Combitone: tapering and reinstatement on doctor's advice has been a nightmare - what now?

[Combitone]

Hi all,

 

This is something of a splurge, because I have had a rough time lately. Effexor has essentially brough my life to a shuddering halt, and I don't know where to turn. Every move I've made recently seems to have made things worse.

 

I'm in my early 40s, and I've taken a 25 year tour of the medical profession in respect of mental health. I can't say it's helped much. I've tried a lot of things - CBT, workgroups, 6 different types of antidepressant (fluoxetine, sertraline, amitriptyline, quetiapine, citalopram, now venlafaxine) mindfulness, counsellors, therapists, etc. The improvements have been very limited.

 

Rewind to March. I'd been on Effexor modified release (225mg per day) for close to 5 years and, encouraged by my therapist, decided to taper off and see what the unmedicated state of play was. I did it under doctor's advice of a 4 week period which turned bad, side effects-wise (itching, aching, headaches, nausea, suicidal ideation), about 2 weeks in, and the doctor tacked on another week. The side effects were still awful all the way to 0mg, but I was advised to push through. From 0mg, I struggled through 4 more weeks without the side effects diminishing, and the mental side was horribly bleak.

 

I eventually decided enough was enough, and got back in touch with a doctor. In order to curb the side effects at least, it was suggested I'd need to reinstate up to a certain dose (75mg was recommended for modified release), at a rate of 37.5mg every 5 days. Some of you will guess what's coming. Going back on was even worse - my body had an adverse reaction and I was basically writhing in discomfort for the best part of two weeks. I've never been through anything like it. The worst of those adverse effects lessened after 4 weeks, but mentally, my mood is extremely unpredictable and my outlook remains very fatalistic. I've not been able to work during this period, which is frightening, and I don't know how long this will last. My money is going to run out entirely in a couple of months, and then I'm *****.

 

Other factors happening are obviously complicating things. I'm currently estranged from my family, as therapy caused me to take a step back, and look at how I've been treated by them in the past. I also have a situation with a tree in my garden that is slowly collapsing and threatening to fall on a nearby industrial estate and cause thousands of pounds worth of damage, but birds are nesting in it, so there's nothing I can do right now. I'm working to get it declared unsafe by the local council, so it can still be cut down, but this outcome is apparently very rare.

 

It's worth mentioning that I became aware of The Withdrawal Project and Surviving Antidepressants during the 37.5mg reinstatement disaster, and other such anecdotal advice websites. My conviction all along the line is that my taper was way, way too quick, and I've spent a lot of time thinking about what stablization at a particular dose means - I guess in this case it could simply be that my condition might be horrible, but it's consistent in its level of horribleness. They've given me a lot to think about for a future tapering attempt at least.

 

The biggest problem is that I don't know how to proceed. My doctors have given me bad advice, but I am also mindful that these groups are anecdotal - it seems as if I need to press forward to going up to 75mg as originally advised, but Surviving Antidepressants doesn't appear to recommend that. The only doctor I've consulted more than once on this issue (the others times were emergency appointments, and who you get is a lottery) is not available until the 26th, and the last week has been so **** that I can't take the idea of doing nothing in the meantime. I have the capsules with the 12.5mg beads in, so I'm mulling over the idea of microdosing up to 75mg over the next 4 weeks.

 

That I've ceded control to this medication over the years without realising it is so frightening, and my future feels incredibly uncertain. **** is just too crazy at the moment. I don't know what to do.

[Altostrata]

Welcome, @Combitone

 

We often see people have a bad reaction when reinstating too high a dose after severe withdrawal symptoms. We have seen that often a very low dose is enough to reduce withdrawal symptoms.

 

On 5/20/2021 at 11:30 AM, Combitone said:

I have the capsules with the 12.5mg beads in, so I'm mulling over the idea of microdosing up to 75mg over the next 4 weeks.

 

We would not recommend automatically increasing to 75mg. Rather, you might take 12.5mg at the same time each day and see if that helps. It will take at least 4 days for this amount to become steady-state in your bloodstream. If it helps even a little, that's a good sign. You will still have to be patient as you stabilize through the usual The Windows and Waves Pattern of Stabilization 

 

Also see 

What is withdrawal syndrome? 
 
About reinstating and stabilizing to reduce withdrawal symptoms 

 

You may continue to feel physical and psychological symptoms of withdrawal for a while, sometimes very intensely, probably for months. One way or the other, you will need to learn non-drug techniques to manage your psychological symptoms, see 

 

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

 

Dealing With Emotional Spirals 

 

Shame, guilt, regret, and self-criticism

 

Please let us know how you're doing.

[Combitone]

Hi @Altostrata, thanks for the reply and information. When you suggest the 12.5mg, is that with the fact that I'm currently taking 37.5mg and attempting to stablise on it? I only ask because users in other places I've posted this have stated that they didn't think I made it clear enough that my current med situation is 37.5mg per day.

 

I'm attempting to put together a bunch of coping strategies, but I've found few so far. The physical symptoms are unpleasant, but they are currently at a level that aren't completely incapacitating me. The bigger problem for me is the mental side, specifically severe anxiety and general despair at my current situation, which tends to ebb and flow in cycles of 4-6 weeks. I have checked out many of the linked threads, and I'm also in long term therapy for issues that are underlying, but they are debilitating to the point that I can't summon the motivation to do anything much when they are at their peak. Considering my work status, this is frightening. The withdrawal symptoms, as long as they aren't at their very worst, I can just about cope with. I can't seem to break the cycle of the mental stuff. whatever I try.

[Altostrata]

On 5/20/2021 at 11:30 AM, Combitone said:

Going back on was even worse - my body had an adverse reaction and I was basically writhing in discomfort for the best part of two weeks. I've never been through anything like it. The worst of those adverse effects lessened after 4 weeks

 

You had an adverse effect to 37.5mg. The activation indicates this dosage is too high.

 

Since you've been on 37.5mg, how has your sleep pattern changed? How do you feel before and after you take your 37.5mg dose?

[Combitone]

18 hours ago, Altostrata said:

 

You had an adverse effect to 37.5mg. The activation indicates this dosage is too high.

 

Since you've been on 37.5mg, how has your sleep pattern changed? How do you feel before and after you take your 37.5mg dose?

I don't think my sleep pattern has changed noticeably. I sleep too much (10 hours a night), and have for a long time before the reinstatement of 37.5mg and before the taper attempt. I've been on Venlafaxine for the best part of 5 years, and I don't recall how my sleep patterns were before that. 

 

The difference before and after taking meds in general is something I've always found difficult to quantify, which is why my previous 5 medications were discarded. I have been labelled on my local surgery file as 'generally unresponsive to treatment', which is why I am in therapy for deeper issues.

 

I have kept records since reinstatement of how I've felt upon waking up, which is going on 6 weeks now (between making the original post and filling in details for the signature, I've realised that some of the post details in terms of time span are not completely accurate). In recent times, this tends to include the worst of the depression and anxiety and the currently manageable levels of itching, aching, nausea and headaches. As I force myself to get up and get busy (and take the med as the first thing I do, along with food), the depression and anxiety is at least reduced, but the other symptoms don't tend to recede much. If there is a change, it's very slight and difficult to notice.

[Altostrata]

So your symptoms are worse in the morning, before you take venlafaxine?

 

What do you mean by "depression"?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[Combitone]

On 5/23/2021 at 11:15 PM, Altostrata said:

So your symptoms are worse in the morning, before you take venlafaxine?

 

What do you mean by "depression"?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

The correlation is there, I suppose, but as I say, there's little dramatic change. I'll give the mapping of a full few days a go, and post it.

[Combitone]

Ok, here are 3 days worth of symptom tracking. Hopefully, these are sufficiently detailed. @Altostrata

 

A few contextual notes:

 

1) It's important to note that there appears to have been a shift since since Saturday 29th in that the nausea has become less potent. I'm not sure what accounts for this - perhaps the reacclimation to the level of venlafaxine in my system. Also, I have upped the amount of exercise I've been doing, as distraction/exercise made it less noticeable. Another possible explanation is that when I was on the med at a consistent level prior to tapering, certain side effects did seem to occur in a cycle of roughly 4-6weeks, though that was the itching, rather than the nausea. The itching is making a return, though.

 

Prior to this, I was very sick Thursday 27th and Friday 28th come evening time. The nausea made the prospect of eating shortly after getting up unpleasant, but I forced that to happen so I'm taking meds with food. 

 

2) Sleep pretty much always been of good quality and largely unbroken, though waking and getting up proves difficult - feel sleepy and lethargic usually despite 8-10 hours of sleep. Thouh I currently will wake upon alarms sounding, I by no means remain awake afterwards.

 

3) What won't have helped my general mood is the feeling of having to 'start again' after the recent taper and reinstatement left me unable to work. My money is running out, and my enxiety about this situation is high.

Monday 31/05/21

 

11am - woke up - nausea low on waking, aching, itching, headache low, anxiety and depression medium
12pm - got up - nausea becomes more noticeable (medium), rest of symptoms rise a little
12.30pm - 1x 37.5mg Venlafaxine modified release capsule & Omega 3 Fish Oil capsule (started taking 1 daily a week ago)
made lunch - small pasta bowl w added spinach
1pm - itching eyes medium, nausea medium, rest low
1.30 - 2.30pm - lay on sofa reading (partially testing how nausea responds to laying still for a period of time, which has been a trigger in recent weeks) - got minor cold flushes
2.30pm - short at-home cardio workout - ate two ginger snaps (currently testing whether ginger helps wit nausea)
3.30pm nausea moderate, not debilitating. Other symptoms same level. Anxiety medium.
4pm - no therapy session - therapist on holiday
4.30pm nausea medium/high - 2 more ginger snaps
5.30pm - itching slightly elevated
6pm - shower
6.30pm - 30min walk to alleviate/distract from nausea
7pm - dinner - chicken burger in bun w salad
8pm - nausea medium, itching medium, headache and aching low. A little fatigued. Mood anxious, medium
9pm - bonfire burning garden waste as distraction
11pm - lay down for 20 mins, got chills
11.30pm - video call to friend as distraction from symptoms (not a good call, unfortunately)
12pm - tiredness creeping in
1am - nausea medium, itching medium, aching and headache low. Depression up. Fatigued.
2am - bed. Depression and anxiety high.
7am - woke up briefly

 

Tuesday 1/06/21

 

10.30am - woke up - nausea medium on waking, itching medium, aching, headache low, anxiety and depression high
11.30am - small breakfast - buttered toast x2
12.30pm - 1x 37.5mg Venlafaxine modified release capsule & Omega 3 Fish Oil capsule (started taking 1 daily a week ago)
1pm - lunch - small pasta bowl w added spinach - symptoms same - 2x ginger snaps
2pm - long walk
3.40pm - stop point - nausea low/medium, itching medium/high, other symptoms same
5.44pm - walk end
6.30pm - nausea low/medium, itching medium, headache medium, aching low
7.30pm - Dinner - peanut satay
8.30pm - fatigue and depression more noticeable
9am - snacks - soda and crisps
9.30pm - lay down for 30mins, got minor chills
10.30pm - nausea low/medium, itching medium, headache medium, aching low
12pm - Fatigued, headache more apparent
1am - itching medium/high
2am - nausea low, itching medium/high, headache low/medium, aching low
2.30am - bed

 

Wednesday 2/06/21

 

10.30am - woke up - anxiety and depression high, nausea low, itching high, aching and headache low. Willingly fell back asleep, sleep mildly broken
12.30pm - got up, had 1x 37.5mg Venlafaxine modified release capsule & Omega 3 Fish Oil capsule (started taking 1 daily a week ago) - 2x ginger snaps
1pm - lunch - small pasta bowl w added spinach
2pm - lay down 20mins - minor cold flushes, aware of nausea, though still low
3.30pm - short upper body workout 
4pm - snack - apple
5pm - shower
5.50pm  -  walk to shops and back home
6.30pm - slightly fatigued
7.30pm - nausea low, itching medium/high, headache and aching low. Mood depressed
9.00pm - snacks - crisps and caffeinated beverage
10.30pm - nausea low, itching high
11.30pm - appetite increased - had sandwich
12.30pm - symptoms same
1.30am - tired, itching high again
2am - bedtime - nausea suddenly medium, itching medium, aching low, headache medium (may be attributable to personal issue cropping up causing extra stress)
6am - woke up briefly

[Altostrata]

You reinstated 37.5mg more than a month ago. At that time, it appeared 37.5mg was too high a dose. In the last 2 weeks, have the nausea or itching increased, decreased, or stayed the same?

 

Has your sleep pattern changed? If so, how?

[Combitone]

On 6/6/2021 at 12:16 AM, Altostrata said:

You reinstated 37.5mg more than a month ago. At that time, it appeared 37.5mg was too high a dose. In the last 2 weeks, have the nausea or itching increased, decreased, or stayed the same?

 

Has your sleep pattern changed? If so, how?

 

I would say the nausea has decreased significantly, though very suddenly. The itching and headaches have increased a bit. The aching is the same.

 

My sleep pattern has stayed the same. I sleep nearly always 9-10 hours a night, and it's largely uninterrupted. Occasionally, I find it difficult to get to sleep, but not staying in it. It's generally of good quality.

[Altostrata]

13 hours ago, Combitone said:

I would say the nausea has decreased significantly, though very suddenly.

 

When was this sudden improvement?

[Combitone]

11 hours ago, Altostrata said:

 

When was this sudden improvement?

Since Saturday, 29th May. As I said in a previous post, I'm not sure what to attribute this to other than perhaps my body reacclimating to the meds

[Altostrata]

Yes, that could be it, your body took about 6 weeks to readjust. 

 

Has how you feel before and after you take venlafaxine every day changed? Has it gotten easier to take 37.5mg? Has the daily pattern of itching changed since mid-April?

[Combitone]

On 6/12/2021 at 1:22 AM, Altostrata said:

Yes, that could be it, your body took about 6 weeks to readjust. 

 

Has how you feel before and after you take venlafaxine every day changed? Has it gotten easier to take 37.5mg? Has the daily pattern of itching changed since mid-April?

 

I would say yes to the first question, though it has some nuances. At the start of reinstatement, I feel there was some sort of difference once the dose was taken, though I was certainly hyper aware at the time, considering how bad the adverse effects were with the first few doses. The adverse effects were there from waking, but taking the dose appeared to heighten them, with cold flushes happening a few hours after the dose. Now, the difference in taking the dose before and after are not perceptible.

 

Assessing the itching pattern has been complicated by the fact that a rash is currently covering my arms, though it only appeared after doing some garden work a week and a half ago with uncovered arms, so that may be an allergic reaction to elements other than the meds. I'm keeping an eye on it. The itching (on the eyes as well) has taken over from the nausea as the main symptom over the last few weeks, along with tension headaches in the last week.

 

On a side note, I appreciate the replies on this, so thanks.

[Altostrata]

Are you light-sensitive? Have you developed a reaction to sunlight?

[Combitone]

On 6/17/2021 at 11:09 PM, Altostrata said:

Are you light-sensitive? Have you developed a reaction to sunlight?

Thankfully, no. I've never had trouble with that on these meds or others.

[Altostrata]

I would be concerned about the high potential of an allergic reaction to venlafaxine. As noted earlier, 37.5mg may be too high a dose. Suggest you lower it a bit, such as to 35mg. Adverse reactions tend to decrease as dosage decreases.

 

Are you taking capsules filled with tiny beads?

 

FYI Tips for tapering off venlafaxine (Effexor)

[Combitone]

On 6/19/2021 at 8:37 PM, Altostrata said:

I would be concerned about the high potential of an allergic reaction to venlafaxine. As noted earlier, 37.5mg may be too high a dose. Suggest you lower it a bit, such as to 35mg. Adverse reactions tend to decrease as dosage decreases.

 

Are you taking capsules filled with tiny beads?

 

FYI Tips for tapering off venlafaxine (Effexor)

Not micro beads, unfortunately - 3 x 12.5mg pills per capsule. From the link, I can see pill cutting is ok with modified release, but unless I can cut these very tiny pills into quarters, I wouldn't get close to the amount you recommended decreasing by (even then, considering the 'decrease by 10% of the previous dose' approach recommended here, a difference of a few mg could make for more of a difference than I expect). Is pill shaving recommended for XR versions?

[Altostrata]

You might cut that one mini-tab in half across its waist and then halve it by cutting horizontally through the half, like a layer cake. That will give you approximately 1/4 of 12.5mg. Put the quarter-tab back in the capsule and take with plenty of water.

[Combitone]

On 6/25/2021 at 2:03 AM, Altostrata said:

You might cut that one mini-tab in half across its waist and then halve it by cutting horizontally through the half, like a layer cake. That will give you approximately 1/4 of 12.5mg. Put the quarter-tab back in the capsule and take with plenty of water.

 

I'll have to order a pill cutter and give it a go. My options are limited at this point, and anything that potentially reduces side effects so that I can concentrate on doing something about the depression is worth a try.

[Altostrata]

A sharp knife will do it. You'll want to be more precise at lower dosages.

[Combitone]

On 6/29/2021 at 12:47 AM, Altostrata said:

A sharp knife will do it. You'll want to be more precise at lower dosages.

Well, I now have a week's worth of 34.375mg(or thereabouts) pills lined up. We'll see how this goes. 

[Combitone]

Already, my itching around the eyes is noticeably worse, my arms also itching and full body chills. Perhaps cutting the 12.5mg pill is causing this, because cutting up XR pills apparently makes the dose immediately release itself. I am not entirely sure how to react to this development

[Altostrata]

On 6/19/2021 at 12:37 PM, Altostrata said:

I would be concerned about the high potential of an allergic reaction to venlafaxine. As noted earlier, 37.5mg may be too high a dose. Suggest you lower it a bit, such as to 35mg. Adverse reactions tend to decrease as dosage decreases.

 

Are you taking capsules filled with tiny beads?

 

FYI Tips for tapering off venlafaxine (Effexor)

 

You may wish to request your prescription be filled with a brand that is a capsule filled with tiny beads, so you can taper by taking out the beads. The beads themselves have the timed-release coating, as do the mini-tablets, but as you have observed, cutting up a mini-tablet may cause the drug to be released faster and beyond the tolerance of your allergy to the drug.

 

The alternative is to reduce by one whole mini-tab, but given your prior withdrawal problems, this may trigger withdrawal again. However, it probably will lessen the allergic reaction.

[Combitone]

Hi all,

 

I'm in protracted stabilisation (is that a phrase? I'm still on Effexor) after a dreadful taper attempt early last year. More details are in my signature, but the short version is that I've been trying to stabilise on one XR 37.5mg capsule per day since an ill-advised reinstatement mid-June last year. I intend to taper again extremely cautiously once I achieve some sort of balance.

 

However, I am experiencing really bad suicidal ideation at the moment. It was not great beforehand, but I went on a trip away with friends for a few days this weekend, where despite them being people I like being around, I was experiencing horrible internal meltdowns which occasionally became visible externally. On the journey home, I was in the grip of the worst suicidal ideation I've yet had, as it seemed even a break I should enjoy couldn't offset the general turmoil I'm experiencing. It's exhausting and frightening.

 

I have a support structure in place, so I'm wondering to what extent this mirrors other peoples' experience of attempting to stabilise long-term...?  It's so difficult to know what is you, and what is the drug.

[Combitone]

I'll put this here for the sake of posterity, because it didn't really garner any answers where I posted it. The suicidal ideation is getting pretty serious, and I'm busy searching for enlightenment as to how much of it can be apportioned to the Venlafaxine.

 

My signature med info has been updated after accessing my medical records from 2004 onwards.

---------------------

 

Hi all,

 

I'm in protracted stabilisation (is that a phrase? I'm still on Effexor) after a dreadful taper attempt early last year. More details are in my signature, but the short version is that I've been trying to stabilise on one XR 37.5mg capsule per day since an ill-advised reinstatement mid-June last year. I intend to taper again extremely cautiously once I achieve some sort of balance.

 

However, I am experiencing really bad suicidal ideation at the moment. It was not great beforehand, but I went on a trip away with friends for a few days this weekend, where despite them being people I like being around, I was experiencing horrible internal meltdowns which occasionally became visible externally. On the journey home, I was in the grip of the worst suicidal ideation I've yet had, as it seemed even a break I should enjoy couldn't offset the general turmoil I'm experiencing. It's exhausting and frightening.

 

I have a support structure in place, so I'm wondering to what extent this mirrors other peoples' experience of attempting to stabilise long-term...?  It's so difficult to know what is you, and what is the drug.

------------------------

Edited May 5, 2022 by Combitone
Added extra info

[Greatful]

@Combitone

I want to stop by and let you know that you are not alone with any WD symptoms.  I know how scary and horrible it is when we feel so bad.  I see you have been pretty quiet for several months, how are you doing?

 

[Combitone]

On 6/18/2022 at 3:46 PM, Greatful said:

@Combitone

I want to stop by and let you know that you are not alone with any WD symptoms.  I know how scary and horrible it is when we feel so bad.  I see you have been pretty quiet for several months, how are you doing?

 

Well thanks, I appreciate you dropping by. I hope things are good for you, whatever stage of your journey you're at. In all honesty, things have been very bad since my last post. It's been a long while since I brought this thread fully up to date, so now is a good a time as any.

 

I still have no real idea what stabilisation looks like. Is it a vast improvement, or simply a consistent state, whether bad or good? There are so many factors in the mix - some circumstantial, some medication-related - that it's difficult to separate out what is truly happening with me, but I do feel that the long-term effects of the taper and reinstatement, plus the venlafaxine dose I'm currently taking serve to magnify every issue I come across. It seems like stress makes the cluster of symptoms I have come to associate with this medication much more debilitating, and coupled with the fact that my experience with the taper and reinstatement in 2021 made it impossible to work for a long while, it left a lot of anxiety attached to returning to the workplace. Any money I brought in during that period was through selling off a huge amount of personal stuff, and my savings were pretty much devastated from picking up the slack. 

However, the period from March to the end of May should have been a triumph, as I scored a contract for some high-end sound design work. I did recognise this as an opportunity to finally get back on track, and the importance of that lead to putting a lot of pressure to make a good job of it on myself. For the first month though, that stress reacting with the meds made me very nauseous and itchy on a daily basis. I'm frankly amazed I managed to get the work done, but I did, and it was largely well-receieved. That should be a triumph, right? However, about 6 weeks in, I got very despondent and while therapy helped me pinpoint some reasons, it was a little puzzling. I didn't expect having a great job to suddenly solve everything, but even so, I was surprised that it didn't buoy me up for longer.

 

About two months in came the trip I mentioned in the last post, which on paper should've been something of a victory lap after being in the doldrums for so long. I was feeling dreadful by that point and probably should not have gone, but as sometimes happens, going and seeing friends pulls you out of a funk, so I went. Unfortunately, I was distressed and melting down for the majority of the time there, so it got somewhat ruined for them as well. On the journey back, I felt like I'd absolutely reached the end of the road. If two things I'd wanted most - to get back into the workplace, at a higher level than I'd been before and succeeded at, and to spend more time with friends who cared about me - resulted in this, where else was there to go? I felt like a suicidal end was inevitable. It felt more assured than it ever had been before. Nonetheless, I finished out my contract. The reason I'm still here is I don't truly want to die, I just don't know what else to do. I don't want to feel like this every single day, and with hope at such a low ebb, back then was the first time I had zero ideas going forward.

 

Currently, I only really have the notion of finding a way to reduce the physical effects as a guiding light. Being nauseous and itchy every day is getting extremely old. As such, I'm looking into the possibility of a low histamine diet, and also appraising a network of psychiatrists I've been picking up on in my country (UK) that are especially vocal about antidepressant side effects and the dangers of tapering. I may go for a consultation with one if I can separate the academics from practicing ones. Perhaps a suggestion exists to curb these effects, and I'm at the point I'd consider nearly anything.

[Ariel]

@Combitone

I'm sorry you're going through this. 

 

1 hour ago, Combitone said:

If two things I'd wanted most - to get back into the workplace, at a higher level than I'd been before and succeeded at, and to spend more time with friends who cared about me - resulted in this, where else was there to go?

 

I can relate to this line of inquiry. I've experienced similar "paradoxical emotional reactions" to events that I've rationally felt good about. 

 

@Dan998wrote something memorable that really helped me. You can find the original posts in Dan's success story, but I'll copy-paste the salient point here: 

 

I should probably point out that while it is true that our brains grow and learn from being exposed to new stimuli. Which is usually reinforced by a dopamine reward when we accomplish a goal. It is important to remember that brains in withdrawal often react completely differently. There will be short circuits, chemical messengers may not bind with their targets properly, and all sorts of other unexpected stuff will be going on. This usually means that withdrawal brains tend to inappropriately trigger a fear response when exposed to anything new or unexpected. The brain during withdrawal needs to be handled very gently. Requiring; quiet, calmness, stability and consistency. 

 

The idea being that even though you got back into the workplace and went on a trip with friends, both of which you wanted, your brain and nervous system reacted in unexpected ways. You didn't feel about it the way one might expect to feel. That's normal in WD as our brains are healing and figuring stuff out (sometimes I think: my brain is reinventing the wheel right now. I also get this image of a switchboard operator new on the job, trying to learn where and how countless wires connect). 

 

I believe the most important aspect is that you actually did take that job, you completed it, and you did well. That's HUGE. You went on that trip with your friends, you showed up and stayed and put in the time. That's a BIG DEAL. Please give yourself all the credit for having taken on these major challenges (however much you wanted them they are still challenges) and seen them through.  You are very brave and incredibly strong. 

 

I have complete confidence that your taking these steps has benefited your brain and contributed to your healing; it's just that you don't yet consciously feel it. But healing is happening all the time, the brain and body and nervous system are working around the clock to recover, even if we are not aware of it. It's one of those things where we may be the last to get the memo, so we have to hold space and have faith and trust in the process, that healing is happening even when it hurts. 

 

Another thing is that the WD body does not discern between stressors. A happy, welcome stressor is still a stressor, and you might view the gig and the trip as two major stressful events. Even though you wanted to be there, the events were taxing to your system and that strain was palpable. That doesn't mean it wasn't a good thing in the bigger picture. After all, when we are working out to build muscles, we are actually stressing our muscles and causing tears that are then repaired, and it's in that repair that we gain strength and grow muscle (something like that, anyway). Not a perfect analogy but I hope you know what I mean. 

 

Do you know this essay, What is happening in your brain?

I find it very useful to help conceptualize some of what may be going on behind the scenes neurologically, physiologically; which helps me accept why I might be feeling so off as part of this unfathomable experience. 

 

Hang in there, Combitone. I know it can feel so, so impossible, but you're doing it. You're working hard and you're doing a great job. It gets better!

Healing is happening all the time, even when we don't consciously feel it. 

 

In solidarity and support,

A. 

 

[Greatful]

@Combitone

I feel for you and all of us that are witnessing the damage the drugs have done to us. Not much more I can say differently then what  @Ariel has said.

 

2 hours ago, Combitone said:

I may go for a consultation with one if I can separate the academics from practicing ones. Perhaps a suggestion exists to curb these effects, and I'm at the point I'd consider nearly anything.

I would love to hear what they have to say?  Thank goodness  the UK is becoming more involved or starting to look at this issue.  My guess is that it will be a guessing game for them too.  There just isn't enough studies to really understand the whole thing.  The movement is just getting started,  now how do we keep pushing the issue forward before big Pharma  shuts it down.  Just enough so called studies to get the drugs on the market.   Funny they were only meant to used for short term use, so how do we get off? 

 

Please keep putting on step in front of the other.  You are not alone. 

[Roserdl]

Have you seen any improvements with your reinstatement?  Any better periods at all? Have you been muscling through the whole way?  

 

It would be great if you could find a functional psychiatrist or physician to help you.  

 

You have done amazing to work and even attempt to travel and successfully take on new work. 

 

So sorry you are struggling.  You are not alone. 

[Combitone]

On 6/24/2022 at 8:34 PM, Greatful said:

@Combitone

I feel for you and all of us that are witnessing the damage the drugs have done to us. Not much more I can say differently then what  @Ariel has said.

 

I would love to hear what they have to say?  Thank goodness  the UK is becoming more involved or starting to look at this issue.  My guess is that it will be a guessing game for them too.  There just isn't enough studies to really understand the whole thing.  The movement is just getting started,  now how do we keep pushing the issue forward before big Pharma  shuts it down.  Just enough so called studies to get the drugs on the market.   Funny they were only meant to used for short term use, so how do we get off? 

 

Please keep putting on step in front of the other.  You are not alone. 

Yes, true. At least they will be slightly more educated guesses, though. Eighteen long months since the taper process started has worn me down, and while I'm aware from some terrible stories on here that recovery can take years, I couldn't honestly say that I've felt any genuine improvement since twelve months ago when the worst effects of the reinstatement/kindling slackened off. The windows haven't gotten larger or more frequent, so I'm finally willing to gamble a little again.

 

If there's anything I wish is that the profile of the movement continues to raise within the mainstream media. Working towards long-term change in the actual industry is a worthy goal to keep in sight, but in the short-to-medium-term, increasing the likelihood of getting this information in front of people before they either start taking meds, or tapering improperly is invaluable. My only regret is that I stumbled blindly into this by trusting my GP, as I'd not experienced issues with other meds, and only found out about these communities way after my reinstatement. Now that I see articles on it appearing in major newspapers and from major broadcasters, it could really people in a similarly blissful ignorant state before doing something irreversible.

[Combitone]

On 6/24/2022 at 7:48 PM, Ariel said:

@Combitone

I'm sorry you're going through this. 

 

 

I can relate to this line of inquiry. I've experienced similar "paradoxical emotional reactions" to events that I've rationally felt good about. 

 

@Dan998wrote something memorable that really helped me. You can find the original posts in Dan's success story, but I'll copy-paste the salient point here: 

 

I should probably point out that while it is true that our brains grow and learn from being exposed to new stimuli. Which is usually reinforced by a dopamine reward when we accomplish a goal. It is important to remember that brains in withdrawal often react completely differently. There will be short circuits, chemical messengers may not bind with their targets properly, and all sorts of other unexpected stuff will be going on. This usually means that withdrawal brains tend to inappropriately trigger a fear response when exposed to anything new or unexpected. The brain during withdrawal needs to be handled very gently. Requiring; quiet, calmness, stability and consistency. 

 

The idea being that even though you got back into the workplace and went on a trip with friends, both of which you wanted, your brain and nervous system reacted in unexpected ways. You didn't feel about it the way one might expect to feel. That's normal in WD as our brains are healing and figuring stuff out (sometimes I think: my brain is reinventing the wheel right now. I also get this image of a switchboard operator new on the job, trying to learn where and how countless wires connect). 

 

I believe the most important aspect is that you actually did take that job, you completed it, and you did well. That's HUGE. You went on that trip with your friends, you showed up and stayed and put in the time. That's a BIG DEAL. Please give yourself all the credit for having taken on these major challenges (however much you wanted them they are still challenges) and seen them through.  You are very brave and incredibly strong. 

 

I have complete confidence that your taking these steps has benefited your brain and contributed to your healing; it's just that you don't yet consciously feel it. But healing is happening all the time, the brain and body and nervous system are working around the clock to recover, even if we are not aware of it. It's one of those things where we may be the last to get the memo, so we have to hold space and have faith and trust in the process, that healing is happening even when it hurts. 

 

Another thing is that the WD body does not discern between stressors. A happy, welcome stressor is still a stressor, and you might view the gig and the trip as two major stressful events. Even though you wanted to be there, the events were taxing to your system and that strain was palpable. That doesn't mean it wasn't a good thing in the bigger picture. After all, when we are working out to build muscles, we are actually stressing our muscles and causing tears that are then repaired, and it's in that repair that we gain strength and grow muscle (something like that, anyway). Not a perfect analogy but I hope you know what I mean. 

 

Do you know this essay, What is happening in your brain?

I find it very useful to help conceptualize some of what may be going on behind the scenes neurologically, physiologically; which helps me accept why I might be feeling so off as part of this unfathomable experience. 

 

Hang in there, Combitone. I know it can feel so, so impossible, but you're doing it. You're working hard and you're doing a great job. It gets better!

Healing is happening all the time, even when we don't consciously feel it. 

 

In solidarity and support,

A. 

 

Thanks for passing this on. That's interesting, because finding solace in achievements was difficult even before the taper when I was technically stabilised. How much of it is me and how much is the med is something I'm now pondering, because memories of how things were before I started taking it are a little fuzzy. Additionally, I've been bouncing between different ADs for decades, so who even knows what normal is?

[Ariel]

6 minutes ago, Combitone said:

Thanks for passing this on. That's interesting, because finding solace in achievements was difficult even before the taper when I was technically stabilised. How much of it is me and how much is the med is something I'm now pondering, because memories of how things were before I started taking it are a little fuzzy. Additionally, I've been bouncing between different ADs for decades, so who even knows what normal is?

 

Unexpectedly/paradoxically lackluster reactions might be related to emotional blunting, anhedonia, emotional anesthesia, apathy, avolition, etc., all of which are common side effects of ADs and common symptoms of WD. These drugs can dull one's emotions and cause a feeling of numbness. 

Many neurotransmitters are involved in our feelings of pleasure and reward (just as they are involved in other emotions), so it's not improbable that these feelings could be affected by AD use while on them and while healing from them in WD. 

[Combitone]

On 6/24/2022 at 10:17 PM, Roserdl said:

Have you seen any improvements with your reinstatement?  Any better periods at all? Have you been muscling through the whole way?  

 

It would be great if you could find a functional psychiatrist or physician to help you.  

 

You have done amazing to work and even attempt to travel and successfully take on new work. 

 

So sorry you are struggling.  You are not alone. 

Thanks for the post. I've been muscling through, really. Unfortunately, the reinstatement (which is about 13 months ago now) made things way worse, as I'd been at 0mg from the taper for 5/6 weeks, and I think my body had sensitized by then. Reintroducing a med really stirred the pot, and in the absence of good information, I simply decided to stick with the dose for fear of further changes making things even worse. It was after that experience I discovered SA, The Withdrawal Project and scattered support groups around Reddit and Facebook.

[Roserdl]

I see.  Are you starting your taper now or going to hold out to stabilize?