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Edmunds: prolonged Wellbutrin withdrawal

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Edmunds

In consultation with my psychiatrist, I am treated mainly for derealization (feeling perceptual disconnect from the world "out there" but no other symptoms all the time). Owing to ineffectiveness, we tapered off Effexor in May (2019) after nearly 2.5 years and without severe withdrawal. The symptoms lasting 2 or 3 weeks were dizziness and a faint thumping sound in my ear when I moved my head. I then also tapered off 300 mg Wellbutrin over 3 weeks, ending with complete discontinuation in mid August. I also started taking Prozac at 10, then 20 mg, mainly because that med seems to have helped me be free of derealization and anxiety for about 16 years before it pooped out. Since I haven't taken it for 4 years, we are trying it again. Since nearly the start of the Wellbutrin taper, I began to feel anxiety on waking in the morning and going up and down all day, plus much heavier derealization fog/haze/perceptual disconnect. This has continued for more than 6 weeks. My psychiatrist (very experienced) told me that Wellbutrin withdrawal symptoms lasting more than 2 or 3 weeks was "new territory" for her.  And now she has suggested going back on 75 mg immediate release Wellbutrin to ease anxiety and if that helps taking tablets once or twice a day, then tapering again but slowly from there (though how do you taper from 75 mg?). I have doubts about this advice since I really don't want to go back on Wellbutrin, and my reading suggests that withdrawal from this med can for some last two months or more. Anxiety and derealization or persistent and very unpleasant, but I have no other symptoms other than possibly blurry vision at times and moderate appetite and weight loss. I'm capable of toughing it out without more Wellbutrin. I will appreciate hearing from anyone having had a similar experience. I should also mention that regarding the dissociative disorder, I'm also working with a good therapist using  acceptance and commitment therapy (ACT) and Cognitive Behavior Therapy.

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Edmunds

Topic title:  Prolonged bupropion withdrawal

 

I would like to ask if other members have experienced prolonged withdrawal from bupropion/Wellbutrin. I took a combination of Effexor and Wellbutrin for 2 years and 4 months, mainly for derealization and anxiety. Owing to lack of much benefit, I tapered off the Effexor in May 2019 without serious withdrawal effects. My psychiatrist was working with me. On August 19, 2019, I ended a 3-week taper of Wellbutrin while starting 10-20 mg Prozac. Even before Wellbutrin taper ended, I started to have sharper and more persistent anxiety plus heavier derealization. This has now lasted nearly 7 weeks. Last week my dr advised going back on 75 mg Wellbutrin immediate release, then taper more slowly. I tried that for 2 days, but the anxiety surged so much that I stopped, and with the dr’s assent. She has no experience of patients having Wellbutrin withdrawal for more than 2 or 3 weeks. At the moment I’m trying to ride out this withdrawal, continuing 20 mg of Prozac. Have others had similar experience with Wellbutrin?

 

Edited by ChessieCat
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Sassenach

Hello     Edmunds and welcome to SA.

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

I am sorry you are having such a rough time but you are now in the right place.

 

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. 

  • 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.

 

I appreciate you have given information above, but we need it in this format as it will appear beneath every post and Mods can see at a glance your history.

 

There is unfortunately a problem here.

You are currently working with a psychiatrist.

We believe that doctors and psychiatrists know little or nothing about withdrawal from these drugs despite a lot of recent media coverage.

On 9/8/2019 at 8:29 PM, Edmunds said:

My psychiatrist (very experienced) told me that Wellbutrin withdrawal symptoms lasting more than 2 or 3 weeks was "new territory" for her.

 

On 9/8/2019 at 8:29 PM, Edmunds said:

I have doubts about this advice since I really don't want to go back on Wellbutrin, and my reading suggests that withdrawal from this med can for some last two months or more.

That is certainly true.

 

On 9/8/2019 at 8:29 PM, Edmunds said:

I'm also working with a good therapist using  acceptance and commitment therapy (ACT) and Cognitive Behavior Therapy.

Provided the therapist knows what they are doing this is good.

I believe your psych has already made mistakes in your treatment.

 

Please find links below that will help you understand our advice.

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

the-windows-and-waves-pattern-of-stabilization/

why-taper-by-10-of-my-dosage/

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

are-we-there-yet-how-long-is-withdrawal-going-to-take/

 

Please feel free to browse the site, it is a wealth of info.

Other members threads will give you an insight and the opportunity to share experiences.

When you have done so please post your thoughts on your thread and we can go from there.

 

Again welcome.

 

Sassenach

 

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Sassenach

Hi Edmunds

 

I believe you are online now, please respond in this forum.

 

Sassenach

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Edmunds

Following up on my previous post, now that my signature seems to have been activated, my experience of withdrawal from XL Wellbutrin has continued for seven weeks. The symptoms are nearly continuous physical anxiety (feeling of moderate foreboding, distressful pressure on my face, intermittent crying brought on by positive family love and support) and aggravated derealization (perceptual fogginess, enhanced in places like the supermarket). Last week my psychiatrist suggested I go back on immediate release Wellbutrin at 75 mg to see if that relieved anxiety. I took it on Sept 6 and 7, but my anxiety shot up so much that I stopped after 2 days. On Sept 10 the anxiety abated somewhat. Heavy derealization has remained unchanged.

I push myself to be active with Iyengar yoga 3 classes a week, cycling, and walking with my spouse. Also a good therapist working with me in acceptance and commitment therapy.

My experienced psychiatrist cannot think of a reason my withdrawal from Wellbutrin should last more than 3 weeks, suggesting I see a neurologist to see if "something else might be going on." I doubt that seriously because I have had derealization off and on since I was in college in the 60s and bad anxiety with it a few times. Doctors have almost invariably diagnosed me as having depression, though I have never experienced most of the listed symptoms (feelings of worthlessness, not being about to get out of bed, etc.). I hit upon derealization just a couple of years ago, having never previously heard of it or had it mentioned by medical professionals. My current psychiatrist seems to know almost nothing about dissociative disorders or prolonged withdrawal experience.

I will appreciate any ideas and advice.

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Sassenach

Hello Edmunds

 

On 9/8/2019 at 8:29 PM, Edmunds said:

I then also tapered off 300 mg Wellbutrin over 3 weeks, ending with complete discontinuation in mid August

Your drug signature says you finished this drug in July.

To be clear, did you taper starting in July over a three week period into August?

This is important for us to get a handle on your recent condition changes.

On 9/8/2019 at 8:29 PM, Edmunds said:

This has continued for more than 6 weeks.

 

Are your symptoms improving or getting worse?

 

The constant drug changes, tapers and reinstatement suggest you are in withdrawal.

Most members would be feeling the symptoms as severe, but you say your's are not.

Please click on the blue link below and use the checklist to advise me on how many of the symptoms you are currently experiencing.

dr-joseph-glenmullens-withdrawal-symptom-checklist/

It is possible that the Prozac is masking W/D symptoms which is why is important you make no further changes for the moment.

You appear to have been on drugs many years to treat the same conditions, have they ever succeeded?

21 hours ago, Edmunds said:

My current psychiatrist seems to know almost nothing about dissociative disorders or prolonged withdrawal experience.

It is not unusual for psychs to be ignorant about W/D and cannot comment on dissociative disorders .

I would however suggest you look for one who can help with dissociative disorders and work with us on W/D.

Experienced or not she has been leading you in circles.

 

It is essential you give your CNS (central nervous system ) time to stabilse.

This will not happen if you make any changes at this moment in time.

 

Have you read the info. in the blue links I provided earlier?

They give an insight into withdrawal and stabilisation.

 

Sassenach

 

 

 

 

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Edmunds

Dear Sassenach

Thanks for your questions.

I apologize for my error. I ended Wellbutrin July 19, 2019. During the 3 weeks of tapering, I started to notice some increase in anxiety and heavier derealization.

My symptoms of anxiety and DR have not gotten significantly worse but no steady improvement either. I wrote that I went back on Wellbutrin IR 75 mg for just two days and anxiety shot up. I stopped. Sept 10 was a little better but yesterday was sharper again, the best indicator of that usually being how much I cry. (I was with my 14-year-old grandson yesterday for awhile. I burst out sobbing when he told me how much fun it was to hang out with me, when I thought I was uncommunicative and preoccupied with my anxiety!) But now today again the anxiety has backed off a little. It seems to abate in later evening, taken over by great fatigue. But I have awakened with anxiety every morning for more than a month.

 

My symptoms are not severe in the sense that I can push myself to function fairly normally. But the anxiety feeling can be really nasty, and the derealization (which has in the past seldom been this aggravated) makes me feel like I'm walking around in a dream or invisible fog. (My psychiatrist has kept calling it "brain fog." And I keep telling her it's not "brain fog," which typically has to do with memory, concentration, and confusion.)

 

I can report the following on the Glenmullons checklist:

crying spells

worsened mood

low energy

change in appetite (moderate reduction)

anxious, nervous, tense (physical feeling of fear, often uncomfortable pressure on my face)

feeling detached (though not unreal, no visual distortions)

intense dreaming (though this is fairly normal for me)

hungover or waterlogged feeling

blurred vision (slight)

feeling of restless legs (chronic for me though maybe worse on Prozac; recently found that drinking a little apple cider vinegar seems to help a lot)

 

DR of mostly a moderate level has come and gone since I was 19. In college and graduate school it occurred in winter months only and without serious anxiety. It frightened and concerned me, but I had no medical attention.

DR returned 1976 to 1978, then disappeared

DR returned 1984; in 1987-88 during a year living in Montreal, anxiety, DR, and maybe depression really hit hard; eased up around 1990 but still evident until 1997. In 1988 I starting seeing psychiatrists, the first one put me on tricylcics to no effect. Several meds from there until 1997, when I went on Prozac for second time. That year the DR dissipated.

I had almost no DR or anxiety on Prozac from 1997 to 1913, when it returned in correlation with stressful situations. In 2015, I discontinued Prozac and tried a series of other ADs. Since 2015 I have had off and on periods of anxiety, and none at all for months at a time. But my current condition of nearly constant anxiety and heavy DR has persisted since I tapered off the Wellbutrin.

 

My therapist seems to understand something about DR/DP, but no psychiatrist has ever even mentioned it.

 

I won't change any meds for now.

 

The article on waves and windows was especially helpful and reassuring.

 

I forgot to include on my drug list that about August 14 of this year I started taking a few sublingual drops of CBD oil (from a reputable source, not online). I've titrated up to about 66 mgs. I got advice from all my California friends to do this! But it hasn't helped yet. Perhaps it's just slowing the stabilization. Advice on continuing or quitting?

 

I've probably written more than you want to know! But warm thanks.

 

Edmunds

 

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Edmunds

During the past week, I’ve had a couple of days when I thought the anxiety pressure was easing but then took a step back again. So the article on waves and windows was immensely helpful. My Wellbutrin discontinuation was now about 7 weeks ago. 

 

I’m noticing two other bupropion withdrawal symptoms. One is mild diarrhea. The other is mild nausea during and following my Iyengar yoga classes, which I make me self attend 3 times a week.

 

I tapered 3 weeks off the Wellbutrin ending July 2019. I have not written much about my tapering off Effexor in mid-May 2019 after 2 1/3 years on it. I thought I got off easy. Some thickening of derealization, plus dizziness and a faint thumping in my ear, both symptoms going away after about 2 weeks. But now I wonder if residual withdrawal effects from the Effexor hung on and have combined with the bupropion effects. Any thoughts on that hypothesis. 

 

Finally, I’m tempted to take a .5 lorazepam (Ativan) some days, but if I’m aiming for stabilization, wouldn’t it be best to try to avoid it? I’ve only taken it a few times total over a month. 

Edited by Edmunds

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ChessieCat
4 hours ago, Edmunds said:

Finally, I’m tempted to take a .5 lorazepam (Ativan) some days, but if I’m aiming for stabilization, wouldn’t it be best to try to avoid it? I’ve only taken it a few times total over a month. 

 

Yes it would be best to try and avoid it.

 

SA strongly encourages members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

 
Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)
 
On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

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Sassenach

Hi Edmunds

 

On 9/12/2019 at 8:13 PM, Edmunds said:

My symptoms are not severe in the sense that I can push myself to function fairly normally.

Most of us can do this at various times during W/D, does not mean symptoms are not severe at other times.

 

On 9/12/2019 at 8:13 PM, Edmunds said:

I'm walking around in a dream or invisible fog. (My psychiatrist has kept calling it "brain fog." And I keep telling her it's not "brain fog," which typically has to do with memory, concentration, and confusion.)

 

Your psych is right.

Not all symptoms are experienced by everybody.

The symptoms themselves present differently at various points during W/D

There is no one pattern that appiles to us all.

The only constant is that they are random.

19 hours ago, Edmunds said:

I tapered 3 weeks off the Wellbutrin ending July 2019. I have not written much about my tapering off Effexor in mid-May 2019 after 2 1/3 years on it. I thought I got off easy. Some thickening of derealization, plus dizziness and a faint thumping in my ear, both symptoms going away after about 2 weeks. But now I wonder if residual withdrawal effects from the Effexor hung on and have combined with the bupropion effects. Any thoughts on that hypothesis. 

You are correct you were almost certainly in W/D from the Effexor when you started Wellbutrin, Prozac was also added to the mix in May.

It is little wonder your CNS is in  a mess.

 

19 hours ago, Edmunds said:

Finally, I’m tempted to take a .5 lorazepam (Ativan) some days, but if I’m aiming for stabilization, wouldn’t it be best to try to avoid it? I’ve only taken it a few times total over a month. 

I concur totally with Chessie's advice above.

There are two reasons:

1- It is yet another drug for your CNS to cope with. Taking meds intermittently slows the healing process and your brain stuggles to cope with the fluctuations.

2- You have experienced DP/DR for many years. If you wish to get off psych drugs then are going to need to put coping strategies in place which do not involve meds.

On 9/12/2019 at 8:13 PM, Edmunds said:

I forgot to include on my drug list that about August 14 of this year I started taking a few sublingual drops of CBD oil (from a reputable source, not online). I've titrated up to about 66 mgs. I got advice from all my California friends to do this! But it hasn't helped yet. Perhaps it's just slowing the stabilization. Advice on continuing or quitting?

Please add this to drug signature, if you have a problem let me know.

 

Below is excerpt from an article on CBD oil from CNET.

"With more research, experts could also discover that CBD alone actually can relieve pain. Early this year an animal study in Pain explored how CBD may interact with serotonin receptors, which are believed to play a role in pain, depression and anxiety."

 

This is a preliminary report, however even the possibility of interaction with serotonin receptors is undesirable.

 

For the moment any changes are undesireable so hold at current dose and frequency.

 

L-methyl folate (Deplin) – 2016 – present 15 mg

B 2, B12, D3, Omega 3

Magnesium Chelate

king-of-supplements-omega-3-fatty-acids-fish-oil/

 

 

Magnesium and Omega3 are good but why are you taking the others. B vitamins can be stimulating which is not great for a sensitised CNS.

 

I am sure you have realised by now this is not going to be a quick fix, but you have a positive attitude which a great benefit.

 

How are feeling today?

 

 

Sassenach

 

 

 

 

 

 

 

 

 

 

Edited by Sassenach
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Edmunds

Sassenach

Thanks so much for the thoughtful reply. I will make no changes in the relevant prescription meds without getting stabilized and free of withdrawal symptoms. And you have confirmed my suspicions about Effexor withdrawal still being in play.

I took B2 and B12 on advice of a neurologist to reduce ocular migraines I occasionally have. But that didn't make much difference. I'm not concerned about dropping them.

I have had few changes symptoms in the past week: persistent unpleasant anxiety, heavy derealization, considerable fatigue.

I'm wondering about withdrawal and sun exposure. Today I sat in a sunny place in 85 degree weather for about 45 minutes (with sunscreen). I got mildly nauseous and that persisted for a couple of hours until after eating. But for the rest of the day my fatigue level was very high (no big anxiety surge). Might an unusual sensitivity to sun and heat be another manifestation of AD withdrawal.

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Sassenach

Hi Edmunds

 

14 hours ago, Edmunds said:

. I'm not concerned about dropping them.

At the moment I advise against dropping them unless they cause you problems.

It would be another change for your CNS to contend with when it is trying to stabilise.

The supplements will need to be evaluated in due course but for the moment slow and steady is the best course.

14 hours ago, Edmunds said:

Might an unusual sensitivity to sun and heat be another manifestation of AD withdrawal.

Is it regularly so hot and if so do you normally spend almost an hour in the sun?

 

Sassenach

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Edmunds

The temperature was somewhat hotter than usual yesterday for Los Angeles. I don't regularly spend an hour in the sun. But I have often watched family members in sports matches in similar conditions. I had sun screen, hat, and plenty of water but still got unexpectedly nauseous and fatigued.

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Altostrata

Hello, Ed. If you have a bad reaction to sun or heat, stay out of it. Some people do develop that sensitivity.

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Edmunds

My withdrawal from both Effexor and Wellbutrin (stopped about a month apart in May and June of this year) seems to have followed a certain daily pattern for the past month or more. I don't experience insomnia, but I wake up in the morning with anxiety sensations. During or after breakfast with my wife, I'm on an emotional hair trigger and usually start to cry. It's not so much the anxiety sensations as knowing that she is there supporting me that brings on the gush of tears. (I'm tearing up just thinking about that scene. If I look at a photo of a grandchild, I start to cry.) The anxiety feelings rise and fall during the day and usually abate somewhat in the later afternoon. After we eat in the evening, they abate more. They then often nearly disappear in the later evening and when I go to bed. Then they are back in the morning. 

Any little thing can set off the sobs and nose-blowing. Late this morning, I arrived home from my Iyengar yoga class (which I go to because that seems much more helpful than not going). I thought my wife had already left for the day, but when I opened the garage door, her car was there. Realizing that she was still home, I immediately burst into tears! This did not mean that I wanted her to stay with me the rest of the day. I will see her later. But the crying spells tend to be exhausting and cause the derealization fog to get very thick, so I want only to lie motionless for awhile.

The anxiety sensations and "fog" are sometimes very hard to endure. (I don't have to tell members of this group!) But so far the withdrawal has not thrown at me a wide spectrum of random symptoms.

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Edmunds

A question about crying: is it simply one manifestation of withdrawal? Or does it have some function in the withdrawal recovery process?

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Edmunds

Thanks to Chessie for good search tips.

 

Yesterday was a bit different, and I wonder if I had a window day.

 

I awoke in the morning with somewhat less anxiety feelings. I did not cry during breakfast or any time in the morning. We met at home with our financial adviser, and I got through that all right. In the afternoon I did productive work with the anxiety as background noise. We watched a TV program while eating dinner. No change in fatigue or heavy derealization fog.

 

This morning. however, I was agitated when I woke up. Sobbed a river in the morning. Heavy anxiety at midday. Abated somewhat when I got busy.

 

Might I count yesterday as a window?

 

Edmunds

 

 

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Edmunds

Sassenach advised me not to take lorazepam, so I have not for a couple of weeks. The only med I’m taking now is the 20 mg Prozac to replace the Effexor. Sassenach advises me to hold at that dose for now, though I will almost certainly want to discontinue it as well—in the right way! Thanks for the reference. 

My psychiatrist is thankfully supportive of what I’m doing on the group’s advice. 

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Sassenach

Hi Ed

 

Looks as though you are progressing slowly, which unfortunately is the only way.

How are you feeling?

Have you experienced any new symptoms in the last 10 day?

Have the symptoms increased or decreased during that time?

Are you keeping a daily diary of symptoms and times?

 

17 hours ago, Edmunds said:

Yesterday was a bit different, and I wonder if I had a window day.

That would count as a window this early in your stabilisation.

They will slowly become more frequent over time, however  windows and waves are a reality in W/D.

The way to success is accept you cannot beat them, roll with them and you improve at whatever rate your brain decides is appropriate.

But you do improve.

On 9/17/2019 at 12:32 AM, Edmunds said:

A question about crying: is it simply one manifestation of withdrawal? Or does it have some function in the withdrawal recovery process?

We all feel tearful at various times during W/D.

Yours does seem extreme but you do not appear to have the full range of possible symptoms, which is good.

Crying is a form of release at any time but as usual in W/D it is likely to be more pronounced.

It is much better than bottling it up which would be more likely to lead to increased anxiety.

You have a long road ahead but are moving the right direction.

 

Please amend your drug signature to confirm you are no longer using Lorazepam.

Do not delete the the drug just add the comment after.

This means that when Chessie or any other med stops by they will not use valuable time asking about the usage.

 

Sassenach

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Edmunds

Yesterday was tough with persistent anxiety, derealization fog (which has remained steadily thick for about 3 months), and fatigue. In the evening I sat with my wife and cried a lot, feeling bad that her current and late-blooming career might be interrupted because she will have to look after me all the time. That just came from a spasm of fear that I will get a lot worse. My wife was totally reassuring.

 

I might be having a somewhat better day today, but not sure, it's only noon. One of my lovely daughters is here, and the neuro-emotions seem to be in check!

I have not had any new symptoms. Anxiety and fatigue have been slightly more intense--anxiety in the first half of the day, fatigue after that.

 

I do keep daily notes.

 

My therapist has a specialty in ACT, and I'm participating in a class with her starting this week. Russ Harris's book The Happiness Trap has been helpful.

 

Regarding the “long road ahead,” I came off Prozac after about 17 years without much trouble and other ADs for fairly short periods without any noticeable withdrawal, certainly nothing like what I’m experiencing now. I’m ready for the long road, but does my extended marriage to both Wellbutrin and Effexor (2.4 years) make the long road inevitable?

 

I will correct my signature, and I've discovered more ADs in my earlier life to edit in.

 

I'm amazed at the attentiveness you and Chessie have shown me. So much appreciated. Should I just continue on this introduction thread indefinitely? At some point (membership?) can I introduce a new topic? Maybe I can do that now but see no reason to.

Edmunds

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