BreathofAir: dual taper mistake

[Sassenach]

Hi Rachel

 

How are you doing now.

What dose are you on now ?

It will be ok, you will get there.

I feel so sorry for you and your family.

You have been in the worst situation at the very bottom but you can go up from here.

Please keep in touch even if only to vent anger because isolation does not help.

You are not being a nuisance or an annoyance it is why we are here, because we have all been at the bottom.

Stay strong.

 

Hugs from Scotland.

 

Sassenach

[Altostrata]

On 5/10/2019 at 12:56 PM, BreathofAir said:

Thank you Alto for your detailed post. 

 

The team ramped me up to 5mg two days ago.  What should I do, go back down to 1mg? 

 

What a cluster mess.  I feel that I am completely out of control with my regimen now.  The updose of Diazepam did not do anything for my anxiety and the only thing that has any effect so far on the severe suicidal thoughts is the Lorazepam, which I was adamant I would not go back on.  

 

I feel as though the depression and anxiety are rapidly spiralling each day and I am clinging to the awful Lorazepam to prevent suicide.  

 

I just don’t know what else to do as I am severely agitated to self sooth.  I’m exhausted. 

 

But thank you so much for taking the time for me.  Bless you. 

Xxxxxxxxxxxxxxx

 

 

 

5mg of what drug? Did it cause a change in your symptoms? Since you are making drug changes, I would keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

This will enable you to see if you are having adverse drug effects.

[BreathofAir]

Thank you Alto, 

 

I have amended my signature.

 

Daily notes:

 

9pm               1mg Diazepam           10pm      7.5mg Zopiclone 

 

Anxious about the following day. Suicidal thoughts constant. Dragging out bedtime routine by colouring or stretching and breathing.  Lay down and try to fall asleep, body starts burning anxiety after 30 minutes and becomes more agitated.  End up taking Zopiclone.

 

12am /1am/4am  wake up, feeling lesser anxiety, but disoriented and agitated. Try to drop back off. Dreading day ahead. 

 

6-7am           1mg Diazepam. Get back into bed to try to motivate for rest of day. Toss and turn, drift in and out. Suicidal.

7.30am         House wakes up. By now have severe burning anxiety and agitation. Try to shower, see my daughter, eat banana             8am               1mg Lorazepam drink water.  Get dressed, eat porridge. 

9am               5mg Escitalopram 

10am             Crisis team arrive for assessment.  Feel extremely depressed, crying, unmotivated.

11am             Go for 1 hour walk with husband.  Have no interest in the walk. Can barely talk. Just want to cry and sit down.

12noon          Lunch. Fish and salad. Can’t eat with anyone. Force down food, feel nauseous and repelled by food.

1pm                Wander around house and garden aimlessly. No interest in anything. Small household chores.     

 

So far since since reinstating Escitalopram have felt no change in anxiety and agitation levels.  Mornings are the same every day. Mood is extremely flat. No interest in anything at all.  Cannot read usual books, watch tv, listen to music, or be around my daughter very much, as this is severely distressing to me. Can talk to certain people for no more than half an hour, then become agitated. 

 

The Lorazepam has taken the edge off the anxiety/akathisia, but I am afraid that depression is now taking over and I am worried that I will have no effect from the Escitalopram.  I am still severely S.  I know what Zopiclone/ benzos do in terms of depression, but the severely agitated state prior to taking the Lorazepam was intolerable and the insomnia made me delirious very quickly. 

 

I don’t really know if there is anything else that can help me, other than time.  I am just exhausted fighting the suicidal feelings and when I can barely distract myself, I am finding it such a battle.  I am so very scared. 

 

Thank you everyone for being there, for keeping going on in your own situations and caring.  I wish you all well. 

Rachel 

xxxxxxxxxxxx

 

 

 

    

[RichT]

Thanks Rachel, stick with it! It looks like you’re getting at least some sleep now, is that right? If so,that will be a help in itself.

 

i’m sorry You’re suffering so much

 

R

[bubble]

Hang in there. I think you are doing all the right things. 5 years ago I also CT-ed Escitalopram and was in a bad state. I also went back to 5 mg and at first I was only happy that things didn't get worse and worse like they did before the reinstatement. Gradually it got better. But it took a few days to notice a more visible improvement.

 

It is extremely scary but time is your friend. It will get better.

[BreathofAir]

Thank you Bubble, Rich, Alto and Sass, 

 

I am trying so hard to keep doing normal things and because I am so depressed, it is causing so much agitation.  Do I just keep doing these things little by little, then running to my safe place when the anxiety gets out of control? 

 

I feel as though I have gone so oversensitive.  I could not cut the grass without crying. I am waiting for therapy to start, but I just wish I could develop some basic coping strategies instead of try, get very upset and spiral into suicidal anxiety.  Is my brain so screwed up this badly? 

 

I am so sorry, I try to research but cannot cope with lots of information right now. I am holding on so tightly every day. 

 

Thank you all so much and best wishes to you. Xxxxxxxxxxxxxxxxxxxxxxxx

 

 

 

 

[Sassenach]

Hi Rachel

 

I c/ted escitaprom 10 mgs in December 2018, stuck with it for 3 months and had to reinstate to 5mgs.

You are only 3 days into reinstatement, and I know it already feels like forever, but it takes 4/5 days reach a level in your body and another couple of days for your brain to register the drug.

It was my 6th day when I felt some slight change and the tenth when I felt just a little bit better.

When you reach that point you start and believe that hope is there.

It is just the beginning, but we all have start somewhere.

It is normal to be demotivated and unable to engage

You went for a walk, small household chores, those are major events at the moment.

Do what you are comfortable with and be where you feel safe.

I only know my experience but my brain was seriously screwed up but is now mending. I know I am going to get there.

You will too.

Time really is the healer in this case and time seems warped, bad days last forever, good days zoom by but they are still good days.

You have your friends on here, you can say whatever makes you feel better, we do not judge.

Hang in there and keep talking to us.

Wishing lots of strength for the next few days.

 

Sassenach

[BreathofAir]

Dear Sassenach, 

 

Thank you once again for your wise and kind words and their timing.  How are you feeling? 

 

I am sitting in my bed in a quiet house. My husband and daughter are asleep in the next room.  My husband is drawn and exhausted after another fraught day, and my daughter is increasingly bewildered by the disappearance of her mother.  I know they have each other. 

 

This is the most searingly lonely and powerless I have ever felt in my life and I have seen and been through many deeply distressing times.  

 

You are right that I am in the early days with regards to reinstating, but this mental health battle has been with me a long time.  The urgency and desperation I feel now has more to do with the force and persistence of the suicidal feelings.  These literally appeared within days of my last tablet and have not let up for one second.  I truly see that my brain has disintegrated and there is just a tiny portion remaining with its fingers hooked on to the cliff edge.  That’s how it feels.  At first the anxiety fried me and now the depression is crushing me as well and I don’t know where to find the coping or distraction skills given that one moment I’m so extremely agitated I pace like a wind-up toy, and the next I’m weeping and wailing and cannot let go of my bed.

 

My dependency on further medication to sleep and stave off the S attempts has also shattered any confidence I had because I now feel in an extremely precarious position. I can’t tell if the Escitalopram or the benzos are aggravating things because I’m pretty much on the ceiling all day and have been from day one.  I just feel my mind is lost and I can’t make sense of anything to try to recapture some control.

 

I am so sorry to go on in the way I do.  I have nowhere else to speak like this and really voice my fears and wishes to just disappear out of this terror, but not to leave a huge print of pain behind, just to quietly erase myself as if I was never here. 

 

I know I must try to be more positive.  I just don’t have that personality, even though I believe in the power of suggestion.  I am just too superstitious and cynical.  

 

Please forgive these morbid ramblings. I just can’t help it right now.  Bless you so very much for being a positive and sensible voice out there.  I am truly grateful to you.  I hope you continue onwards and upwards on your recovery journey. I am so pleased for you. 

 

Goodnight. Sleep well. Heal well. May peace keep you safe and calm. 

Rachel 

xxxxxxxxxxxxxxxxxx

 

 

 

 

 

 

[bubble]

5 hours ago, BreathofAir said:

Do I just keep doing these things little by little, then running to my safe place when the anxiety gets out of control? 

You don't have to force yourself to do anything especially if it makes you feel worse. Imagine you are in early days of recovery from a bad physical injury. I bet your expectations from yourself would be a lot more modest. I can only echo what Sass put so nicely.

 

Don't worry about your daughter at the moment. Parents get ill with various things and children cope. It's all temporary. The fact that it feels like it will be forever is just another symptom. Don't worry about oversensitivity in the same way you wouldn't worry that you can't walk if you had a broken leg. Also there is no need to force yourself to be positive. Just be very gentle with yourself and pamper yourself. Your brain is working on fixing itself. I like it very much that you go for a walk. You don't have to enjoy it at the moment (as long as it is not making you worse) - your brain is getting soothing messages although you might not feel it. Its ability to heal itself is icredible. 

Also don't feel bad about taking drugs which help you. It is harm reduction. You will deal with them when you get stronger. You are making it.

[RichT]

Hi Rachel,

 

I really relate to your feelings. I too have felt I want to ‘unexist’. I know the power of SI feelings. I am so sorry you’re going through this. It is great that you can express your feelings here.

 

I reinstated Abilify after an onset of withdrawal symptoms, and it took about a week and a half to kick in before I felt any effects. That could well happen to you too - it happened to Sassenach! 

 

When end you start therapy, that will help too.

 

You will get better - this won’t last forever.

 

thinking of you, I hope you get some rest tonight

 

Rich

 

 

 

 

[Songbird]

When I've crashed and updosed I've found it takes two to three weeks to feel a significant improvement, and there are still ups and downs along the way to stabilising.  I found it helped to keep telling myself that the updose was working even if I couldn't feel it just yet.  I've also found that when I've been in a severe anxiety state for a while, when it finally abates I've been left with feeling quite depressed.  I believe this may happen because it's quite exhausting for the body to remain in a high anxiety state, so what you're feeling as depression is kind of the aftermath of anxiety.  You might like to think of the depressed feeling as your body being tired and needing a rest.  If you're feeling tearful, having a good cry can often be helpful.

[Sassenach]

RxHi. Pl Rachel hi stop worrying about the past you cannot change it and you did not cause it 

I reinstated escitalopram after 3 month cold turkey it took 10 days for my first relief to be felt but now 8 weeks on I am now feeling much better you can do the same you will get the help and encouragement you need on this site look after yourself we'll speak later try and have a good day bye

[Sassenach]

Good morning Rachel songbird set it beautifully in her post and I learnt something as well which is always good I hope you are feeling a little better this morning more importantly I hope you are also telling your psychiatrists what you are telling us on this site they are also here to help you you still keep saying sorry please don't we're here to help you were here to listen and above all we here to try and help you get stronger speak to you later strength for today sassenach

[Sassenach]

Apologies for the grammar not good at dictating on the phone yet but trying to learn bye

 

[BreathofAir]

Terrible night

No sleep, in and out of terror and nausea all night. 

 

Is there nothing that will help me off to sleep and keep me asleep?  What has happened to my brain that it is so terrified of sleep.

 

Exhausted, hopeless, cannot get out of bed. So nauseous cannot eat. Locked in syndrome. Everything filled with terror other than my colouring pencils.  Can’t read or watch anything. My family and friends trigger me.  Can’t get comfortable anywhere. The state of heightened anxiety is like being suspended between electric currents. 

 

I cannot nap for relief during the day. I stare into space trying to block out the auditory hallucinations.  I dare not close my eyes. 

 

I just want to go. I can’t take it. I don’t know what to do.  Xxxxxxxxxx

 

 

[Songbird]

You never answered my question about whether you tried the "Just Relax" video.  It starts with movement and gradually calms your body down.  Please try some relaxation exercises.  If you keep doing them, they really do work to calm down the severe anxiety.  A sleep hypnosis recording might be helpful for getting to sleep or at least rest.

[RichT]

Hi Rachel,

 

sorry to hear things are so terrible at the moment. 

 

Keep hanging on! Lots of people here are rooting for you. Things will change.

 

There is a thread on dealing with insomnia on this forum - sorry, I don’t know how to add a link.

 

There is a website  / app called Sleepio that might help, supported by the NHS. It easy to access if you’re in or near London, but I think it can be accessed on other parts of the country too.

https://www.nhs.uk/apps-library/sleepio/

 

warmest wishes,

 

Rich

 

 

[Sassenach]

Hi Rachel

 

Four days in your brain will not yet be aware of drug in your body, but it will be shortly.

When I first joined this site I thouight it would not be possible to feel worse but I now know that there are so many people worse off than me.

I have only one drug to contend with but I have experienced how good it feels to start to mend.

You say you have a history of mental health issues but to fight them you need your brain and body to heal.

You also say that these overpowering sensations started after your last pill so hopefully they will stop when your brain gets the message.

We all have an inner strength we do not believe is there until we really need it, you can be proactive and follow the help given by Rich and Songbird.

We all want you to get through.

 

When you walking through hell, keep walking.

 

Sleep tonight, tomorrow will come soon enough.

 

Sassenach

[Altostrata]

21 hours ago, BreathofAir said:

this mental health battle has been with me a long time.

 

What do you mean?

 

If I were you, I would not increase escilatopram beyond 5mg. If it was going to help, you'd feel it by now.

 

On 5/12/2019 at 5:37 AM, BreathofAir said:

body starts burning anxiety after 30 minutes and becomes more agitated.

 

@Shep, this looks to me like too much diazepam, what do you think?

 

Breath, we need to see notes for an entire 24-hour day (or more) to study your symptom pattern, thank you.

[BreathofAir]

Thank you Alto, 

 

I meant I have always had anxiety, but never to the extent of resorting to medication. 

 

Is it not too soon to feel the effects of the Escitalopram?  I was at 2.5mg for three days and this will be my fifth day at 5mg? 

 

Are you saying that the Escitalopram is possibly not working or working against me? 

 

I don’t feel my mental anxiety has abated at all and the 1mg Lorazepam is easing the akathisia and agitation, but not entirely.  My depression is now very severe and I am struggling to function because of this and lack of sleep. 

 

I really do not know what to do. My doctor has not got a clue and has pushed me on to the Crisis team, who do their best to counsel my suicidal thoughts. 

 

Everyone is predicting the medication should start working very soon and now I feel that hope has gone.  I am really really distressed. 

 

Xxxxxxxxxxxx

[Sassenach]

Hi Rachel

 

Are you feeling any better today?

Can I suggest you contact Alto again maybe use private messenger for initial contact.

I can only relate my own experience and what I have read on here.

The mods are asking specific questions which you are not fully answering. I know it is difficult but they need accurate information.

I am not sure whether Alto may have misunderstood, or whether your circumstances change the situation it is beyond my scope.

Take your time and spell out accurately the dates, dosages and names of the drugs you are curently taking, dates when you stopped and reinstated.

I know it is hard but you need to help them to help you.

There is a way forward and you will find it.

You said you live near Scotland so I am sending strength for today.

Please do this to help yourself and find the way forward.

 

Rooting for you.

 

Sassenach

[BreathofAir]

Dear Alto / Sassenach / Rich/ Bubble/ Songbird 

 

Thank you again for your generous support.   I am struggling to keep track of any slight variations in my symptoms because the severe anxiety has not let up since I crashed 3 weeks ago and the suicidal ideation is overwhelming day and night. My objectivity is not working so well. 

 

I thought I had put my dates in my signature. 

 

My med times are based around if can get up, if the night has been bad, but never deviate very far from:

7.30am            1mg Diazepam 

9.00am            5mg Escitalopram 

10.00am          1mg Lorazepam 

9.00pm            1mg Diazepam

10.00pm          7.5mg Zopiclone

 

I know I am “worse” in the mornings with a more physical component such as stronger nausea, shakes, knotted stomach, no inclination to eat or get going.   I feel no difference in the anxiety after taking 1mg of Diazepam or the Escitalopram.  

After coming out of hospital last Thursday, I have followed the same pattern every day virtually.  Try to do small household tasks, eat small meals at the same time.  Go in and out of bed when I feel too overwhelmed.  I have someone who helps take me to appointments, but I can only engage for around 30 minutes before becoming distressed.  Nothing distracts from my suicidal thoughts. 

 

I started to feel more “agitated depression” after leaving the hospital.  I don’t know if this is linked to using the Lorazepam, it is hard for me to tell.  

 

After my evening meal i usually feel less agitated, but my depression and suicidal thoughts never fluctuate that far throughout the day. 

 

I am keeping a log of things that I do each day. 

 

Sassenach, I just wanted to express my sincere gratitude that you care. I hope, in return, you are continuing to do well.  

 

I am now terrified to do anything with the Escitalopram other than wait for a further few days. 

 

Sending you all my best wishes for further healing and recovery.

xxxxxxxxxxxxxxxx

 

 

 

[Shep]

16 hours ago, Altostrata said:

@Shep, this looks to me like too much diazepam, what do you think?

 

Alto, I'm wondering about interdose withdrawal from the lorazepam. But I do think the diazepam may be contributing to the depression. 

 

12 minutes ago, BreathofAir said:

My med times are based around if can get up, if the night has been bad, but never deviate very far from:

7.30am            1mg Diazepam 

9.00am            5mg Escitalopram 

10.00am          1mg Lorazepam 

9.00pm            1mg Diazepam

10.00pm          7.5mg Zopiclone

 

On 5/8/2019 at 9:07 AM, BreathofAir said:

The Diazepam is not touching the symptoms.  The 1mg Lorazepam calms the akathisia a little. 

 

@BreathofAir I'm posting your latest schedule along with something you wrote last week about the Lorazepam helping. It may be less that the Lorazepam is helping and more that it's worn off in the morning and when you take it, it's stopping the interdose withdrawal. 

 

Lorazepam's half-life is only 10 - 20 hours. By taking it at 10 am, if you're a fast metabolizer, it's reached the half-life point by 8 pm, and if you're a slow metabolizer, you'll hit the half-life by 6 am the next day. 

 

I know you were having severe symptoms prior to adding the Lorazepam back in, but the interdose withdrawal may be making it worse, especially in the early morning, as well as making the insomnia worse. 

 

Some options:

 

1. Divide the 1 mg Lorazepam and take it three times a day.

 

2. Replace the 1 mg diazepam in the morning with the equivalent amount of Lorazepam (lorazepam is ten times more potent than diazepam, so 1 mg diazepam = .10 mg lorazepam). You may still need to divide out the lorazepam for more doses throughout the day. 

 

Questions that will help decide which to do:

 

1. How did your crossover from lorazepam to diazepam go last year?

 

2. Did you feel more depression on diazepam than on lorazepam? (I'm wondering if the diazepam is contributing to the depression and SI). 

 

28 minutes ago, BreathofAir said:

I started to feel more “agitated depression” after leaving the hospital.  I don’t know if this is linked to using the Lorazepam, it is hard for me to tell.  

 

3. Does the agitation get worse at 9 am when you take the Escitalopram? Does it get better or worse at 10 am when you take the lorazepam?

 

Another confounding factor are drug interactions. 

 

Report - drug interactions

 

You may be getting a drug interaction between the lorazepam and escitalopram, especially since you take them so close together. You may want to separate those two drugs by at least 2 hours. This will also help you tell the effects of each drug. The diazepam is also listed as having a moderate interaction, as well, but I think your diazepam spacing is okay. 

 

You also may be getting some interdose withdrawal from the Zopiclone, but it's not clear when you started taking that drug.

 

4. When did you start taking Zopiclone? Please list the date in your signature. A direct link to your signature is here:

 

Account - Settings - Signature

 

BreathofAir, I know this is a lot of information to place out here for you, so I've posted in blue the questions we need answers to. 

 

[BreathofAir]

Thank you Shep,

 

I had no problem crossing from Lorazepam to Diazepam last February that I can remember.  I need to go back through my records and see regarding depression.  I recall I had monthly mood and function drops whilst tapering, but nothing so severe and persistent as how I feel now.

 

This morning I took my Escitalopram on time and an hour later I noticed I felt much more agitated. This was during a Crisis team visit as well. 

 

I delayed the Lorazepam to see if I could go without it, but the agitation got too much, so I took it at 11.30 and had to go to my room.  I now feel slightly less agitated at 12.45.  I have an appointment with my doctor and this is where I was admitted to hospital from last week, so this is not helping the agitation either, from a psychological point of view. 

 

I will think a bit more and post back further details xxxxxxxxx

 

[BreathofAir]

Dear Shep/Alto, 

 

I have updated my signature as best as I can remember.

 

I see from my old notes that I complained of suicidal feelings on both Lorazepam and Diazepam whilst being on and tapering down the Escitalopram.  These drops in mood usually happened around the end of the month and either coincided with the week after my period ended or after a taper cut.  I would always pick up after each episode.

 

I feel very low, nauseous and jittery in the morning, with the usual feeling of dread that people describe with morning anxiety.  I don’t feel anything on taking the Diazepam or a while afterwards.  On taking the Escitalopram I am not sure if this is more psychological, since I am desperate for it to have some positive effect.  I feel that the Lorazepam has calmed me, but taken over three hours to do so today. 

 

I have seen my doctor this afternoon and he agrees with the hospital psych team that I need to be reinstated on the Escitalopram at the minimum therapeutic dose as safely as possible, titrating up in small increments (1.75 - 2.5mg every two weeks, as tolerated), with the use of Lorazepam if and when needed.  Their opinion is that I have untreated, uncontrolled, severe anxiety with some elements of withdrawal from both the ssri and benzo.  

 

No suggestion was made of amalgamating the Diazepam dose into the Lorazepam, as I have been viewing the Lorazepam as a separate entity.  Now, I don’t know. Psychologically it upsets me that I have gone from two to four drugs.  I keep trying every night not to take the Zopiclone, but the anxiety kicks in after an hour or so and I start to get very very distressed.  I have not tried taking the Lorazepam at night because I did not think it was a good idea? 

 

I don’t know what other information to add.   I thank you once again for all your time and help. It is very much appreciated. 

Rachel 

xxxxxx

 

 

[Sassenach]

Hi Rachel

 

Just to get this clear your GP wants you to reduce your current dose of 5mgs and then increase gradually from 1.75 to 2.5mgs.

Is that correct?

Have you taken 5mgs today?

Please do not change until you get a response from the mods in case a change could a catalyst for more problems.

Can you check back later ?

 

 

Sassenach

[BreathofAir]

Hi Sassenach, 

 

No, the plan is to titrate UP to a therapeutic dose, possibly 10mg, but done very gradually over several weeks.  The team wants me back on the medication for the foreseeable future because they want me to have therapy as well.  

 

How are you feeling yourself?  I know why and when you like to post and I understand.  I am a pathetic leech at the moment and wish I could flush away this terror and agitation so that I could be more use to people.

 

You seem very brave and sensible.  I have lost a lot of self control at the moment, all my defences have been flattened. 

I honestly don’t know what I will do if the Escitalopram doesn’t work.  I find the counselling and distraction techniques exhausting at the moment and my depressed mind so powerfully negative.  I need to learn how to have hope and faith. 

 

I hope you are well and feeling positive.  You are such a wonderful, kind, generous support here. Bless you so much. 

 

Rachel 

xxxxxxxxx

 

 

[Sassenach]

Hi Rachel

 

You are not a leech, you are a young woman going through hell, but neither are you a hopeless victim.

I get you still feel lousy but look back over earlier posts and the desperation is less intense.

You will get better in time.

Sleep better tonight.

I am doing OK thank you.

Positive thought can work wonders and you are slowly getting there.

 

Sassenach

[Shep]

5 hours ago, BreathofAir said:

This morning I took my Escitalopram on time and an hour later I noticed I felt much more agitated. This was during a Crisis team visit as well. 

 

Is there a chance that the Escitalopram is causing agitation? Does this happen if it the crisis team is not there?

 

29 minutes ago, BreathofAir said:

No, the plan is to titrate UP to a therapeutic dose, possibly 10mg, but done very gradually over several weeks.  The team wants me back on the medication for the foreseeable future because they want me to have therapy as well.  

 

Therapy may help you develop some non-drug coping skills, however, it will not help with nervous system deregulation caused by the drugs. Please see:

 

What is withdrawal syndrome?

 

Please note Alto's recommendation here:

 

On 5/10/2019 at 3:44 PM, Altostrata said:

Even though your care team will be eager to get you to a "therapeutic dose," please do not jump up in dosage. They probably don't understand your nervous system is bruised from withdrawal. Too high a dosage of escilatopram can irritate it more in a reaction called "kindling."

 

Kindling means that your nervous system is becoming more and more traumatized due to all of these changes. 

 

Regarding a "therapeutic dose", what works for you is therapeutic. If the drug makes you agitated, increasing the dose is likely to make you feel worse, so that's not therapeutic.

 

3 hours ago, BreathofAir said:

I have seen my doctor this afternoon and he agrees with the hospital psych team that I need to be reinstated on the Escitalopram at the minimum therapeutic dose as safely as possible, titrating up in small increments (1.75 - 2.5mg every two weeks, as tolerated), with the use of Lorazepam if and when needed.  Their opinion is that I have untreated, uncontrolled, severe anxiety with some elements of withdrawal from both the ssri and benzo.  

 

The doctor's opinion that you have a "untreated, uncontrolled, severe anxiety" is the chemical imbalance theory, which has been discredited. There is no "anxiety disorder", which is what it sounds like your doctor believes. 

 

Again, chemical imbalance is a myth. Stop the lies, please.

 

What you have is a very sensitive nervous system due to drugs and drug changes. That's not an untreated anxiety disorder. 

 

3 hours ago, BreathofAir said:

I see from my old notes that I complained of suicidal feelings on both Lorazepam and Diazepam whilst being on and tapering down the Escitalopram.  These drops in mood usually happened around the end of the month and either coincided with the week after my period ended or after a taper cut.  I would always pick up after each episode.

 

There may possibly be some hormonal issues going on, but I would be hesitant to increase the escitalopram, especially all the way up to 10 mg. I would give your nervous system time to adjust to the reinstatement and see if dealing with the interdose Lorazepam can help, as mentioned in my previous post. 

 

[RichT]

Hi Rachel,

 

You might be able to reconcile the views of Alto, Shep and your doctors - I was able to reconcile the views of Alto and Many more Days with my psychiatrist.

 

My psychiatrist suggested I reinstate at half dose or full dose of Abilify while the team at SA suggested a much lower dose. I asked my psychiatrist if I could try a low dose for a while and go up if it didn’t work, and he was open to that, even though it was  a ‘sub-therapeutic’ dose.

 

I hope you feel better soon

 

warmest wishes,

 

Rich

[Sassenach]

good morning Rachel and thank Rich T you beat me to it.

Remember your care team have a duty of care to you but they work for NHS.

They must stay within NHS guidelines which will put you back to  10 mgs in due course.

But they must follow your wishes and care for  you whatever your decision.

My GP changed his tune immediately once I told him what I wanted and helped, the same for Rich T

Take your time, look back at your posts and try to be objective about where you are now.

Remember you can still updose in a few days time if you wish.

You have Shep and Alto,s advice your body and brain need stability

Will be thinking of you at escitalopram time 9am.

Let us know your decision

We are all rooting for you.

 

Sassenach.

 

 

[BreathofAir]

Very bad night.  My brain will not allow me to drop off at all, neither day or night.  Anxiety so terrible this morning, feeling exhausted and delirious.  Husband wants me on a boot camp schedule of get up, eat a full bowl of porridge, shower, walk, household tasks, three walks a day.  He does not want me to take the Lorazepam. 

 

I have dreadful period pain this morning, my periods are all over the place, should not be having one again so soon.  I was crying and did not want to get up and my husband got angry. I know he is desperate and frightened.  I was so hysterical I asked for my Lorazepam early and he did not want me to have it and said only half.  I got so upset and I thought he would choke me when he pushed the pill into my mouth. 

 

My family cannot cope with me, hospital is even more distressing. I have nowhere to go.  I do my best for everyone trying to eat, walk, do small things.  My husband says I should read nothing of this sort and use exercise and distraction, but I am struggling with energy because of lack of sleep and depression.  I do what I can. 

 

I just want to go.  I am so traumatised and lacking in hope and resilience. 

 

I am so sorry everyone.  You are all doing so well.   Xxxxxxxxxxxxxxxxxxxxxxxxxxxxx

[BreathofAir]

My doctor also does not want me back on the higher doses of Escitalopram, he is hoping a lower dose will stabilise.  He agrees I am in withdrawal, but also that my psychological state was not prepared to cope because my previous anxiety was still there.  

 

My SI is so very bad today.  I don’t think you should all listen to me any more because I am so negative and distressing. 

I do thank you all so much for your support and kindness.  

 

I cant say anymore I am too upset xxxxxxxxx

[Songbird]

25 minutes ago, BreathofAir said:

I don’t think you should all listen to me any more because I am so negative and distressing. 

 

We want to help if we can.  I'll tell you the things that helped me when I was in a similar state:

 

1.The "Just Relax" yoga video - Please try it!!!!

2.  Sleep hynosis recording.

3.  Every day I made a list of things to do that day.  There were only a few things on it - not so much that it felt overwhelming.  I ticked off the items on the list as I did them so it felt like an achievement.

4.  Going for a walk - this was good, but I went once a day (not three - that sounds like a lot).

5.  Writing down positive affirmations, then reading them to myself several times a day.

6.  Journalling - just pouring stuff out - helps to get stuff out and stop it going round and round inside my head.

7.  Doing some easy, gentle household tasks - I liked hanging out laundry, bringing it in, folding it, putting it away.  I did it slowly and calmly.

8.  Practising Claire Weekes' techniques for anxiety.

9.  Practising breathing techniques for anxiety - in particular exhaling for twice as long as the inhale, e.g. in for 3 out for 6.

10.  Watching lightweight and amusing TV such as game shows.  (Seriously, Wheel of Fortune was the highlight of my day for a while!), and reading lightweight happy books such as romances.  (I avoided anything stimulating such as coffee, tea, alcohol, scary TV or movies, etc.).

11.  Sitting in the sun.

12.  Epsom salt baths.

 

That's all I can think of for now.  Please try to be kind to yourself.

[Shep]

1 hour ago, BreathofAir said:

My doctor also does not want me back on the higher doses of Escitalopram, he is hoping a lower dose will stabilise.  He agrees I am in withdrawal, but also that my psychological state was not prepared to cope because my previous anxiety was still there.

 

I'm glad your doctor is open to the lower dose approach and even recognizes withdrawal as a reality.

 

1 hour ago, BreathofAir said:

 I was so hysterical I asked for my Lorazepam early and he did not want me to have it and said only half.  I got so upset and I thought he would choke me when he pushed the pill into my mouth. 

 

Rachel, I'm very concerned about you. If you are not safe in your own home, please reach out to the Crisis team and let them know. If you need to go some place else for awhile, do you have a relative or close friend you could stay with? 

 

You are not hysterical. You did your research, you found a support and information site for withdrawal, and you are perfectly capable of handling your own drugs. Most people on these drugs never find SA or any other resource. So pat yourself on the back for being as capable as you are. 

 

It's important that you stay on a steady dose of lorazepam and are able to work out a schedule to handle interdose withdrawal. It's possible that interdose withdrawal and / or rebound benzo anxiety are at play. 

 

When you feel up to it, check out the list that Songbird left for you. You can find links to resources for many of them here:

 

Non-drug techniques to cope with emotional symptoms

 

Songbird mentions Dr. Claire Weekes work on anxiety and I also want to mention how wonderful her techniques are. She's a powerful resource.

 

Dr. Claire Weekes - How To Recover 01 video (17 minutes)

 

Dr. Claire Weekes - How To Recover 02 video (16 minutes)

 

Please let us know how you are doing. 

[RichT]

Hi Rachel,

 

I’m so sorry things are continuing to be so difficult for you.

 

From my own (quite extensive) experience of anxiety and powerful depressive feelings, I have noticed that feelings of depression mean you don’t want to do things, and anxiety tells you that you can’t manage to do them anyway.

 

But there are things that are good for you, such as self-care, being active, and getting gentle exercise and I think this is what your husband is trying to do.  

 

Maybe you can discuss the situation with him and agree what you’re going to do, then you might feel less that he is dictating what you do and more that you’re working together on this.

 

warmest wishes,

 

Rich