Tone: Introduction and question

[Tone]

Hi there, until recently, I  took Venlafaxine (Effexor) for around 4-5 years at various doses, with one failed discontinuation in 2018. Given the regularity with which my depressive episodes began to manifest over the last few years, I was labelled with Persistent Depressive Disorder (PDD) and my GP gradually increased my dosage of Venlafaxine late last year as I fell into yet another depressive episode. What became clear to me was that I was still suffering with depressive episodes despite therapy and implementing all the coping and preventative strategies I've picked over the years, and regardless of using antidepressants...so what the hell was I taking them for? I also became increasingly concerned about links between the antidepressants and hypertension. 

 

Having decided I'd had enough of the cycles of depression, and becoming more and more convinced the antidepressants had become part of the problem, my GP finally agreed to a programme of tapering off them - my aim being to manage my condition 'naturally' instead. I realised that drastic action would be necessary to achieve my goal. Successfully maintaining my job as a teacher was increasingly difficult, if not impossible during depressive episodes, and I realised I would would have to give it up to get through the withdrawal and discontinuation of antidepressants. It has been difficult, but I have been lucky - given how long I had been on them - that the worst of the 'visible' physical symptoms has been nausea and shivering. 

 

I took my last antidepressant just over a month ago, and as far as I'm concerned, there is definitely no going back. Of course, other symptoms have been much more pronounced than the physical. To great relief, the numbness and disconnect gradually faded, but only to be replaced by incredibly intense mood swings, during which I swing from feeling motivated and positive about my progress to a level of despair and demotivation that is, quite frankly, scary. At first, the mood swings could almost be hourly, sometimes daily. They are better now in that they're not so regular or intense, but still problematic, and I wonder when...or if  I will ever stabilize. So, one question is: how can I tell the difference between relapse and Protracted Withdrawal Syndrome (PWS)?

 

I am also curious about (what I think is) a specific withdrawal symptom. Although it's not quite so difficult to manage as it was at first, I continue to to be ridiculously tearful and very easily overwhelmed. I'm not over emotional in general; it's simply that I'm rather easily moved to tears now - sometimes just the mention of crying sets me off. It's kind of like the crying amplifier is set to maximum all the time so there's no normal regulation of emotion, or, to continue using simile to describe it, it's like I'm kind of constantly full to the brim with tears, so the slightest knock means they spill out. Of course, I understand there is nothing wrong with crying, and I don't take on board archaic ideas of toxic masculinity, but this really does feel a little ridiculous, and difficult for me to manage in company or public. So, I was wondering if anyone else is familiar with this experience? Is it a symptom of withdrawal or something else? Should I expect it to gradually pass or not? 

 

 

 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.

 

On 10/17/2021 at 1:35 PM, Tone said:

I took my last antidepressant just over a month ago

Did you quit cold turkey or did you taper?  

 

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 vertical 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.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.   This explains why we get symptoms from going off of these medications, and why it's so important to taper so slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

Windows and Waves Pattern of Stabilization

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

On 10/17/2021 at 1:35 PM, Tone said:

how can I tell the difference between relapse and Protracted Withdrawal Syndrome (PWS)?

The quality and intensity of depression from PWS tend to be different than natural depression.  Most people report that PWS depression is more severe.  The same is true for anxiety from PWS.  This link discusses how to tell the difference:  

 

Withdrawal vs. Relapse

 

On 10/17/2021 at 1:35 PM, Tone said:

So, I was wondering if anyone else is familiar with this experience? Is it a symptom of withdrawal or something else? Should I expect it to gradually pass or not? 

This is common in withdrawal.  I have had this symptom myself, although it is gradually abating.  We refer to this as neuro emotion.  I personally think that for me, the drug covered up my emotions, and I had a lot of unprocessed grief.  Now that the chemical straitjacket is gone, the tears are flowing and I'm able to process my grief. 

 

Neuro Emotions

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

[Tone]

Wow, finally some proper information - thank you!! I am going to read through everything thoroughly and thoughtfully, then

 make my replies. It may take me a little while to reply as I am so easily overwhelmed atm, and have to kind of work up to it, but I definitely will.

[Tone]

Hi there. I have now put my medication history in my profile. To answer the specific question, no I did not quit cold turkey; I tapered down in 2 week intervals (details on my profile).

 

A massive benefit of joining this forum is that I can now access so much relevant information. Just understanding better how the gut, brain and nervous system heals, and the kind of time it could take, is a massive relief compared to not knowing what the hell was happening to me, and not being able to judge whether it was withdrawal or relapse. The notion of "waves and windows" really helps me understand the inconsistency and intensity of my moods. Knowing that I'm not alone with - what I now know is called - "neuro-emotions" as a symptom, and that I'm not 'broken' forever, is a huge relief too. 

 

 

[Tone]

MEDICATION HISTORY:

 

Venlafaxine from October 2016- August 2018:

 

(up to 375mg daily at maximum usage down to 37.5mg before tapering off July-August 2018)

 

Failed discontinuation with a rapid relapse so started taking again from September 2018 - 21/08/21:

 

Highest dosage 225mg daily.

 

 

 

(switched to modified release venlafaxine (Effexor)

 

01/01/2021-14/03/21 Venlafaxine 225mg daily

 

15/03/2021-11/06/21 Venlafaxine 187.5mg daily

 

 

 

Most recent tapering history:

 

12/06/21 - 26/06/21 - 2 weeks at 150mg daily

 

26/06/21 - 10/07/21 - 2 weeks at 112.5mg daily

 

10/07/21 - 24/07/21  - 2 weeks at 75mg daily

 

24/07/21 - 07/08/21 - 2 weeks at 37.5mg daily

 

07/08/21 - 21/08/21 - 2 weeks of 37.5mg on alternate days

 

 

[Kiasofia]

Hello @Tone

I'm so glad you found this forum and that you read the links from @getofflex. Although you did taper, we would consider this a fast taper. This works for some people, while others need to taper over a year or even several years. This is very individual. Please let us know if your withdrawal symptoms get worse. Some find they need to reinstate a small dose and then taper off more gradually. Please consult with us before reinstating, if you end up considering it. Most doctors advise a much higher dose than is safe or even necessary.

 
About reinstating and stabilizing to reduce withdrawal symptoms

 

What is withdrawal syndrome?
 

In case you end up needing advice from us, put the information in the previous post in your signature here: Create Your Signature in "Account Settings"

That way we can see your history and current situation at the bottom of each post you write, without going back and reading all posts. Also add any other medications and supplements you use.

 

Use this format:

 

FOR READABILITY, SHORT LINES ARE BEST.

• A list is easier to understand than one or multiple paragraphs
• Include ALL drugs, doses, and dates (starting and stopping)
• Any drugs prior to 24 months ago can just be listed with start and stop years
• Use actual dates or approximate dates (e.g. mid-June 2018) rather than relative time frames (e.g. 3 months ago)
• Spell out months (e.g. "January" or "Jan" as 9/1/2016 can be interpreted as 9 Jan 2016 or 1 Sept 2016)
• Please leave out symptoms and diagnoses

 

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

To make sure someone sees your post write @ and then start typing the username of that person. Then they get a notification.

 

Good to have you here!