches, palpations, wired feeling, etc). A doctor then prescribed trazodone to stabilize me (and I followed his advice, again, stupidly, believing the nonsense about being chemically 'imbalanced'). It did stabilize me and knocked me out, but it also caused horrible nerve pain and anxiety (that lovable mCPP metabolite). I was on it for 3 months total and I've been off for 1 month. To help me stabilize overall, after learning in February how different generics can cause odd side effects and how ADWD truly works (and wondering why doctors don't know this stuff!), I asked to go back on my original generic of sertraline for cross taper (Greenstone, made by Zoloft's creator, Pfizer) with the goal of being off these evil meds for good by July. When I got to 37.5mg on my trazodone taper (and 4 weeks into my sertraline restart), I started getting the same dull, constant headache.

 

I know there's no way to really know what's causing the headache. It started 2 months into starting the Aurobindo sertraline. It started back up a month into restarting my original Greenstone generic, which was also in the middle of another AD taper. To top it all off, I threw my back out bad last summer and then went to go hike the Grand Canyon 4 days later. I've started seeing a chiropractor who has identified via X-Ray that I have misaligned vertebrae.

 

The question I'm pondering over and over is whether anyone has had a symptom like this, either as a side effect of WD or as a side effect of a medication. I'm fortunate in that my pharma-nightmare has been over a short period and at low doses. The fact that it's made me so sick these past months makes me tip my hat to the veterans on this site who have had to come down off multiple drugs over years. Your stories matter, because they are a big part of the reason I decided not to let the medical establishment pull me further into its unwavering philosophies of passing out pills like candy. Has anyone experienced a dull tension-type headache like this, either while taking or while discontinuing a drug? I should note that the brain zaps and hellish nerve pain I got upon cessation of the trazodone have been fading (90% better now, although I admit I stopped the taper two weeks early), but this tension headache has remained constant. Back in December/January, when I was in the thick of it, I told myself I'd be happy just to get back to a place where my main concern was headaches. I'm back to that now, but my goal isn't to feel 90% better. It's to feel better and more alive than I ever have before. These drugs took something from me, but in an ironic way, they've made me realize how much I can become and how amazing life is, because if you can look through the chaos of these "medicines" and seize the will to live, to love, and to thrive, you can do anything. And yet, despite that empowerment, the headache remains, and I won't rest until I've vanquished it! (Now I'm waxing poetic, so I'll stop).

 

Edited April 24, 2019 by ChessieCat
added topic title

[ChessieCat]

There are many existing topics on SA.  I like to use google and add survivingantidepressants.org to my search term.

 

migraines-headaches-neck-ache-pain-and-head-pressure

 

[ForMyGirls]

Now that I know how the forums work a bit better, figured I'd post an update here for anyone who comes across my profile. My headaches haven't gotten better or worse in the last several weeks, so I've decided to start tapering my sertraline down to 12.5mg from 25mg. I've read all the advice on the forums regarding cutting pills and am doing an okay job of getting a 25% reduction of the pill (and hoping I'm not too sensitive to a bit of give on either side). I've come off sertraline several times before, and it was only the last two that I had any trouble. I didn't used to have headaches on sertraline, and quite honestly, with everything I've been through with these meds in the last year, I wouldn't mind stabilizing on it a bit, but the shoulder/jaw/neck/head ache is driving me a bit crazy just like it did back in September and October. I know SSRIs can affect dopamine pathways and cause muscular tension. I used to have sore calves and a mildly upset stomach when I woke up on sertraline back in 2014-2016. Now those symptoms are gone and it's just pain in my head and neck. When I went off it in November, the same aches went away after about 2 weeks.

 

I wish I would have thrown away the remaining old sertraline I had in March 2018 instead of bringing it with me on a work trip. I thought that taking it for a flight would be better than taking a Xanax when I was being worried about leaving my family on an extended trip for the first time. Boy oh boy was I wrong! I thought the symptoms that started 4 days later were panic attacks when I now know they were withdrawal symptoms. I then went back on it for 4 weeks, went off for two months, then went back on it because I didn't know what withdrawal symptoms looked like and I thought it was all anxiety. Live and learn. Here's to the first reduction of the sertraline. I plan on going a bit faster since I've only been on for 2 months. If the tension/pain reduces at a lower dose, I plan to hold for at least a month. Here's praying for that!

[Songbird]

On 5/2/2019 at 7:16 AM, ForMyGirls said:

Now that I know how the forums work a bit better, figured I'd post an update here for anyone who comes across my profile. My headaches haven't gotten better or worse in the last several weeks, so I've decided to start tapering my sertraline down to 12.5mg from 25mg. 

 

Please do not do a 50% reduction of sertraline - that's seriously asking for trouble.  It could end up a lot worse than the headaches.  You've been through a lot of drug changes recently - why not take some time to let those settle and get really stable, and then taper the sertraline slowly.

 

See:  Why taper by 10% of my dosage?

The rule of 3KIS - keep it simple keep it slow keep it stable

Before you begin tapering - what you need to know

[ForMyGirls]

Wanted to update here for all the other people searching through Google and these forums for stages of recovery. First, I want to say again that I'm thankful this site exists and that I found this information before the roller coaster of drug interventions got out of hand. I really though I was going crazy back last Dec/Jan when I was going through the worst of the withdrawal from the initial, Indian brand of Zoloft that caused so much misery after just a few doses.

 

I have been completely medicine free since May 12. In general, I have seen a massive improvement. Except for ringing in my ears from some WD effect, I've been enjoying life and the birth of a new child. I have more to fight for now than ever. It does get better. I'm happy to say my mood has improved, I'm not having random crying spells every two minutes for no reason, and I'm back to doing things and planning for the future. If I would have never learned about WD, I might still be on a cocktail of drugs. The education this site offers was integral to that; it puts the academic and medical world to shame.

 

One question. The past few days, I've started to have the same headache I had on the sertraline again. It's located in the neck and radiates into the head. It feels electrical and I feel fatigued. Last night, I also had the familiar dysregulation with my sleep cycle for the first time in weeks (buzzing in my head combined with sleep starts and overheating). This is a bit discouraging, as the muscle pain, electric feelings, and sleep dysfunction went away several weeks ago (end of May). It feels odd to have such a pronounced WD effect pop back up after resolving weeks ago. I've read the community posts on "waves and windows" and discussed this with my chiropractor (who has been amazing) in terms of how the nervous system heals. I would just like to hear from someone who experienced a return of WD symptoms after they recovered from the initial WD symptoms of total discontinuation.

[RichT]

Hi ForMyGirls,

 

I think your experience of wd effects coming back after they resolved is shared by very many people on these forums, almost all in fact! It’s an unfortunate fact of life in withdrawal.

 

I hope you return to the good place you’ve been in very soon.

 

Warmest wishes,

 

Rich

[ForMyGirls]

Thought of this site and wanted to share an update for people like me who read so many stories looking for answers and hope. I’ve still got some scars from the WD, including daily tinnitus that is sometimes very quiet and other times very loud depending on the day and stress levels. I get frayed easily now by stressors, but I’ve been keeping up with a job change and a newborn and loving the way I can be a “person” again - feel awake and alive and engaged - even though my autonomous systems are still out of sort. I’m becoming more adventurous and willing to take risks - betting on the fact that my body needs new experiences to relearn how to regulate itself. That’s been the biggest help: don’t overdo it, but focus on one adventurous thing you can do each day. For me as a Christian, giving up my perception of control to God and leaning into whatever suffering I may feel on a given day, but existing through it and using it to somehow better love and serve others has been a life lesson worth it’s weight in gold. 
 

I still return to the site occasionally because I have times where my heart is pounding 20 beats higher at rest for no apparent reason and I need reassurance about how the adrenals/autonomic system works and that I’m not crazy to think that WD combined with my own propensity for worry is a difficult mountain to climb. I thank Alto and everyone who went before, that they endured and made record of this process to help people through what is really the hardest fight and greatest pain one could imagine existing through.

 

I tapered quickly last spring. Off two medicines in the matter of 3 months. I know that goes against advice here, but even though I made it harder on myself, I’m glad to be done with it. On the days when my adrenals are acting weird or I get phantom pains of my old electric headaches or I have trouble sleeping (which has gotten better each day step by step), I can remind myself that so many people have gone through this and endured!

[Ripley66]

On 9/27/2019 at 7:34 PM, ForMyGirls said:

still return to the site occasionally because I have times where my heart is pounding 20 beats higher at rest for no apparent reason and I need reassurance about how the adrenals/autonomic system works

I had random waves of increased heartrate, sometimes out of nowhere, "bad days" where I didn't know what was wrong with my nervous system. I had this before my experiences with medication. It is very normal with anxiety disorders. 

Now that you have experienced a sensitized nervous system it makes sense to me that maybe your anxiety is a bit higher...I know after my serious WD experiences my regular anxiety felt more like an apprehension that WD would come back, so I was hyperaware of every symptom I felt.

Thats just my experience, but you know your body best. I find it fairly easy to distinguish between WD and my mental illness now mostly. WD anxiety feels chemically pervasive and ominous. My regular anxiety is largely situational worry and some increase in heart rate. My WD anxiety usually spikes without warning and my regular anxiety has a situational trigger.

All the best