VivaLaVida Is this withdrawal (vs. "relapse")?

[VivaLaVida]

Hi everyone,

 

I have been lurking here for a few months, and I am at a point where I want to introduce myself and see what everyone thinks of my situation.

 

Here is my history:

December 2019: Panic attack out of nowhere. Never even knew what I was feeling. It was terrifying.
January-February 2019: Anxiety slowly set in and became so severe that I worried for my life. Prescribed clonazepam that I took when feeling anxious. It helped in the beginning but my anxiety kept ramping up to multiple panic attacks a night, severe anxiety by day. Quit my job. Tried THC which gave my psychosis (lasted for the duration of the "high"), and 2 days later (mid February) I took myself to a psychiatric hospital because I was desperate - didn't know what to do.
At the hospital many health tests were run: several blood tests, CT scan, etc. Everything came back normal. I was diagnosed with severe anxiety and depression. Although the doctors had no idea what caused it or how to help it with anything other than medication. 
February - March 2019: Escitalopram 20mg (from 5mg to 10mg to 20mg over the course of 5 days), Zopiclone for sleep, 0.5mg Clonazepam at night time for sleep as well
March -April 2019: Was discharged in March. Had 2 crisis where I ran back to the hospital (felt unsafe). First time I was given clonazepam (for what was believed to be internal akathesia by one of psychiatrists there), and the second time I was prescribed Abilify 4mg (because even after around 6 weeks at that point I hadn't felt much better). Suddenly felt much better after 2 days and stayed stable until I started tapering the Escitalopram in July. At that time I had also discontinued the Clonazepam at night. Shortly after I also discontinued the Zopiclone.
Stayed on the Escitalopram 20mg and Abilify 4mg until April 2020. Discontinued Abilify slowly - 1mg per month. Felt totally fine after discontinuing.
July 2020: 15 mg escitalopram
August 2020: 10 mg escitalopram
September 2020: 5 mg escitalopram
October 2020: 0 mg escitalopram

 

November - Early January: horrible physical withdrawal effects. Brain zaps several times a minute, balance issues, tinnitus, dpdr, lots of very strange feelings and experiences (like feeling like falling through the ground) - I honestly don't even remember everything, it was so bizzarre. I went to the doctor to get an MRI test to see if my brain is O.K. Everything is fine...

 

Mid January: Physical withdrawal symptoms greatly improved. No brain zaps anymore, minimal dizziness, minimal everything else. Anxiety and depression started. They have been ramping up since. At this point I'm not very functional. Thankfully I am working from home, but I wouldn't be able to go in person. I feel defeated and like at "square one" again. 

 

Lifestyle: I have been doing yoga and meditating for years. I am a "fit and healthy" 33 year old otherwise. Anxiety and depression affect my eating in that I have no appetite, I have lost a lot of weight due to this. 

 

So my question is: Is this still withdrawal (vs. "relapse")? Considering my physical symptoms have steadily improved and are mostly gone....

 

At this point I just want some relief. Everyday is a struggle with severe anxiety and depression. 

[VivaLaVida]

Just to add: I will be starting CBT tomorrow with a therapist over Zoom. Not sure how much that helps (I know there are several studies that show that CBT is just as helpful as ADs in depression - but I feel like my depression and anxiety are not due to poor thinking patterns...), but I'd really like to get out of this without having to take medication again. 

 

Anyone who also experienced a re-emeregence in anxiety and depression months after stopping ADs, I'd appreciate your input in what worked/what didn't, etc. Also, any input of experience with CBT to help symptoms would be appreciated as well. 

[Altostrata]

Welcome. Viva.

 

On 1/31/2021 at 8:35 AM, VivaLaVida said:

Mid January: Physical withdrawal symptoms greatly improved. No brain zaps anymore, minimal dizziness, minimal everything else. Anxiety and depression started. They have been ramping up since. At this point I'm not very functional. Thankfully I am working from home, but I wouldn't be able to go in person. I feel defeated and like at "square one" again. 

 

Yes, many people here have the distinct initial acute withdrawal symptoms, as you did, and later have less defined symptoms that may be mistaken for relapse.

 

How do you feel this anxiety and depression? Are they constant? Do they have triggers in thoughts or external events?

[VivaLaVida]

Thank you for your reply Alostrata.

 

The depression/anxiety come on without notice, with no descernible triggers, thoughts or external events! Suddenly (within the span of a minute) I would just feel very anxious for no reason and it ramps up to the point where it is severe and very uncomfortable physically. Usually it stays for several hours and then goes down. Same with the depression - I could be just sitting there reading something and I would just suddenly feel depressed until it is severe (it is almost like I can feel the shift of chemicals in my body and brain if that even makes any sense! It is the strangest thing). I have been timing these episodes - about 5-6 hours each, sometimes I would have both a day, sometimes it is both depression and anxiety at the same time... 

I am also still experiencing physical symptoms, like shakiness, weakness (I used to be very active physically, but now I can only really manage walking), "head fullness" that comes and goes, pulsating tinnitus, air hunger, RLS (which was quite bad during the first bit of withdrawal)...on the whole though my current problems are mostly psychological. 

[Altostrata]

That symptom pattern is characteristic of post-acute withdrawal symptoms. You are also having physical symptoms. You can assume both are from withdrawal and not relapse. They should very gradually fade over months.

 

From a therapist, I would seek coping strategies for these symptoms. You may have to surf them until they go away.

 

If they become intolerable, you may wish to reinstate a very small amount of escitalopram, such as 0.5mg, to reduce those symptoms and "do-over" the last bit of your taper. You'd taper off by miniscule amounts later.

 

Please let us know how you're dong.

[VivaLaVida]

Thanks Alostrata.

 

Just had my consultation with the therapist. She said what I am going through sounds chemical (and possibly what I went through the first time around? But she doesn't know). She said CBT won't help me because there is nothing we can address in our sessions in my life that is causing the anxiety and depression...(like I said, they even FEEL like a chemical shift!). I mentioned PAWS and she said he isn't in a position to say for sure.

 

At this point I feel like I know HOW to cope with these feelings (not well at all when in the middle of one, but can anyone really deal "well" with such severe shifts? I also don't think a therapist at $200/hr is going to tell me anything I don't already know about "breathing" and "going for a walk"). 

[Lucy1983]

Hi. Have you had your hormones / testosterone levels checked? Even if you are young hormones can get out of whack and cause these problems. 

 

 

[VivaLaVida]

Thank you for chiming in Lucy.

As far as I know, they gave me “all” the tests when I was hospitalized - not sure if that included a hormones one. I also don’t seem to have any of the symptoms of hormonal imbalance that I see online. 

[Altostrata]

4 hours ago, VivaLaVida said:

Thanks Alostrata.

 

Just had my consultation with the therapist. She said what I am going through sounds chemical (and possibly what I went through the first time around? But she doesn't know). She said CBT won't help me because there is nothing we can address in our sessions in my life that is causing the anxiety and depression...(like I said, they even FEEL like a chemical shift!). I mentioned PAWS and she said he isn't in a position to say for sure.

 

At this point I feel like I know HOW to cope with these feelings (not well at all when in the middle of one, but can anyone really deal "well" with such severe shifts? I also don't think a therapist at $200/hr is going to tell me anything I don't already know about "breathing" and "going for a walk"). 

 

That is actually very well-informed, Viva. CBT can be useful if you have intrusive thoughts as a withdrawal symptom, but that may not be her style.

 

Stress reduction techniques such as meditation can help. See

 

The Windows and Waves Pattern of Stabilization

 

Neuro-emotions

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

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

 

Ways to cope with daily anxiety

 

@Lucy1983 Vida's symptoms are classic protracted antidepressant withdrawal syndrome.

[VivaLaVida]

Thank you Alostrata.

 

I have been trying to tune in to pinpoint more of the shifts happening, and they’re not just anxiety and depression. I get this shift where I just feel “terrible” but it isn’t anxiety or depression. I also get this shift that I noticed yesterday that is “too” good - well “good” isn’t a good word for it really, it is like a surge of energy in my body and head and it makes me feel “better” but it isn’t like a normal “good.” It is hard to describe. I almost feel like I’m going to lose my mind! I breathe through it and it eventually passes.

 

Thankfully I have been getting decent sleep (around 6-7 hours) and then waking up with either the terrible feeling or the anxiety.

 

I went off the medication in hopes of getting pregnant. At this point this is definitely not a option while I’m going through this.

[VivaLaVida]

Has anyone else gone through these emotional shifts like this? How long did it take for them improve? Really in need of hope that this isn't just how I will be for the rest of my life...

 

Currently I feel angry and unhappy (and a little out of it)- I am not sure if it is another emotional shift or just me being angry at this situation I find myself in. My head hurts and I have these surges to the top of my head, I almost want to grind my teeth. My visual disruptions are also back which I had for a few weeks early on (illusory palinopsia). 

 

I am not sure what I should do. Ride this out? Tell my psychiatrist from the hospital? I don't know if they'll have any solutions for me (other than medication). Last time I spoke with them, right after I stopped the Escitalopram, I told them about the brain zaps, and they basically said "well that shouldn't happen." They're a nice person, but not sure if they'd recognize this as PAWS. 

 

[Kingfisher86]

Hi Viva,

 

I just wanted to say that things do get better... as for the timeline it is very hard to say since we are all so unique. I belive it is somewhat good not knowing, beacuse it helps you go day by day.

 

I started very rapid tapiring May 2020, so even then I started experiencing milder symptoms of what was to come. You could say I strated suffering progressively since then. But wow time is running us over even when it is rough. We endure. Acute phase of WD is the worst and for me that was 3-4 month (started later in August 2020) after completly stopping lexapro. It was pure hell. Brain zaps, whole body shaking, nausea, headache... but it passed for me.  February 1st was my  6 months aniverssary off med. It has gotten MUCH better. No physical symtomps any more, but still working on my emotions. I did not believe 100% it wouldget better. I mean I wanted to believe but it was hard. Sometime emotions got progressively  better for me. Sometimes I would just feel great, like no fear every existed. Normal, whatever that meant:) Periods of where I feel just good are getting longer by each month. There are days where I feel off but I from experiance I just know now that I will get better all the way. 

Brain just needs time and love.

 

I believe psychoterapy could help a lot! Even when anxiety or depression are chemical, they can get worse or better depending on our thought process. Plus, sensitive NS need all the support because regular problems can hit twice as hard. I hope you can find more affordable therapist, if you decide to go down that path.

 

It is very important for anybody to make sure their body chemistry is right... like some of my female hormones were a huge problem for me. Some people have vitamin or mineral deficiencies. It seems like a small thing but it could make a huge difference.

 

As for thinking about relapse... the way I think of it is... were the anxiety and depression before medication just a natural response to something bad that happend to us? Could it be that things piled up during years of some kinda a hardships? Could we try to go through those seasons of pain and greiving with help of psychotherapy? With help of the family and friends.... Trama asks to be digested, we need, unfortunately, to feel some pain...but for limited time.

I am not a doctor... I can only tell you what I went through and hope it gives you some insight.

Things will get better!

 

 

[VivaLaVida]

Hi Kingfisher,

 

Thank you so much for your reply. Seems like you are two months ahead of me in this process. Today has been especially rough this morning (severe agitation, I feel like wringing my hands and clenching my teeth :(). I have decided to take a leave from work and focus on healing. 

 

I am currently in a rollercoasted of emotions and sensations. I hope it gets better. 

[VivaLaVida]

I made an appointment with my psychiatrist from when I was hospitalized. My husband is very worried about me (poor guy), and suggested that I do that.

 

Would it be really harmful to reinstate Escitalopram at 5mg (like I think the psychiartist will say to do?). I was actually never really supposed to be on such a high dose of 20mg since I am a very small person (around 110lbs). 

 

I don't think the psychiatrist will appreciate that this may be PAWS, and will just see it as a relapse. I already know they won't be prescribing me anything less than 5mg, probably in 10mg form that I break in half...

[PerAsperaAdAstra]

Hi @VivaLaVida! I'd really take Altostrata's word for it and if you were to reinstate Escitalopram only reinstate a very small amount like 0.5mg. Escitalopram is quite potent so reinstating to 5 mg in one go might confuse your CNS more.

Perhaps the reinstatement might give your body the rest it needs now. And after stabilizing you can choose to taper 10% each month or even use the Brassmonkey slide method.

 

I wish you all the best in taking a wise decision!

[VivaLaVida]

Thank you PerAsperaAdAstra, I was having a particularly bad couple of days... Suprisingly today was generally fine! Some physical symptoms, and some anxiety in the morning, but otherwise completely tolerable. I have to get used to the up and down rollercoaster of this withdrawal and not let what I think during the hard times colour what I truely want to do long term, which is be off the meds for good (I had some very bad side effects on them - dpdr basically full time. I don't even really remmeber much of the last two years, I was zombified). 

 

I have come up with the idea of writing myself some cue cards to read while I am going through anxiety/depression/physical symptoms/aggitation. One cue card for each "state", to tell myself what to do during those times to float through it and make it "easier."

 

I have also decided NOT to go on leave from work for now. I should only make decisions like this when I am more balanced and not going through one of my "states."

 

[VivaLaVida]

How is it possible that I am doing (much) worse at 4 months than at 1-3 months off the Escitalopram? Both physically and mentally at this point. Different physical symptoms have crept up over the last few days...

 

I will be on a leave from work because it seems unpredictable when I feel ok, and when I am nonfunctional. 

[VivaLaVida]

Back to experiencing "only" physical symptoms over the last few days. The "chemical" (no trigger, reason, etc) anxiety/depression have subsided, which is great! I have been sleeping well - about 7 to 8 continuous hours a night (I think wearing a sleeping mask has helped a lot). 

 

I have definitely seen (VERY SLOW) improvements in the physical symptoms over the last few months (one step forward, half step back) but I am feeling discouraged by just how slow this process has been. I was hoping to get off the meds and try to get pregnant right away - Looks like I'll be waiting a while.

[Kingfisher86]

1 hour ago, VivaLaVida said:

The "chemical" (no trigger, reason, etc) anxiety/depression have subsided, which is great! I have been sleeping well - about 7 to 8 continuous hours a night

@VivaLaVida this is really good news🥳 know we only need to remember these good moments when we hit a rough patch👌🏼

 

1 hour ago, VivaLaVida said:

been. I was hoping to get off the meds and try to get pregnant right away - Looks like I'll be waiting a while.

Yeah, not easy putting off some things. But time is passing and your future baby needs you to be at the top of your game. One day this will be behind you☀️

[VivaLaVida]

Thank you Kingfisher! I keep reminding myself that this is temporary and as difficult as it is now to accept that I may actually feel good someday, I'm not letting go of the hope. It has been 4 months... which doesn't sound like much, but for going through withdrawal day in and day out it can definitely be exhausting. 

[VivaLaVida]

I had a phone coversation with my gp and told him generally about my symptoms (there are honestly too many to list). He said he agreed that it is probably related to going off the medication. He was surprised it lasted this long, but he said it may last a year. I am glad that he recognized this as withdrawal. He also said I should consider taking magnesium for the anxiety/brain function. I asked him if he has had other patients with the same thing, and he said not to this degree, and that other patients just "ignore their symptoms."

 

I started therapy yesterday. We will be doing Acceptance and Commitment Therapy (ACT) as well as some exposure and challenge for OCD/intrusive thoughts (not sure if anyone else gets these, but things like "I will never get better," "this can't be just withdrawal, it's too severe," and such thoughts). We'll see how it goes. 

 

 

[VivaLaVida]

This week has been significantly better than last week. Each day has been slighly better than the last. Still many physical and psychological symptoms but much of the time they have been mild enough to be in the background while I push through and do other things. 

 

Has anyone had experience with pregnancy while going through withdrawal? Not something I am planning on right now, but in a couple of months if things are even better, but not fully there... does pregnancy make it better or worse? I know this is a difficult question as who can predict, so if anyone has experience please share :).

[BooBoo19]

Hello Viva, I cannot answer about the pregnancy side of withdrawal.  I am also withdrawing from lexapro after being on it for only 7 weeks and having side effects that the GP kept saying 'just get over the hump'. I stopped at 5 mg 3 weeks ago and have experienced debilitating anxiety, low mood and jitteriness all the time, a little bit of insomnia is now kicking in.  I never experienced any of this (mild anxiety and depression when I lost my mum) the anxiety just comes out of nowhere and can be very intense. At the beginning I was also restless and was worried about my thoughts thinking I could not go on like this anymore.  This has calmed a little although jitteriness , tight chest, what feels like heart palpatations and intense anxiety.  My GP said lets 'just get it out of your system', I am also angry about this but know that I just have to ride it out.  I have taken time off work as not ready to commit to work yet.

 

I read your post with interest that we will get better, good luck I am cheering for you from the sidelines.

[VivaLaVida]

Hi BooBoo! Thank you for your reply. Yes, it is definitely a tough challenge getting off these medications... When I went off in October I didn't even know what I got myself into! I have a couple of friends who were also on Lexapro and they can go on and off them with no problem whenever they want - I don't really understand why some of us tend to have such a hard time.

 

Yes, my doctor just says that time and patience is what will get rid of this. I reccently read the book DARE, and it has been really helpful with the anxiety aspect of things! I highly reccomend it. Cheering you on as well, here's to feeling better :).

 

What do you do for exercise if you don't mind me asking? Before all this withdrawal I was really active, working out intensely 3-4 times a week and doing active things on the weekends. Now I feel so sensitive to even walking quickly, and I want to figure out how to build myself back up.

[Aeroman]

On 2/21/2021 at 7:16 AM, VivaLaVida said:

Yes, my doctor just says that time and patience is what will get rid of this.

I absolutely agree with this.  I tell people TIME is what helped me with anxiety, insomnia, and depression.

[BooBoo19]

Hello Viva, before my withdrawal symptoms started I was running 5K three times per week.  When WD hit it was not possible but I try and run 2K six times per week.  I also swim in the sea regularly (even in winter in the UK) but again when WD hit, I have not done that since.  I hope that helps that I am the same , exercise took a hit.  I spoke to a specialist nurse yesterday who has kept in touch to monitor me and the WD symptoms.  I asked her if this was typical for the anxiety to last this long and so intense, the reply was, 'I do not know as you are the first patient who has perservered, every other patient could not cope with the anxiety and went back on them'.  Unbelieveable, for a prescribed medication is said and she totally agreed.  We will get there - eventually.

[VivaLaVida]

5.5 months off SSRIs.

 

I'm posting here to update my "progress". 

 

So things have been up and down. This last week has been very difficult with (quite severe) anxiety (my original anxiety has returned) and on top of that withdrawal symptoms. Some symptoms have completely gone away, while others have recently appeared. I haven't felt "normal" since I have gone off the meds. In fact, I haven't felt "normal" in a long time - even when I was on the meds I didn't feel normal (lots of side effects). Withdrawal is a whole other beast though. 

 

I am doing my best to deal with the anxiety using skills I have been learning (DARE, if you're familiar with it), as well as therapy every two weeks. As for withdrawal, I don't have nearly as many brain sensations, but what has remained is still quite bad. I have brain zaps, dizziness/imbalance, aches and pains/tingling (this one is quite new), and restless leg at night, weird body sensations, and just a general feeling of sickness. My anxiety has many, many symptoms as well (mostly physical), and it is hard sometimes to know whether a symptom is anxiety or withdrawal. I am never free of symptoms. 

 

I have been back at work for a few weeks. It is difficult going into work and pretending I am a normal functioning person while I quite literally feel like my body and brain are falling apart. Here's to better days. 

[VivaLaVida]

6 months off. I don't think there have been any improvements since my last update. Still taking things day by day, but the brain zaps/sensations/headaches are driving me crazy. 

 

Trying my best to take good care of myself with eating (when I can), baths, hugging my partner, going for gentle walks in nature... Whenever I think about this (which is all the time) I feel so hopeless and like it will never end. I know there are many success stories on here, but the last 6 months has felt like 5 years. Not seeing an end in sight and few improvements over the last 6 months has been disheartening. Any hope welcome :). 

 

Edit: I have had a lot of strange dreams and today I had what I believe is sleep paralasis. It was terrifying. I have little tolerance for any added stress these days. 

[VivaLaVida]

Almost 7 months off.

 

Nothing much has changed. If I was trying to look really hard, I'd say maybe the headaches are slightly less intense sometimes. Things are mostly the same though. Each day is a struggle from start to finish. I have been doing all the self-care things one can do (therapy, speaking with friends, massage, resting), but most of the time I am on edge and it is hard to relax to enjoy any of this. 

 

I am really looking forward to the day I can feel better. I am not losing hope...I know most people eventually recover and move on to bigger and better things, I just don't know how I am going to go through each day like this until then. I am almost in disbelief everyday at what I am experiencing. 

 

Current symptoms:

• Brain zaps/strange brain and head sensations: these are very persistent and annoying, my worst symptom. They go on for hours and hours, several times a minute at times.
• Headaches/head pressure, especially when going to bed
• Internal buzzing through head and body, sometimes unbearable
• Tight and painful muscles
• Eye problems: difficulty focusing eyes, after images sticking around for too long, flashes
• Balance/vertigo/false sensation of movement/things looking tilted 
• Hearing: tinnitus/pressure in ears
• Anxiety (sometimes severe)
• Depression (sometimes really deep and painful)
• Agitation
• Heart palpitations
• Difficulty breathing (sometimes coupled with the brain zaps)
• Difficulty regulating emotions

 

...One day at a time. 

[VivaLaVida]

8 months off. Just as sick as ever. Maybe even sicker, hard to tell. The brain zaps/head sensations are driving me crazy. Also, new symptoms of wanting to vomit all the time.

[VivaLaVida]

Hi everyone, so it looks like I have to get back on escitalopram. I am still experiencing horrible withdrawals, but my original anxiety/OCD are back, and lifestyle/therapy stuff can't touch it.

 

How do I go about reinstating the escitalopram? I will have a call with my dr on Tuesday and ask him to prescribe it to me.

 

Also, could I try something else, like Trintellix? Or is it best to stick with the one I was on originally?

 

Thanks you.

[siderale]

Hello @VivaLaVida. I read through your withdrawal progression and relate to a lot of it. First, congrats for pushing through and trying to overcome these awful feelings.

I am also thinking about reinstating. I will let the mods advise your regarding the dosage and eventual antidepressant switch, for I don't know much about it. I know that over here in France it is extremely likely that I get put on 5mg again, but I will ask about the liquid escitalopram/discuss about first reinstating a smaller dose. Maybe you could do this as well, so even if you decide to reinstate a different dose, the liquid presentation might help if the pills won't go below 5mg!

Best of luck, I hope all turns out well.

[Greatful]

@VivaLaVidaHI, how are you doing?  Did you reinstate?  If so did it help?  I read through you experience and feel your pain.  

 

I can relate to all the brain zaps, tingling, numb feeling, pressure, sometimes it feels like something is trying to bore a whole through my brain, or a vice grip on both sides of my brain..  not always in the same spot. The sensations can move around my brain.  Mine go on pretty much most of the day. It really makes it hard to think and concentrate.  It feels like disconnected thinking.   They let up at night.  It's kind of like you have your head plugged into a outlet set on low voltage.   

 

Take care and let us know how you are doing

Greatful

[VivaLaVida]

 

@Altostrata @brassmonkey @Gridley

Hi everyone, I am wondering if I can get some help please.

 

Last week I became acutely suicidal and was put on effexor 37.5 for three days (without much choice). My skin burned from the inside and I literally lost my mind. I stopped after three days. Now I am back home and can do things properly.

 

After 8 months of absolute mistery (extreme physical and emotional turmoil) I have decided to reinstate, and actually go back on the antidepressant as well. I began with 1mg yesterday (cut off a sliver off the pill and weighted it very carefully), and will continue with that for a week to gauge reaction. Yesterday, 2 hours after taking this tiny amount I felt amazing for the first time in a very long time, so I am hoping that's a good sign and not just by chance. I am back to misery today.

 

How fast can I go up with the reinstatement and how long should I wait between updoses? My goal is to go back up to 10mg as soon as I can. I have become acutely suicidal at times, and this is the only help that our system provides... I will taper off properly in the future, but in the mean time I believe I need to be back on these drugs and attempt this ordeal in the future. 

 

Any help would be greatly appreciated.

[brassmonkey]

Those 3 days of Effexor are going to cause a symptom blip that can last for several weeks. During that time it will be impossible to tell if a reinstatement is working. Once stable from this any dose changes will take a minimum of 4-7 days to kick in and become steady state in the blood. Once the change is steady state you can gage how affective the RI has been. Because of the 3 day blip and having been off drugs for many months there is a good chance that 10mg is going to be much too high a dose and will cause problems. I would stick with the 1mg for a while and see how it goes before making any other additions.

[VivaLaVida]

@brassmonkey

Thank you brassmokney. So if the reinstatement is working I should be able to tell in around a week or so? If it is at that point and I feel better, would be be safe to go up a bit? to maybe 2mg? 

I haven't been "stable" in all of the 8 months and my symptoms are contiuously changing every day.