Givemepeace: So confused, feel like giving up.

[Givemepeace]

Every morning about 10am I get this intense shaking fits that will then wax and wane during the day. Can't stop shaking now!!!

 

I read on a benzo withdrawal site that you should steer clear of antihistamines and they can cause severe agitation when in benzo withdrawal.

 

Doesn't the mirt contain this, could it be this causing problems.

 

Please help me guys, don't want to end back at doctors.

[Givemepeace]

I don't know fresh, so many drugs involved up till October I don't know what to do.

[Fresh]

I hope Alto can advise GMP.     I just sent you a message with my wd story.   I'd hate you to suffer like that.

[Fresh]

GMP , none of the thoughts or sensations can kill you , they're just part of the withdrawal process.     Try to distract yourself any way possible.   Take a bath , do household jobs , watch animals on you-tube , anything.     On ang's thread , btdt has posted some lovely relaxation/meditation tracks , try listening to them.   Try not to let yourself worry , everything you've described is "normal" in withdrawal.

I hope you get some sleep tonight ,    xxx

[Givemepeace]

Thinking about increasing the mirtazapine.

 

I need to try and function for my family.

 

My symtoms are daily morning terror, then body shakes and agitation, apathy then dreadfull depression in afternoon.cant eat all day till late evening which is a little better. This is everyday without much change since November.

The only symtom that has calmed down a lot is the intrusive thoughts( just fleeting now not as strong)

 

As well as finishing my valium taper which I know is a hell of withdrawal in itself.

I was wondering if my 3 months of escitalopram really upset things of which I did fast taper.

 

Do I need a bit more mirt to help ??

 

Any one have any thoughts? Any mods??

[ten0275]

GMP,

 

I am sorry you are struggling, brother.

 

I am going to cast my vote for not increasing the mirtazapine. Based on the symptoms you are experiencing, I don't see crossing that 15mg barrier on the upswing as being beneficial to you. The general rule of thumb is above 15mg for depression, below 15mg for anxiety. I fear that you raising your dose could serve to rev your system - something you absolutely don't need.

 

I would be curious if Alto would advocate a cut actually. If you are not stabilizing on 15mg, perhaps it is too much. I know I didn't truly start stabilizing on the Mirt until I got below 10. And things were very, very much improved around 7. The sedative effects of Mirtazapine increase as you decrease in dose. So technically, 7.5mg is more sedating than 15mg. Moderators please weigh in on possible directions for GMP.

 

Hang in there, G. You're not alone. You will function for your family. And be thankful those intrusives have mellowed. Don't ever forget how terrifying those are. That is big stuff that that symptom has actually abated. That is some healing on display.

 

In solidarity...

 

Dave

[Givemepeace]

Thanks ten, I feel the depression comes from this horrendous morning ritual of intense anxiety, morning terror, agitation, confusion just extremely ramped!!!

 

By the end of the day I am mentally exhausted, and seem to just crash and feel mentally numb/depressed that I have survived another day.

 

Then a little easier/normal late evening before my next dose.

[ten0275]

GMP,

 

Do you find it interesting that things mellow right before your dose - in the evening? The very same pattern applied to me at the higher doses. This is perhaps another indication that 15mg could be further revving you. Again, I would probably wait for Alto or a mod to weigh in. But I believe somewhere, and I have been looking without success to this point, that Alto did once reccomend a cut to stabilize someone on the Mirt. I will keep looking for that.

 

In the meantime man, really - hang in there.

 

Dave

[Fresh]

GMP ,    I didn't realize you have been tapering valium.   Of course that wouldn't have helped !!  

 

What has the course of the valium taper been , dates , doses etc.

[Altostrata]

GMP, you've been getting excellent advice from the mods and others. Thank you, ten0275 and Fresh for being such a good friend.

 

My guess is you are experiencing benzo withdrawal syndrome, plus your system was over-stimulated by the escilatopram. It can take many months for these symptoms to very gradually fade. It's only been about 2.5 months for you.

 

You are having waves and windows. This is a good thing. You are sleeping. That is a very good thing. Many people also have a grueling sleeplessness on top of all the other symptoms.

 

I know it's hard not to think of a pharmaceutical solution, such as adjusting your mirtazapine dose. Given its half-life of 20 to 40 hours, it's unlikely your morning symptoms are due to rebound from the drug itself.

 

More likely, you've got a typical morning cortisol peak that sets off reactions throughout the early part of the day.

 

If I were you, I would not change the mirtazapine dosage because you're sleeping so well. Have you tried fish oil and magnesium, see http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/
 

These can be soothing. You might want to try Epsom salts baths (magnesium sulfate) in the morning, or sip some magnesium citrate in cold water throughout the day.

 

However, if you are sure you are suffering adverse effects of mirtazapine and you feel you absolutely must reduce it, you might try reducing by 1mg to see if these symptoms lessen. It will take at least 4 days for the new dosage to register in your system.

 

No one can predict what this will do. If it makes your symptoms worse, you will have to cope with them.

[Givemepeace]

Thanks alto and guys,

 

I know it's very confusing, with all that's gone on. My sleep has worsened a little, I am now waking about 4-5am, I was sleeping before till 7-8.

 

I remember the morning cortisol thing really got bad I last time I messed with the mirt. I dropped from 15mg to 7.5mg after two weeks I got hit really bad and went back up, but the mornings have never improved since. At the time I was on 1mg of valium ( which I had been holding for a while at least 6 weeks) This was in early August.

 

It's wierd how memories come back, I remember taking St johns wort in my early 20's and reacting with this kind of feeling, I think I only took it for a day!!!!

 

I guess I will hold a little longer and see if there is any change while I learn how cut my 15mg tablet by less.

 

What is the best way of cutting these tablets?

 

G

[Fresh]

Good on you GMP.     The last time you :messed with the mirt"  you did a 50% decrease , and you know now that's too much of a cut.

Check out the tapering section , I'm sure there's a thread specifically about Mirtazapine there.

Nice to see you're a little more calm at the moment ... I'd call that a window  ; )

[Givemepeace]

Things are still very intense for me, looking at my journal I feel like things are worsening.

 

I have become very afraid (slightly agoraphobic)

Can't manage to work today.

Agitation and panic

Crushing depression

Sleep has got worse over the last week (been awake since 2.30 am

Numbness

 

I will not contemplate ri valium, (3 months out today) that was my catalyst for more meds and was never well on it ever.

 

Still on mirt 15mg, but am now wondering if I am suffering from my basic c/t of 3 months use of escitalopram (2months 3weeks off today) could a slight ri of this help or would it be best to just ride this with the 15mg mirt alone.

 

G

[Fresh]

So sorry to hear it's getting harder GMP.    It's 11 weeks since you stopped escitalopram (quickly).   The mirtazapine isn't doing what you want it to in terms of stopping your withdrawal process.

Did you ever try reinstating with a small dose of escitalopram?    

[Givemepeace]

I haven't tried but felt this drug reved me up even worse.

 

I suppose it was a bad thing to try while I was finishing my valium taper.

 

i am really scared about trying this again for it to make matters worse again.

 

The only thing I am hanging on to at the moment is the tiny windows I have had, I just feel though that the windows are getting less.

 

Can these windows fluctuate like this.

 

Can new symtoms introduce themselves like this the further out.

[Fresh]

I'm afraid so GMP.    Lots of people report that their worst symptoms set in between 9 and 12 months , so 4 months out is early days.

 

The mirtazapine hasn't been able to halt the withdrawal.     Escitalopram  (Lexapro) might.

 

I'd give it a try , but I don't know about how you'd discontinue the mirtazapine safest at this point.    I'm sure others can advise.

[ten0275]

GMP,

I'm going to toss my two cents in and be fairly blunt about it: No.

As counterintuitive as it may seem to do nothing right now, that is exactly what you need to do. As Alto expressed, you are almost certainly experiencing benzo withdrawal syndrome. Every symptom you are describing is a textbook symptom:
 

 

I have become very afraid (slightly agoraphobic)
Can't manage to work today.
Agitation and panic
Crushing depression
Sleep has got worse over the last week (been awake since 2.30 am
Numbness

There is no cure for this. None. You can drink the first milk of a brown cow from Drapung Monastery in Tibet in on the 3rd day and 4th hour of March and you will not feel better. You can take a bazillion mgs of GABA, you can come off the Remeron, you can reinstate some other drug, stand on your head and chant to the sun lord - try anything - the truth is, you will not touch it. This is out of your control. It is up to your body to correct itself. And it will. Your GABA receptors have atrophied from Valium use. And until your GABA system comes back online, you are going to be stuck with getting through. It sucks the say it, but that is the truth.

 

Trying to magic-pill your way through is what got you in this train-wreck in the first place. I made the same mistake.

You need to do one thing and one thing only right now and it is likely going to be damned inconvenient: you need to endure what you are going through and do nothing to impede that healing of the GABA system. The GABA system is not touched by the Mirtazapine, so the fact that you are still on the Mirt is of little consequence in that department. You'll be in a better position to get off the Mirt when the Valium withdrawal has lessened. Different receptors.

I'm not talking out of some philosophical space, GMP. I came off the benzo, healed from it while still on the Mirt, and am now coming off the Mirt. And I tried to introduce new drugs to hurry it up and tried to reinstate and both failed miserably and set me back. If you want to make the same mistakes I made for the sake of trying, no one is going to stop you. After all, you must make your own choices. But I'd love to see you heal faster than I did by making the better choice of letting your body do its thing without adding new hurdles.

Hang in there.

Dave

 

PS:
 

 

The only thing I am hanging on to at the moment is the tiny windows I have had, I just feel though that the windows are getting less.

 - You are SO lucky to experiece these, you should know that you are fortunate. Consider there are many on here who are without a window at the moment, or have not had one at all.
 

 

Can these windows fluctuate like this.

 - Yes, without question
 

 

Can new symtoms introduce themselves like this the further out.

 Yes, without question

[Givemepeace]

Thanks Dave,

 

I wouldn't say the windows are like feeling normal, just less intense of most symtoms.......would that still be some kind of window??

 

Thanks again Dave, really do need these words.

[ten0275]

GMP,

 

No problem, brother. You are truly healing in a very "normal" and predictable way for someone who is going through benzo withdrawal.

 

So windows are like this: if withdrawal is like getting punched in the face repreatedly by a professional boxer with no gloves on, then windows are like little children crawling all over you and flicking you on the nose and ears. The volume is turned way down. Do you understand? Judge it this way - any downturn in symptoms that allows you to say, "oh, I feel a little better," is a window of sorts. Some of these windows can be very profound where you feel almost right-as-rain, others are more subtle but a release and respite nonetheless.

 

If you hang in there with this, you are going to see the light at the end of the tunnel rapidly approaching. The early signs of your recovery have already presented. People who are not healing do not have windows or anything close to them.

 

Patience is going to be the hardest thing here. Our intuition is always to "fix" things. This is one of those life lessons that not everything can be fixed. Fortunately, this is something that does self-correct. Those debilitated GABA receptors up-regulate and start binding with the GABA the way they did before the Valium messed them up and feeling good becomes a more regular occurence.

 

I don't BS, brother. I promise if I believed or understood anything different for you, I'd dish you the straight dirt. But I lived through the precise type of withdrawal you are experiencing. Please don't make the errors I made. I could beat myself up and call myself dumb for making the choices I made then, but I was desperate and refused to listen to those who told me the way it was. I think Alto nailed what you are going through precisely - and she's seen a load of us come dancing through here.

 

Don't try to fix what truly is fixing itself.

 

Hang in there GMP.

 

Dave

[Givemepeace]

Thanks Dave,

 

You word things brilliantly, I don't suppose 3 months of the other ad helped either, I suppose it could of masked the benzo for a while....but I suppose that's all water under the bridge now.

I need to let go and look forward, but I seem to keep looking back for some kind of fix and like you said there isn't one.....only time I guess.

 

Thanks Dave.

[ten0275]

GMP,

 

Anytime - you know that.

 

And just so you know, this is part of it too:

 

 

I need to let go and look forward, but I seem to keep looking back for some kind of fix

 

It's very normal to do this. Over and over and over. Question after question.

 

You are doing really well, despite the horrific things you continue to feel.

 

Hang in there brother.

 

Dave

[Altostrata]

GMP, ten0275 said it better than I can.

 

Hang in and see if your sleep pattern fluctuates. If so, that is a wave and window effect. Do not panic when you hit a bad spot, remind yourself it's going to go up and down. See

 

Non-drug techniques to cope with emotional symptoms

 

My guess is your nervous system needs stability above all. Adding or changing a drug does not further this purpose. If we knew of a cure in a pill, we would tell that to everyone.

 

I have no idea if more or less mirtazapine would help or hurt. Adjust the dosage at your own risk.

 

The topic for titrating mirtazapine Tips for tapering off Remeron (mirtazapine)

[ten0275]

GMP, hello.

 

How are you holding since we last spoke? I know things were ferocious and turbulent at that time. I hope things have improved for you. When you have a chance, check in and let us know how you are faring.

 

Hang in there, brother.

 

Dave

[Givemepeace]

I've struggled to work this week, feel like things are getting worse but I have also experienced some moments of normalcy if you like, very strange.

 

At the moment I don't know what the day will bring, keep getting these serious waves of fatigue where I just have to lie down. Did you experience this???

I have totally lost all strength, I mean serious fatigue like I can't get up mentally and physically, this is a new one to me.

Also like my body goes numb, and I have no feeling mentally and physically. My day can change by the hour at the moment, apathy, agitation, panic, numb, no feeling, depressed, fatigue.

 

Really starting to think the escitalopram has been the major effect here...I know the benzo is bad also but I was only at .8mg valium last August and slowly tapered off jumping nov. I seemed to have more strength in the so called acute phase. The longer out people improve, I feel the opposite. I know I was only on escitolopram 3 months, but I was on 10mg tapered to 5mg for 2 weeks then off that basically c/t. I've read its a very powerful drug, double the strength of many.

 

Still on the mirtazapine 15mg, don't know weather to updose to try and get me out of this slow slide.

 

G

[ten0275]

GMP,

 

Your first sentence indicates you are still having windows, those periods of "normalcy." Not strange at all. Encouraging and affirming. That is called nervous-system-finding-the-sweet-spot for a moment goodness. And those will get longer and longer.

 

On the fatigue, without exaggeration, I would be with my wife and kids in the evening and literally fall asleep sitting upright on the couch at the end of a day. I don't know what the hell that was all about, but I would say that every day in withdrawal is an endurance event, so exhaustion probably comes with that territory.

 

It doesn't matter in the least what dose of diazepam you were on last August. At one point, you were taking 3mg. Your receptor damage began occurring then. I still think Alto is right on this. And to note, when I jumped from my benzo, things went crazy month 1. Then there was a mellowing for some reason month 2. Then it all roared back to life months 3 to 7. And then the ash began to settle. But that is neither here nor there because your body and brain are different than mine, but the receptors will upregulate nonetheless.

 

You are having windows. I would hate to see you make a change that would shift those small islands of respite. They are going to widen.

 

Hang in there, brother. You are doing the right thing. And you got through another week. You're in a waiting room of sorts. You have to live out the days. That's what it comes down to. Like doing time. But those windows you are having, small as they are, are the bizarre and glorious workings of a healing brain.

 

Dave

[Muddles]

Extreme fatigue is common - I have had this all week to the point of slurring words at times.

 

Hold on to the small windows you have experienced.

 

Hang on in there.

[Givemepeace]

Cheers Guys,

 

I hate this inner dead feeling, don't want to get up,talk, I can't even sit on the couch!!!

 

Losing my confidence, I really feel the escitalopram did this to me with all the emotional crap I'm experiencing, and horrid depression.

 

Never had depression ever before all this but this feeling even scares me.

 

And then there's the poxy mirt I'm still taking, so much for its antidepresent qualitys!! And it's meant to make you eat, I can't stomach anything!!

 

Rant over, sorry guys.

[Givemepeace]

Ok this is where I am still.

 

Feel like I i have worsend, pretty much housebound the last couple of weeks and now can't work. Symtoms are:

Morning terror

Severe fatigue

Terrible depression

Dp/dr

Lost confidence

Intrusive thoughts

Panic

Fear

Can't stomach food till late evening.

Losing a lot of weight

Can't leave bedroom

Killing me to do even small things around house

Uncomfortable inner feeling.

Basically non functional.

 

Things have definately got worse, can't even do household chores now and the windows I was getting early this year has pretty much diminished.

 

Had to see pdoc yesterday, (3 month review) told him I have discontinued valium, and escitalopram.

 

Told him how I was: he wants me to increase mirt from 15to30mg...I am reluctant to try this but then again getting very desperate now, I have lost all strength to fight this.

 

Any thoughts please guys!

[Fresh]

Dearest GMP . . . I'm so sorry to hear this.    I do think you need to try something different.   Although it may not seem possible , it could actually get worse.

 

You've put in a valiant effort , but it's gone too far.

 

You have my full respect for whatever you decide to do.

 

xxx   Fresh

[Martina23]

Givemepeace wait on Dave, maybe he has some ideas, please do not take it yet

[ten0275]

GMP, hey.

i am sorry you are still in the throes of withdrawal. the place you are now is terrible and it is painful. it is the definition of suffering. i understand how frightening all of this is. you have lost control of your body and your mind. that is what happens in withdrawal. when our receptors have decided that they are no longer going to respond to the chemicals we have been bombarding them with, they seize control and they steer the ship until they feel the course is corrected. i need to remind you that there is no rushing this process. you are where you are at. we all hate the lack of control. it is a helpless and frightening feeling.

i still get the sense that you are trying to look at healing as a linear event. and it is not. withdrawal is not linear 99.9% of the time. it's not like a cold or a stomach virus where you get better day-by-day. there are more ups and downs than an amusement park rollercoaster that suddenly veers off into the house of f'ing horrors! people can be fine for a month or two after stopping a drug and get whacked down the road. there are some who have subtle symptoms for the first 8 to 10 months and then get clobbered around the year mark and heal rapidly after that. we are all different, so what your personal story will be - i cannot tell you. but it will be yours.

nothing you are going through is unique. it is unique to you, but for people, including myself, that have gone through withdrawal, what you are experiencing is the "norm." but as these symptoms are the norm, so is healing. which will happen for you.

i cannot tell you what to do. i can only try to appeal to your reason which lies terrified beneath the tsunami that is pounding you. i know that this situation is like having an itch in the center of your back that you cannot reach. it is maddening like that. you cannot reach this itch, my friend. it dissipates on its own.

you know a common line used by doctors worldwide? "you don't need to suffer this way. here, take this, it will help." that is precisely the line that got us where we are. and it is precisely the line that the crack dealer down on 3rd avenue uses as well.

my advice to you would be to not increase your dose of mirtazapine. simply understanding the way mirtazapine acts in the body, going from 15mg to 30mg will be an activating/stimulating change. if you want to activate/stimulate yourself, then 30mg is your way to go. do you know what the slang term is for mixing mirtazapine and venlafaxine? "california rocket fuel." some people combine these drugs recreationally so they can sail through the night and screw like the energizer bunny. to each his own i guess. anyway, i would say if you are getting desperate, i would do as alto floated awhile back. and cut a very small amount. cut. yeah, cut. not increase and stimulate. because anyone who understands the activation properties of mirtazapine knows that the lower you go, the more sedating the drug is. but you still need to be slow. don't go whacking a hunk of the stuff off!

so if anything, i would cut. but holding is the other option which makes me feel more comoftable. i truly think these are your only two viable options. just my two cents. hold or cut. your choice.

but i'll leave you with the below illustration of what you are encountering. i took your symptoms on the right and pasted in Professor Heather Ashton's notation in her manual - The Ashton Manual - which was written based on her clinical study of those undergoing benzodiazapine withdrawal. I bolded them. I did this so you can see that you fit a damned template, man! i know you would prefer fitting the template nearly anything else - but you fit the template of a man experiencing benzo withdrawal syndrome.

i want you to hang in there, man.

dave

Morning terror => Increased anxiety, panic attacks

Severe fatigue => Fatigue, influenza-like symptoms

Terrible depression => Depression

Dp/dr => Depersonalisation, derealisation

Lost confidence => Agoraphobia, social phobia / Depression

Intrusive thoughts => Intrusive thoughts, memories

Panic => Increased anxiety, panic attacks

Fear => Increased anxiety, panic attacks

Can't stomach food till late evening => Appetite/weight change

Losing a lot of weight => Appetite/weight change

Can't leave bedroom => Agoraphobia, social phobia

Killing me to do even small things around house => Weakness ("jelly-legs")/Fatigue, influenza-like symptoms

Uncomfortable inner feeling => Excitability (jumpiness, restlessness) / Increased anxiety, panic attacks

Basically non functional => well... yeah! when all of these symptoms are occuring, it is debilitating.

[Pugknows]

GMP, hang in there. You are healing and you will recover 100%.

[Givemepeace]

I have just had quite an intense discussion with my wife.

 

I thought she would want me to increase my meds (which is the norm) but to my suprise she wants me to get off them. She said in the last 20 months of taking these I have only deteriated.

We also sat and looked back at the last time I was on 30mg of mirt, we realised I was on that amount last June around my mothers birthday with the valium also....at her birthday celebration I was upstairs on there bed having a panic attack because I couldn't handle the party.

 

She said we tried the med route and it hasn't suited me and that the only other route is off sensibly. We've decided we can manage financially for the next 6 months for me to hopefully get stable, stronger and hopefully will be tapering.

 

I'm gonna sit tight for now and see if I can see any signs of improvement.

 

I am sat in the lounge at the moment, I suppose it's a start!!

 

G

[ten0275]

GMP, yo!

 

I am so proud of you, man. It is my opinion that you have made the correct choice. You have seen back to prior experiences and realize that the way out is not backwards in your particular situation.

 

Hang in there. You will get there.

 

Dave

[mammaP]

Hi GMP, I just caught up with your thread and think you and your wife were right to sit down and talk it through. She sounds very supportive and understands all this stuff and that is brilliant. So many here don't have anyone who understands and even have partners who are telling them to get it together or else!  I'm so glad that you have her by your side through this. 

 

I agree that holding is best for now then try a tiny cut.  The mirt is very activating and a nightmare for some people, sadly you are one of them. Dave talks a lot of sense and is very wise, with him and your wife by your side you will get through this. 

[Givemepeace]

Thanks mammap & ten,

 

Yes my wife has been fantastic through all this, at first she thought I would just snap out of it, but now she is starting to understand this alfull illness.

 

She gets up 2 hours earlier each work morning to make sure everything is sorted for our 2 young kids for school because I can't function of a morning, she then commutes to work.

 

There's many a time I sit here thinking I will make it up to her, I also tell her a lot. She celebrates her 40th in March 2016, she has always wanted to visit New York. My hope is to take her and the kids there to celebrate this.

 

Thank you for your kind support today guys. You people are amazing.