purple: I'm hoping it's withdrawal and not relapse; also, maybe I should quit now while I'm ahead?

[purple]

Thanks for checking in on me, @AndyPants. I'm still in the same funk. Will try to get a walk in tomorrow!

 

@Colonial, thanks for stopping by and for those words of wisdom! That's exactly what I'm noticing, a certain "rush" and comfort when I doomscroll.

 

Will attempt at healthier habits tomorrow. Glad I can still brush my teeth and take my meds and that I still have my jobs. Will add a walk and a meditation tomorrow!

[purple]

Finally! This is day 4 of recovering from a huge wave of apathy/nihilism/what's-the-point-ism. It's been a few tough-ish months of mostly being in bed and escaping as much responsibility as possible and procrastinating as much as possible. While it's been "bad," it doesn't top last year's mess or my first-time withdrawal where I was swimming in despair. At the same time, it makes me realize that these variations are more like flavors of depression (I wish there was a better term for it) and less so levels that go in only 2 directions... This is probably making more sense in my head.

 

Anyway, just wanted to update that I'm starting to pick things up again. Realized the other day that movement is actually more important than meditation for me when I'm not well so that if I had to choose only ONE thing to make a habit of doing everyday, it'd be to move my body. I made a tracker for myself to keep track of doing it everyday. Rereading Power of Habit. Remembering that most things we do are a result of habit and that I need to re-develop and establish new ones for myself and make sure they last. I've often fooled myself into thinking I got something down only to feel better/let go of doing that thing that helped me get into that good place. Pretty sure I'm not alone. Perhaps this time, I can make this movement habit a permanent thing

[Greatful]

@purple  Yes this can be grueling at times.  It is a relief when we get a break from the bleakness.  Are you walking everyday?  I have to admit I was doing great on the walking all summer then fall hits and I put on the lazy habit.  I still try to meditate everyday.  

 

On 10/17/2021 at 5:51 PM, purple said:

At the same time, it makes me realize that these variations are more like flavors of depression

The depression is one of the hardest to talk yourself through.  Mine comes and goes with the wind.  The deep stages seem to be lasting shorter amounts of time.  I also thing some of mine comes from negative self talk.  Working on positive talk about myself.

 

Looks like you are cutting about once a month.  What % are you doing?

 

One day at a time is all we need❤️  

[purple]

@Greatful, I've been starting to walk everyday and plan to continue to do so. Interesting how we start and stop habits and repeat the cycle again. I hope I can make movement a permanent habit. It's been something I've wanted to make a habit of ever since college...

 

Glad to hear that your deep stages are lasting shorter amounts of time. I'm not finding a lot of patterns to mine but there's also been a lot of variables. Yes, I've noticed a lot of negative self-talk for myself too. I need to reprogram again and keep at it to make that another habit but one thing at a time for me.

 

I was doing 5% cuts but the last time, definitely did less since I wasn't doing too well but still wanted to move forward even if more slowly. I plan to return to doing 5% cuts every month.

[AndyPants]

On 10/19/2021 at 5:05 PM, purple said:

@Greatful, I've been starting to walk everyday and plan to continue to do so. Interesting how we start and stop habits and repeat the cycle again. I hope I can make movement a permanent habit. It's been something I've wanted to make a habit of ever since college...

 

Glad to hear that your deep stages are lasting shorter amounts of time. I'm not finding a lot of patterns to mine but there's also been a lot of variables. Yes, I've noticed a lot of negative self-talk for myself too. I need to reprogram again and keep at it to make that another habit but one thing at a time for me.

 

I was doing 5% cuts but the last time, definitely did less since I wasn't doing too well but still wanted to move forward even if more slowly. I plan to return to doing 5% cuts every month.

 

Glad you're getting in walks, I think just having some movement and being outdoors is helpful.  How is your latest cut going?

[purple]

@AndyPants, I think I'm getting fatigued again and having some body temperature issues. Otherwise, nothing too noticeable yet.

 

I'm happy to report I've been moving my body (even if just a quick yoga routine at night) for the past week and a half except for yesterday. It'd be nice to establish a permanent habit of moving my body, esp since it's been a goal of mine since college.

 

I've also decided to become addicted to coffee. While I know we shouldn't be taking things that could upset the nervous system even more, I'd rather have a coffee habit than a lexapro one. This is simultaneously to battle the fatigue and to create a habit of getting out of bed at a more reasonable time. I've always loved the taste/aroma of coffee but my body is sensitive. Whenever I do get out of bed by 8am, I'll treat myself to a tiny cup of coffee. It hasn't happened yet since I decided on this a few days ago but hoping this will go well.

 

Something I'd tried at the beginning of 2020 to prepare myself for tapering that time was adding mineral drops to my water. I'm not sure if I really felt any difference then but just going to give it a try. I've been adding it to my morning water for the past few days. Still no noticeable difference but will keep it going just to have a routine.

 

A friend today pointed out that I'm still recovering from trauma and I think I forgot that. I was hoping that by ignoring it, it would not be real. But talking to her was nice and realizing I do have PTSD from my vocational training. I'm going to seek a therapist that is focused on trauma and does it either through art or the soma. I overthink so much I'm pretty sure it's better to approach therapy in this new way instead of what I've done before with talk therapy and CBT. Those have been helpful but I do need something new/different.

 

[AndyPants]

I'm no expert but you may want to excercise caution with highly caffeinated drinks. An occasional one might not be too bad but developing a dependence right now might not be the best time with everything else your body is going through. Feeling so fatigued is rough though.

 

I should try yoga probably, glad you are finding some things that are working for you. Hopefully the therapy helps too!

[purple]

@AndyPants, that's a good point. I was thinking yesterday that I should just focus on the exercise habit and worry less about the getting up at x time.

 

I hungout with a friend who's a yoga teacher and she agreed that yoga would be a helpful thing. I looked up some yoga studios near me and then kind of talked myself out of it when looking at the pricing. I know I can just do it for free alone but I think having the community and accountability would be good for me.

 

I know I need to invest in my mental health but it's hard with having to pay down student loans and tight budgeting. Also just having an unsteady income. I hate how stressful finances are. I am ashamed that I have a medical degree and was able to get my medical license but have been so paralyzed these years that I haven't been able to use it fully. I hate that the system only employs board-certified doctors so I can't even be an employee. I have to find other avenues like this independent contractor thing and I was looking forward to building a private practice but I seem to just keep getting in my own way, letting fear take over. Overwhelming imposter syndrome. There's so many more thoughts I want to share but now I worry about oversharing. I do need a therapist, huh? 🤣

[AndyPants]

@purple Finances in general can be so stressful, and it's extra frustrating that mental health resources like therapy can be so expensive.

 

But you have to cut yourself a little bit of slack with all the stuff your brain and body are going through right now. Sometimes just getting by is OK. No reason to get down on yourself for that.  And when you're ready to start doing more, start with the baby steps.  Thinking about the big end goal (owning your own medical practice, in this case) can be overwhelming, so instead focus on the next step you can take to get yourself started on that path. Breaking things down can help, at least for me.

 

But definitely if you can manage the cost, I think probably most people would benefit from some therapy.

[purple]

@AndyPants, thank you. I think I just needed to rant and let it out. What's frustrating is not realizing how much comes with going down the path of medicine. License renewals, continuing education, malpractice insurance... and not letting there be any gaps in there or else they'll raise eyebrows like they already did when I first applied. The cost of maintenance is high.

 

Also, you were right about the coffee. I had a tiny cup (2-3 sips) yesterday at 10am and couldn't sleep well last night.

 

Also realizing I need to take everything easy so thank you for the reminder. I went on a longer walk today and noticed a heavy sensation in my chest like the onset of a panic attack. Tried to walk further to walk it off but it's still present as I type.

 

Yeah, I'm doing baby steps like finding a CPA and stuff. Sometimes, I wonder why I got myself into this mess but I'm realizing now that I really just want to move forward and past all the trauma and tapering. My brain tells me so but my body says no. Learning to be patient again and not rush.

 

I dislike how sensitive I am to even minor stress now.

 

Yeah, therapy has helped me for the most part in the past. I'm sure it will help again.

 

Thank you for listening.

[purple]

So I've been feeling better for over a month now, just recently feeling more normal and like myself--or is it just the version of myself that I like best? Anyway, in hindsight, I went through a long wave and am now in a window. I did take some steps to decrease my stress, like paying for a financial advisor.

 

I've also been taking my supplements regularly, continued to do some movement almost everyday. I plan to start meditating again soon.

 

Knowing that these windows and waves will continue to happen, I have to prepare myself the best I can. I worry about starting a private practice and then not being well enough to take care of patients. Perhaps, I'll have to wait a few more years to do that and find other means of income in the meantime.

[ChessieCat]

15 minutes ago, purple said:

continued to do some movement almost everyday

 

I have found that exercise, like taking a shower (sometimes), can be a bit of a bother to do because it takes both physical and mental energy.  But I have found with both after you have done it you feel a bit better and can be glad that you have made the effort.

[purple]

2 minutes ago, ChessieCat said:

I have found that exercise, like taking a shower (sometimes), can be a bit of a bother to do because it takes both physical and mental energy.  But I have found with both after you have done it you feel a bit better and can be glad that you have made the effort.

 

Completely agree and well said. Now that I'm in a window, it is less of a bother and effort. Hopefully I can turn these into habits so they're automatic the next time I'm in a wave.

[AndyPants]

@purplethat's great that you are in a better space now. It's hard to keep doing the things we need to do when things are well but that's a good point we have to make them habits so when things get hard again we have the tools we need to fight through it.

[purple]

Just wanted to provide an update that I'm still in a window--phew! I get a little worried when I start feeling fatigued but that seemed to be temporary. I did remind myself though, that if I am in a wave or heading into one, aside from seeing how I can delay its onset or prevent it by intentionally working less, to just accept it. So that may have helped too. Acceptance is so powerful.

 

Also, I think I've got a stable clinic job but I don't want to be too hopeful or celebrate until the papers are presented and signed. Having income stability will help my stress/mental health A LOT!

[ThatOneGirlStitch]

2 hours ago, purple said:

Just wanted to provide an update that I'm still in a window--phew! I get a little worried when I start feeling fatigued but that seemed to be temporary. I did remind myself though, that if I am in a wave or heading into one, aside from seeing how I can delay its onset or prevent it by intentionally working less, to just accept it. So that may have helped too. Acceptance is so powerful.

 

Also, I think I've got a stable clinic job but I don't want to be too hopeful or celebrate until the papers are presented and signed. Having income stability will help my stress/mental health A LOT!

Congratulations! I wish you a long wave and many more. The power of acceptance is hard but it seems you are wielding it well. I am excited for you about the job opportunity! Let us know how it goes.

[AndyPants]

Hope the job works out, that will help provide some good stability.

[purple]

Thank you! I'm starting soon so nervous and excited about this job!

[purple]

Also, I've been experiencing fatigue again where I nap during the day and can fall asleep just fine. It's been about two weeks since my last decrease, which was to 6.9mg. I'll see how I feel in the next week or two. I may hold at 6.9mg for a little longer than my standard month before doing another 5% decrease.

[ChessieCat]

From Post #1 of the Tips for Tapering Escitalopram topic:

 

On 5/27/2011 at 12:16 PM, Altostrata said:

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

Consequently, when you taper off escitalopram, you should be careful to decrease by small amounts, as each drop is magnified by escitalopram's extra potency. If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount.

 

Some members find that the lower their dose gets the slower they need to go, holding longer and or reducing by lesser.

 

The no more than 10% about every 4 weeks is only a guideline (I realise you said you are doing 5%).  It is important to listen to your symptoms.

 

You might consider doing this taper method:

 

the-brassmonkey-slide-method-of-micro-tapering

 

[purple]

Thank you, CC! I did try the brassmonkey method in the beginning when I was doing 10% decreases but stopped after I got my first round of fatigue and bumped back up. I may try it again with my 5% decreases to see if that helps

[AndyPants]

@purplehow are you doing? Hanging in there I hope?

[purple]

@AndyPants, thanks for checking in! I'm doing alright. Got a job in January so that's been keeping me busy. I've been going super slow with the taper since the learning curve has been hectic and stressful. I'll update more later

[purple]

So it's been awhile. I was working almost nonstop from January until recently. Unfortunately landed at another toxic work environment and now even brought a lawyer in to protect my rights as an employee. Searching for another job but having anxiety again and sick of the rejections/limitations/gatekeeping due to my background. Still on 6.4mg as I don't want to deal with any effects during this stressful period. Been tapering real slow because of this job. Not looking forward to returning to work this Friday even though there's lots of patients who want to see me, which has been great for my imposter syndrome and ego. It's not the patients but my employers. They're being more micro-manage-y and I suspect they're looking for a way to fire me without it looking like retaliation for whistleblowing. To be continued.

Are there organizations that are mental health friendly? I really just want to work at a lower paying job for the decreased stress.

[AndyPants]

@purplesorry you're going through all that, that sounds miserable.  One of the most frustrating aspects of job searching is the you never know how a job will really be until you get there and are there for a little bit. I think holding at your current dosage during this time is a good plan.

 

The fact that your patients like working with you shows you are competent at your job and that you are making a difference in your work.  You shouldn't feel any imposter syndrome.

[purple]

Thank you @AndyPants, I appreciate hearing that.

[purple]

Just wanted to rant a little bit about the therapist I saw yesterday. I had been seeing one directly under my insurance but it wasn't helping because the biggest issue was my workplace, though also if we'd been doing deeper therapy, it would've been clear that there's been childhood things like lack of assertiveness and stuff like that. Anyway, I knew I was going into a more problem solving based therapy but I suspect the therapist I had was burned out so couldn't remember things like that I could only do appointments on a certain day of the week, the same day of the week every week. So I had to keep reminding her each time we scheduled the next appointment.

 

Since that didn't work, I was finally able to vocalize it and she also noted my depression/anxiety/ptsd scores didn't have much improvement. The insurance placed me with a third-party agency (why are there so many third-party things nowadays it's so friggin frustrating) and I saw this new therapist yesterday. Everything was actually going really well until she asked me about my medication and I told her what happened and so she used the usual defaults of, maybe it shows you really do need the medication. She also asked me if I'd heard of serotonin syndrome which I thought was an odd question. One, I think this is me over-reacting, because duh I went to med school and learned about it and she knows I'm a doc. I suspect that's me overreacting because she doesn't know what I did and didn't learn in med school. Two, though, serotonin syndrome is when there's too much serotonin in the system and I'm not sure how that could be an issue given I'd only ever been on one SSRI at a time and didn't take something like St. John's wort or other at the same time. *Big sigh* In the end, her default/cop-out was that we should let a psychiatrist handle stuff like this because they're the expert. Uh huh.

 

Ok rant over. That was good to get out. I'll continue to see her since I can't fully blame her for not knowing what she doesn't know and perhaps she'll have insight into things that aren't medication related...

 

So yeah, keeping on with the 6.4mg for... is this my 3rd month? Frustrating to be going so slow, tempted to do another little like 5% drop but scared of possible consequences... though could be a good facing-fear move... hmm lol

 

Going easy on myself as much as I'm able to. Trying to find the next job. Healthcare benefits end soon so that'll be fun.

 

Hope y'all are doing well!

[ChessieCat]

4 hours ago, purple said:

Two, though, serotonin syndrome is when there's too much serotonin in the system and I'm not sure how that could be an issue given I'd only ever been on one SSRI at a time and didn't take something like St. John's wort or other at the same time.

 

Escitalopram is a very strong drug.

 

You can get serotonin toxicity from too high a dose of ONE serotonergic drug without being on any other sertonergic substance.  This happened to me when I was taking 100mg Pristiq ONLY.  It took me a long time to work out that the reason I felt so awful was it was the drug causing the issues.  Once my dose got down lower the side effects of mild serotonin syndrome gradually reduced.

[purple]

Ahh, I see. I was suspecting that's what she meant but was still weird that she brought it up because I was having the odd symptoms while not being on the drug.

[purple]

I'd like to start posting daily updates to keep myself accountable. I've been having a lot of trouble again just adulting haha. These past few weeks have been spent sleeping/napping, watching lots of YouTube, playing Snake on google. I've recently added in taking daily walks with my brother after dinner which has been nice.

 

I know it's okay to not be productive but I feel like I'm taking it too far. The main issue I see myself having is anxiety. Anxiety over doing anything related to job searching. I've taken some steps like sending out a few resumes and signing up for a free job agency help thing but I know it's not enough... My goal was to get a job by the end of this month and I feel like I should've sent more resumes and job applications out. I'm looking for "low" paying jobs like $20/hr.

 

Anyways, today as I was washing the lid of a pot, I thought about how I had a tendency to overthink when I was younger but it seems to never have been as big an issue as it has since starting the AD. Maybe I'm just making it up/making it make sense to me. But it does make me think about how people have noted how significant and deeply AD affects us.

 

So today, I slept in until 11:11am actually and then stayed in bed until about 2pm watching videos. (I've tried deleting YT from my phone twice but keep reinstalling it.) I got out of bed, had a homemade burrito, and continued to watch some videos while playing Snake. I fixed my resume up so it was more career change worthy and sent it to this place that seems like a good fit for me. Would be ideal as it's just under 30 hours of work per week but with full benefits. I'm hopeful but prepared for rejection.

[purple]

Today I tried to finish my application on Rover but couldn't get a reference/testimonial so thinking maybe I shouldn't bother moving forward with them. Dunno why that $35 application processing fee is also getting to me too.

 

There's hope for medical jobs. Looks like there's a few opportunities in-state that will require relocation but I guess I'm willing to move. I don't want to but don't feel like I have much choice.

 

I was going to apply for a library assistant job but didn't get around to it. Played more snake and watched YT.

[purple]

Oh yeah also met with therapist. She wanted me to increase my dosage because I was a crying mess and told her about my anxiety. It's so hard to put in words how WD is when they don't really believe it. I have one last appointment with her next week until my insurance runs out but I'm thinking of canceling.

[Ariel]

@purple

 

On 6/21/2022 at 12:53 AM, purple said:

I've been having a lot of trouble again just adulting haha.

I can assure you you're not alone in this. WD can make it very difficult to function in just about every way. It can be hard to accept. I imagine it may be even more difficult if one was "high-functioning" prior. 

 

I understand the argument about not lapsing into learned helplessness; at the same time, it's a balance. Taking WD seriously sometimes means allowing for plenty of time and space to rest and do nothing. I'm no expert, I find this to be one of the more confounding challenges throughout this long, slow process: when do I push, when do I let go? I don't know. I feel like I get it wrong all the time. I just keep trying to explore and inquire into various possibilities as they arise, and, perhaps most importantly, I try not to beat myself up when I fail or attach too much meaning to desired outcomes either. Easier said than done. 

 

From my perspective, you seem to be making admirable efforts looking for work and submitting job applications. Pretty sure that's nobody's favorite pastime, even when they're feeling in peak condition. Give yourself lots of credit for what you're doing under adverse circumstances, and go gently. 

 

1 hour ago, purple said:

Oh yeah also met with therapist. She wanted me to increase my dosage because I was a crying mess and told her about my anxiety. It's so hard to put in words how WD is when they don't really believe it.

 

I'm sorry your therapist doesn't understand WD and suggested you increase your dosage when you are trying to get off of psych drugs. It can be so hard to confide in a therapist and allow ourselves to be vulnerable only to be met with incredulousness, skepticism, doubt, or worse. Really shakes the foundations of what we thought was a safe space.

 

I agree with you that the WD experience is slippery to convey. Whenever I try to describe it to someone who hasn't been there, I end up feeling like I'm either exaggerating or underplaying it, and I end up getting confused about it myself. I wish I could dispassionately articulate how it is but I can't. I imagine that if the person at the receiving end is an excellent listener, curious and open and empathic, that this may help things along; but such people seem rare, as does opportunity/access to interface with them. I'm sorry your therapist wasn't helpful in trying to understand what you're going through. 

 

Of course I don't know exactly what you're going through, either. I'm holding space for your experience and sending good thoughts and healing vibes your way. I'm glad to be part of this community with you, among other people who are equipped to have some insight into this weird thing.

 

In solidarity and support,

A.

 

 

[purple]

12 hours ago, Ariel said:

when do I push, when do I let go?

So so true!

 

@Ariel thank you so much for the thoughtful response. Everything you wrote, I feel it. You articulated it so well too.

 

I just got off the phone with a career advisor (found a government funded program where they offer free job placement services) and am happy with the encounter.

 

I woke up this morning feeling like I'm losing touch with reality. It's scary because it reminds me of 2 years ago (2020) where I'd been the same way but wasn't as aware of it. It's interesting trying to figure out what is AD related and what isn't. I've never had this sensation before... though now that I type this, I do remember that during school breaks (summer, winter), I would feel like my brain was rotting because it wasn't being stimulated and doing schoolwork. I guess this is similar but not the same. The similarity is in how when I lack structure, I feel disoriented. I do feel like making a schedule for myself though and fearing I won't stick to it haha. It's all so conflicting.

 

Anyway, all this seems so disjointed too. I am just so thankful to have this forum and for you all to validate that I am not alone. I feel seen and heard. I think that's what's really important in the end.

[AndyPants]

Instead of setting a goal to have a job by x time, have a goal with something like "I will apply for one job every day". (You can't control the interview process or people hiring you, only what you can do).

 

Something I've been finding is focusing on just the next step is a lot less overwhelming than looking at the big picture. Sometimes easier said than done, but it really helps. You can do this!

[purple]

@AndyPants I love that! Thank you for that tip. I was just realizing how my goal-setting seems to be missing the point but couldn't figure out how to troubleshoot it. I think you just helped me do that!

 

Definitely. It's been really hard to accept that this AD stuff has had such a huge impact on me and my life. I really feel like I'm not who I used to be but not in a good way... I'm not sure. Basically, I can't handle as much stress in my life as I used to be able to. Part of it is not tolerating certain things. But the other part is something I can't quite put words to. So yeah, one day at a time. I forget to come back to that. Thank you for the reminder!