STKEire: 3 months off sertraline - Intense relapse - Advice welcomed

[STKEire]

Hi! 

 

New to the forum so thought I would post about my current experience of coming off of Sertraline and what I'm currently struggling with in the hopes there's some common knowledge among you all that can help me. 

 

My battle with OCD and health anxiety has been one that started when I was 17 years old. I was in an abusive relationship and had my first ever panic attack at school one day, and for the weeks that followed I endured horrendous electrical zaps all over my body - I thought I was dying of a horrible neurological disease. The anxiety went away for a while after ending the relationship, but revisited in the years that followed when life got stressful.

 

I had taken Citalopram from 2015-2016 for an intense period of anxiety, and 2 months after I quit (because I was feeling better and was assured by my doctor I didn't need a withdrawal plan) - I had a major existential crisis where I ruminated over death for weeks. I can't remember how I got over it in the end up but I did (though I still get those thoughts, I tend not to dwell on them). 

 

I had more anxiety at the beginning of 2018 and went on Citalopram again, lasting 3 weeks until one night I felt my face get itchy and hot and was convinced I was having an allergic reaction (didn't know at the time anaphylaxis is virtually impossible after 3 weeks of taking a medication lol). I freaked out and quit taking them.

 

Fast forward two months to March 2018 and the intense health anxiety returns: This time it's a troubling sensation down the right side of my body (as if one side was lighter than the other, or that I was overly aware of it - not clinical weakness, but perceived weakness) - it drove me nuts. It was a symptom I had about 6 months before that came and went and always got worse after a nights drinking. When it came back in March 2018 I fixated on it for weeks and cried every day, my moods would change by the hour going from intensely anxious and depressed to periods of relief when I'd reassured myself it was just anxiety. I ended up seeing a doctor who put me on 50mg Sertraline: within days the sensation was gone, I felt relief almost immediately and even planned a trip to London to visit my sister, which had been totally out of the question while I was suffering. I had my life back. 

 

I think somewhere after the 6 month mark I dipped again. The sensation didn't return, thankfully, but I did end up experiencing some new fears - things like allergic reactions to food I'd never tried or hadn't eaten in a while, reactions to medications, and I'd even developed this strange paranoia about my food being spiked or tampered with (not in restaurants or anything, but store bought food where the seal didn't feel "right" coming off or looked strange. These were all fears that weren't very disruptive to my life because I felt I could control them: I could just throw out the food or not eat it, and no one was forcing me to take medication. The doctor recommended I up my dose to 100mg because I was starting to feel a little bit depressed again, but the thought of upping my dose and reacting badly scared me so stupidly I didn't. I rang back and got my original prescription of 50mg, stayed on it for a few months but felt OK. I did feel a bit better for a while, and then not so much, so went back to the mental health doc and told him I maybe wanted to come off them again (think this was around January 2020 by this stage) - he referred me for therapy but I was told the waiting list was long and could take months, and told me if I wanted to come off sertraline (at this stage on it for almost 2 years) all I had to do was take the 50mg dose every other day for a week and then stop. I was assured I was on a "mild" dose and that the withdrawal would be barely noticeable. I told myself I'd keep taking them until I'd been to therapy. The therapy referral came through in September and I went for 8 sessions. It was nice to talk to someone I didn't know about all the problems I'd faced in my life, but ultimately it was not very helpful as she would have told me to block out my intrusive thoughts instead of giving me practical advice to sit with uncertainty. 

 

Things were looking up for me at the beginning of this year and I felt the medication was no longer serving me: I didn't feel fantastic but I didn't feel awful either so decided I would stop. I had sort of formed a bit of an online relationship with someone and we had big plans to meet up once it was safe to and restrictions were lifted, and he waited until the week I took my last sertraline pill to tell me he was no longer interested (we had talked all day every day for 8 months). I was upset, but if therapy taught me one thing it was to stop placing a lot of value in romantic relationships with others. The week that followed I thought constantly about suicide, not that I would (too afraid of dying!), but I kept thinking to myself that if I knew there was something better after this earth I'd be away.  This was the last week of April this year.

 

Now it's July, and the last few months haven't been an easy ride, and in particular the last few weeks have been hell. One of the side effects of going on Sertraline in 2018 (and I had it with Citalopram many years ago too) was difficulty swallowing and I would sometimes choke (or feel as though I was choking on my food). It was bad in the first few weeks back in 2018 but I have a note on my phone from when I had to visit the doctor every few weeks after starting about my symptoms and side effects and I had written "difficulty swallowing - mostly subsided" - this was about 6 weeks in to my treatment. This symptom (which I know is also an anxiety symptom) has still remained but now I'm fixating on it. Back when I was on sertraline I just put it down as a side effect but now it's really troubling me.

 

Over the last 3 weeks the anxiety I've faced over swallowing has grown more intense by the day (and it's not lost on me that the same amount of time has passed as the same time I had went off Citalopram and had the existential crisis). I'm hoping it passes but I've lost 9lb in the space of these weeks and I can't even think about eating steak or chicken etc. I have booked a session with a new therapist to start this coming Tuesday. I rang my GP this morning who was absolutely useless and just suggested I go back on medication but I really don't want to. So afraid of choking or not being able to swallow. I do have a few other symptoms too: brain zaps (that don't really feel electrical but more of a dull internal thud), some tension around my right temple, and a horrible feeling in my fingernails and toenails which I'm trying not to think about. Also feeling a bit confused at times, mainly when my anxiety is heightened (mixing up my words the odd time which I tend to do when anxious, weird deja vu etc)

 

I'm trying all the usual OCD and anxiety management techniques that I can because I'm determined not go back on Sertraline. Trying to keep busy and distracted, and eating even when I don't feel like it. The best thing I've found is doing yoga at night - last night I felt like I could have ate a whole pizza afterwards haha.

 

I just found out about this forum today, I've asked for advice on No More Panic and OCD UK, but maybe some people on here can help me with words of encouragement or advice when it comes to getting off meds completely. Even tips for managing some of the symptoms I've been feeling would be good too. 

 

Well done if you've read all of this - I didn't mean for it to be so long! 

 

Thanks :)  

 

 

[Go2zero]

Hi STKEire

 

Welcome to this support site. Before we can answer your questions, please give us more information first. 

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

https://www.survivingantidepressants.org/topic/18343-please-summarize-your-withdrawal-history-in-your-signature/

 

Reading your post it seems that you are suffering from WD, because of several times starting and stopping and going down in dosages too fast. Welcome here again; most members (including me) have made these "mistakes". Just because we did not knew what the effects might be of these actions. And most doctors do not know either and advise us to do these things. And yes, the most well know advice from doctors is to start the meds again. Which often makes things worse after easier AD use, because every time we start and stop the Central Nervous System gets more deregulated.

 

There is a lot of knowledge available here and support between the members. I am glad that you have found this site!

 

Time will be the big healer. This often goes in "waves and windows" patterns. Although a wave may give us the feeling that we have a big fall back, we heal in time.

 

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

 

Also look at non drug coping techniques and neurological emotions. Understanding is may be very helpful:

 

https://www.survivingantidepressants.org/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

https://www.survivingantidepressants.org/topic/14397-neuro-emotions/

 

 

 

 

 

[STKEire]

Hi Go2zero and thank you for taking the time to read and reply. I've just updated my signature so hopefully that helps clarify my history with ADs a little bit, though I'm quite unsure on some of the months for earlier treatments. 

 

Thanks for providing the links, I will take a read through these over this weekend. Looking back at my history it seems that I normally have one of these waves around the 2-3 month mark after stopping. The hypochondria link under neuro emotions is very interesting: The member states his anxiety is worse in the morning, eases through the day and is virtually gone by night and that describes how I'm feeling with this current intense anxiety. Every morning I wake up I am filled with dread, but by the time I go to bed I'm thinking a bit more clearly and feeling more positive. 

 

When I consider my past treatment with Citalopram, I did have a major wave 2-3 months after stopping then too which I mentioned in my intro, where I ruminated for weeks about death. I wish I could remember how I got out of that mindset back then, but I know I've been through these major waves of anxiety before and have got through them, even years before I had ever taken any antidepressants. 

 

Though at the minute I am preoccupied with food and swallowing, I am forcing myself to eat whatever I can as opposed to letting my anxiety win and in the hopes I will become desensitized to it through time, and that this fear will stop as quickly as it started. I'm due to see a new therapist on Tuesday night and have already explained to her about having recently withdrawn from Sertraline, and my reluctance to start on them again. She seemed very open to trying to help me get to the root of my issues without medication which is good. 

 

I just want to feel like my old self, I think I truly haven't been happy since I was about 18 and I'm 29 now. I can't stand the thought of living my life dependent on medication! 

 

 

 

[Go2zero]

11 minutes ago, STKEire said:

Thanks for providing the links, I will take a read through these over this weekend. Looking back at my history it seems that I normally have one of these waves around the 2-3 month mark after stopping. The hypochondria link under neuro emotions is very interesting: The member states his anxiety is worse in the morning, eases through the day and is virtually gone by night and that describes how I'm feeling with this current intense anxiety. Every morning I wake up I am filled with dread, but by the time I go to bed I'm thinking a bit more clearly and feeling more positive. 

 

The 2-3 month period is very well known. Very often WD kicks in after 2-4 months after a major drop in dosage or after stopping completely. 

 

The anxiety patterns you describe are also very well known. Lots of us experience that. I experience it also, but I notice that it becomes much better since I started a longer period of stabilization. So I am positive that these symptoms will go after we have tapered CAREFULLY and SLOW to zero.

19 minutes ago, STKEire said:

When I consider my past treatment with Citalopram, I did have a major wave 2-3 months after stopping then too which I mentioned in my intro, where I ruminated for weeks about death. I wish I could remember how I got out of that mindset back then, but I know I've been through these major waves of anxiety before and have got through them, even years before I had ever taken any antidepressants. 

 

This can be also a WD symptom. However you say you also experienced it before getting on AD's. Everything passes in the end. It is very important to remember that and have trust and faith!

 

21 minutes ago, STKEire said:

She seemed very open to trying to help me get to the root of my issues without medication which is good. 

 

This sounds good. Very important!

22 minutes ago, STKEire said:

I just want to feel like my old self, I think I truly haven't been happy since I was about 18 and I'm 29 now. I can't stand the thought of living my life dependent on medication! 

 

I totally understand what you mean. This is a great attitude! We can get of these drugs and we can learn to live without them! Wits such an attitude you will get there. And you can find support here when you need it!

[STKEire]

Thank you! Is there an average for how long the individual waves tend to last or does it just tend to vary person-to-person? And likewise for a full recovery or for ADs to leave my system completely? For me, I kind of feel like I am having all the symptoms of sertraline that I had in the first few weeks when I first started: the difficulty swallowing, getting a bit warm and sweating a bit more than usual etc, cognitive function is not good either but it usually isn't during intense periods of anxiety. I constantly swing between "it's just withdrawal/anxiety" to feeling completely hopeless and like I'm losing my mind.

 

I have a trip coming up at the end of the month and feel so scared that my anxiety around swallowing food is going to prevent me from going altogether. I manage to get myself calmed down periodically throughout the day but then when it comes to sitting down and eating everything tenses up again and it's like I've forgotten how to swallow automatically, I am so scared

[Go2zero]

9 minutes ago, STKEire said:

Is there an average for how long the individual waves tend to last or does it just tend to vary person-to-person? And likewise for a full recovery or for ADs to leave my system completely?

Unfortunately it cannot be said. It is really different for all of us...

 

Here is some more info:

 

https://www.survivingantidepressants.org/topic/23081-are-we-there-yet-how-long-is-withdrawal-going-to-take/

 

11 minutes ago, STKEire said:

I constantly swing between "it's just withdrawal/anxiety" to feeling completely hopeless and like I'm losing my mind.

 

This is a good reaction. Try to get back to the "it's just withdrawal/anxiety" when you start losing your mind. It really helps to become the Observer of what you experience and feel. In that way you disconnect from identifying with the WD symptoms. You ARE NOT the anxiety. The anxiety is "just" an energy running through your system. Try to look at it as an observer and see that is not you!

 

Do you know the book The Power of Now from Eckkart Tolle. This may help you in this as well.

[STKEire]

I thought that - thanks for the link, I've had a skim through it. Just hoping it doesn't take long, or at the very lease gets less intense. 

 

That is good advice, thank you. It can be hard to stay present when this is happening as you know. I haven't read that book but the title sounds familiar - I will definitely look in to it! Really appreciate you taking the time to reply. I only really have my mum for support but she has a lot going on at the moment and I feel terrible for adding to her worries. Sometimes it's just good to vent to a stranger! 

 

 

[Go2zero]

26 minutes ago, STKEire said:

Sometimes it's just good to vent to a stranger! 

That is also where this site is for. You are not alone!