Alan1234: desperately seeking help

[Rosetta]

All right.  You have stores that you could walk to, right?  Grocery, pharmacy?

[Alan1234]

Just now, Rosetta said:

All right.  You have stores that you could walk to, right?  Grocery, pharmacy?

No I don’t. I’m living with my elderly mother who can’t walk very far and we live 8kms  away from the nearest stores. It’s ok I can survive a day and see if I am able tomorrow.

The pains, vertigo, heart stuff doesn’t feel like anxiety but I just have to trust them, it’s just hard to know if I should still be in hospital or if it’s just a bad prolonged withdrawal reaction. They’ve said anxiety can’t cause the VT and electrical things that have shown up on my Ecgs and they need to do another scan to look at the structural changes. If they have discharged me I have to assume everything is all good and safe it’s just hard to believe how I’m feeling could be anxiety/withdrawal. If I have another day and night like yesterday I may have to go back. I just don’t want to stay in hospital again if it’s not necessary as I feel lots worse for being in there a week 

[Rosetta]

Oh, they are not really concern you will have a serious incident with your heart.  That’s reassuring.  I mean that.  I mean, they are not taking your dizziness seriously, and that very irritating, but it sounds like you are safe according to their assessment of the heart issue.  
 

I feel this is mostly wd.  I did not want to say so if the heart issue was life threatening.  
 

How is your water intake?  Can you focus enough on that?  It’s really important.  
 

The mirtazapine is going to take a while to get to a level that gives relief.  Four or five days.  You have to hold on and think of only getting through hour by hour.  Let’s put aside everything ekes for today.

Edited June 19, 2021 by Rosetta
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[Alan1234]

Just now, Rosetta said:

Oh, they are not really concern you will have a serious incident with your heart.  That’s reassuring.  I mean that.  I mean, they are not taking your dizziness seriously, and that very irritating, but it sounds like you are safe according to their assessment of the heart issue.  
 

I feel this is mostly wd.  I did not want to say so if the heart issue was life threatening.  
 

How is your water intake?  Can you focus enough on that?  It’s really important.  
 

The mirtazapine is going to take a while to get to a level that gives relief.  Four or five days.  You have to hold on and think of only getting through hour by hour.  Let’s put aside everything ekes for today.

My water intake is fine, I just have been suffering with an overactive bladder for the last 3yrs. That’s why I originally came off venlafaxine as the urologist thought it could be the cause. My bloods always come back with high inflammation and poor kidney and urea indicating dehydration. So whatever I drink I pee out more my body can’t hold onto it. They want to test me for Diabetes insipidius some time. Just been one thing after another this last 18mths of my life. Before that other than taking an anti depressant I’ve always been super healthy 

[Rosetta]

Right.  Wd can cause vertigo.  It can cause electrical issues.  That’s usually a benzo wd issue, I have heard, and a high dose benzo issue.  In that case, it’s extremely serious.  I guess it could be because of all the drugs in March.  I don’t know.  You never took benzos, so maybe it’s an adverse reaction issue or some benign fluke that you have.  People do have odd heart rhythms that are harmless.

 

Did they say you have long qt syndrome?  Did they mention an implantable defibrillator?

[Alan1234]

Just now, Rosetta said:

Right.  Wd can cause vertigo.  It can cause electrical issues.  That’s usually a benzo wd issue, I have heard, and a high dose benzo issue.  In that case, it’s extremely serious.  I guess it could be because of all the drugs in March.  I don’t know.  You never took benzos, so maybe it’s an adverse reaction issue or some benign fluke that you have.  People do have odd heart rhythms that are harmless.

 

Did they say you have long qt syndrome?  Did they mention an implantable defibrillator?

I have had benzodiazepines for 6wks last year but not high dose. I also had to take one before I went it hospital as it was the only thing with Zopliclone that stopped the vertigo so had to take for 2nights otherwise my symptoms were to bad as I hadn’t slept for 4 straight nights again. 
 

no I don’t have a long QT wave as far as I know. It’s potentially more serious than that. 
they said a leftward axis with poor narrow wave progression and narrow complex QRS sinus rhythm, Mild MR with undiagnosed RV impairment 

[Alan1234]

Just now, Alan1234 said:

I have had benzodiazepines for 6wks last year but not high dose. I also had to take one before I went it hospital as it was the only thing with Zopliclone that stopped the vertigo so had to take for 2nights otherwise my symptoms were to bad as I hadn’t slept for 4 straight nights again. 
 

no I don’t have a long QT wave as far as I know. It’s potentially more serious than that. 
they said a leftward axis with poor narrow wave progression and narrow complex QRS sinus rhythm, Mild MR with undiagnosed RV impairment 

They did also mention i need to be tested for Brugarda syndrome and said yes I might have to have an implanted defibrillator but need further tests to confirm this 

[Rosetta]

I remember being dehydrated no matter what for a while.  I live in a desert, so it’s hard enough to stay hydrated.  
 

The system that is affected by wd controls everything. There’s so much going on automatically in our bodies.  When that is disrupted it causes very odd symptoms.  Adverse reactions further disrupt it.  You could ask for a neurologist to assess you for dysautonomia.  It is worth a shot.  He might not find it, but that’s clearly what is happening.  Your body should use water properly, for heavens sake.  Then vertigo, dizziness, anxiety.  Don’t tell him that you think ADs caused it.  Just lay out the symptoms.  Let him see it without the opinions on your part.  You might get more drugs — that’s the risk.

[Rosetta]

Did they say anything about hyper or hyponatremia?

[Alan1234]

No nothing, they said other than kidneys and me having a low resting heart rate  everything is fine. They said my blood pressure is normal. They think the cause of my low resting heart rate is I’ve always exercised over the years never really missed any weeks up until this year with everything that’s gone on. I’ve just not mentally or physically been upto it. My blood pressure used to actually be higher when I was well it’s lower and more normal now 

[Alan1234]

Just now, Alan1234 said:

No nothing, they said other than kidneys and me having a low resting heart rate  everything is fine. They said my blood pressure is normal. They think the cause of my low resting heart rate is I’ve always exercised over the years never really missed any weeks up until this year with everything that’s gone on. I’ve just not mentally or physically been upto it. My blood pressure used to actually be higher when I was well it’s lower and more normal now 

When I was on venlafaxine the excessive sweating was ridiculous full body. All my problems with palpations and sleep, anxiety only started after stopping. I’m Now the opposite I’m really sensitive to the cold and can’t get warm 

[Rosetta]

Venlafaxine is poison.  I’m so disgusted.  It’s one of the worst to quit.

 

Low resting heart rate is a good sign.  You are going to get well.  It’s going to have rough patches, but your body will return to normal.

 

Are you feeling better now?  I hope it helped to chat.

[Alan1234]

No I’m not feeling better but it is good to chat. 
I just don’t know when to push it with the Doctors and be looking for further diagnosis like you say disautonomia. The Uk health care system is incredibly slow even before Covid and now it’s a bad joke. I know they will just keep putting it down to anxiety and my mental health and if I don’t take their medications for that I doubt other than investigating my heart anything will be looked at 

[Rosetta]

You should put the benzo info in your signature and all the drugs from this last week, too.

 

link for that

 

https://www.survivingantidepressants.org/settings/signature/

[Rosetta]

It’s all right.  They can’t treat dysautonomia without risking making it worse.  Maybe you wouldn’t feel better having the diagnosis either.  
 

You have anxiety — of course you do — you have PWS.  Benzo PWS is a recognized illness, and has been for ages.  Six weeks is long enough to be dependent.  That may be complicating the matter, but AD wD causes the same syndrome.  Both heal the same way.

 

I’m going to try to go back to sleep now.  Hang in there.  Your wife is unaware.  That’s not surprising.  So many are.  The quetiapine is a terrible idea and can only cause this to last longer.  Hold fast against that one.  It can cause long qt, also.  Terrible, terrible drug.  All the anti psychotics are.  Someday they will be understood to be on par with lobotomies.

 

Goodnight, R
 

 

[Alan1234]

2 minutes ago, Rosetta said:

It’s all right.  They can’t treat dysautonomia without risking making it worse.  Maybe you wouldn’t feel better having the diagnosis either.  
 

You have anxiety — of course you do — you have PWS.  Benzo PWS is a recognized illness, and has been for ages.  Six weeks is long enough to be dependent.  That may be complicating the matter, but AD wD causes the same syndrome.  Both heal the same way.

 

I’m going to try to go back to sleep now.  Hang in there.  Your wife is unaware.  That’s not surprising.  So many are.  The quetiapine is a terrible idea and can only cause this to last longer.  Hold fast against that one.  It can cause long qt, also.  Terrible, terrible drug.  All the anti psychotics are.  Someday they will be understood to be on par with lobotomies.

 

Goodnight, R
 

 

Thank you for your support 

Goodnight 

[Rosetta]

Hi.  How are you feeling?

[Alan1234]

I’m feeling absolutely awful.

im not sure if I need to go the hospital 

I tried to go out for groceries and I can’t walk for more than 10 meters without intense dizziness and feeling like I’m going to pass out.

 

then I can’t sleep again because as soon as I lie down every few mins for the first 5 hours of lying my heart suddenly jerks and pauses then beats again but it feels so strong my whole body spasms. It’s frightening. The longer I lie the episodes in between it happening eventually get bigger. 
 

if it gets worse or keeps happening I will have no option to go back the hospital. That’s two days it’s been doing it fairly constantly. I just don’t want to go in there and feel even worse as they will want me to take all these meds. I had to take the beta blocker last night .

[Kostas]

Alan ,

As long as the heart is structurally OK, and you don't feel a very fast and abnormal cardiac pulsation , the pause/ jerck feelings could be  just symptoms of a very sensitized nervous system !

 Lots of people have them, they are normal, and many not even feel them ...

The pause ,is not a cardiac pause, but a premature electrical signal from another point of the cardiac muscle.

Since during that time there is no enough blood in the ventricle, we do not feel the pulse ,thinking that our hearts stop working!

As soon as the normal signal comes, there is then more blood than usual in the ventricle ,and we feel the jerck. 

It happens to many of us ,but please keep in mind ,that according to the doctor, our hearts are functioning perfectly normal!

Wishing you the best .

 

[Rosetta]

Does the jerk happen as you are falling asleep or before that?  Is it after you lie down even if you are not falling asleep?  Look up myclonus, and see if that is what you think is happening.  Instead of head zaps, I had heart zaps.  They made me feel that my heart was being electrocuted.  The contraction was so strong that the muscle ached afterward.  It was a scary feeling.

[Alan1234]

It usually happens as I’m falling asleep but when it’s bad it happens very often as soon as I lie down. It started first last night when I was falling to sleep. It then awakes me and then it then happens as soon as I lay down. They went on for four hours last night. It makes me sacred and anxious about going to bed and trying to sleep.

 

I would describe it as heart jolts. I get a feeling of a very strong jolt of a heart beat that wakes me. Often I have lots of vertigo type symptoms when I lie down before it too.

[Alan1234]

Just now, Alan1234 said:

It usually happens as I’m falling asleep but when it’s bad it happens very often as soon as I lie down. It started first last night when I was falling to sleep. It then awakes me and then it then happens as soon as I lay down. They went on for four hours last night. It makes me sacred and anxious about going to bed and trying to sleep.

 

I would describe it as heart jolts. I get a feeling of a very strong jolt of a heart beat that wakes me. Often I have lots of vertigo type symptoms when I lie down before it too.

This is why I had an ECG and how they found the heart problem 

[Alan1234]

3 hours ago, Kostas said:

Alan ,

As long as the heart is structurally OK, and you don't feel a very fast and abnormal cardiac pulsation , the pause/ jerck feelings could be  just symptoms of a very sensitized nervous system !

 Lots of people have them, they are normal, and many not even feel them ...

The pause ,is not a cardiac pause, but a premature electrical signal from another point of the cardiac muscle.

Since during that time there is no enough blood in the ventricle, we do not feel the pulse ,thinking that our hearts stop working!

As soon as the normal signal comes, there is then more blood than usual in the ventricle ,and we feel the jerck. 

It happens to many of us ,but please keep in mind ,that according to the doctor, our hearts are functioning perfectly normal!

Wishing you the best .

 

Hi Kostas

3 hours ago, Kostas said:

my Echo shows my heart isn’t structurally normal so I’ve awaiting a cardiac MRI for further investigation. I also alternate between bradycardia and episodes of VT that last for around 15secs on 24hr ECG.

so that’s why I don’t know if I need it go to the hospital with these hypnic jerks/heart starts as  I’m not sure if it’s a sensitised nervous system or to do with my undiagnosed heart issue.

 

 

[Alan1234]

Really getting to the end of my tether.

just been cooking some dinner and felt myself going and passing out so managed to stop it and sat down. Head spinning for about 15mins and then get double vision. Is this a migraine or is it to do with my heart. I’ve never had a migraine before in my life and surely prolonged withdrawal can’t do this after 3mths 

[Rosetta]

Hi, Alan, 

 

If you feel you are in danger, you have to act accordingly.  

 

It’s a very difficult situation because we know people get more intense dysautonomia from missing doses of only 3.75 mg of mirtazapine.  So, ideally, you would get mirtazapine while you were at the hospital being checked out for these scary symptoms.  The fact that the doctor will not prescribe that is extremely problematic.  I’m wondering what might happen if you prepared many doses of mirt for yourself and took them with you to the hospital.  Maybe you could take them when no one was looking.
 

As the doctors have sent you home and you have to wait months for a specialist perhaps you are safe at home.  That is what I would have assumed, under your circumstances, before I went through PWS with no help from doctors.  I no longer trust the doctors to act with an awareness of all the facts.  
 

This may or may not be relevant to you —POTS.  I do not mean to down-play your condition, and I am not saying that it is non-serious.  However, maybe you are having both conditions at the same time.
 

I used to have POTS — postural orthostatic tachycardia syndrome.  If I stood up, I would get light headed and my vision would go black.  I would have fallen down if I had not had something to steady me.  This is a symptom of post withdrawal syndrome. I had it for months at a time over the years.  Once I quit all the drugs, it happened for years at a time.   I never had an EKG to check it out.   It was very common before my 2 year CT anniversary.  Here’s one person’s account:  https://benzowithdrawalhelp.com/coping-skills/handling-p-o-t-s-and-other-alarming-symptoms-in-benzo-withdrawal/

 

People who have it wear compression socks on their legs, and get up very carefully in stages from the bed or a chair.  They give their bodies time to adjust to each stage in the process while standing up.

[Alan1234]

5 minutes ago, Rosetta said:

Hi, Alan, 

 

If you feel you are in danger, you have to act accordingly.  

 

It’s a very difficult situation because we know people get more intense dysautonomia from missing doses of only 3.75 mg of mirtazapine.  So, ideally, you would get mirtazapine while you were at the hospital being checked out for these scary symptoms.  The fact that the doctor will not prescribe that is extremely problematic.  I’m wondering what might happen if you prepared many doses of mirt for yourself and took them with you to the hospital.  Maybe you could take them when no one was looking.
 

As the doctors have sent you home and you have to wait months for a specialist perhaps you are safe at home.  That is what I would have assumed, under your circumstances, before I went through PWS with no help from doctors.  I no longer trust the doctors to act with an awareness of all the facts.  
 

This may or may not be relevant to you —POTS.  I do not mean to down-play your condition, and I am not saying that it is non-serious.  However, maybe you are having both conditions at the same time.
 

I used to have POTS — postural orthostatic tachycardia syndrome.  If I stood up, I would get light headed and my vision would go black.  I would have fallen down if I had not had something to steady me.  This is a symptom of post withdrawal syndrome. I had it for months at a time over the years.  Once I quit all the drugs, it happened for years at a time.   I never had an EKG to check it out.   It was very common before my 2 year CT anniversary.  Here’s one person’s account:  https://benzowithdrawalhelp.com/coping-skills/handling-p-o-t-s-and-other-alarming-symptoms-in-benzo-withdrawal/

 

People who have it wear compression socks on their legs, and get up very carefully in stages from the bed or a chair.  They give their bodies time to adjust to each stage in the process while standing up.

Yes the doctor just laughed at me when I said I take 3.75mg of mirtazapine as he says it’s not a clinical dose. 
 

I don’t know if it’s POTS as it doesn’t happen when I go from sit to stand it seems to happen after standing for longer than say 5/10mins. It’s like extreme vertigo and after the attack I notice I’m left with double vision and can’t focus for 15mins or so. I never had this before I went into hospital and missed the doses of mirtazapine. Maybe I might increase my dose from 1mg up to 3.75mg. 
 

I guess I just don’t understand why I have chest pain and like you say having the abnormal ECG and Echo means I can’t 100% reassure myself it’s all caused my withdrawal 

[Rosetta]

Ooh, not directly to 3.75 mg, right.  Definitely don’t do that.  Stay with 1 mg for at least 5 days.  Then you will go up a little bit more, but not directly to 3.75.

 

Your doctor is mistaken.  How unfortunate for you.

[Rosetta]

I suppose the doctor does not understand that the need for tapering antidepressants the same way as benzodiazapines, in the method that SA uses which is hyperbolic, has nothing to do with whether the dose is “therapeutic.”  Once the receptors have been occupied during the ingestion of therapeutic doses for a period of time, the withdrawal of that dose can and does cause withdrawal syndrome.  The body has changed to operate based on that drug dose.  Without that dose, the autonomic system may not operate properly.  Yours apparently cannot operate properly. (Putting aside the question of whether there is a therapeutic dose that is the same for everyone — a thorny issue, and putting aside the question of whether SSRIs and TCAs are therapeutic at all — an even thornier issue.)

 

What you describe happening after standing for several minutes might be vasovagal syncope.  It’s somewhat like POTS.  The constriction of the arteries in your body keeps blood pressure up.  If the autonomic system is in chaos, the signals to your arteries may be directing them to relax at random.  When they relax, the blood pressure drops due to gravity.  Your head loses too much blood, too fast, and you lose consciousness.  
 

People often faint due to a fright.  The fright causes the system to relax the arteries.  While in wd, our fight or flight system is in chaos.  We become ready to flee or fight, and then our bodies get tired from being ready to flee or fight for a long period of time.  Eventually, the body relaxes for at least a short while.  Yours may be relaxing suddenly.  If so, you don’t faint because your heart stopped.  You faint because your arteries relaxed.  Of course, if the system does not restore the pressure fast enough, that’s dangerous.   Lying down is a very good idea, and you may wish to elevate your feet, too.  Those are the ways I was taught to help a person in shock.  That position makes it easier for blood to return to the organs and brain.

 

The fact that you have trouble retaining fluid may be intersecting with other issues.  For instance, if your arteries relax and you are dehydrated, the effect of syncope would be greater.  Maybe you should drink extra — not massive amounts — but extra.

[Alan1234]

2 minutes ago, Rosetta said:

I suppose the doctor does not understand that the need for tapering antidepressants the same way as benzodiazapines, in the method that SA uses which is hyperbolic, has nothing to do with whether the dose is “therapeutic.”  Once the receptors have been occupied during the ingestion of therapeutic doses for a period of time, the withdrawal of that dose can and does cause withdrawal syndrome.  The body has changed to operate based on that drug dose.  Without that dose, the autonomic system may not operate properly.  Yours apparently cannot operate properly. (Putting aside the question of whether there is a therapeutic dose that is the same for everyone — a thorny issue, and putting aside the question of whether SSRIs and TCAs are therapeutic at all — an even thornier issue.)

 

What you describe happening after standing for several minutes might be vasovagal syncope.  It’s somewhat like POTS.  The constriction of the arteries in your body keeps blood pressure up.  If the autonomic system is in chaos, the signals to your arteries may be directing them to relax at random.  When they relax, the blood pressure drops due to gravity.  Your head loses too much blood, too fast, and you lose consciousness.  
 

People often faint due to a fright.  The fright causes the system to relax the arteries.  While in wd, our fight or flight system is in chaos.  We become ready to flee or fight, and then our bodies get tired from being ready to flee or fight for a long period of time.  Eventually, the body relaxes for at least a short while.  Yours may be relaxing suddenly.  If so, you don’t faint because your heart stopped.  You faint because your arteries relaxed.  Of course, if the system does not restore the pressure fast enough, that’s dangerous.   Lying down is a very good idea, and you may wish to elevate your feet, too.  Those are the ways I was taught to help a person in shock.  That position makes it easier for blood to return to the organs and brain.

 

The fact that you have trouble retaining fluid may be intersecting with other issues.  For instance, if your arteries relax and you are dehydrated, the effect of syncope would be greater.  Maybe you should drink extra — not massive amounts — but extra.

Ok brilliant thanks for all the information 🙏 I’ll get my fingers crossed it passes soon. Upto now with the severe anxiety, insomnia and those heart starts I thought I was doing pretty well. Hopefully this will pass and it could actually be a sign that my system is resetting it self 

[Rosetta]

I hope so, and I hope you get some rest tonight.  Take care.  I’ll talk with you tomorrow or the next day or so.  

[Alan1234]

Thank you 

take care too 

[Rhiannon]

9 hours ago, Alan1234 said:

 

I don’t know if it’s POTS as it doesn’t happen when I go from sit to stand it seems to happen after standing for longer than say 5/10mins. It’s like extreme vertigo and after the attack I notice I’m left with double vision and can’t focus for 15mins or so. I never had this before I went into hospital and missed the doses of mirtazapine. Maybe I might increase my dose from 1mg up to 3.75mg. 
 

 

Alan I don't know if this will be any help, but I have chronically low blood pressure and low heart rate (I think it's dysautonomia from the drugs combined with my genetics). One symptom is that I get lightheaded and weak when standing for more than about 5-10 minutes. One thing that is supposed to help with that is actually crossing your legs while standing, as soon as you feel yourself getting dizzy. You might try that. It mechanically raises the blood pressure.

 

Another thing is keeping the calf muscles strong. If you can, try Googling "calf muscle pump hypotension." You can do easy seated exercises to pump that calf muscle as well as just using it during the day when you are moving around or when you are sitting.  Apparently the soleus muscle in the calf has a special function to help pump blood from the lower part of the body up to the heart, they even call it the "second heart."

 

Of course, if low blood pressure isn't the problem for you, it won't help. But maybe it will help, and no drugs involved.

 

My heart goes out to you, such a situation you are in.

[Alan1234]

3 hours ago, Rhiannon said:

Alan I don't know if this will be any help, but I have chronically low blood pressure and low heart rate (I think it's dysautonomia from the drugs combined with my genetics). One symptom is that I get lightheaded and weak when standing for more than about 5-10 minutes. One thing that is supposed to help with that is actually crossing your legs while standing, as soon as you feel yourself getting dizzy. You might try that. It mechanically raises the blood pressure.

 

Another thing is keeping the calf muscles strong. If you can, try Googling "calf muscle pump hypotension." You can do easy seated exercises to pump that calf muscle as well as just using it during the day when you are moving around or when you are sitting.  Apparently the soleus muscle in the calf has a special function to help pump blood from the lower part of the body up to the heart, they even call it the "second heart."

 

Of course, if low blood pressure isn't the problem for you, it won't help. But maybe it will help, and no drugs involved.

 

My heart goes out to you, such a situation you are in.

Thank you Rhiannon I will try this 

[Gridley]

20 hours ago, Alan1234 said:

Maybe I might increase my dose from 1mg up to 3.75mg. 

I'm gathering you're not having any difficulty in getting your 1mg dose.  If you are, let me know and I'll tag Brassmonkey.  He's very good at making these types of calculations.

 

I agree with Rosetta that you shouldn't increase from 1mg to 3.75, which could overwhelm your system.  Give the 1mg a chance to work for several days.  If it doesn't you could increase very slightly, perhaps to 2mg and see how that works.

[Alan1234]

31 minutes ago, Gridley said:

I'm gathering you're not having any difficulty in getting your 1mg dose.  If you are, let me know and I'll tag Brassmonkey.  He's very good at making these types of calculations.

 

I agree with Rosetta that you shouldn't increase from 1mg to 3.75, which could overwhelm your system.  Give the 1mg a chance to work for several days.  If it doesn't you could increase very slightly, perhaps to 2mg and see how that works.

Thanks for your reply Gridley

ive managed to get an .5ml insulin syringe and taken the needle off it. It loosely fit in the bottle with abit if spillage but it has loads of little markings on it so I can precisely calculate the dose 0.8ius should be about 1mg if 25ius is 3.75mg

[Surviving82]

20 hours ago, Rosetta said:

I suppose the doctor does not understand that the need for tapering antidepressants the same way as benzodiazapines, in the method that SA uses which is hyperbolic, has nothing to do with whether the dose is “therapeutic.”  Once the receptors have been occupied during the ingestion of therapeutic doses for a period of time, the withdrawal of that dose can and does cause withdrawal syndrome.  The body has changed to operate based on that drug dose.  Without that dose, the autonomic system may not operate properly.  Yours apparently cannot operate properly. (Putting aside the question of whether there is a therapeutic dose that is the same for everyone — a thorny issue, and putting aside the question of whether SSRIs and TCAs are therapeutic at all — an even thornier issue.)

 

What you describe happening after standing for several minutes might be vasovagal syncope.  It’s somewhat like POTS.  The constriction of the arteries in your body keeps blood pressure up.  If the autonomic system is in chaos, the signals to your arteries may be directing them to relax at random.  When they relax, the blood pressure drops due to gravity.  Your head loses too much blood, too fast, and you lose consciousness.  
 

People often faint due to a fright.  The fright causes the system to relax the arteries.  While in wd, our fight or flight system is in chaos.  We become ready to flee or fight, and then our bodies get tired from being ready to flee or fight for a long period of time.  Eventually, the body relaxes for at least a short while.  Yours may be relaxing suddenly.  If so, you don’t faint because your heart stopped.  You faint because your arteries relaxed.  Of course, if the system does not restore the pressure fast enough, that’s dangerous.   Lying down is a very good idea, and you may wish to elevate your feet, too.  Those are the ways I was taught to help a person in shock.  That position makes it easier for blood to return to the organs and brain.

 

The fact that you have trouble retaining fluid may be intersecting with other issues.  For instance, if your arteries relax and you are dehydrated, the effect of syncope would be greater.  Maybe you should drink extra — not massive amounts — but extra.

@Alan1234, I second what @Rosetta said about vasovagal syncope. I've had those since I was a teen, so way before any drugs. Out of the blue I have this very uncomfortable sensation that I can't breathe, I get dizzy, weak, and sweaty, and my heart beats like crazy. This lasts for about 10 seconds. The only remedy for me to prevent fainting is to sit or lay down. If I keep standing, I WILL faint. This can be triggered by prolonged standing, amongst other things, like heat or exhaustion, or even a bowel movement. These episodes are VERY scary. I've had multiple medical tests done and nothing medical was ever found to cause these, so I was told to avoid the triggers as much as I can. And if I feel an episode coming, to immediately sit or lay down. What you describe does sound like a vasovagal episode. I would suggest to try and stay calm as much as you can and to lay down immediately when you feel this happening, if possible with your legs elevated above your head. It should go away, and if it does, then most likely that's what it is. However, if you do that and still faint, then I personally would be more suspicious and would mention this to the doc next time you see them. Sorry you are going through this. I hope you feel better soon!