CatMan: Horrible morning anxiety / derealization

[CatMan]

Hi everyone, this is my first time posting here, hope that I am doing everything correctly. I am recovering from fluoxetine (Prozac), I took it for about 8 months and I have been off it for about 3 months now. I have searched a lot on the internet and this forum but I was not able to find anyone who suffers from similar issues, so I was hoping for some kind of support from here Every morning, I wake up with horrible anxiety and a feeling of "depersonalization", it is kind of like sitting in the back of your head and having some kind of tunnel vision. Apathy is a big part of it and there is a weird feeling of having to supress a panic attack at any moment. The weird thing about it is that this feeling goes away in the afternoon and I feel completely fine the entire evening until I wake up the next day. I think this might be related to cortisol levels rising in the morning but I am not sure. Does anyone have similar experiences or tips to share with me? Thank you so much

[Gridley]

Hello, Catman, and welcome to SA. The symptoms you describe are very typical withdrawal symptoms.  They often accompany a too-fast taper off psychiatric drugs.  What dosage of Prozac were you on and how fast did you taper off it?

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can.  Please include the information about your Prozac dosage and taper, including dates you started and stopped.

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

So that you have an understanding of what you're experiencing, here is some information on antidepressant withdrawal.  Doctors know very little if anything about protracted antidepressant withdrawal and in fact don't believe it exists.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

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. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

Here are some links dealing with the symptoms you described.  Waking with anxiety or panic and having the symptoms fade throughout the day is generally associated with the fact that the body has elevated cortisol in the morning.  I had this symptom for several months but it gradually faded away.  The other symptoms will too, but it is impossible to predict how long it will take.

Waking with panic or anxiety - managing cortisol spikes - Page 4 ...

Derealization or Depersonalization - Surviving Antidepressants

Anhedonia, apathy, demotivation, emotional numbness - Symptoms ...

The only known way to reduce withdrawal symptoms is with a very small reinstatement of the drug you were taking, in your case Prozac.  Reinstatement doesn't always work and works most dependably within 3 months of your last dose.  The other alternative is to wait it out until your system returns to homeostasis.  Again, there is no way to predict how long this will take.  While some recover fairly quickly, for others it can take months or longer.  Please read:

 

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

If you are interested in reinstating, please let us know and, after you've completed your signature, we can suggest a reinstatement dose.

Then, after you've stabilized on that dose, you can begin on a slow taper to zero of 10% of current dose every four weeks.  

Why taper by 10% of my dosage?

 

Please don't reinstate without letting us suggest a dosage.  Reinstating a too-high dosage can result in further destabilization.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

Please continue to use this thread to document your taper and to ask questions.  After you've completed your signature, we'll be in a better position to help you.

[intothewoods]

4 hours ago, CatMan said:

Every morning, I wake up with horrible anxiety and a feeling of "depersonalization", it is kind of like sitting in the back of your head and having some kind of tunnel vision. Apathy is a big part of it and there is a weird feeling of having to supress a panic attack at any moment. The weird thing about it is that this feeling goes away in the afternoon and I feel completely fine the entire evening until I wake up the next day. I think this might be related to cortisol levels rising in the morning but I am not sure. Does anyone have similar experiences or tips to share with me?

 

I have this, too @CatMan. It started two years ago and has morphed in and out of severity as I dropped too much or was given med trials by p-docs before finding SA in December 2018. Until March, I believed it was withdrawal from one of my morning meds that has a half short-life. In fact, I wrote this in my thread in January: 

 

Every morning  I wake in full-blown withdrawal from Provigil. It's so violent I can't hold a glass of water until lots of deep breaths and determination. My one goal for an hour is to calm to a state of being able to get out of bed (vs falling out... LOL). As well, I feel like I'm vibrating from the inside out, those infamous akathesia electric shocks, in near perpetuity along with the dyskinesia daily. I just shudder always. Some seems from WD. Some seems from the meds. 

 

Now after what I've learned on SA, I believe it's primarily cortisol gone-crazy as described in the link that Gridley gave you. Plus years of iatrogenic harm that simply has to heal. The whole fiesta (my loving term for it ) starts just like you said, with horrible anxiety, depersonalization, panic implosion. As morning dawns, feelings of terror and dread seep in, like poison in an IV line I've suddenly been hooked up to. As long as I stay hidden under the covers with a mask in pitch-black room, the physical symptoms hold off. The minute I move, they kick in. In the cortisol thread, you'll see advice to keep a dark, cool bedroom and wear a sleep mask. This has helped tremendously.

 

I've been on Prozac since 1999 and last year dropped too fast, had to reinstate a bit. This is when the mornings reached full intensity. Since yours is for sure sparked by Prozac WD, I suppose there could be a common factor but there are many of us with this symptom but who took meds other than Prozac. 

 

It will subside and resolve, for you I would think sooner than later because you only took it for 8 months. It might subside some if you reinstated a small amount; Gridley gave you the link for that too.

 

Whatever you decide to do, you've come to the best place. SA is an amazing encyclopedic resource for WD that's unmatched online. Mainlly, Altostrata and the mods are very skilled at helping members stabilize. They've been through every symptom -- including the morning fiesta. 😊

 

All the best to you.

[laydefish]

Hi & Welcome to the Group! Congratulations on getting off these awful drugs! Yes, I too took Prozac for severe chronic pain, I took an average dose of 60MG daily for 11 years as well as Benzo's for 7 years (and Hydrocodone for about 15 years & Gabapentin for 7 years) after an uniformed CT & * 1/2 months of healing by God's grace, I feel great! I haven't felt this much like myself in years- it's truly unbelievable- so Hang in There! It does get better & you will heal!

[thecowisback]

hi and welcome. i came off prozac over 2 years ago and this has been a problem for me too - waking up terrified in the mornings. i'm almost afraid to say it but this symptom has faded quite a bit and it now depends on how much sleep i've had or how stressful the previous day has been. i found the best way for me to deal with it was to get up and carry on with my morning routine despite the feelings of terror. i have to keep telling myself it's 'just' withdrawals and carry on with what i have to do. 

 

[CatMan]

I quit prozac cold turkey back in feburary (bad decision i know) and tried a reinstatement in march (went horrible). I found that using propranolol (20-40mg 1-2x per day) takes off most of my horrible symptoms, i know that it is not recommended to „muddy the waters“ even more, but it is kind of the only hope I have left. The relief I got from it was so great, I literally cried for half an hour. Will it be okay to use this for a couple of months to get me through the roughest patch? 

[CatMan]

I quit prozac cold turkey back in feburary (bad decision i know) and tried a reinstatement in march (went horrible). I found that using propranolol (20-40mg 1-2x per day) takes off most of my horrible symptoms, i know that it is not recommended to „muddy the waters“ even more, but it is kind of the only hope I have left. The relief I got from it was so great, I literally cried for half an hour. Will it be okay to use this for a couple of months to get me through the roughest patch? 

[Songbird]

Hi CatMan, I moved your question to your intro topic.  Please post updates and questions about your situation here in your intro topic.

 

We have a couple of topics about beta blockers you may like to read:  

Beta Blockers: Propranolol, Metopropol, Atenolol etc

Tapering beta blockers or alpha blockers

 

In general we don't recommend adding in drugs to treat withdrawal symptoms.  With regular use beta blockers need to be tapered.  You might avoid that if you keep it to occasional use.

 

To help deal with the anxiety I highly recommend books and recordings by Dr. Claire Weekes, as well as regular relaxation exercises.  See:

The Dr. Claire Weekes method of recovering from a sensitized nervous system

Relaxation exercises, guided meditations, calming videos, sleep hypnosis