Sneha: The fear/anxiety attacks are terrifying, this kind of life seems almost impossible

[Sneha]

Hi all, 

 

Just stumbled across this website an hour ago.  I desperately needed it. I'm 35, in India. Over the last 16 years I've been prescribed around 10 different antidepressants in series or in parallel, for 12 years totally. 

 

Tried stopping them 3 times in my life so far. 

 

I tapered escitalopram 20mg over 30 days (reduced 25% of original dose every ten days) after 10.5 years of various antidepressants. My last taper date was December 2nd, 2020. Since then it's been 0mg. (I'm only just realizing, after seeing this website, that it was way too fast.) Because of my past experiences I knew I would experience diarrhea and visceral attacks of anxiety/fear. But apparently just the knowledge couldn't prepare me enough.

 

I'm trying my best to handle the extreme fear/terror with meditation and observing my body sensations. But it's exhausting to do this every day, and I've only done it for a short time! It's wiped out my cognitive abilities (which means I can't even explore this website properly). My first withdrawal (cold turkey, 2006) lasted two years, I don't know if I can face that again, the thought makes me panic and feel suicidal.

 

There are some life changes coming up this year for me, I will have to move house and do some new things, I don't know if I can cope but I've begun to hate these pills so much (they were effective but their effectiveness was tangential and caused other big problems with my functionality) that I don't want to go back on them. Sometimes I do feel determination to keep going, if only I knew how. 

 

(Also, the last time I tried this taper in 2017, going back on antidepressants didn't stop the fear attacks. I was forced to take pregabalin for the anxiety which made me put on 18kg in 6 months. So I don't even know if going back on antidepressants will help this time either.)

 

Thank you for reading. I feel a bit better just for sharing this. 

[Shep]

Hi, Sneha.

 

Welcome to Surviving Antidepressants.

 

Yes, it does look like your taper was too fast. You may want to reinstate at a small dose. I'll give you some links to read over.

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

The Windows and Waves Pattern of Stabilization

 

Please see this thread specific to escitalopram:

 

Tips for tapering off escitalopram (Lexapro)

 

Please read through this thread on reinstatement: 

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Were you on 20 mg of escitalopram at the beginning of this month, December 2020? 

 

I'm going to ask the moderators more familiar with this drug to advise a reinstatement dose. In the meantime, please read through the links and post if you have any questions. 

 

Please also add the dates you were on pregabalin to your signature and any other psychiatric drugs you have taken that aren't already listed. 

 

[Sneha]

Thank you so, so much @Shep.

 

I will go through these links. 

 

As far as I know, escitalopram is not available in liquid form here in India. 😕

 

To answer your question: I started tapering on November 2nd or 3rd, 2020. Reduced 25% of the original dose (20mg) every ten days. On December 2nd, my last taper date, I took 5mg. On December 3rd I started 0mg. Since then I've been on 0mg.

 

I look forward to advice about a reinstatement dose, though I still need to make up my mind about it (with the help of this wonderful website). 

 

I have expanded my signature section with the info you requested. I took pregabalin 75mg, then 150mg between June 2017 and March 2018. I can't remember the exact durations and dates of many of the medications. Especially now with cognitive difficulties due to withdrawal it's hard to look it all up in my prescription history and makes me too emotional. Sorry about that. 

 

Since I posted my original post, I have experienced 2 windows which have made me feel a little less despair and put the waves into perspective a little bit. 

[Shep]

19 hours ago, Sneha said:

I look forward to advice about a reinstatement dose, though I still need to make up my mind about it (with the help of this wonderful website). 

 

Thanks for the additional information and adding to your signature. I bolded some key points to make it easier for the mods to see.

 

I asked the mods more familiar with escitalopram what would be a good reinstatement dose and they recommend starting at 1 mg. You can always increase. 

 

I would really encourage you to try this reinstatement and see if it brings some relief. Usually SSRI withdrawal is delayed for several months, so you likely aren't even feeling the worst of it yet. This isn't to frighten you, but to inform you and encourage you to try a reinstatement. 

 

Please write more about your lamotrigine history. According to your signature, you also stopped that recently. Were you taking this drug to sleep at night? How is your sleep? 

[Sneha]

Thanks for this, @Shep,

 

Since there is a 2.5mg tablet available, I can break it into half and take 1.25mg. I assume the idea is to start with that dose, wait and see if symptoms abate, and if not increase it until they do. (Sorry if this is already mentioned in the links you sent me, currently I read things and then forget and then forget where I read them.)

 

I agree with you, based on my own withdrawal timelines in 2006 and 2017 too, that realistically I can expect symptoms to keep popping up months from now. I've been asking myself again and again what my problem is with going back on a reinstatement dose. Some irrational part of me would feel trapped and defeated, I think. My guess is I will go back on a reinstatement dose only from a place of extreme distress, like I did last time in 2017. 😕 I have spoken to my family and postponed my plans to move house this year.

 

Thanks for your question. I took lamotrigine for about 8-9 years, for hypomania and depression (my diagnosis is bipolar type 2). Yes, I tapered it off side by side with the escitalopram at the same rate – 25% of the original dose every ten days – only now am I seeing the "3 Keep It Simples" post on this forum. *facepalm*

If I stay calm throughout the day, try to avoid catastrophizing thoughts, and if I get into bed 4 hours ahead of my bedtime and do sleep meditations, listen to sleep audio tracks etc, I get 6-8 hours of sleep per day with one wake-up in the middle. (After I wake up the physical panic starts in my body and then I get some relief only in the second half of the day, even if it's not a window.) Luckily I can spare the time for all this. The melatonin pill I used to take for sleep doesn't work any more so I've stopped it.

Currently reading Claire Weekes for my fear/panic attacks after seeing the thread here on her books.

 

Thank you so much for your replies and your inquiries on my behalf, it's meant a lot. Wishing you a wonderful, happy new year!

[Shep]

4 hours ago, Sneha said:

Since there is a 2.5mg tablet available, I can break it into half and take 1.25mg. I assume the idea is to start with that dose, wait and see if symptoms abate, and if not increase it until they do. (Sorry if this is already mentioned in the links you sent me, currently I read things and then forget and then forget where I read them.)

 

Yes, this will work and it's something you can try right away until you can get the gear required (such as a scale or materials for a liquid taper). 

 

For info on using a pill cutter, see:

 

How to cut up tablets or pills (using a pill cutter)

 

For information on using a scale and liquid, please see:

 

Using a digital scale to measure doses

 

How to make a liquid from tablets or capsules

 

4 hours ago, Sneha said:

Thanks for your question. I took lamotrigine for about 8-9 years, for hypomania and depression (my diagnosis is bipolar type 2). Yes, I tapered it off side by side with the escitalopram at the same rate – 25% of the original dose every ten days – only now am I seeing the "3 Keep It Simples" post on this forum. *facepalm*

 

I'm concerned you may also be experiencing withdrawal from the lamotrigine, so we need to address this.

 

Please do not reinstate the lamotrigine just yet, as you wisely note, we do need to go by the Keep it Simple rule. So let's give the escitalopram reinstatement some time. 

 

It will help if you can set up a daily drug and symptoms journal. Please see the below for instructions and also include:

 

• how many hours you sleep at night.
• any supplements you may be taking (name and dose)

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

 

 

 

 

[Shep]

4 hours ago, Sneha said:

If I stay calm throughout the day, try to avoid catastrophizing thoughts, and if I get into bed 4 hours ahead of my bedtime and do sleep meditations, listen to sleep audio tracks etc, I get 6-8 hours of sleep per day with one wake-up in the middle. (After I wake up the physical panic starts in my body and then I get some relief only in the second half of the day, even if it's not a window.) Luckily I can spare the time for all this. The melatonin pill I used to take for sleep doesn't work any more so I've stopped it.

Currently reading Claire Weekes for my fear/panic attacks after seeing the thread here on her books.

 

I just wanted to make a separate post to thank you for writing out all of the great non-drug coping skills you're learning. This will serve you well now and for many years to come. 

[ryan1982]

Hey @Sneha-

Just read your thread and have no wisdom to share but wanted to pass along some encouragement. You’re going to stabilize and be fine- just give it time and trust the folks on this site!

[Sneha]

Hi @ryan1982, thanks so much for your encouraging words. They were much needed!

[Sneha]

Hi @Shep,

 

Thanks so much for this info and these links. I'll go through them slowly, currently I'm in a wave and finding it a bit difficult emotionally to think about withdrawal and reinstatement both. I still haven't decided about the reinstatement. Also feeling intimidated by the idea of measuring fractional amounts, buying equipment etc. all by myself. 😕 I'm guessing many of you would have felt like that initially.

 

Thanks also for pointing out what I'm doing right – hopefully – the meditations etc.

 

I hadn't considered lamotrigine withdrawal – I thought it was just antidepressants that got this bad when tapered. Thanks for pointing it out.

 

I will post about my supplements and put together a symptom diary for a few days as you suggested.

 

Best wishes to you Shep!

-Sneha

[Shep]

54 minutes ago, Sneha said:

I still haven't decided about the reinstatement. Also feeling intimidated by the idea of measuring fractional amounts, buying equipment etc. all by myself. 😕 I'm guessing many of you would have felt like that initially.

 

Perfectly understandable to be intimidated by the process, but please don't let that stop you from reinstating. As you mentioned earlier, you can break your pill in half to reinstate at 1.25 mg. This will work fine to start. And when it comes time to updose a bit more, if needed, the moderators will help you with the math and any questions you have about using a scale or working with liquid titration. 

 

Please note that reinstatement is time-sensitive. The sooner you reinstate after coming off, the smoother the reinstatement will go. 

 

This is a brilliant post by ChessieCat, recounting her experience:

 

On 12/18/2020 at 11:24 PM, ChessieCat said:

I tried to reduce my drug by 50% because of mild serotonin syndrome and the drug only being available in 100mg and 50mg and supposedly not able to be cut the tablet.  After 2 weeks of very bad cog for I was unable to type.  Because I am a professional typist I knew that something was wrong.  SA suggested updosing, which I did, and after about 4 hours (not days) my brain fog was clearing and I was able to type again.  I knew it was because of the drug due to the fact that I had a benchmark.  I knew that it was not a placebo effect.  I was astounded then, and still am now whenever I recount my experience, at what happened to me and how I was able to know for a fact that it reducing the drug that caused the issues and that updosing resolved it.

 

If you are really worried about it but do want to reinstate you could start with a really tiny amount which will prove to you that it is okay to take it.  It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  It is better to start with a small amount and increase by a little bit more than to risk taking too much.

 

I found that the more I understand how the drugs work the less scared I was.

 

1 hour ago, Sneha said:

Thanks also for pointing out what I'm doing right – hopefully – the meditations etc.

 

We love to see folks working on the non-drug coping techniques, so do write more as you feel able. 

[mstimc]

Hi Sneha

 

I just wanted to second Shep's statement that you're on the right track starting coping skills like Claire Weeks and a nightly sleep routine.  I struggled tremendously with fear, guilt and anxiety until I started using acceptance and other Cognitive Behavioral Therapy (CBT) practices.  At first, it is difficult to stick with them because anxious thoughts are so intrusive, but it will get easier with time.  Anxiety is a selfish beast and wants all your attention; without it, anxiety starves and dies.  Because of that, it fights any practice that releases anxious thinking.  But the more you practice coping skills, the weaker the thoughts will become.  And you found the right place for support!

[Sneha]

Thanks so much @mstimc, I'm using the Headspace app's (paid) course on "Managing Anxiety" too, thanks for your encouragement and advice, it made me feel more hopeful about the future. Hopefully as I practice detaching my thoughts from my physical sensations and try to learn "floating" through panic attacks I'll get better at these things.

[Sneha]

Thanks for this account from ChessieCat, @Shep, and for making the measurements sound doable. Will read through all this.

 

For now, here is my supplement list and one day's diary from yesterday. Will post more diaries as the days pass.

 

Supplement List

 

Many of these I've been taking for or because of my diarrhea for about 3 weeks now:

1. 1 Vitamin B complex capsule with folic acid on alternate days, alternating with 1 vitamin B12 500mcg tablet on alternate days
2. 1 vitamin C 500mg tablet per day
3. From today onwards will start magnesium citrate 330mg tablet on alternate days, alternating with 2 cod liver oil capsules (each Cod Liver Oil Type B, B.P. 300mg) on alternate days
4. 1 capsule of probiotics every day
5. 1 capsule of psyllium husk every day
6. 1 multivitamin tablet per week
7. I also take an oral contraceptive called dienogest (for the past year, and before that, another pill for 5 years) every day, it's a progestin-only pill that stops one's period. It is for premenstrual dysphoric disorder, a severe form of PMS with difficult mood swings.

Symptom Diary for 1st Jan

 

Approx between 0300-0500 Fell asleep

 

0900 Woke up in the middle of sleep. Normal bowel movement. Physical panic attacks with spasms in hips, back, neck, shoulders, subtle pain in stomach, heavy palpitations

 

---- Went back to sleep

 

1400 Woke up. Moderate physical panic attacks continued

 

1440 Breakfast

 

1530 Went for a short walk

 

1730 Lunch, took supplements and dienogest pill

 

1800 Physical panic attacks subsided

 

(Evening sometime) Moderately upset stomach, not as bad as it can get these days

 

1830 emotionally "upset" feeling, tightness in the throat 

 

2110 Dinner

 

2130 Tightness in throat increased, heavy crying episode

 

2200 Clear mind for some time (though not like a window)

 

2330 Racing thoughts, mild palpitations through the night

[mstimc]

2 hours ago, Sneha said:

Hopefully as I practice detaching my thoughts from my physical sensations and try to learn "floating" through panic attacks I'll get better at these things.

You are on the right track!  Your physical symptoms are a manifestation of your anxious thought patterns.  The more you search for a "cause" the more anxious you'll become.  Accepting them for what they are--just feelings and sensations--will indeed let you float through them.  I know that's easier said than done but just having that knowledge will help.

[Sneha]

Thank you for your encouragement @mstimc, it helps to see it all written out like this.

[Sneha]

Symptom Diary for 2nd Jan (diary for 1st Jan earlier in this thread)

 

Approx between 0300-0500 Fell asleep

0900 woke up anxious, heavy, hard palpitations, scary thoughts, no physical panic attack

---- Went back to sleep

1000 briefly woke up for a few minutes

1210 woke up, some palpitations, mild physical panic attack with spasms in shoulders, hips, neck and back. Thoughts tried to join in

1230 Normal bowel movement

1300 Breakfast

1340 spasms and palpitations became milder but continued

1445 Mind got clearer and calmer, doing work got easier

1715 snack. took supplements and dienogest pill

1830 snack. physical panic spasms gone.

1910 disproportionately upset over friend's last minute cancellation of our plan to meet. anger, lump in throat, racing thoughts etc.

2000 finally feel a bit lighter

2030 dinner

2100 able to have a long phone conversation with mother and sister, which sometimes post tapering I'm too nervy to do

2120 normal bowel movement

2210 able to read Covid news for 5 minutes, previously too emotional

Night - mild palpitations and wandering thoughts into the night (used to be the same on medication too) 

[mstimc]

Hi Sneha

 

I think you'll find morning anxiety and physical symptoms are fairly common.  They're among the symptoms others report quite often.   Even many years after my own recovery, I sometimes experience anxious thinking early in the morning when I'm under a lot of stress.  I think you'll find they decrease as you recover.

[Sneha]

Hi @mstimc, it's  so reassuring to hear this. Thank you so, so much. 

[Shep]

On 1/2/2021 at 7:02 AM, Sneha said:

Supplement List

 

Many of these I've been taking for or because of my diarrhea for about 3 weeks now:

1. 1 Vitamin B complex capsule with folic acid on alternate days, alternating with 1 vitamin B12 500mcg tablet on alternate days
2. 1 vitamin C 500mg tablet per day
3. From today onwards will start magnesium citrate 330mg tablet on alternate days, alternating with 2 cod liver oil capsules (each Cod Liver Oil Type B, B.P. 300mg) on alternate days
4. 1 capsule of probiotics every day
5. 1 capsule of psyllium husk every day
6. 1 multivitamin tablet per week
7. I also take an oral contraceptive called dienogest (for the past year, and before that, another pill for 5 years) every day, it's a progestin-only pill that stops one's period. It is for premenstrual dysphoric disorder, a severe form of PMS with difficult mood swings.

 

Thanks for writing out such a detailed list of your supplements. I'm concerned about the alternating days, though. We recommend taking drugs and supplements at the same time(s) of the day and at the same dose each day. Your nervous system is fighting for stability, and alternating days can be confusing for the nervous system. 

 

Some people find B vitamins to be stimulating, so if you do stay on it, you may want to take it early in the morning so it doesn't affect your sleep.

 

Please note that multivitamins can also be problematic because if you do have a reaction, you won't know which vitamin is causing the problem. Some of us become sensitive to foods and supplements that we never were sensitive to before withdrawal. The simpler you keep it and the more you get your nutrients from a clean and healthy diet, the better. 

 

For more on supplements, please see:

 

Important topics about tests, supplements, treatments, diet

 

Vitamin B3 (niacin, niacinamide)
 
Vitamin B8 (inositol)

Vitamin B12: essential for mood, nervous system

 

You can also also use the search box or google "surviving antidepressants" + [name of supplement] to find more information. 

 

12 hours ago, Sneha said:

2210 able to read Covid news for 5 minutes, previously too emotional

Night - mild palpitations and wandering thoughts into the night (used to be the same on medication too) 

 

Just a tip - no Covid news before bed! Even after writing a success story, I couldn't handle Covid news so close to bedtime. Perhaps save this type of news for earlier in the day for a better night's sleep. 

 

Any thoughts on reinstating? 

 

 

 

 

[Sneha]

Symptom Diary for 3rd Jan

 

Approx between 0400-0530 Fell asleep

1145 woke up with palpitations, physical panic attacks (spasms in back, shoulders, hips, a little in stomach). Thoughts tried to join in. Normal bowel movement 

---- Went back to sleep

1315 woke up with same physical panic attack spasms and some heavy palpitations. The better the quality of my "floating" through the palpitations, the faster each attack subsided. Thoughts tried to join in with catastrophizing as usual. Sitting up and moving about doing things seemed to help a bit

1400 Breakfast plus half of the day's supplements

1430 Able to briefly scroll through social media and watch a few minutes of a comedy show (was unable to do either last month), even laughed a tiny bit. had completely lost my sense of humour earlier. Physical panic spasms and milder palpitations continue, with brief breaks, in an on/off cycle

1600 lunch

1710 went for a walk with a friend, long chat. Panic spasms gone. 

1815 snack

2115 dinner + supplements + dienogest pill

Night - racing thoughts, very poor concentration for sleep meditations, overstimulated by meeting friend

[Sneha]

Thanks for all these tips @Shep, it's such a relief to hear advice from people who have experience with this. Will shift the B vitamins to daytime (I seem to be ok with them so far) and take them every day instead of alternate days. Will take the magnesium and cod liver oil every day too – was concerned about the magnesium because it's a capsule, not a breakable tablet, and I eat bananas which are rich in magnesium and didn't want to overdose. But I'm sure I'm just being paranoid.

 

Good point about reading covid news in the day time! I can apply this principle to other things in my day too, thanks.

 

Yes, as you said, during my 2017 withdrawal I developed a food allergy (to a particular type of chilli pepper) that I hadn't had before. So far I seem to be fine with this multivitamin pill once a week, but I see no harm in stopping it since I eat vegetables, bananas and eggs every day.

 

About the reinstatement: Applying Claire Weekes' advice (just as a beginner, though – true acceptance and good quality floating are still out of my reach) and doing meditation using the Headspace app every day seems to be making the panic attacks more manageable. I also decided to abstain from catastrophizing thoughts as much as I can (they're practically an addiction, I realized) and it has helped a bit. And surprisingly my diarrhea seems to be improving. Under these circumstances it's hard to decide to go back on a reinstatement dose that I'm already irrationally reluctant about. 😕 I'm very lucky that my workload is light right now and I was able to postpone moving house. So I'll wait and see what the next round of symptoms brings. 

 

By the way, I read some of your profile (couldn't read the full thing because of my sensitivity to emotional content), it is so so inspiring, love your analogy to Plato's cave. 

 

[Shep]

6 hours ago, Sneha said:

About the reinstatement: Applying Claire Weekes' advice (just as a beginner, though – true acceptance and good quality floating are still out of my reach) and doing meditation using the Headspace app every day seems to be making the panic attacks more manageable. I also decided to abstain from catastrophizing thoughts as much as I can (they're practically an addiction, I realized) and it has helped a bit. And surprisingly my diarrhea seems to be improving. Under these circumstances it's hard to decide to go back on a reinstatement dose that I'm already irrationally reluctant about. 😕 I'm very lucky that my workload is light right now and I was able to postpone moving house. So I'll wait and see what the next round of symptoms brings. 

 

These are great skills and techniques, Sneha! 

 

You may be in the earlier stage of withdrawal and SSRI's are notorious for delayed withdrawal, so reinstating a tiny amount may prevent some future suffering. A lot of people don't even experience withdrawal from SSRI's until several weeks or months after stopping. 

 

6 hours ago, Sneha said:

By the way, I read some of your profile (couldn't read the full thing because of my sensitivity to emotional content), it is so so inspiring, love your analogy to Plato's cave. 

 

 

Thanks, yes, the cave analogy just seemed right. 

 

[Sneha]

Hi @Shep, I know you're right about the likelihood of more symptoms over the coming months of 2021, thanks for all your reminders about this. This last one month, since I finished tapering, has been pretty horrible with cognitive reduction, brain zaps, nausea, crying, fear/panic attacks, intense loneliness and diarrhea. I'd still like to wait till the next round of symptoms, thanks. (Not that I'm symptom-free right now but I'm not constantly in extreme crisis and suicidal.)

 

PS: I forgot to add I feel weird about some of my "windows": sometimes my mood doesn't feel normal during them but strangely blank, too calm, devoid of emotion, which is an improvement on anxiety but not really something I like. 

[Sneha]

Symptom Diary for 4th Jan

 

Approx between 0400-0530 Fell asleep

Approx 1100 onwards - in and out of sleep

1230 woke up. Mostly normal bowel movement. Some palpitations and subtle on/off tension in stomach. No panic spasms (have had one morning without these physical panic attacks before). Tired (from yesterday's simple but hours long outing, which I don't seem to have the mental stamina for any more) 

1410 breakfast + half the day's supplements

1430 Started experiencing a sort of micro-version of the panic spasms, just feels like light nervy physical pain in my shoulders but not overtly associated with panic or anxiety.

1600 Able to concentrate on work

1720 lunch

1830 Very tired (possibly because of yesterday's outing). Emotional numbness set in (didn't think to write it as a symptom till today). Able to continue working.

2115 Dinner, supplements, dienogest pill

2130 able to watch 20 min of a comedy before it got too emotional for me, then stopped

2230 anxiety/fear after clicking and scrolling through this site too much, too fast (wrong time of day too!) - thought I could handle it

Night - emotional numbness slowly subsided. Mild palpitations and wandering thoughts into the night. Tried not to let them bother me and thereby escalate. 

[Sneha]

Symptom Diary for 5th Jan

 

Approx between 0400-0530 Fell asleep

1100 woke up, no panic spasms, some palpitations

1145 normal bowel movement. Panic spasms started to some extent along with palpitations. Any anxious thought was starting off the spasms and vice versa. Tried to keep the two separate and think safe thoughts

---- Went back to sleep

1345 woke up. Spasms gone

1440 lunch + first half of the day's supplements

1515 panic spasms and subtle tension in stomach came back in mild form, on/off cycles. saw some emotional content (short inspiring video), cried a little, felt positive about it

1630 went for a short walk

1730 lunch. Spasms reduced to light nervy physical pain in shoulders with no overt connection to anxiety

2050 dinner, supplements, dienogest pill. Appetite is increasing, had low appetite for the last few weeks. Overstimulated from too much virtual social interaction, tired

2200 overstimulation/agitation feels better after meditation

Night - began ruminating about some perceived wrong someone did me (was common before tapering too but this time it agitated me a lot more). Took a long time to tear my thoughts away and settle down. Should have tried "floating" through it

[Shep]

On 1/4/2021 at 11:16 AM, Sneha said:

PS: I forgot to add I feel weird about some of my "windows": sometimes my mood doesn't feel normal during them but strangely blank, too calm, devoid of emotion, which is an improvement on anxiety but not really something I like. 

 

Do you think it could be depersonalization? 

 

Alto posted an article about it here in the dp/dr thread:

 

Derealization or Depersonalization (DR and DP) - Alto's post

 

[Sneha]

Thanks for this @Shep. After reading this, I can't really say. It's a feeling of detachment/numbness that comes and goes especially it seems when I'm tired. And yeah there is a little bit of a glass wall feeling. So far it hasn't been severe enough to scare me too much or make me feel very disconnected from myself. If it gets worse I will probably panic about it, which I can't afford. Thanks for flagging this. The thread says it's not a permanent symptom and it goes away with time. That's reassuring.

[mstimc]

2 hours ago, Sneha said:

The thread says it's not a permanent symptom and it goes away with time. That's reassuring.

Hi Sneha

 

This is an important point to remember--the symptoms are temporary.  Its easy to fall into the trap of thinking you'll never get better, but you will.  There's a school of thought that says the universe will always send you what you're interested in, even if what you're interested in isn't what you want.  In other words, our darkest thoughts often create their own reality.  Expect and work toward healing and that is what you'll get!

[Sneha]

Thanks for these encouraging words @mstimc. This sounds like the right attitude to cultivate. 

[Sneha]

Symptom Diary for 6th Jan

 

By 0300 Fell asleep 

0330 woken up by/with negative  ruminations 

By 0530 Fell asleep 

1100 woke up, panic spasms and  subtle tension in stomach inviting thoughts to join in

1145 normal bowel movement. Tried floating through the spasms. Found a nice explanation of floating at https://www.anxietycoach.com/claire-weekes.html Getting up and moving around helped too, it grounded me by restoring a sense of normalcy of everyday life

By 1300 went back to sleep

1330 woke up. Panic spasms + heavy palpitations inviting thoughts to join in. "Floating" helped

1400 breakfast + half the day's supplements. Panic spasms reduced to their physical aspect

1515 went for short walk

1600 moderately upset stomach

1700 upset stomach (last night's agitation?)

1730 lunch

1830  Tiredness, slight emotional numbness set in

2100 upset stomach

2130 upset stomach

2155 upset stomach (This pattern is like the early days of withdrawal.) 

2200 dinner, supplements, dienogest pill 

2230 agitated about something sister said, it seems my tolerance for even slightly "off" remarks in conversations with people has gone down

2250 upset stomach

Night -- mood improved. Numbness gone 
 

[Sneha]

Symptom Diary for 7th Jan (last one)

 

0005 upset stomach

0025 upset stomach

Approx 0300 Fell asleep 

0920 woke up. Upset stomach. Intense panic spasms with different body sensations from the ones I'm used to. Urge to panic with the new sensations was strong. Tried floating and observing body sensations to separate them from thoughts

0930-1230 In and out of sleep, with intense panic spasms and some palpitations coming and going

1230 Woke up. Panic spasms reduced but the tightness in the neck and shoulders was still there

1330 breakfast + half the day's supplements

1400 Physically tired, rested, drank fluids

1730 lunch, supplements, dienogest pill

1745 tired. able to work

1945 almost normal bowel movement

2200 dinner

2300 twinge of depression

Night - better than the last couple of nights

[Shep]

On 1/2/2021 at 7:02 AM, Sneha said:

Supplement List

 

Many of these I've been taking for or because of my diarrhea for about 3 weeks now:

 

Any thoughts on a small reinstatement, Sneha? From your latest journal, it looks like you're getting a lot of GI symptoms that started around the time you came off the escitalopram and lamotrigine. GI symptoms are very common, especially in SSRI withdrawal. Half of your serotonin is located in your stomach. 

 

3 hours ago, Sneha said:

1230 Woke up. Panic spasms reduced but the tightness in the neck and shoulders was still there

 

If you're not already doing so, you may want to try some gentle yoga for the neck and shoulder tightness. This is from the Beyond Meds site, written by someone who survived psychiatric drugs and blogs about withdrawal and recovery: 

 

Beyond Meds - Yoga at Home

 

 

[Sneha]

Hi @Shep, yes, these digestive symptoms come and go in some sort of cycle. For example, today I'm back to normal, though it usually takes about 3 weeks of supplements, fibre, meditation and staying calm about it, with gradual improvement, till I reach normalcy. I know it's weird but I keep a log. When I had these symptoms in 2017 a gastroenterologist told me to keep eating my usual diet so that I don't get a deficiency, so that's what I'm doing. He also told me not to obsess anxiously about symptoms, so I'm trying to avoid that.

 

These days if I'm feeling desperate I do have "reinstatement ideation" along with the suicidal ideation. Meanwhile I have realized it would be very difficult to find a psychiatrist here who would support my tapering with the right prescriptions, and also that if the police here were to find my lab, which is admittedly unlikely, they would misunderstand it, especially since I wouldn't have a psychiatrist to explain it to them. It feels unsafe. I do need to ask around if there are any very open-minded and up-to-date psychiatrists in the city, but all these years I've not heard of any who might know about PAWS and the 10% rule. Usually in the past when I've mentioned antidepressant withdrawal to a psychiatrist they've either denied it or told me smoothly that antidepressants don't have withdrawal, just discontinuation (their way of using a technicality to trivialize the symptoms.) But this is only part of the reason for my reluctance, the rest of which is the usual personal resistance.

 

Thanks so much for this yoga link! This site is new to me, will check it out. I need gentle yoga to help with my anxiety, though I've not done any yoga since my slip disc happened 2 years ago (following rapid weight gain on pregabalin) and I started having sciatica trouble. I can just about manage a short walk every day, which is invaluable for my mental health.

[Sneha]

Hi @Shep,

 

Today I started reinstatement. The old escitalopram 2.5mg tablet seems to have gone off the market so I cut a 5mg tablet in half and took 2.5mg as my starting dose. Will do this every day and hopefully I'll feel well enough to see a psychiatrist soon. (They can be hostile about these things in my experience, which is why I'm not going to see one in my current state.) 

 

Was getting very tired of managing the panic/fear every waking minute. 

 

Even if I can't slow taper in the near future it just seems to make sense. 

 

Thanks ❤️

[Sneha]

Had taken the tablet at noon, around 5pm some intense panic spasms started which usually doesn't happen at that time of day. Hope this isn't the kindling effect. Will try to break down the tablet further tomorrow to approx 1.25mg.