Gustl: tapered completely, now having constant anxiety

[Gustl]

I had sporadic anxiety issues as a teen, maybe even panic episodes, but I didn’t attribute them to a disorder (I’d never heard of such a thing at that time).  I just figured I was an ‘anxious person.’  In my early 30s, sometime after my wife and I had our first child, I began having panic attacks at night.  I didn’t know what they were and my fear exacerbated the problem.  Panic attacks began happening during work, waiting in lines, at theaters, in my car.  Eventually, I started reading books about anxiety, saw my doctor, and then started counseling.  I got lots of great non-med help, but still felt like my daily life was a fight from morning to night, so I finally accepted that I needed to try medication.

 

I started on Zoloft and was on that for a few years, maybe 5 or 6.  Then I switched, with my doctor’s suggestion to Paxil, which I was on for about 7 years.  I don’t know my dosage history anymore, but for the last many years I was taking 10mg a day (half a pill).  I can’t remember why I made the switch.  Over this time anxiety got better.  The daily fight dwindled to weekly and then occasionally and I even forgot it was an issue for periods of time, though I would be reminded when I had to be up in front of people, which my job requires.  

 

With my wife’s encouragement, I decided to try to wean off Paxil and, with my doctor’s direction, did so over the course of one and half months from November to December 2019.  And...everything seemed great for 4-5 months.  I couldn’t believe it.  I felt just like I had felt under medication-no big issue at all with anxiety (and now I didn’t have any of those pesky side effects from the meds!).  

 

But in May 2020 (about 4-5 months after I weaned off the meds) i started waking up feeling anxious-pit in the stomach, like one feels when going to give a speech.  There was no ‘thought’ or actual life worry-I just felt anxious every morning.  I hadn’t had that experience since I was a teen/early 20 year old.  I am 45 right now.  Now I wake up nearly every morning at 3:30-4:30am and cannot get back to sleep, no matter how long I lay there.  I either wake with the anxiety in my stomach or, if it’s not there right away, it comes on by the time I get up.  That anxious stomach feeling can go all the way until 9-11am, sometimes longer, though it eventually is gone by midday.  

 

But even though it is gone by midday, it has triggered my body and mind and I feel so susceptible to anxiety throughout my work day that I feel I have come full circle once more and am seeing every work day as a fight just to make it to the end of the day.  It’s so exhausted and I feel so helpless and worry that it won’t change.  The Lord is my strength and He has helped me get through, but I hope, and it’s why I came to this site, that He may have taken me to this forum to get some insight here.

[Gridley]

Welcome to SA, Gustl.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  If you don't know exact dates or dosages, just do the best you can.

 

Account Settings – Create or Edit a signature.

 

Your psychiatrist's taper schedule was much faster than we recommend, which is no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

Delayed withdrawal symptoms after a honeymoon period are not uncommon, and this is likely the explanation for your anxiety, which is one of the most common withdrawal symptoms, as is insomnia.  Morning anxiety is typical as this is when many members report experiencing cortisol spikes as part of withdrawal.  Thew new symptoms of cortisol spikes and insomnia, along with the fast taper of Paxil, are what lead me to suspect that the return of the anxiety is due to withdrawal rather than relapse, which is what doctors generally misdiagnose withdrawal to be.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

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 symptoms occur.

 

The withdrawal symptoms will slowly go away and you will heal, but unfortunately we can't predict how long it will take.

 

These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Brain Remodelling 

 

Here are some links to help you cope with anxiety.

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

VIDEO:  Peace from Nervous Suffering - Claire Weekes (1 hour) (http://sendvid.com/vgquc1dg)
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help …

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

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

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

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

 

 

 

 

 

 

 

 

 

[Gustl]

Thanks so much for your reply and those resources.  I look forward to exploring them.  Since I went off my meds too quickly, is there any wisdom in going back on them and eventually tapering more gradually?  Or is it better to stay off them since it has been  8-9 months since I went off them?

[Gustl]

I have been reading through the links and various posts.

I see that I have to accept that my body is in the process of healing.

There was some suggestion by an administrator to “Focus on stress reduction, it's very important.”  

How important is this?  And will It be likely to help my recovery much?

I ask because we live a fairly active life-not unhealthy, but active in terms of people, inviting others over, hosting gatherings, and so forth.  I have been able to keep up with those activities despite my WD symptoms, but if I thought pulling back on activity would help my healing, I would do it ASAP.  

[Gustl]

In reference to my question above about restarting Paxil, I found this in a study that was linked somewhere on this site: 

“When someone experiences withdrawal symptoms after stopping an antidepressant, the initial response should be to avoid any treatment because of the high likelihood of the symptoms resolving on their own. If the symptoms do not resolve or they increase to an unsustainable level, the same antidepressant should be restarted, followed by a slow taper. While a lower dose of the medication may be effective, the original dose has the greatest chance of working.

If restarting the prior antidepressant does not work, is not possible, or is not warranted, other medications can be used.”

 

Just wondering if this is a good idea.

[Gridley]

@Gustl

 

Reinstatement works most predictably within 3 months of the last dose.  Since you are 8-9 months out, it would be risky and could make matters worse.

Regarding the study you quoted in your last post, we don't recommend taking a new drug to deal with withdrawal from the old drug, and, as I said, reinstatement this far out would be risky.

3 hours ago, Gustl said:

 

I see that I have to accept that my body is in the process of healing.

This is the approach that I would recommend.  

 

3 hours ago, Gustl said:

ask because we live a fairly active life-not unhealthy, but active in terms of people, inviting others over, hosting gatherings, and so forth.  I have been able to keep up with those activities despite my WD symptoms, but if I thought pulling back on activity would help my healing, I would do it ASAP.  

It depends on whether the activities are having a positive or negative effect on you.  Stress reduction is important, but if the activities are a good distraction (distraction is another important aspect of dealing with withdrawal) for you or are enjoyable for you, I would use your own discretion  as to which activities are positive and which are negative.  If you re handling the activities well, they could be a positive influence.  If you are not, then you could cut back.

Edited September 7, 2020 by Gridley

[Gustl]

I can’t thank you enough for the insight and recommendations.  I really thought I had just relapsed until I found this forum.  I am grateful, just to know that I am healing and that my sensations may even be a part of that healing.

 

I love Dr. Weekes’ encouraging words.  I happened to have finished a book by hers just recently and now have begun to listen to the audio tracks that you recommended.  I have one difficulty and I wondered if you might have some direction for me.  Much of Weekes’ suggestions are based on anxiety being mainly a sensation that we fear and that there is nothing that our anxiety will actually do, so we should just accept the feelings and learn not to fear the unknown.  This was true for my panic attacks many years ago, however, I have had a particular situation where my body does do something in response to intense anxiety. It has happened rarely (only 3 times between my teens and my 40s), but without full disclosure, leaves me in an embarrassing situation.  

 

Unfortunately, then, I have something specific that I do indeed fear.  I haven’t feared it regularly for years, but now with my withdrawal issues it is constantly on my mind at work (I am in front of groups of people all day) and makes feelings of anxiety particularly threatening.  Do you have any suggestions for how to cope with this or some threads/posters on this forum that seem to struggle with something similar?  

 

Thank you.

[Hanna72]

@Gustl

Hi there. Just read your post. I will tell you that I know exactly how you feel. Being myself almost 6 months off Paxil, I started having all kinds of symptoms flare up at 4 months off, and I have  been in a panic and anxiety state for mostly 2 months now, with limited relief. 
What I have come to realise is that my intense connection to my emotions and thoughts are new to me. Since it has been depressed with drugs for 20 years. No wonder this is new to us. Also our nervous system is super sensitive and in the midst of healing process so we need to be patient. What helps me is listening to my body, and being gentle to it. I used to push myself through it, but that doesn’t work for me anymore. 
The tools I am using now are avoiding stressful situations as much as I can, I meditate and do conscious breathing, take cold showers with meditated breathing, practice the present moment and observe my surroundings without thoughts being attached to it. Listen to calm soothing music,

Gentle walks, being aware of my thinking patterns and ignoring the negative and self criticism thoughts.

You have come such a long way and I have to congratulate you on being drug free. That’s a huge accomplishment, so keep that in mind and remind yourself that you are travelling on an unknown road which will bring you to the destination that you deserve and desire.

I believe that sometimes we are giving things in life that we need instead of what we want. This journey will push you in a state that will improve, strengthen, and make you unstoppable in the long run. 
 

Never give up

there is no such thing as ending 

just a new wonderful beginning 

All the best to you🙏

 

[Gustl]

Thank you so much for sharing.  It makes me tearful just reading of hope beyond what I am slogging through each day.  Also helps to make more sense of what is going on in my body and why.  At least I can see the reason to an extent.  It was also helpful to know that your withdrawal symptoms were months after stopping meds as mine are.  Maybe if they had happened right away I would have expected it, but when I did so well for several months I was so flustered when I suddenly had all these issues seemingly “out of nowhere” and felt like I must have relapsed.  It was devastating to think I had reverted to the state I was in nearly 15 years ago.  Thankfully, I can start to see things differently now.

 

I like the strategies you’re using.  It’s weird for me, even when I have worked on slow breathing exercises and meditation or other relaxing activities-I can calm my mind, but my body just won’t respond yet.  The anxiety in my abdomen (I’m learning that these are cortisol spikes) seems to not care if I am emotionally or mentally calm.  I have some control over rising panic, but the general state of ‘nerves on edge’ doesn’t seem to respond to anything right now.

 

I’m going to give some of the supplements Gridley suggested a try, starting with Magnesium.  

 

Anyway, I started rambling.  Just feels good to share with others who understand.  Thank you again for your encouragement. 

[Gridley]

3 hours ago, Gustl said:

 

Unfortunately, then, I have something specific that I do indeed fear.  I haven’t feared it regularly for years, but now with my withdrawal issues it is constantly on my mind at work (I am in front of groups of people all day) and makes feelings of anxiety particularly threatening.  Do you have any suggestions for how to cope with this or some threads/posters on this forum that seem to struggle with something similar?  

 

 

This link on Neuroemotions, including neuro-fear, is a another perspective on dealing with fear in withdrawal.  

 

Neuro-emotions - Symptoms and self-care - Surviving ...

 

 

 

 

Edited September 7, 2020 by Gridley

[Gustl]

I picked up some Magnesium at the drug store and the lowest capsule was 250mg.  I’m trying to cut it down to about 25mg, but that really leaves a small bit.  Seems hard to believe that little 25ish mg piece of magnesium will do anything.  Is this correct?

[ChessieCat]

Does your capsule ONLY contain magnesium?  Some contain B vitamins (which can be activating, especially B6) and some contain calcium which cancels out the calming effect of the magnesium.

 

Magnesium

 

Only make one change at a time.  You start low to see how you respond and then you can gradually increase.  Getting stomach pains and/or diarrhea is a sign you are taking too much.

 

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

 

Magnesium's calming effect works better if it is taken throughout the day.  You may be able to dissolve the contents of the capsule in water and sip it throughout the day.

 

Edited September 7, 2020 by ChessieCat

[Gustl]

You mentioned taking Magnesium throughout the day.  What kind of regimen is good?  Do I take 25mg every few hours?  I just have no idea how often or how much.  

 

The bottle I got is just Magnesium.  No B vitamins or calcium, as far as I can find on the label.

[Gustl]

The more I explore this forum the more supplements I find people talking about to help with morning cortisol spikes.  I just started magnesium a few days ago.  So far i can’t tell a difference, but others suggest I need to stay on it for a while (weeks) before it takes effect.  My question is: I’m eager to try other suggestions (like melatonin), but should I wait until I see if magnesium works?  One post above said to only do one at a time.  That seems like such a long time to wait.

Thank you for anybody’s thoughts.

[ChessieCat]

If you start adding more than one thing at a time it complicates things.  If you start feeling better or you start feeling worse, you won't know what is helping or "harming".

 

If you run into problems it can end up taking longer because you have to stop all the new things, wait for things to settle and then try them one at a time.

[ChessieCat]

The 3KIS topic was started by Altostrata, SA's owner and she created for a very good reason.

[Gustl]

So, the morning anxiety thing is frustrating and some mornings I just cry thinking I have years ahead of me to feel this way.  Yet, I can somewhat face that because I know logically that it’s just my body trying to readjust/heal after all those (15ish) years on Zoloft/Paxil.  The part that really sends me in despair, though, is that all these nerves have returned me to mental fears that I passed through so many years ago.

 

I am a Christian school teacher and I also regularly lead chapel worship (singing/guitar).  Yesterday I led and my whole body and mind went through a war throughout the 3 songs.  My heart began to beat rapidly before I began.  Then, as I started, my mind swirled with fears and my arms and hands tingled.  I went through a full wave of panic as I sang.  Got through that, but then as I calmed I began to fear that I had a couple more songs to lead.  My mind swirled with escape strategies.  I have them-so that’s good, but then when I think of actually pulling the trigger on them my mind races with the fear of actually doing it-as in ending a song early and stepping off the stage etc.  Up and down, up and down my fears go through all three songs.

 

It was awful.  No one knew-only me, but it was terrible.  These are the experiences that years ago led me to meds in the first place.  These experiences chip at my confidence and make me afraid to do the things I love and feel gifted at.  

 

I feel I have learned every cognitive therapy strategy that exists in the world and still don’t know if they’ll help anymore.  Now that I don’t want the meds, I’m desperate for some sort of counseling or therapy.  Is that worth it?  I went years ago, but honestly what can they tell me now that they didn’t tell me then?  Has anyone here ever found a really good therapist that made a difference for these kinds of things?

 

I find myself longing for a job where I’m not in front of people or just plain retire (I’m only in my 40s though), but—I love my present work.  Anxiety is doing it again: making me want to run away and hide, to hole up in my house and not come out.  I know I won’t go to that extreme, but it’s so hard to regularly fear getting to the end of each workday.

 

I’d sure love any insight or assurance that anyone might have.  

[Ymmit]

Hi Gustl!

 

Your story is like reading mine, I also found most of my old anxieties nicely waiting in line when I was around 3 months off Paxil. I had a talk with the GP and thought counseling might help. At the moment I cannot really answer your question if it will be worth it. I had one consultation with a psychologist at the GP so far and that definitely helped me a bit. He talked about ACT (acceptance and commitment therapy) and that was something I was already trying out myself with the DARE approach I was reading about to deal with anxiety. I cannot really do much about most of my withdrawal symptoms so I feel I just have to ride those out and wait until it gets better. The anxiety however is an old adversary and I believe this is something I can control and am determined to do so and get my life back using any non-medication help I can get.

 

A kind member here told me about Youtube channel called The lovely Grind (https://www.youtube.com/channel/UCuPoxyZksrRlDJojuJeNs2g. He went to much of same struggles and is helping me, I hope it might help you too.

 

Hope you are doing well!

 

[Daisygirlsk]

On 9/7/2020 at 2:43 PM, Gustl said:

Thank you so much for sharing.  It makes me tearful just reading of hope beyond what I am slogging through each day.  Also helps to make more sense of what is going on in my body and why.  At least I can see the reason to an extent.  It was also helpful to know that your withdrawal symptoms were months after stopping meds as mine are.  Maybe if they had happened right away I would have expected it, but when I did so well for several months I was so flustered when I suddenly had all these issues seemingly “out of nowhere” and felt like I must have relapsed.  It was devastating to think I had reverted to the state I was in nearly 15 years ago.  Thankfully, I can start to see things differently now.

 

I like the strategies you’re using.  It’s weird for me, even when I have worked on slow breathing exercises and meditation or other relaxing activities-I can calm my mind, but my body just won’t respond yet.  The anxiety in my abdomen (I’m learning that these are cortisol spikes) seems to not care if I am emotionally or mentally calm.  I have some control over rising panic, but the general state of ‘nerves on edge’ doesn’t seem to respond to anything right now.

 

I’m going to give some of the supplements Gridley suggested a try, starting with Magnesium.  

 

Anyway, I started rambling.  Just feels good to share with others who understand.  Thank you again for your encouragement. 

Hello,

This is so interesting because I am the opposite. I can get my body very calm but my mind is never calm.

[Gustl]

Ymmit,

Thank you for writing and relating.  I haven’t been very good about staying on this forum.  It was crucial for me when I found SA because I finally understood what was happening to me, though.  I did end up getting counseling and did it from late September through now.  At first I didn’t like that we were going over all my childhood stuff and the source of my anxiety (I spent years dealing with it In counseling in the past), but eventually we got to dealing with the present.  I definitely got some tools there that have helped.  In particular, my counselor helped me see that I was fearing (in the sense of respecting and giving weight to) my body’s feelings more than I was fearing God.  This helped me to stop pining after a fantasy of ‘running away’ from all the challenging parts of my life, but instead recognizing that these things (my role as a teacher, in particular) were roles God had given me and that I wanted to face them, not flee from them, that God’s kind calling on my life was more important that the yuck-feelings I suffer with right now.  I did a style of counseling called ‘biblical counseling, which I know not everyone might pursue, but as a Jesus-follower it was very meaningful.

 

The second great source of help so far has been Claire Weeke’s book on Agoraphobia.  I never would have tagged myself as an agoraphobic, but I related, though in less extreme forms, to so many of her points and examples in this book (that I randomly found at the library).  Best advice from there:

Don’t be bluffed by your feelings-I tell myself this very regularly.  It is me telling myself that while my body feels awful, that’s all it is-my body feeling awful.  I hate that, but it doesn’t have to stop me from living or doing the things that I believe are important.  

Face, Accept, Float-this is her mantra.  It has helped me to particularly accept that this is my life, crappy physically feelings, and up and down insomnia, for now.  I don’t like it, but if I tense up and fight it and fear it, I just increase my anxiety.  Better to accept it and “float” through the feelings-let them come and just try to ride them out.  They’re just feelings anyway.  Awful ones, yes, but just feelings.

 

Of course, I’m writing as if this is easy, but it’s not.  I’ve needed to make notecards of scriptures and Weeke’s sayings and memorize and read and recite them, but I’m crying at lot less in the mornings (down to one morning a week lately!) and the constant depression has become sporadic instead of daily.  

 

I hope and pray you too will find some sources of comfort and practical help soon, Ymmit.   

[Vasherr]

Hi, @Gustl,

 

long time has passed since Your last update, if it isn't a hassle please let us know how are You, hope everything is fine

 

Wishing You a lifelong window!

V.