bmix86: my unexpected journey

[bmix86]

Where to even start with this....I've been on lexapro and trazodone since June 2019. I recently moved earlier this year to a new part of the state and got a new PCP once I got here. My sleep had been pretty garbage for a few weeks. Rewind a little.....I had gone to the gym on Tuesday March 5th and had a pretty good workout. That morning I woke up at 1am feeling like my heart was going to beat out of my chest. I went to the ER and was told my potassium was low. I was also told I was hypothyroid, which later turned out to be false. After that was when I noticed a significant uptick in general anxiety and significant decrease in quality of sleep. I wasn't able to sleep more than an 2-3 hours before waking up and having to go to the bathroom. I tried most everything I knew to improve my sleep: keeping the same routine, drinking tea, taking supplements. Not much really helped. I got engaged in May and as soon as the wedding planning started everything continued to get worse. Sleep was restless and I started to have more anxiety throughout the day because of it. I was never really an anxious person (other than with stuff like public speaking and what not). But after continued worsening of my sleep and not being able to figure out anything to help I went back to my new PCP, and he put me on lexapro 10 mg and trazodone 50 mg. The trazodone would knock me out but I'd still wake up a few hours later having to go to the bathroom and just feeling like a zombie. The sleep was never restful and I continued to get more frustrated about the situation.

 

Since I had been to this new MD twice and spoken to him for a total of less than 10 min, but he still felt confident about putting me on two meds, I decided it was time for me to find a new PCP. (I had blood work down as soon as I moved and he said "everything looked good." I got a copy of my blood work and there were a few things I was a little worried about, cholesterol levels primarily. This also made me want to find a new PCP since he didn't even take the time to discuss anything he found on the blood work. Just a little about my background, I have a master's degree in exercise physiology and a Doctorate of Physical Therapy, and spend a lot of free time reading about nutrition.) So because of this I decided to get an online MD, someone I follow online and look up to. The first time I talked with them, we were on the phone for almost an hour discussing my current situation and past medical history. I already felt 10x more confident in my new MD and had a lot more faith in getting through the situation. 

 

He asked me about the trazodone and if I thought it had been helping at all, I told him no. He recommended coming off it if I wanted to. At this point I had only been on it for about 10 days. I came off the 50 mg of trazodone and felt absolutely terrible that whole week. Anxiety was through the rough, I felt like I was constantly peeing, and sleep just got worse. Not to mention the heart palpitations, gastric distress, stomach cramping, jaw clenching, nasal congestion, headaches, blurred vision, change in appetite. I didn't sleep longer than 2 hours and couldn't remember the last time I had a dream. I normally had a few dreams per week and was often able to recall them. That Friday I ended up in the hospital thinking I was having a bad reaction to the lexapro since I was started out on 10mg rather than 5mg. Only later did I learn it was from quitting the trazodone.  Because of this I dropped from 10mg to 5mg of lex and reinstated 50mg of trazodone. Over the next month I tried to get my exercise schedule and diet on point. Before all this started I felt like I was pretty healthy. Went to the gym 4 days a week and lifted for ~2ish hours, ate what I thought was pretty healthy, enjoyed my morning coffee every day (probably had a bit of an unhealthy relationship with that haha), didn't smoke, rarely drank, no recreational drugs. So all of this was extremely foreign to me.

 

When I tried to start exercising more I noticed that my heart rate stayed elevated for hours after I got done working out, my sleep would be garbage that evening, and the next day always resulted in a lot more anxiety. It would take 2-3 days before I felt like I was back to this "new normal." So at this point I decided to read more about both of these medicines and really buckle down on improving my sleep, diet, and stress levels before returning to the gym. As of writing this point I haven't stepped foot in the gym since early July, which is really killing me. I can't stand to look at myself in the mirror. My body weight has dropped around 15lbs and it seems like I've lost every bit of muscle I've ever put on. I am so ready to get back into the gym and squat something but at the same time I'm also worried about never getting back to where I was physically before all this happened.

 

Fast forward to September and I'm exactly 2 months away from getting married. My sleep has improved greatly, I can sleep for 6+ hours straight before waking up most every night, I'm having vivid dreams almost every night of the week, the side effects have decreased significantly, and I'm starting to see that there will be a light at the end of the tunnel. I'm still on 5mg of lex and down to 6mg of traz. My spiritual life has improved significantly during this time. I have spent more time in my bible, more time praying, and more time listening to spiritual discussions/sermons online. My fiance is great and has been there every step of the way with me! Supporting me during those terrible days and not getting upset when I just don't feel like doing anything and only want to watch TV all afternoon. As someone who hasn't relied on people in the past for emotional support this has been a big change for me. The lack of ability to contribute as much to the wedding planning and being able to concentrate long enough to be of help has been one of the worst things. I have hated that so much of this process has fallen on her. And even though it should be one of the happiest times in our lives, right now it has this dark stain on it. 

 

I know this is a lot of rambling but I want to lay out of a few the things in the following posts that have helped me the most during this process. One thing I keep telling myself is that this is a season of life that will pass and because of it I will be able to help someone else in the future. I'm sure there's a few things that I've missed or left out during this post. 

[bmix86]

This post will be more about my sleep and what I've found has helped.

 

The turning point in my sleep was when I started sleeping with my head elevated. I had always thought I had a little sleep apnea but was never tested for it. When I was initially put on the trazodone I asked about getting a sleep study and the doc said "maybe, after we see how the medicines affect you." This was another thing that really irritated me about him. I had to pretty much chase him down the hall to ask about that. 

 

So it was towards the end of June and I just happened to think it might feel better sleeping with a bunch of pillows under my upper back and head. Not sure what it was that made me try but I figured why not. That night I only woke up twice to go to the bathroom. I had been getting up to go 3 or 4 times each night. The next night I only got up once to go to the bathroom. I knew I had hit a turning point with my sleep. There have been some nights here and there where I got up 2-3x to use the bathroom, primarily from drinking too much water too late, but in general I'm only getting up once around 430-5 to use the bathroom. After that I got some bed risers and put them under the head of my bed so there's about a 10* incline. I also got a sleeping wedge that props me up a few more inches as well. Both of those have helped significantly! (There's a few really random articles online by someone about "incline bed therapy." Not sure if there's much science supporting it or if any sleep researchers have some other knowledge about  it but it seems to have really helped me.)

 

Another thing I started doing is really dialing in my sleep hygiene. Minimal to no phone time after 830-9, always dimming the lights down or totally off by 730-8, and wearing blue light glasses while watching tv at night. I always keep my bedroom very cool and sleep with as little clothing as possible. I know that dropping your core temperature will help falling asleep and staying asleep. It took some time to really get into a good groove with those things but I know they have helped.

 

Set backs and poor nights of sleep still happen, but I try not to focus on them and try to think of how to improve that situation for the next evening. For a while I was almost afraid of falling asleep or going to bed because no night was restful. Every night caused me more stress than the relief I got from actually sleeping. But now I look forward to it. Part of me is interested in seeing what sort of dreams my mind will come up with. I try to have 2 nights a week where I don't set an alarm and just let my body rest as much as possible. I still have difficulty sleeping past 7-730 but the lack of an alarm keeps my body from getting so revved up when I roll over and wake up.

 

In regards to supplements before bed, I take magnesium glycinate, melatonin with L theanine, and zinc. While I don't think this has played as large of a role as the other areas, I do still feel like this has helped with how deep I am sleeping and the vividness of my dreams. 

[Carmie]

Hi Bmix, 

 

Welcome to SA. Your sleep hygiene sounds fabulous.

 

You’ve made a lot of changes in your medication in such a short period of time. It’s usually recommended not to taper by more than 10% a month. I wouldn’t be doing any more tapering for now, especially with your wedding coming up in a couple of months. Sometimes withdrawals can be delayed and can hit you much later on. I wouldn’t want them to wreck your wedding. 

 

Are you still on 5mg Lexapro, as well as the 6mg of Trazodone?

 

Are you on any other medications?

 

You said you’re on a number of supplements. Besides the ones you take before bed, are there any others you are taking?

Certain supplements, like B vitamins can ramp up withdrawals. The only two supplements recommended on this site are magnesium and fish oil, I see you’re taking magnesium already. Some people can’t even tolerate these supplements. I took magnesium once, and it ramped up my symptoms severely. A lot of people going through withdrawals find it extremely beneficial though. 

 

I’m sorry you can’t do the exercises you enjoy doing so much at the moment. A lot of people going through withdrawals find they can only do very gentle exercise, like walking. Exercise ramps up the CNS, which is already struggling due to withdrawals. There a few people that are able to do strenuous exercise, but the vast majority find it makes their symptoms worse. 

 

Please keep us updated as to how you’re doing. 

 

Sending hugs🤗

[bmix86]

Hello Carmie! Thanks for the warm welcome!

 

Yes, I'm currently on 5mg lex and 6mg of traz and holding. I think I am going to hold now until after the wedding just so a wrench doesn't get thrown in on the big day or during the honeymoon. Currently taking no other medications. The MD I got rid of tried to put me on hypertension meds but after taking my BP on a regular basis it was well within normal, <120/80.

 

I am not taking any B vitamins. I tried to take them a few months back but noticed a significant uptick in anxiety symptoms. I've tried keeping things the same for ~2 weeks before I change or add anything. I'm taking fish oil and garlic other than those I'm taking right before bed. I have really noticed benefit from the magnesium. (Part of me thinks that a lot of the initial symptoms were ramped up due to low magnesium. I wish I would have had my magnesium levels checked during the beginning of all this.)

 

Thank you for the support!

[bmix86]

The past few days have been going pretty well. I've noticed that the effects from dropping the dose of trazodone don't really hit until about 4-5 days after the drop and will then last for another week or two. The worst symptom by far is the heart palpitations. Sometimes I can figure out what triggers them and then other times I can't. Just really frustrating.  Sleep has been decent. It seems no matter what time I go to bed or plan on getting up I always roll over and look at my phone around 345. I try not to check the time when I wake up during the night, not wanting to trigger any anxiety about how long I've been asleep or how much longer until my alarm goes off. I've thought about just putting my phone under the bed so I'm not even tempted to look at it.

 

I wanted to make this post concerning some of the things I've changed with my nutrition. I heard about the website cronometer a while months back and decided to start logging my food to see where I was lining up. It turns out my magnesium, zinc, B vitamins, omega3's, and quite a few other minerals were all on the low side. I was way over consuming carbs and not getting in enough fruit. I know a lot of us would rather get all or most of our nutrition from food compared to taking supplements, but I was unable to hit some RDA's unless I supplemented, especially when it came to magnesium and zinc. Some of the foods I started cooking and buying to help out with that are sardines, mushrooms, romaine lettuce, pumpkin seeds, almonds, and cashews. I also tried getting in more foods with higher fiber content to help with motility issues. Dates and raisins have been my go to's for that, along with a few slices of Ezekiel bread with breakfast. 

 

I try to keep the same eating schedule every week to keep things simple and easy to plan. Breakfast is pretty much the same every day, 4 eggs and 3 slices of Ezekiel bread, and maybe a glass of milk. Lunch is either 2 cans of sardines, an avocado, and rice cakes or a romaine lettuce salad, chick peas, pickled beets, sliced turkey, and a cup of garlic mushrooms. Dinner isn't as routine but I normally have chicken, sometimes ground beef or the occasional beef liver, some brussel sprouts, asparagus, spaghetti or butternut squash, a container or two of yogurt, and handful of raisins or dates. I try to snack on almonds, cashews, and pumpkin seeds throughout the day.

 

I've noticed that I cannot eat many sugary foods especially on an empty stomach or if I have just dropped the dose on trazodone. I was at the movies a couple months back and got a bag of twizzlers. About 15 minutes after starting on them I noticed a significant increase in my heart rate and intensity of each beat. It definitely freaked me out when it started until I realized what caused it. It took about about 45 minutes for it calm down. Not sure if anyone else has noticed something like that at all but it definitely caught me by surprise. 

[Gridley]

18 minutes ago, bmix86 said:

got a bag of twizzlers.

Sugar is very activating, and many of us in WD, myself included, can't tolerate it.

[bmix86]

Quick update. About a week ago I cut out the trazodone altogether. Sleep has been a little off during that time but the other symptoms have significantly improved, primarily jaw clenching, random waves of anxiety, and heart palpitations. I definitely don't feel as wired as I use to be. During the worst of it I would wake up multiple times during the night, heart racing, with a feeling of dread. Now when I wake up, it's to roll over or go to the bathroom. I will sometimes lie there for an hour or so, not able to fall back asleep and with my mind racing, but there's no feeling of panic. I really wanted to get off the trazodone more than a month out from my wedding since I know that it can take a little while for some WD symptoms to pop up. I'm hoping things can stay pretty steady until after the wedding. I haven't changed the dose on the escitalopram and don't plan to until a month or so after the wedding. 

 

I haven't really changed much in my diet other than adding another egg to the morning mix and trying to eat a little more fish during the wk.

 

Just curious if anyone tracks their choline intake? I've read a few things on the importance of it for brain and nervous system health. Not sure if it is something like omega 3s and magnesium that has a beneficial effect on some and not so much on others, but it was just something that crossed my mind.