Cigale: reinstating help

[Altostrata]

Thank you. Please do take care of yourself.

[Tom37]

Thanks for posting on my thread. Had a quick read of your thread and see that your trying to get stable after re in statement. I hope that you are seeing some improvements no matter how small and that you keep believing that you will feel better. It can just take some time and we are all unique in that.

 

I see lexapro affected your sleep in pretty much the same way it did mine. Was a good sleeper and never woke until lexapro then was 5 to 6 hours and waking once or twice. So frustrating as nothing you can do about it. Hopefully once stable then taper off it sleep will return to normal.

 

Take care.

[composter]

Hi there!! I’m glad you found my snippet with how I determined I was stable enough to taper. I plan to make a more comprehensive guide on reinstatement soon. 
 

While our medication histories don’t look exactly the same, I did go through a reinstatement after a too-fast taper from 10 mg to 2.5. mg over 3 months. I went through waves while trying to stabilize, which were confusing and disheartening. But ultimately after each wave something always healed. I went through very similar questions and doubts about whether I reinstated too high or if I was experiencing poopout. Neither were true and I would say that now that you have your reinstatement dose of 5 mg, stick to that and expect that windows will grow longer. 
 

Perhaps you can take heart in reading through my timeline of stabilizing: 

- Reinstated to original dose in Sept 2018

- 1st wave in Dec 2018 (3 months later)

- 2nd wave in Jan 2019 (4 months after reinstatement)

- Stabilized by Apr 2019 (8 month period) began taper

- 3rd wave in Sept 2019 (1 yr after) held dose for 1 month

- 4th wave in Dec 2019 (1 yr 3 mo) held dose

- currently no wave since, fingers crossed

 

Continue to focus on a steady routine with soothing activities away from screens. Journaling helped me a lot, as well as talking with trusted family and friends. Hoping the wave clears very soon for you!!

[Cigale]

Thank you @Tom37 for the visit and advice. I have been following your journey for a bit, but am a bit shy about leaving comments on others’ threads. Though I am starting to embrace how much that sort of support helps both the giver and the receiver.

 

Yes, Lexapro (newly christened eSHITalopram in the cursing thread, thanks to sunnysideup69) has really messed with my sleep. I used to get at least 8 hours and a good nap. But now I can’t nap at all and get about 5-6 hours sleep with 1-2 cortisol wake-ups. I haven’t been able to tolerate any supplements, so I just have to stick to good sleep hygiene - no screens after 9pm, gentle yoga for 30-45 minute, and gratitude meditation as I drift off. 

 

I have been cheering on the sidelines for you to stabilize soon. I continue to be impressed with all you are able to do despite the daily challenges. That you can work and keep moving through the days, and also support others so gracefully. You are inspiring! I really appreciate your visit and continue to keep you in my thoughts!

[Cigale]

1 hour ago, composter said:

I’m glad you found my snippet with how I determined I was stable enough to taper. I plan to make a more comprehensive guide on reinstatement soon. 

 

Hello @composter! Wow, thank you for the visit. I am obviously a big fan of yours. I have read your entire thread and was excited to see your ‘reinstatement rules.’ I go back to that snippet often to remind myself to slow down and relax into the daily challenges. 

 

1 hour ago, composter said:

Perhaps you can take heart in reading through my timeline of stabilizing: 

- Reinstated to original dose in Sept 2018

- 1st wave in Dec 2018 (3 months later)

- 2nd wave in Jan 2019 (4 months after reinstatement)

- Stabilized by Apr 2019 (8 month period) began taper

- 3rd wave in Sept 2019 (1 yr after) held dose for 1 month

- 4th wave in Dec 2019 (1 yr 3 mo) held dose

- currently no wave since, fingers crossed

 

And a huge thanks for sharing this. I have a couple of questions if you don’t mind. Though please know I completely understand that we are all very, very different.

 

- It is interesting how you track progress by waves, when I am tracking by windows. I think that could be a paradigm shift for me. So I wonder what motivated you to take that approach? 

 - How long did each wave last? For me so far, I have mostly been in a wave since reinstatement with windows that have been 3 hours to almost 2 days long.

- How did you know you had stabilized in April 2019?

- How did you decide to reduce by .2mg/month? I am planning to do try the traditional Brassmonkey slide. 

 

And YES to your reinstatement guide, that would be such a gift for this community.

 

I love your suggestions and have started journaling (I am a writer by trade.) I really wish I could have more open conversations with family and friends, but for now at least, only my husband believes me. My sisters (both nurses), my doctor, my therapist and a few friends all think I am suffering needlessly and that I just need to add or change drugs. 

 

I hope you are doing well and continue to move forward with ease.

 

Thank you again for taking the time to visit and share your wisdom. 

[composter]

17 minutes ago, Cigale said:

- It is interesting how you track progress by waves, when I am tracking by windows. I think that could be a paradigm shift for me. So I wonder what motivated you to take that approach? 

 - How long did each wave last? For me so far, I have mostly been in a wave since reinstatement with windows that have been 3 hours to almost 2 days long.

The answer to the first question lies in my response to the second. My waves lasted 2-3 weeks each and windows were all the periods in between the waves. So 2-3 weeks between Waves 1 and 2, then 8 months between Waves 2 and 3, and 3 months between Waves 3 and 4. I must be lucky in that my windows were long and uninterrupted periods of time. But during each of those waves there were never any hour-long windows or anything. Just pure wave. 
 

It’s precisely because of this very discrete patterns of windows and waves that I could track progress by waves. I would tell myself that something is trying to heal while the wave is happening and, sure enough, something new would heal after the clouds parted. 
 

17 minutes ago, Cigale said:

- How did you know you had stabilized in April 2019?

- How did you decide to reduce by .2mg/month? I am planning to do try the traditional Brassmonkey slide. 

This will be a very individual process and a lot of it comes down to becoming in touch with your body and how you feel. I believe my reasoning for stabilizing was included in the part that you quoted from my page earlier. It had to do with: not having any waves for around 3 months, having most of my WD symptoms gone, and feeling emotionally and physically prepared to taper. 
 

Mine is a sort-of Brassmonkey slide but I don’t follow the math to a tee. I guess it’s more of a gradual slide. It’s simply easier with my measuring syringe to reduce by increments of 0.1 mL at a time (=0.1 mg). And so I do 0.1 mg reductions every two weeks with one extra week of hold after 0.2 mg total. I have found this is a good rate where I hardly notice any symptoms when making cute. 
 

PS very kind words and I’m glad my thread has been a source of comfort to you. Hoping to expand on my experience in a couple guide-like posts when I get the time. 

Edited August 7, 2020 by composter

[Cigale]

Thank you @composter again for sharing your experience. I hope your studies are going well, and I love your focus on giving back to the community. The world needs smart, experienced and aware people like you to educate the world on the true impact of ADs. Keep fighting the good fight. 

 

Take good care!

[Cigale]

Is there such a thing as a Dream Window?

 

Though I am still in a rough wave, I had an amazingly peaceful dream for the first time in months. I woke at 530 am in panic and started ruminating about lost sleep, lost life, etc, thinking I was going to just lie there agonizing...and then I woke again at 745 am (the latest in months). In that short period, I had the sweetest, most peaceful dream. I was beautiful and graceful and surrounded by family and friend and really good food. There was so much good food and lots of chocolate (have given that up for now). It was glorious.  

[Hanna72]

3 hours ago, Cigale said:

. In that short period, I had the sweetest, most peaceful dream. I was beautiful and graceful and surrounded by family and friend and really good food. There was so much good food and lots of chocolate (have given that up for now). It was glorious.  

Hi @Cigale Just read this and it gave me goosebumps😊 That’s a lovely dream and it might  just be a indicator that  a sweet lovely window is coming your way😃

Remember that the sun is always behind the clouds 🙏

Take care☀️

[Cigale]

Thank you @Hanna72 for your sweet, sunny visit and kind wishes for a window. I hope you are still dancing  !

 

[Erell]

Wow, this dream sounds delightful 🤗

No matter if you were asleep : your CNS seems to be calmer for a time, and that's great !

I like to think that sometimes our inner child find nice ways to give us strenght to hang on ... ☺

😙

[Cigale]

Great insights and tools from @Light:

 

I journaled daily, my deepest most primitive feelings, which really helped to turn the volume down on my nervous system. Many people with mind body issues report that this practice alone resulted in symptomatic relief if not a cure. There are over 300 studies showing the positive effects of expressive writing ranging from wound healing to PTSD. 

 

I also worked on focusing on my body less, tried to live my life despite symptoms, and to co-exist with them with less fear and anger. These emotions fuel symptoms so if you an find a way to increasingly be more at peace with your symptoms it will make a difference. I am also trying a technique called somatic tracking where you tune into the sensations of your symptoms and learn to just sit with them without fear, judgement, or ulterior motive. In response to these sensations I try to "soften, soothe, and allow." The technique of outcome independence or authentic indifference can also be very helpful. Again, simply learning to not care about these sensations so much, knowing that they are just that and that they are not dangerous. All of these techniques are aimed at "unlearning" the symptoms. If you can experience the symptoms enough time without fear they begin to fade. 

 

i've included links below to Dr, Howard Schubiner's website. He has a workbook that is well regarded. There is also a link to an interview with Nicole Sachs LCSW about her Journalspeak practice.  And finally a summary of Alan Gordon's, Pain recovery program, which includes essential tools. These techniques can be helpful for many symptoms beyond pain.  I hope this helps. 

 

https://www.unlearnyourpain.com

http://www.tmswiki.org/forum/painrecovery/

 

https://www.freeconferencecall.com/wall/recorded_audio?audioRecordingUrl=https%3A%2F%2Frs0000.freeconferencecall.com%2Fstorage%2FsgetFCC2%2FOCq7B%2FDNIuD&subscriptionId=6714329

 

[Erell]

Hello dear,

 

How are you doing ?

 

I've taken a look to Alan Gordon's Pain recovery program : found it very interesting.

Even if the subject is physical pain, I think we can apply the advices to any symptoms.

The aim is to become The Observer : learning to observe our symptoms and thoughts without identifying or fearing.

 

Slowly but surely we are learning  ☺

 

Take care ☀️

 

[Cigale]

Bonjour @Erell 

 

Thank you for stopping by. I have been thinking about you and hoping you are doing better and on your way to stabilizing.

 

I am still really struggling but trying to use my tools (meditation, yoga, distraction, easy walks, and acceptance, acceptance, acceptance - so hard that one). And I keep looking for new ways to help my CNS heal (thank you for EFT info). I am building quite a library of self-help materials!

I agree that pain management programs have a lot to teach those of us going through WD. You summed it up perfectly: we must step back and be observers of our symptoms. I have been reading through Alan Gordon’s program, and have found some helpful tips. It is similar to Claire Weeke’s AAF approach in many ways. I have also purchased Dr. Shubiner’s workbook, “Unlearn Your Anxiety and Depression,” and will share any insights from that when it arrives.

 

I am also very interested in journaling. I did some research and found a program that suggests doing 20-minutes of journaling for 3-4 consecutive days can provide some relief. In some cases, therapeutic writing can be as effective as cognitive behavior therapy. If you are interested, here’s a video from James Pennebaker and here’s some research on the concept. At the very least, writing engages and exercises important parts of our brains, which is alway a good thing.

 

Thank you again for being by my side along this long road. I say it every night: I am so grateful for Erell (and Gridley, and Sunnysideup69, and Brassmonkey, and composter, and Hanna72, and Longestroadhome, and Altostrata, aand this community).

 

♥️

[Erell]

5 hours ago, Cigale said:

And I keep looking for new ways to help my CNS heal (thank you for EFT info). I am building quite a library of self-help materials!

 😅 I'm with you on this one : I include the tools I use and practice in my daily notes, and sometimes I'm quite amazed by all this ! 

It is a real full-time job 😉

 

It can be ambivalent sometimes : on one hand it is important to help our CNS and learn non-drug coping skills.

But on the other hand, some of us (myself included) have a tendency to hope miracles from these tools, or blame ourselves if we think we don't practice 'enough'.

Yes, even with selfcare our little monkey has a lot to judge 😄

That's when I try to remember to be The Observer...and The Lover : instead of judging myself while practicing or pressuring myself (which would be the opposite of selfcare), I try to see every practice or tool I try to learn as a gift I'm making to myself.

 

And think about all the amazing skills we'll have in our pockets for the rest of our life ? ❤

 

We are learning together, it is very precious to have a place like SA to share our journey toward healing and joy !

 

I'm sorry to read you're struggling : I truly believe that heat waves can exacerbate WD symptoms. (In fact, lot of people have noted this on SA).

Weather is really hot these days in France.

I don't know if it could help you : Yesterday evening, I took a cold shower before going to bed and I think it helped to relax a bit.

 

Hugs ❤

[Cigale]

Hello @Erell - I am going to try a cold shower tonight. It certainly can't hurt. This has been a particularly long and rough wave me for some reason, and the insomnia has been intense this week (second only to my first week of lexapro reinstatement). Though I have darkened my room and have AC, doing my usual bedtime routine, I have only been able to get a couple of hours of sleep for the past four nights. Racing heart, anxiety, and sweating like crazy. My CNS won't let me nap during the day, but I do rest and try to meditate and accept and hope for relief.

[Gridley]

57 minutes ago, Cigale said:

I have only been able to get a couple of hours of sleep

Cigale, I sympathize.  I don't know if I've sent you this post from Apace43, one of our moderators, about sleep.  I found his thoughts about attitude about sleep to be helpful in coping with sleep issues.

 

 

"There is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

Insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict. 

 

So, what do you do?  In no particular order, some of the things to try:

 

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself."

 

 

 

[Cigale]

Thank you so much @Gridley for sharing that post and tips. I do okay accepting insomnia, it’s just the cumulative impact it has on my ability to function during the day. Plus it feels like it slows the healing process. But it is what it is, alas.

 

I hope you’re doing well. How is your final taper going?

[Gridley]

8 minutes ago, Cigale said:

How is your final taper going?

It's going fine.  My WDnormal stays about the same, some symptoms (mostly anxiety and insomnia) but tolerable.  I will hold at 0.1 for 4 weeks.  If all is well, I'll drop to 0.05 and see how I'm doing after 4 weeks.  I may jump to zero at that point or do one more cut to 0.025.  It's just a tiny bit of powder at this point.  

 

I'm a big reader and luckily I can still enjoy reading, which is a big part of my distraction.  

 

The other thing I've been doing is cranio-sacral therapy.  I don't really understand it, but it has to do with the CNS and brain and involves very gentle massage mostly on the head and also on other parts of the body.. There's a good practitioner in our tiny village, and it does seem to help my mood.  

 

I hope you get some rest tonight.

[Cigale]

I love your update @Gridley! I’m excited to hear how close you are to giving Lexapro the boot. 

 

22 minutes ago, Gridley said:

cranio-sacral therapy.

 

This sounds very interesting, and I am glad it helps. I just might see if I can find a practitioner here. 

 

I am so grateful for you. And do hope I get some sleep tonight. 🤗 

 

PS I am a big reader too and just started a seven book series on French history...

[Cigale]

Thank you so much @Longestroadhome for stopping by to share your wisdom on insomnia. This is a brilliant idea! In fact, in the afternoons when I try to rest (since a can’t really nap), I just listen to Eckhart Tolle. And I often catch myself dozing for a few minutes. His voice and his message is so soothing, he would be a great book narrator!

 

I am going to give this a try tonight since it feels like I am starting to anticipate the insomnia. Now I just have to decide what book to listen to.

 

I can’t tell you how much I appreciate all the tips and kind guidance you have shared. Though I would not have ever chosen this journey, I am happy to have you and so many others here by my side.

 

🙏

 

 

[Cigale]

First off, I am not freaking out about this, just trying to be an informed patient. Some recent blood tests have shown a significant increase in my Gamma-GT (57), which is up from my January results (42) - which indicates potential liver issues (normal range is 7-35). I have never been a heavy drinker, and have been totally off any alcohol for 3 months. I have a very healthy diet (lean meats, veggies, and lots of fruit) and drink 3-4 liters of water/day. (TMI but oddly my urine is still yellow.) So I believe that Lexapro is the culprit here since I have read that antidepressants can cause this number to be high.

 

My doctor wants to see me this week to talk about further tests and treatments. Any advice, tips? I realize this might be too far off topic for this community, but thought I would ask.

 

Thank you!

 

PS - I did a search and I think that @Frogie may have dealt with this situation...

[Cigale]

Hello @Altostrata - Sorry to bother you but I wonder if you are aware of antidepressants affecting the liver. 

 

14 hours ago, Cigale said:

Some recent blood tests have shown a significant increase in my Gamma-GT (57), which is up from my January results (42) - which indicates potential liver issues (normal range is 7-35). I have never been a heavy drinker, and have been totally off any alcohol for 3 months. I have a very healthy diet (lean meats, veggies, and lots of fruit) and drink 3-4 liters of water/day.

 

Thank you.

[Altostrata]

Yes, antidepressants can affect the liver, particularly in combination with other drugs or alcohol.

[Cigale]

Thank you for the fast reply. Take care!

[Cigale]

This wave is unrelenting with the worst insomnia I have had since reinstating in February, constant anxiety, and unfortunately, deepening depression. It feels like I am going backwards. And though I realize these are all classic WD symptoms, I thought that I would see improvement especially since I still have the Lexapro in my body. After six months, it feels like reinstatement isn't helping. I am less functional now than I was in April and May. 

 

Though I see courageous people like @mirage who didn't see improvement for months and yet is stable now. I see that and I try to be hopeful. If I could just get some relief from these symptoms.

[Hanna72]

Dear @Cigale

My heart goes out to you. This is such a hard road for many. I am praying for a relief for you🙏

57 minutes ago, Cigale said:

It feels like I am going backwards.

No, you are not. You are coping the best you can. Don’t be hard on yourself. Sometimes we are just exhausted, and we so need to see improvements. I think to myself when my waves are super bad... oh ok, guess now my system is really working hard for me to improve. It is to me a comforting thought. 
I also always would feel improvements afterwards, so keep that in mind.

 

57 minutes ago, Cigale said:

Though I see courageous people like @mirage who didn't see improvement for months and yet is stable now. I see that and I try to be hopeful. If I could just get some relief from these symptoms.

You are also courageous, and strong. I love also to read about successes from people, it truly shows us it can for sure be done. It always seems impossible, until it’s DONE 💪

My thoughts are with you.

 

Edited August 18, 2020 by Hanna72

[Dejavu]

@Cigale

2 hours ago, Cigale said:

who didn't see improvement for months and yet is stable now. I see that and I try to be hopeful. If I could just get some relief from these symptoms.

I too was one of those people. I was essentially bedbound after a CT and reinstatement of way too high a dose of zoloft. And I gradually got worse before I got better, just as you have done. Then, tiny little improvements, followed by bigger ones. In total, it took me about 10 months to reach full stability, but I began to see meaningful improvements and slowly became functional after about 4 or 5. It might not have taken me as long if I had not changed my dose up and down 4 times during that period, but I was stubbornly looking for that non-existent "sweet spot" that would make it all go away. All I succeeded in doing was to reset my clock each time I made a change. 

 

My point being: I made so many blunders and tried so many quick fixes that sent my brain into orbit so many times, and I still fully  stabilized. You will too. You will. Don't make any changes - even when the temptation is great to do so. Your body knows what it needs to do. 

[Cigale]

Thank you @Hanna72 and @Dejavu for your kindness and hard-earned wisdom. I have read your entire story Dejavu and need to remember that you made it through to stabilization by holding steady. You both give me hope. 🙏

[Cigale]

On 8/7/2020 at 10:59 AM, Cigale said:

I really wish I could have more open conversations with family and friends, but for now at least, only my husband believes me.

 

I want to make sure I correct this. Actually, other than my husband, I have only been able to talk to my little sister about my challenges. And she has been incredibly supportive. She is the strongest (and funniest) woman I know. Though it is hard to understand (I don't even understand what I am going through...), especially from so far away, she believes me and loves me and keeps me and my struggles in her thoughts.

[Cigale]

Hello @Gridley -  I could really use one of your virtual hugs. I am still really struggling with sleep, and my appetite has gone and eating is challenging. My weight is worrisome with my BMI around 16. I swear I am doing all I can to help myself - meditating, yoga, walks with dogs, gratitude journal before bed, no caffeine, no alcohol. But my brain won’t give me a break from the anxiety/fear/agitation. I am so tired.

 

I do hope you are doing well.

 

Hugs, Cigale

[Gridley]

24 minutes ago, Cigale said:

virtual hugs

I'm sorry you're feeling low, Cigale.  It's going to get better.  Sleep and appetite can get you down, I know.  You're doing everything you can and healing is going on right now though it doesn't feel like it.  My appetite isn't great either and my weight is way down.  As they say often here, this is the hardest thing you will ever do, and you will be so much stronger when you emerge on the other side (and you will).  In fact, with all the tools you've learned how to use, I would say you're already a stronger, more resilient person than before you started.  You're going to be fine.

 

 

[sunnysideup69]

Hey @Cigale

Sorry you're feeling bad. You will absolutely get through this. It's early days yet, you're only six months into reinstatement. Healing takes its time.

Sending a hug, also xxx

[Cigale]

Thank you both for your encouragement. 🤗 

 

I do hope you’re both doing well.

[Tom37]

Sorry your not feeling too well at the moment. I wouldn’t stress about eating just make sure your eating enough of the foods that matter. In the beginning of my wd I lost a lot of weight and was only eating small amounts but I was fine. Regarding sleep again try not to stress about it. It’s not pleasant but lack of sleep won’t hurt you it’s just uncomfortable. 
 

Just remember that how your feeling now won’t last and things will get better.

[Cigale]

Thank you @Tom37 for your encouragement. I know I need to believe in this reinstatement, that I am doing the right thing, and that this process isn’t linear. One day, one hour, one moment, one breath at a time. 

 

I hope you are continuing to improve. Take care and thanks again!