Fightinghard: overcoming

[Fightinghard]

Hello everyone-  my story began in early April when coronavirus was just shutting everything down. The quick story is I have a history of anxiety that I managed with exercise(gym)and diet, etc.  When everything shut down, my anxiety went through the rough and my coping mechanisms were all hampered.  I had a panic attack.  My sleep was suffering. A good friend is a pcp and I reached out to her on a Saturday (April18) for help and she started me on Zoloft 100mg and buspar 10mg 2 x a day.  My initial 2 days of buspar were actually only 5 mg total per day.  At her request, I followed up with my pcp that Monday April 20.  This PCP was new to me as mine had retired.  Anyway, my sleep actually got worse when I started the meds.  My PCP added trazadone 50mg as needed To help with sleep.  I took that on april 20 but it did nothing so I called my new pcp on Tuesday April 21.  I told her what happened and I asked could the Zoloft be affecting my sleep?  I told her I had taken it at night and maybe that was the issue.  Her answer was probably not and I needed to relax.  She switched me to lexapro at that point. So I started 5 mg of lexapro April 22nd.  she also added ambien.  I took ambien for 3 nights total.  I also tried trazadone maybe 2 more times as well in April.  
 

i switched my care to a psych NP as I thought it made sense.  Starting in May 1st I was upped to 10 mg of lexapro.  It was in May I started to think the meds were the root of my sleep issue. I was having a completely different sleep pattern than when I started the meds.  Before meds it was more I couldn’t fall asleep.  After meds it was I could stay asleep and it was very light sleep. So decided to taper off buspar for about a week where I took 5 mg 2x a day.  I finished taking it on May 27.  June 1 I asked my psych NP to come off the lexapro.  He recommended I cut down to 5 mg.  I did this for 2.5 weeks and at that appointment my psych NP told me I could stop.  I decided to cut down to 2.5 mg for 1 week and then 1.25 for 9 days.  I came off on July 4.  
 

April 18-Zoloft 100mg and 20 mg buspar 
April 20- trazadone 50mg

April 21 - change to ambien 2.5 mg

April 22- started lexapro 5 in place of zoloft

April 25- stopped ambien

April 27,28- tried trazadone 50 mg But stopped

May 1- Lexapro 10 mg

May 18- buspar reduced to 5 mg 2 x a day

May 27- stopped buspar

June 1- lexapro reduced to 5 mg

June 3-5- trazadone - when I realized it was an SSRI I stopped.

June 18- lexapro 2.5 mg

June 25 - lexapro 1.25 mg

July 4 - off

 

My current withdrawal pattern seems to have windows and waves. My sleep quality seems better but duration fluctuates. Typically I sleep 4-5 hours then have a hard time falling asleep.  Occasionally I have fallen back to sleep and I’ll get 7-8 hours total which is encouraging. I was having nightmares, vivid dreams and some very light sleep but that seems better.  I’ve had some days with depression, anxiety, joint pains, brain fog, memory issues, ruminating thoughts, GI issues, weakness and fatigue.  Things seem to fluctuate.  Yesterday was a good day.  I felt tired but almost normal. Today not so much.  So I’m thinking waves and windows?  
 

Supplements:

omega 3 1000 mg 3x a day

magnesium glycinate 400-600 mg

melatonin 1 mg

vitamin C 1000 mg

probiotics

 

i walk 4-5 miles per day.  
 

any thoughts?
 

thanks!  

 

 

 

 

Edited August 16, 2020 by Gridley

[Gridley]

Welcome to SA, Fightinghard.

 

You tapered the Lexapro much faster than our recommendation, which is no more than 10% of current dose every four weeks. You jumped to zero from 1.25mg, which is much higher than we recommend. 

 

Why taper by 10% of my dosage?

 

As a result, you are experiencing withdrawal, which doctors don't believe exists.  

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric 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 withdrawal symptoms occur.  

 

Reinstatement of a very small dose of the original drug (in your case Lexapro) is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  You're still in the time period where reinstatement predictably works, up to 3 months after last dose.  We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, your system has become sensitized and has become somewhat accustomed to being off the drug and If you take too much it may be too much for your brain.   Once you've stabilized on the reinstated dosage, which can take several months,  you can begin a 10% per month taper down to zero.   Please read:

 

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

 

If you reinstate, I'd recommend reinstating 0.5mg Lexapro--no more.  It takes a little more than a week for the drug to reach full effect in your system.  It's a good idea to keep daily notes on paper to track how the reinstatement is going.

 

It's good you're on the magnesium and omegas.  

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

Edited August 16, 2020 by Gridley

[Fightinghard]

Hello Gridley!  
 

Thanks for the welcome! I’ve thought about reinstatement but I’m so torn.  My major concern is the insomnia.  Not that the other symptoms are comfortable but overall they’ve been tolerable most days. While on the Lexapro, I had insomnia so I’ve thought even if I reinstate and stabilize on it will I sleep better?  I know that there is no answer.  I’m also hoping that since I was only on it 11 weeks total that time could be on my side. I’ve had some windows as well which I’m hoping is a positive sign.  It’s such a tough decision. 
 

does sleep typically resolve over time?  I feel like over the last 6 weeks there have been changes. I started with nightmares and vivid dreams and very light sleep and now I don’t seem to have that. I get better quality sleep just not a full night. 
 

thanks again!

[Gridley]

1 hour ago, Fightinghard said:

 

does sleep typically resolve over time?  I feel like over the last 6 weeks there have been changes. I started with nightmares and vivid dreams and very light sleep and now I don’t seem to have that. I get better quality sleep just not a full night. 
 

Sleep issues, like other withdrawal symptoms, do typically resolve over time.  From your description, it sounds like you're healing.  The windows are a very encouraging sign, as are the disappearance of some symptoms, the better quality sleep and the fact that your symptoms are tolerable.  Please keep us updated on how you're doing.

[Fightinghard]

Thank you so much Gridley!  I’ll be sure to check in as I go forward. I can’t tell you how much I appreciate what you and the entire site offers to people like me.  Be well and continue healing!  

[Fightinghard]

@Gridley  quick question on magnesium.  I take 400mg before bed and sometime another 100-200 when I wake up hoping to fall asleep again. Is it better to take it throughout the day in smaller doses?  Maybe 4 x a day 100mg?  Magnesium is good for anxiety correct?  

[Gridley]

27 minutes ago, Fightinghard said:

@Gridley  quick question on magnesium.  I take 400mg before bed and sometime another 100-200 when I wake up hoping to fall asleep again. Is it better to take it throughout the day in smaller doses?  Maybe 4 x a day 100mg?  Magnesium is good for anxiety correct?  

 

It's generally recommended to take it throughout the day in smaller doses. 4 x a day 100mg sounds good.  You might be able to tolerate a little more but  your current dose sounded a little high to me.  Everybody's different, so gauge your dosage on how it affects you.  Yes, magnesium can help with anxiety and have a calming effect.

 

[Altostrata]

Hello, Fighting.

2 hours ago, Fightinghard said:

@Gridley  quick question on magnesium.  I take 400mg before bed and sometime another 100-200 when I wake up hoping to fall asleep again. Is it better to take it throughout the day in smaller doses?  Maybe 4 x a day 100mg?  Magnesium is good for anxiety correct?  

 

Smaller doses throughout the day are better for anxiety.

 

Also see our topics for

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

What is the sleep cycle?

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

White noise devices for sleep

 

Waking with panic or anxiety -- managing cortisol spikes

 

and fish oil https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Fightinghard]

Thanks @Gridley @Altostrata thanks for the info!  Something I experienced that may be useful is I took an Epsom salt bath last week before bed and then took my 400mg of magnesium and ended up with terrible diarrhea that night. I’m assuming it was too much magnesium with what my body absorbed and the dosage. I didn’t consider the magnesium in the bath. 
 

 

[Gridley]

48 minutes ago, Fightinghard said:

I’m assuming it was too much magnesium

That is very likely the explanation.  You can continue to fine-tune your dosage to get what's best for you.

[Fightinghard]

Hello Again @Gridley @AltostrataI’m struggling with the insomnia which sure seems like from WD.  My recent pattern has been going to bed between 9:30 and 10 and I wake up between 2 and 2:30.  I occasionally fall back to sleep for another 1-2 hours or so and my wake up is at 6:30.  Prior to lexapro I would sleep about 7 hours or so with some broken nights.  During my Covid panic attacks I started having more issues with sleep especially onset.  When I started my SSRIs this became worse with Sleep onset a big Issue.  That resolved over a few weeks but this pattern of about 4-5 hours stretch of sleep started with the lexapro.  I’ve had some nights since I stopped lexapro on July 4 where I slept 7-8 hours with 1 wake up.  So I’m encouraged from that because I know my body can do it.  Also, I think my sleep quality has improved since I quit on July 4.    Although last night I had my first nightmare in 2 weeks.  
 

I’m currently doing CBT therapy weekly and I also am doing CBTi every other week.  I take magnesium glycinate and melatonin( although last night I didn’t- was curious if it would change anything). Omega 3s, probiotics and I’ve thought about vitamin D.  I eat a lot of fruit and veggies, nuts.  I avoid caffeine.  Walk 1 hour every day. 
 

My other symptoms really seem to be better.  I do have anxiety- especially in the AM.  I struggle with stress and How much I can handle.  At times I’m ok but others I’m not.  My emotions are highly sensitive. I feel like crying sometimes but I can’t.   I’ve had some bouts of depression but not recent.  I’ve felt sad but not depressed.  Low energy, fatigue, poor focus and concentration.  The tingling in my arms and ‘burning’ I felt earlier on in my body has reduced.  I do ruminate and obsess a lot.  
 

What I’m debating is whether to reinstate since I have a few more weeks to do so.  I don’t think I was ever stable on the lexapro.  I can’t say I ever felt good.  In fact I’d say it was bad,  It was a short period of time (11 weeks) with 5.5 weeks of taking it and 5.5 weeks tapering down.  But if I took a small dose like you suggested, could it stabilize me without the bad feelings Since it would be such a small amount compared to what I took?  My positives are I do get windows where I feel pretty good With little anxiety or any other symptom other than tired from lack of sleep. I’d say several times a week if not more.  I’ve had a full day window a few times.  Now that said, I do try to reduce my stresses though during these days.  I’m not ‘normal’ but feel much better.  I’m 6.5 weeks off now so it’s still early.  do you find a correlation between the duration of the time someone takes the SSRI with how long the WD is?  I realize everyone is different but it seems that a shorter time on them would be a positive.  

thanks for your thoughts!

 

[mstimc]

37 minutes ago, Fightinghard said:

My other symptoms really seem to be better.  I do have anxiety- especially in the AM.  I struggle with stress and How much I can handle.  At times I’m ok but others I’m not.  My emotions are highly sensitive. I feel like crying sometimes but I can’t.   I’ve had some bouts of depression but not recent.  I’ve felt sad but not depressed.  Low energy, fatigue, poor focus and concentration.  The tingling in my arms and ‘burning’ I felt earlier on in my body has reduced.  I do ruminate and obsess a lot.  

 

Hi FightingHard

 

Have you looked into CBT or other behavioral management techniques to help you with your anxiety and ruminations?  I suffered from that as well and a good therapist who taught me CBT really helped. 

[Fightinghard]

Hey mstimc-

 

yes-  CBT has helped. I’m currently doing that now. I appreciate the suggestion!  Generally I get anxiety in the AM after a bad night. I can almost tell you what time it is Based on how I feel. I think it’s cortisol spikes which then lead to anxiety. 

[mstimc]

Yes, I still get the early morning spikes too.  I try to play thought games like remembering lines from a favorite movie until the feeling subsides and I can get back to sleep (most of the time).

[Fightinghard]

Did you have sleep issues during WD?  If so, did it just gradually improve?

 

[mstimc]

28 minutes ago, Fightinghard said:

Did you have sleep issues during WD?  If so, did it just gradually improve?

 

 

Oh yes, I sure  did!  I've always dealt with insomnia but WD made it worse.  Rather than taking yet another drug, I adopted a pre-sleep ritual; I went to bed at the same time; made soothing tea, (not really sure if it had an effect but it made me feel better), I set aside time to read affirming or positive books, and I'd often listen to sleep-inducing recordings.  The object was to quiet the recurring thoughts so I could relax.  And if didn't get a good night's sleep, I'd tell myself I would the next night.  I still do a lot of these to help me sleep.

[Fightinghard]

Thanks mstimc!  It’s good to hear that things can get better!  There is nothing easy about WD but for me the sleep is the hardest. I’m trying to take the approach that I really don’t care and I’ll be ok regardless but it’s hard.  I guess our bodies heal with time. 

[Gridley]

2 hours ago, Fightinghard said:

What I’m debating is whether to reinstate

That'll have to be your decision.  From what I'm reading, you're doing pretty well, all in all.  The windows are a very good sign.  

 

Regarding length of time on the drug correlating with length of WD, there's no absolute correlation.  We just can't predict how long WD will last. That said, being on the drugs a short period of time is a positive.

[mstimc]

2 minutes ago, Fightinghard said:

 I guess our bodies heal with time. 

 

They sure do!  It takes time and patience.  Part of the solution is to cut ourselves the slack we need and not judge our progress.  Trying too hard can be counter-productive and puts us in a pass-fail pattern of thinking that just adds more stress.

[Fightinghard]

Thanks Gridley!  I think the sleep is what’s getting me.  I’ll stay strong. Seeing people improve and recover their sleep motivates me. I guess acceptance is key. I must take it one day at a time. 

[Fightinghard]

Mstimc-  great advice!  Thanks for your thoughts.  

[Altostrata]

10 hours ago, Fightinghard said:

My recent pattern has been going to bed between 9:30 and 10 and I wake up between 2 and 2:30.  I occasionally fall back to sleep for another 1-2 hours or so and my wake up is at 6:30.  

 

This is very normal for withdrawal syndrome. Getting about 5 hours a night is typical. This should improve, very gradually. Have you implemented any of the sleep tips? They can help.

[Fightinghard]

hey altostrata,
 

Thanks for the response! I do follow many tips.  I wear a mask, use ear plugs, go to bed around 10 wear blue blocker glasses, dim lights, no computer after 7, meditation before bed.  I’m started CBTi back in April when my sleep issue started not realizing that the lexapro was probably at the heart of it. Truly I fall asleep fairly well and consistently. And there have been many nights I fall back to sleep after awakening and sleep another 1-2 hours. It’s almost an every other or 3rd day scenario. My sleep has improved in that it seems a better quality. Less nights waking up with burning and tingling in my arms. When I do wake up I’m generally calm versus very anxious. Where I struggle is how long do I lay in bed?  Most suggest if you’re awake for 30 minutes get up. But I feel I’m training myself to get up early then.  Tough call. 
 

I take magnesium and melatonin.  Warm Epsom baths seem good also. 
 

I used to exercise 6 days a week pretty hard.  Since I’m in WD, I’ve back off substantially because I didn’t want to overdue it. I walk now for at least an hour everyday. I’d like to start more aerobic but I wasn’t sure. That used to help me sleep back in March...

 

thanks again!

 

fighting

[Altostrata]

You're doing pretty well, considering. You need to be patient.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Fightinghard]

Thanks Alto-  I appreciate the advice.  I’ll hang tight. I have to accept where I am and that I will continue to heal with time.  One day at a time.

 

Ive been a ‘voyeur’ of this site the past few months. It’s been such a valuable source of support and information. Thank you for your efforts.  

[Fightinghard]

Today is 7 weeks since my last dose of lexapro so I’m thankful for that. It’s not been an easy 7 weeks for sure. As I look back on my short journey, I realize I actually started WD symptoms back in early June when I reduced my lexapro dose from 10 to 5 Mg and 10 days earlier in May finished Buspar.  Anyway, these past 2 days I would say I was in a window.  Outside of my sleep still being disturbed (roughly 4-6 hours) my symptoms were minimal with neuroemotions my worst.  I actually felt normal some of the days. When I got home from work yesterday I did feel ‘amped’ up ( I had to drive 5 hours plus work 4 hours)but I was able to calm my body down with meditation and supplements.  I slept albeit not great (4 hours). I had some minor depression earlier today and I’m tired from the insomnia but generally ok.  
 

My sleep regiment Has included melatonin. I take about 1mg (I break a tablet in half). I’ve taken melatonin well before lexapro probably over a year ago. I was taking 3mg.  Anyway I’m thinking of stopping it because I’ve seen it can have a paradoxical effect and cause awakening.  Since I’ve been on it pretty much the whole time it’s hard to know. I also read it takes some time for your body to adjust to not having it?  Sleep could get worse?  I’m just curious if anyone has experience with this.  

[Gridley]

1 hour ago, Fightinghard said:

I’ve seen it can have a paradoxical effect and cause awakening.  

In too high doses that can definitely happen.   It happened to me when I was starting out and took 3mg.  I've  had good results with 0.3mg.  There's a brand available on Amazon at this dose.  Here's the link if you want to try it:

 

(available on Amazon) is exactly 0.3 mg. 

[Artistic1]

@Fightinghard Hi. I read your thread, and your symptoms sound so much like mine. I've had terrible sleep patterns for the past 3 years, but now that my dose is getting lower, my sleep is getting better. My insomnia and sleep issues were definitely related to the Zoloft I'm taking, and yours sound related to the meds, too. I was determined NOT to go up in dose. If my daily symptoms were manageable, I could do that and wait for the healing. I decided to just deal with the insomnia with CBT and an occasional dose of Benadryl (only 12. 5 mg) for when I have a really bad night.  

 

I tried Magnesium Glycinate, and it did NOT help my sleep. It made me groggy and gave me intense dreams, even if I lowered the dose. I take a different magnesium called Tri-magnesium, which seems to help with my anxiety and my sleep. I also tried melatonin. The recommended dose is 0.3 mg. That didn't help me, either, so I stopped it. I believe if you take melatonin long term, it can interfere with your body's ability to make its own melatonin. But you should check into that for yourself. I just wanted to go the most natural way I could with my sleep, because our bodies do know how to sleep naturally. It's our heads (and meds) that get in the way.

 

I wish you all the luck with your journey. Hang in there!

[Fightinghard]

@Gridley-  Thanks for the advice!  I’ll order it now!   I think I’m going to go a few nights or so without Melatonin and just see what happens.  I’ve tried it a few nights and I still fall asleep ok.  My problem with sleep is waking  up 4 or so hours later and having a hard time going back to sleep.  I’m thinking the main role of Melatonin is to help fall asleep and but it wears off quickly.  Maybe go a week and see if anything changes.  By that time, I’ll have the lesser dosage and i can try that with a clean slate.  

 

 

[Fightinghard]

@Artistic1-  This sleep has been really the hard part.  Not that the symptoms aren’t tough at times, but so far they’ve been manageable.  I think I’ve been blessed with some windows pretty frequently where i feel okay.  Not 100% by any means but much better than when I’m in a wave.  You’ll know when I’m in a wave because I’m posting here!  LOL!  I’m in a tough position;  my sleep issue really started in April from stress with COVID, work and family.  When the Dr gave me the antidepressants I think I immediately had a side effect of insomnia on top of what i was dealing with.  I say that because even the ambien and the trazadone I took did almost nothing.  I would get about 4 hours of sleep on them at best.  Anyway, I actually asked the Dr if she thought the Zoloft I was taking (the first few days) was causing the insomnia which is when she switched me to Lexapro.  At that point, I was having a hard time falling asleep.  Once the Lex settled in, I started sleeping the pattern I’m in now with 4-5 hours then I wake up.  The difference then was I’d wake up and lay there and I wouldn’t know if I was asleep or awake.  It was bizarre.  My therapist had given me strategies for the ‘anxiety’ when i woke up but I didn’t have any anxiety.  I didn’t know how to help myself . I just laid there in a weird state.  Anyway, my care was switched to Pysch who I asked could the Lex be causing my sleep issues?  this was about 2 weeks into this.  He said no, not likely... well 3 weeks later I was convinced which initiated my tapering down.  It was a fast taper(5.5 weeks) for sure but my Psych guided me and I wasn’t on that long.    I don’t want to reinstate because reality is I think the Lex wasn’t helping it was hurting.  It would be a big gamble to find out it doesn’t work.  

 

I’m with you on Melatonin;  I’ve been taking it for at least a year or so at higher doses.  I don’t think it’s to blame for my problems but I’m not sure if it’s hindering.  So I’ll try without for a week or so and see what happens.  I read something similar in that I want my body to know how to make Melatonin itself.  I agree that our heads and meds are what cause the problems.  We will sleep again.  Time heals.  

 

Thanks for reaching out and for the support.  I am trying my hardest not to ‘count’ sleep anymore.  Really, what does it matter.  I believe eventually I will sleep again.  My goal is to get ‘restful’ sleep each night.  Whatever that means in terms of hours doesn’t matter.  I have to accept where I am if I am going to heal.  I need to enjoy what I can while I’m going through this.  Life will go on. 

 

Continued success for you on your journey!  We’ll make it thought this!

[Artistic1]

@Fightinghard It sounds like you are really grounded in your attitude about everything. You're right - sleep will come back eventually. For me, at 71, I just don't sleep as well anymore, anyway. You're smart to not "count" it anymore. I was so focused on it for a while, and that just made things worse! Now I just try to go with the flow. If there are nights where I can't sleep, I get up and do some reading. I figure if I can't sleep, then resting is the next best thing. Best wishes!

[Fightinghard]

I’m trying to understand the waves and windows concept.  Currently my sleep pattern is pretty consistent with 4-5 hours of sleep with and occasional 1 hour more After I wake up.  With the lack of sleep I’m tired most of the time. My other symptoms are lack of concentration, cortisol spikes, anxiety in he mornings, occasional depression and ruminating.  I had paresthesias but they’ve subsided.  The heavy feeling in my head is gone.  My question is some days I feel ok.  Like I’m almost normal.  I’m tired, my concentration isn’t great, low tolerance for stress but I feel almost like I did before this debacle.  I still have insomnia but otherwise not bad. I’m calling days when I feel good a window.  I’m not great but I feel better.  It’s very tolerable.  So is a window symptom free or just feeling good?  

[mstimc]

1 minute ago, Fightinghard said:

So is a window symptom free or just feeling good?  

IMHO, windows can vary in symptom relief and in length.  During WD, my first window lasted no more than 20 minutes.  We were watching our son play guitar in his junior high jazz band and suddenly I let all my anxiety got and just enjoyed the music.  It didn't last long, but from then on I knew I'd recover because I could feel normal again, if only for a brief period.  The window/wave pattern isn't consistent in time or intensity, except in the long-run.  Gradually, the windows are longer and the symptoms less severe.

[Fightinghard]

Got it.  So I’ve had several moments where I felt almost normal.  My major emotional symptoms are anxiety and depression. Also, I can’t handle stress very well.  My brain gets tired and anxious.  I also have neuroemotions.  Many days I don’t have either depression or anxiety much at all.  Anxiety is in the mornings but not very long.  If I could sleep, I think I’d feel much better.  I guess I’m encouraged I’m 7 weeks out getting some windows each week.  Hoping sleep improves little by little.  I’ve actually stopped counting the hours like I did.  I’m more going by how I feel the next day.  Thanks for your input!

[mstimc]

Seven weeks is great if you're already getting windows!  It took me almost three tears to fully recover.  I'd say the danger right now is not to set your expectations too high and beat yourself up if you think you're in a wave or your window isn't perfect.  Don't rush it.  As you said, your brain gets tired and anxious--that's because its trying to heal and handle day-to-day life at the same time.  It may not seem like it, but you're on a good path.

[Fightinghard]

I’m trying to stay in the mind set of acceptance.  Obviously there are days I struggle with that but it’s all I have. I’m hopeful the windows are a good sign and things continue to progress. But I’m also realistic in that this is not a sprint it’s a marathon.
 

I really appreciate you taking the time to respond.  You obviously understand how it feels to go through this and how hearing encouraging stories and thoughts helps so much!