Cal1000: Introduction - Advice needed

[Cal1000]

Hi, 

I began tapering off sertraline last march (2021) 75mg down to 25mg, then off completely, under psychiatric supervision over the course of 4 weeks, after floating between various SSRI's for 6 years. I realize now that my doctor may have made a mistake, and that I maybe should have gone off significantly slower.
My initial symptoms were practically non-existent, however after 3-6 months I began noticing more and more issues, including muscle spazams, light brain zaps, depressive waves, visual disturbances, dyslexia, auditory disturbances, general overstimulation, focus impairment, brain fog, and memory difficulties.
(I had a particularly bad experience with mistakenly going CT off Venlafaxine in winter 2020, resulting in hospitalization, so I'm not sure if what I'm experiencing is withdrawl symptoms from sertraline, or lingering symptoms from my bad experience with Venlafaxine a year ago.)

I've found that I'm able to stomach most of the symptoms that I'm experiencing, 
But I've been finding the cognitive impairing symptoms (brain fog, dyslexia, focus impairment, and memory difficulties) to be very very challenging,

I'm 20 years old, I want to make friends and I want to go back to school,
But I've had extraordinary difficulty holding conversations with people,
And I worry that the cognitive impairment I'm experiencing is going to make education and learning in general impossible.

I'm basically here looking for some source of hope.
Am I really looking at 5 years+ before my brain starts to work normally again?
If so, what can I do with my life in the meantime?

I am considering reinstating sertraline to maybe salvage what remains of my brain, 
But I don't know, it's been 8 months since my last dosage, is there any hope there? Would I have a chance at improvement if I started at a significantly reduced dosage?

I would love to see some light at the end of this very very long tunnel. 

Thanks

[Onmyway]

Hi @Cal1000, 

welcome to SA. I am so sorry you are going through all these difficulties. 

You could try reinstatement at a very low dose - 0.5 or 1mg perhaps and see if that makes things better. If not, you can stop it. You may have seen this already but here is thread on reinstating. 

 

About reinstating and stabilizing to reduce withdrawal symptoms - Symptoms and self-care - Surviving Antidepressants

 

Cognitive difficulties can be quite distressing but please don't lose hope. There is no specific time line - some people get through withdrawal in shorter time, others take much longer. It is impossible to predict how long yours is going to last. The other thing with withdrawal is that it changes. Symptoms come and go, other symptoms appear, things become better or worse. 

 

The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants

 

Just want to say that your brain is not permanently damaged, it is just re-adapting to the new normal. And luckily at your age, it will likely re-adapt faster and more efficiently. Have you seen some of the research on brain plasticity? I quite liked the book "The Brain that Changes Itself" by Norman Doidge. Here is some info on the brain and withdrawal 

 

What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants

How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants

 

Are you getting enough sleep now? Often cognitive symptoms appear or get worse with insomnia (it was the case with me). 

Are you taking Omega-3 and Magnesium? There are a couple of very informative threads on these on the site.

They can support recovery. 

 

One thing you have going for you is that you are a young and as such your body is much better able to re-generate and heal itself. 

In the meantime focus on taking good care of yourself - sleep well, eat well, do exercise as much as you can. 

We have discovered here that any psychoactive substances - alcohol, recreational drugs can set people back during recovery. Caffeine can also make people more anxious and on edge than it would normally, our nervous system is just so sensitized. 

 

Please keep us updated on what you decide to do about reinstatement. 

 

Hope you feel better soon and the cognitive issues fade away. FWIW, your message is well written and clear and you did the signature carefully. This doesn't mean that you don't have cognitive issues (I am myself writing this in a dazed state) but it means that you can likely manage school and other things you want to pursue. Take good care of yourself!

 

Hugs,

OMW

[Cal1000]

Hi @Onmyway,

Wow, I really can't thank you enough for the quick and thoughtful response,
I really found what you wrote helped me chill out a bit, and put my experience into perspective.

I believe that perhaps my recklessness with psychoactives may have had some part to play in my cognitive difficulties.
I had been drinking once every two or three weeks socially, (but pretty heavily, since I have a couple bartender friends),
I would also occasionally microdose a very small amount of mushrooms, in hopes that It might help with depression.
Now that I'm thinking about it, it's not unlikely that the brain fog and memory issues were influenced by these factors (and I feel awfully stupid for not picking up on that fact myself).

I will try a complete psychoactive cleanse, and see where I'm at in a few months. 

My sleep is good, I was recently diagnosed with sleep apnea and have since received very effective treatment for that with CPAP therapy.
Also, I do already take Omega-3 and Magnesium, and have been daily for about 3 months.

I'll look at some more of the threads, and I'll check out The Brain that Changes Itself,

Again,
I am so grateful for your response. It was honestly so helpful, and brought me quite a bit of peace of mind,
Thanks,
Cal

[Onmyway]

Dear @Cal1000, 

thanks for your nice words and am happy that the information that I provided helped calm your worries. Withdrawal itself makes us more pre-occupied with things (this is simplistic but serotonin acts as a "brake" to lots of emotions and without it sometimes our mind can run away with worries, anger, sadness and so on). 

 

I hope that the psychoactive substances cleanse brings some stability. In withdrawal our brains become very sensitized to all kinds of stimuli (for some people it can be light, sound as well) but especially chemicals that impact the brain. Vitamins that impact the nervous system - vit B and D for example -  can send people into anxiety and akathisia as well. Alcohol is one that we don't think about because it is so common in our lives but it is a potent brain chemical. 

 

It might be helpful to think of ways in which you can refuse drinks before you are in that situation. In our culture there is a lot of pressure to drink, especially if you are young. I hang out with people who drink quite a lot and have told them that I am taking a specific medication that interacts with alcohol (this is not untrue as I am tapering citalopram which makes me sensitized) and as a result can't have any. Some of my friends know about my withdrawal but not everybody has to know esp because there is so much stigma around addiction and MH and withdrawal/physical dependence is  seen as addiction. You might also want to think of what you would drink when your friends drink alcohol, water, alcohol free beer etc. Note that coke can also be activating (as it has caffeine). 

 

Hope this clears things up and please update us on how you are doing

Be kind to yourself, 

OMW

Edited November 17, 2021 by Onmyway

[Cal1000]

Update: Finding identity and patience

 

Hey guys, 

I just wanted to provide a brief update, as well as maybe ask for some advice during a somewhat frustrating wave in my recovery.

A summary of my experiences with ADs: In 2016, at age 16, I went to my doctor with concerns that a feeling of chronic fatigue was interfering with my ability to engage productively with my studies at the time. My Doctor, convinced that It was impossible that I could be experiencing something like sleep apnea at such a young age, chalked up my symptoms as an obvious indication of MDD, and I was promptly put on a generous helping of Sertraline.

 

In the years following I would float between various dosages of various antidepressants, while experiencing worsening symptoms of fatigue, the onset of actual depression, anxiety, social and academic avoidance, as well as multiple stays in psych wards for instances of enacting self harm.
Fast forward to the beginning of 2021: after 5 years I finally convince my doctor to book me in for a sleep study, where, of course, I am not long after diagnosed with severe obstructive sleep apnea.

After about a month of CPAP therapy for my sleep and unbelievable improvements to my motivation, my focus, memory, energy, everything, I decide that not only do I wish to discontinue my use of antidepressants, but that I almost certainly never needed them to begin with.

I began tapering off sertraline last march (2021) 75mg down to 25mg, then off completely, under psychiatric supervision over the course of 4 weeks.

It's now been 8 months. I've been absolutely fortunate enough to have not experienced many of the more intense symptoms like brain zaps, headaches, etc., but what I have been experiencing is a very troubling degree of cognitive impairment. 

Memory, recall, focus, creativity, my sense of humor, attention to detail, It's all completely shot.
This really really sucks for me, because my whole life I've never been a big sports guy, or a big music guy, or the kind of guy who's into any real tactile hobby, besides a very passing competence with visual art. My only real major strength my entire life has been what I believed to be a (relatively) quick wit.

I've always felt as though I had a pretty strong sense of humor, but now, not only can I not form a joke or funny statement or observation to save my life, but I can hardly ever immediately recognize when a joke is being made at all; I find almost nothing funny.

 

I used to be able to talk and talk for hours about philosophy, politics, psychology, physics, you name it, now I can hardly hold a conversation for a few minutes about the news of the day without feeling completely out of my depth.

I used to be able to formulate the most beautiful sentences, stringing together all kinds of words that I had read or maybe heard in passing once or twice, now I find myself struggling to find the right words on an hourly basis.

 

I used to write a mean essay, but even all this has taken me hours to compose.
I can just barely read.

And, oh. my god, my memory. It's nothing. Tatters. It's. so. unbelievably bad.

Every day "What's the word for ___?" "Who's the actor who played ____?" "When did ___ happen?".

 

My question is this: While I recover. If I recover. Who am I? 

I have no personality. I'm humiliated to be around others because I feel like I must just seem like a husk, or totally brain damaged. And worst of all, I have no idea what makes me me.

 

Should I bother trying to identify with the pseudo-self I am now,

Or should I retain hope that a more authentic version of myself waits on the other side of healing, and that I should wait until then to try and find self-identity?

I find it so hard to find patience. Particularly when the "official" statement from the "professionals" is that it's all in my head.

I can't help but feel my mind be plagued with "what if" after "what if". "What if it is really all in my head, and I'm just a dummy forever?", "What if I was of ADs at such a crucial period in my development that my brain will simply never function well without them?"

 

I beat myself up every single time I forget a word, say something stupid, or laugh awkwardly at a comment someone made (just in case it was meant to be a joke that I didn't catch).

I know the only way to truly heal the fastest is to have patience, 
So my second question is:
How do I hold onto patience, and the faith that I can actually improve?

 

P.S. Also,

How often should I check in with myself?

Checking my own improvement every day is frustrating as progress is so slow. Should I be journaling my progress every moth instead? 6 months? 


Thanks!

 

Edited December 16, 2021 by ChessieCat
added Intro topic title before merging with intro topic

[BelaLugosi]

On 12/16/2021 at 3:52 PM, Cal1000 said:

How often should I check in with myself?

 

Checking my own improvement every day is frustrating as progress is so slow. Should I be journaling my progress every moth instead? 6 months? 

 

oh that's really a good question actually

because it seems  that being obsessed about the improvements (that r so slow) can be a bad thing