Techniques for Managing an Adverse Drug Reaction or Cold Turkey Withdrawal

[Scrountz]

I thought I'd write something up for the CT/ADR crew, as those who are tapering are often able to manage their symptoms well through a gradual hyperbolic taper. For those of us cast out to sea, so to speak, and with no choice but to endure suffering, I think the only thing we have control over is our attitudes and our relationship to what we're experiencing. This means that though we have no choice over what we experience, we have the power to decide whether we suffer it. 

 

I may only be 30 days into my ADR experience, but I think given the intensity of my symptoms I've done remarkably well. Part of the reason that's the case is that I'm already well versed at managing suffering by virtue of struggling with CPTSD. One of the most helpful resources I found in my trauma recovery has been Pete Walker's 13 Steps for Flashback Management. I feel Pete's strategies could similarly be helpful for those suffering symptoms from Withdrawal/ADR. CPTSD flashbacks often resemble Withdrawal/ADR symptoms in their overwhelming and intense quality, and are similarly difficult to assign meaning to. Pete's steps help people to endure and manage their suffering, and support people to develop a healing attitude towards a complex and often lifelong syndrome. 

 

So here I present to you, adapted directly from Pete's steps,  Scrountz's 10 Steps for Managing Withdrawal/ADR Symptoms:

 

1. Say to yourself: "I am experiencing a symptom."

Its important when symptoms arise to name them what they are. When in a wave it is easy to lose perspective and believe that what we are experiencing is a sign that we are going crazy, mentally ill, that our brains are broken, or that we are dying. Symptoms are not characterological defects, nor are they signs of a deeper problem. Symptoms are time limited experiences that will gradually resolve. When you name what you are experience as a symptom, you are reinforcing what is real.

 

2. Remind yourself: "I would not be feeling this way if it was not for the medication."

Withdrawal/ADR symptoms are compelling and have a tendency to pull us in to a unique physiological reality characterized by interminable suffering. Neuro-emotions, ruminating thoughts, and unrelenting physical ailments feel so real it is sometimes hard to believe that we are experiencing is drug induced. Falling into this pit can send us into a spiral of googling symptoms, experimenting with remedies and endlessly theorizing about our condition. Reminding ourselves that it is the medication (or for withdrawal, its absence) that is causing this experience grounds us in the appropriate context for recovery. When we remind ourselves it is the medication, we open the door to taking the right action to promote recovery. 

 

3. Own your right and need to have boundaries

Remind yourself that you are injured, and have a right to do what is necessary to heal. Respectfully communicate to others when you are distressed/overwhelmed/debilitated and need space or freedom from responsibilities that may burden your already over-sensitized nervous system. Own your right to take care of yourself and put your wellness first. Remove or reduce distressing factors in your environment and focus on finding a space for you that is safe and conducive to healing. Remember you are free to leave overstimulating situations and to protect yourself from the dismissive behaviour of others. 

 

4. Seek reassurance

When symptoms arise, they can be incredibly distressing and debilitating. Many people in withdrawal feel as though their lives are ruined and they may never feel better again. Seek reassurance from loved ones and compassionate others to remind you that you will heal in time. Call your parents, talk to your spouse, connect with your counsellor, or phone a friend. Journal in your introductory topic or reach out to other members of this forum. Find whoever you can to reassure you things will get better. Often just hearing that from someone else is enough to provide some strength to keep going. 

 

5. Deconstruct eternity thinking

Withdrawal/ADR symptoms are incredibly compelling. Often when a wave of symptoms arises, one feels they will always feel this way forever. I know for me, when a wave of depression hits, I have a hard time believing it won’t last forever. The reality is that symptoms change over time. Recovery follows an unpredictable course, yet no feeling is final. Waves will always end eventually. Remind yourself that symptoms are not forever, and you will feel differently eventually. Symptom journals can be incredibly helpful in this regard, as when eternity thinking sets in, you can revisit past journals to see how your experience has changed over time. 

 

6. Remind yourself of the resources you have

While time is the only factor that truly resolves Withdrawal/ADR symptoms, there are numerous resources available to help with coping and reducing symptom severity. When distressing symptoms arise, remind yourself of the resources you have to cope. It can be helpful to make a list of the things you find helpful in managing symptoms (for me it's talking with loved ones, journaling, Qigong, Acknowledge/Accept/Float, CBT exercises). In withdrawal/ADR, you are out of control but you are not powerless. There are ways to increase comfort and help manage your experience.

 

7. Ease back into your body (this is copied verbatim from Pete’s flashback management as it is just as applicable to us)

• Gently ask your body to relax: Feel each of your major muscle groups and softly encourage them to relax. (Tight muscles send unnecessary danger signals to the brain.)
• Breathe deeply and slowly. (Holding the breath also signals danger).
• Slow down. (Rushing presses the psyche's panic button.)
• Find a safe place to unwind and soothe yourself. Wrap yourself in a blanket, hold a stuffed animal, lie down in a bath, take a nap
• Feel the fear in your body without reacting to it. Fear is just an energy in your body that cannot hurt you if you do not run from it or react self-destructively to it.

 

8. Resist drasticizing and catastrophizing

Withdrawal/ADR symptoms throw us into a state of high distress, where it is easy to begin catastrophizing (believing the world is ending) and drasticizing (believing that something needs an immediate and severe response). It’s important to forcefully resist this, as this kind of thinking only serves to increase distress and reinforce the notion that recovery is not possible. Use whatever strength you can to push back against this thinking, reminding yourself that symptoms are not life threatening, and that this is not forever. CBT techniques that challenge catastrophic thinking are particularly helpful in managing this dimension of symptoms. 

 

9. Allow yourself to grieve

Withdrawal/ADR can be a debilitating, life altering experience that has robbed some of us years of wellness and prosperity. For many the loss of a sense of safety and trust in the medical system leaves one feeling existentially exposed. The symptoms of withdrawal/ADR can impact our relationships, sense of self and life direction. It is important to leave space to express the healthy feelings that come up as a result of this demoralizing, often traumatic experience. Pain, sadness, anger, despair and anguish all have a place in the recovery process. Give yourself permission to express whatever feelings are present in relation to the inevitable loss that withdrawal.

 

10. Be patient with a slow recovery process

I was sobered when I read on this site that recovery takes longer than you’d like. The truth of iatrogenic injury is that there is no clear timeline for anyone’s recovery process. Everyone experiences a unique healing trajectory, with some going very slowly and others experiencing more rapid progress. Whatever the pace, it is important to be patient. You simply cannot rush your healing. Most of us will be at this for months or years. Raging against this fact only engenders needless suffering. Though in many ways the hardest step, this is the most important, and feeds back positively into the other steps. If you can take things one day at a time, you’re more likely to successfully manage your symptoms as they arise. If you’re fixated on getting well NOW, you’re less likely to do what's actually helpful (see steps 1-9).

 

This list is far from exhaustive. I’d love to hear from the collective wisdom of this forum about other necessary “steps” in coping with hard symptoms. 

 

[Onmyway]

I would like to add my favorite advice here as well mostly from my observation over time on the forum. 

 

11. Decide quickly if you would like to reinstate especially if your CT was recent.  A trial with a 0.5-1mg of the medicine is lower risk than full reinstatement and reinstatement does not always work. But it can sometimes help quite a lot. [Note that anything that is not done at the 10% every 4 weeks rate is akin to CT to our brains]

 

12. Do not try to solve the problem with  different drugs or combination, supplements.

This often leads to worse outcomes as your nervous system is sensitized and sensitized nervous systems do not react well to psychoactive drug/supplement introductions. Especially beware of adding benzos, sleep drugs etc. Melatonin, magnesium and Omega-3 are OK for most people. We recommend the latter two. 

 

13.  Beware alcohol. It is known to set people back quite a lot in withdrawal. Sometimes years back. Beware pot or things that claim to increase serotonin/GABA etc etc. 

 

14. Do not blame yourself if you CT-ed on your own. Blame is best placed on doctors and the system for prescribing these in the first place but it rarely helps as it fuels anger and emotional spirals. Try to look forward. 

 

15. Accept that this is how things are. This is easier said than done but the sooner you come to this place the sooner you will turn a corner. Withdrawal has its own logic and timeline. Only patience and calm help with it. Accept your symptoms - the more you try to fix the symptoms, the more frustrated you get; the more you wish that this was different, the angrier you get; the harder the striving, the harder this journey. I don't mean be happy about your symptoms or where you are but a gentle acceptance and self compassion for where you are is powerful. If you are having trouble sleeping - accept that this is how things are going to be for a while, once you stop trying to fix it, your sleep might actually improve. If you are having cognitive issues, accept that this is how things are going to be. Once you relax into that, you may find yourself better able to focus/understand. This is hard! Try it anyway!

 

16. Give yourself a break. This is possibly the hardest thing you will do in your life. Be gentle to yourself when you can't be at your previous best. Treat yourself well - get a massage, take time off to enjoy yourself. Being kind to yourself may be a difficult experience for some but do it anyway. 

 

17. Reframe this experience as a learning experience. Likely for the first time there won't be a quick fix for your emotions and you will have to face them head on. This will be terrifying. You may have depths of despair you didn't know before. You may feel agitation you didn't know was possible. You may not be able to sleep for a few nights. You may have symptoms that are scary. You will learn that you can get through them. You are, in fact, capable of facing these hardships and coming through. You will realize, likely for the first time, how much you are capable of enduring and overcoming. This is powerful. You may not have control over what happens to you but you will be surprised by what you can deal with. 

 

18. Use this time to learn ways to manage your emotions - you may want to do CBT, you may want to start a mindfulness or meditation practice, you may want to get into therapy. We do not recommend exploring deep traumas to process them now but if they are already giving you a hard time you may as well deal with them. CBT is a gentle way of dealing with unhelpful thoughts and would generally not cause as much upheaval as trauma therapy. Mindfulness does help rewire your brain if practiced consistently to the best of your ability. 

 

19. Forgive yourself for failing your family's, your own or society's standards of how capable/productive/well you should be. Forgive yourself for all kinds of trespasses you think you may have committed, for all kinds of failures you attribute to yourself, for all kinds of imagined shortcomings. Accept yourself radically and lovingly. Wipe the slate clean. Rehashing old mistakes is a common WD symptoms. It is not useful to ruminate over past wrongs. You might imagine that if you do this you will learn something etc. No. You will just make yourself suffer. 

 

20.  Help others. This is often overlooked as a healing technique but it is powerful - when you are at your worst suffering, extend a kind word to a fellow sufferer here. Offer support, commiserate. Focus on others. This will get you out of your head and out of your symptoms. It will connect you to others and invite kindness back. It will make you part of the community. 

 

YOU WILL HEAL if you let your nervous system do its own thing. NO, YOU ARE NOT THE EXCEPTION that won't heal.  YES, YOU! YOU TOO will heal. 

 

It will be lovely if more people add their hard earned wisdom to this thread. 

Edited February 13 by Onmyway