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Psychoanalysis and withdrawal


Bonpensiero
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Hi there

 

Just wondering if anyone has experience of undergoing psychoanalysis while going through AD withdrawal. 

 

My withdrawal symptoms are mainly deep depression and despair, much worse than the original depression I took the drugs for in the first place. The problem is that psychoanalysis, far from helping, actually seems to be making me feel worse, to the point where I am just about ready to quit.

 

I am wondering if this is because my CNS is basically in a hyper-raw, hyper-sensitive state due to withdrawal symptoms and the constant analysis of my problems is actually making it harder for my CNS to regain equilibrium.

 

I am familiar with the arguments often made in favour of psychoanalysis: that sometimes you need to feel worse in order to get better. I am also aware that psychoanalysis isn't necessarily supposed to make you feel better (it's analysis, after all, not therapy). Nonetheless I do wonder if now, in the throes of severe withdrawal, is quite the right time to be doing it.

 

So I was just wondering if any one has experience/thoughts around this.

 

Thanks everyone,

Bonpensiero

20mg Fluoxetine daily for 13 years. I did two tapers (both before I found this site). The first, about three years ago, was by breaking open the capsule and reducing the amount of powder. I did that for about 8 months. My doc then told me this was wrong and that, if I wanted to taper, I should use the liquid form. I then went on to the liquid form at full dose and started to taper again. This second taper took about a year, ending in about May this year. Since then, due to bad withdrawal, I have reinstated to 2mg and am just about coping, but not exactly thriving.

 

Update: November 2015: upped reinstatement dosage to 4mg on advice received here. Since then, periods of feeling OK alternating with deep pits of suicidal despair, but the former are just about winning out over the latter. Was seriously considering going back on at full dosage for good, but have so far managed to resist that temptation. 

 

Update Feb 2016: feeling OK, although still not immune from waves of despair and deep depression. Reduced the 4mg by 10% with the aim of eventually getting back down to zero again, which I will be doing very, very, very slowly. Also taking 100mg 5HTP daily, which helps a little.   

 

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I understand what you were saying this is not the time to analyze yourself or judgments or past wrongs. This is the time to be gentle to yourself physically emotionally and mentally and spiritually. We have neuro emotions and any stress or emotion is exaggerated from what our normal self would be.

Started Effexor August 2012 Sept'12-150mg=extreme anxiety Oct'12 cut half-75mg severe wds

Feb 2013 68.5mg. Mar'13- 65mg. Apr'13-59mg. May'13-57mg. June '13-52mg Aug'13 49.75mg.

Sep'13-48.75. Nov'13-47mg Dec'13-45..5mg

May 2014 42mg. Jun'14 40mg (depressive mood started). Aug'14 -40mg/ started brintellix 2.5mg

Oct '14 -39 Nov'14 36.89 Dec'14 34.45

Jan 2015- 31 Feb'15 29mg. Mar'15 26.72. Apr'15 24.48. May'15 22.31mg. Jun'15 20.30mg

Aug'15-18.89. Oct'15 16.96. Nov/16- 16.10. Dec/15- 15mg

Jan 2016-14.22. May'16 11.45. Aug'16-9.60. Sep/16- 8.88mg. Oct/16- 8.39mg. Nov/16- 8.13. Dec/16- 7.89

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Bonpensiero, I moved your new topic here because it's a good general discussion topic.

 

One can learn a lot from the fears and emotional pain that surface from withdrawal syndrome.

 

However, you and your therapist also need to understand that such feelings are exaggerated by the nervous system instability. Few psychotherapists understand this.

 

It can also be harmful to dig into exaggerated feelings of guilt. We need to forgive ourselves and focus on healing rather than raking over and re-experiencing past wounds.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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In my opinion, when in the worst of wd, therapy may only serve to direct your focus onto your (often exaggerated) hurts, fears, regrets ect, and without the proper perspective to deal with what comes up...I dont know. I've never seen therapy as overly helpful during wd, other than helping to keep secondary fears (being afraid of the symptoms of wd) at bay and honestly, these forums help more with that than anything because we understand whats happening, whereas a lot of therapists dont. In all other ways I have found therapy helpful in my own experience, but just not during wd, and I've had therapy in both circumstances.

2 Timothy 1-7 For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.

Effexor 75mg to 262.5mg 2005-2010 for post partum depression

Started having poop out mid 2010, also switched generic brands, then crashed in Dec 2010 (anxiety/ "terror", intense DR, anhedonia, suicidal ideation, chills, insomnia, horrible intrusive thoughts, disorientation, ect)
Rapid "tapered" from 262.5mg Effexor in 3 months

Tried Celexa,Cipralex, then Paxil to deal with wd(this switching made things worse and added akathesia)

Found online support and started tapering Paxil 7 months after quitting Effexor (at this point was having small windows).

Paxil taper: dropped 10% every 4-8 weeks

Year 1 October 2011 to Nov 2012 20mg to 10mg

Year 2 March 2013 to Feb 2014 10mg to 4mg

Year 3 April 2014 to May 2015 4mg to 1.1mg

Year 4 June 2015 1.1mg , dropping by 10% until .5mg, after then dropped by 0.1mg every 5 weeks until 0.1mg.

Finished! Official last dose of 0.1mg on June 15/16

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These are very interesting viewpoints for sure. I am really struggling with this issue. I have been seeing a therapist for most of my life and have had positive results from supportive therapy. 

 

I am currently seeing the same therapist for the past 5 or so years. He has helped me a lot, but he is not versed on antidepressant W/D even though he tells me that he "believes what I feel." The problem is that I am not sure he understands or truly believes in the concept of neuro-emotions. Surely, most people don't, and think we can just control the level of our emotions. 

 

Right now, I truly feel I have no emotional reserves and my emotions are very heightened. I am experiencing some major life issues and, even though, my friends have even remarked that I have a lot going on, I have always been able to manage things without feelings of complete overwhelm. Except, now, I vacillate between irritability/anger and despairs with tears that will not quit. 

 

I do not know how to deal with these things in therapy as I believe that at least some are physical and cannot be helped. I am afraid that, at least some of my heightened emotions, will be seen as "going backwards" and decompensation. Worst of all, my neuro-emotions are confusing to me because I often have a hard time understanding were my "normal" reactions ends and the euro-emotions secondary to W/D begin. If anyone can shed light on this, I would greatly appreciate it.

Username: quitpaxil2015 - Started antidepressants sometime in 1990. Misdiagnosed with Bipolar, but later with thyroid disease in1998 (8 years of being on several different psychiatric meds with several psychiatric hospitalizations). Total thyroidectomy in 1999. At the time, was on 85 mg of Paxil. In 2001, tried to get off Paxil and had car crash due to vertigo and w/d symptoms. Given more psychiatric meds including Prozac and Trazodone to treat SEVERE w/d from Paxil - which is the only reason I still take Paxil. Tried to taper off Paxil again in 2004  - from 25 mg to 20 mg (5 mg cuts) - had to go back on 25 mg on the 10th day of the taper due to inability to function (dizziness, vertigo, motion sickness, crying spells, depersonalization, etc). Currently on Paxil 25 mg and Trazodone 100 mg. Trying to quit Paxil in 2015. April 22, 2015 - Paxil 22.5 mg. May 13, 2015 Paxil 20 mg. June 3, 2015 - Paxil 17.5 mg. June 24, 2015 - Paxil 15 mg. Don't remember  - 12.5 mg. August 5, 2015 - Paxil 10 mg. September 16, 2015 - 7.5 mg (considering going back up - severe anxiety/panic) September 28, 2015 - back up to 10 mg. October 6, 2015  - back up to 15 mg.   :unsure:

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Thank you everyone for your comments and insights.

 

Aberdeen and Altostrata, you seem to be suggesting that, helpful though talking treatments can be in 'normal' (!) circumstances, it is perhaps best not pursued during w/d. 

 

This is interesting, as it suggests that, right when we are most in need of psycho-emotional support and help, that support is not really available, because our CNS is so out of kilter that it renders therapy/analysis ineffective, or less effective.

 

This is troubling, isn't it. When the pain of w/d can be so difficult to bear, to whom/what can we turn?

20mg Fluoxetine daily for 13 years. I did two tapers (both before I found this site). The first, about three years ago, was by breaking open the capsule and reducing the amount of powder. I did that for about 8 months. My doc then told me this was wrong and that, if I wanted to taper, I should use the liquid form. I then went on to the liquid form at full dose and started to taper again. This second taper took about a year, ending in about May this year. Since then, due to bad withdrawal, I have reinstated to 2mg and am just about coping, but not exactly thriving.

 

Update: November 2015: upped reinstatement dosage to 4mg on advice received here. Since then, periods of feeling OK alternating with deep pits of suicidal despair, but the former are just about winning out over the latter. Was seriously considering going back on at full dosage for good, but have so far managed to resist that temptation. 

 

Update Feb 2016: feeling OK, although still not immune from waves of despair and deep depression. Reduced the 4mg by 10% with the aim of eventually getting back down to zero again, which I will be doing very, very, very slowly. Also taking 100mg 5HTP daily, which helps a little.   

 

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in withdrawal, you might need a different therapeutic approach, which sometimes requires a different therapist altogether.  competence is separate from understanding and method---if they cant approach the issue in a way that you feel is adequately constructive, perhaps searching out a more informed or helpful psychologist is in order.

 

after going into withdrawal, i went through a few less than helpful doctors/counselors, but i got a new one in the past 6 or so months that is a lot better.  he never even encountered/heard of protracted withdrawal, but he rolls with the punches and has a genuine interest in increasing his practical knowledge of the subject.  its less psychoanalysis and more mutual musing in our sessions, since i tend to be a more self-responsible patient of sorts, but i think the principle stands that there may be someone more complementary out there for your therapeutic needs.

 

understanding the source of an emotion is not always important or helpful in how you choose to deal with it.  an overwhelming urge or feeling doesnt have to be dismissed or accepted as valid and 'the normal you' for you to find an appropriate way to handle the surge of experience.  withdrawal is more about coping than purely understanding, and i would call into question the appropriateness of defaulting to the practice of 'making things worse to make things better' in a situation where we are already quite on the edge of the precipice.  i have learned and grown a lot through confronting the fears that have arisen in withdrawal, but that is easier and safer to do within a supportive and understanding environment.

 

maybe you cant determine the true cause of everything right now, but your responsibility to yourself is to deal constructively with your situation.  the whys and hows and ifs are less material.  therapists have to be able to see the multi-dimensionality inherent to the condition of a person with medication-induced neurological dysregulation, otherwise separating the 'self' from the 'symptoms' cannot be done so well.  my treatment right now is basically just 'talk therapy', because everything else i can do is already being done, and it helps to have someone to converse with about life when friends and family might be more skeptical or distant.

from 2005-2012, i spent 7 years taking 17 different psychotropic medications covering several classes.  i would be taking 3-7 medications at a time, and 6 out of the 17 medications listed below were maxed or overmaxed in clinical dosage before i moved on to trying the next unhelpful cocktail.
 
antidepressants (SSRIs, SNRIs, NDRIs, tetracyclics): zoloft, wellbutrin, effexor, lexapro, prozac, cymbalta, remeron
antipsychotics (atypical): abilify, zyprexa, risperdal, geodon
sleep aids (benzos, off-label antidepressants & antipsychotics, hypnotics): seroquel, temazepam, trazodone, ambien
anxiolytics: buspar
anticonvulsants: topamax
 
i tapered off all psychotropics from late 2011 through early 2013, one by one.  since quitting, ive been cycling through severe, disabling withdrawal symptoms spanning the gamut of the serious, less serious, and rather worrisome side effects of these assorted medications.  previous cross-tapering and medication or dosage changes had also caused undiagnosed withdrawal symptoms.
 
brainpan addlepation

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Dear InvisibleUnless

 

Thank you for your thoughtful comments. You seem to be suggesting that, in withdrawal, we need to deal with the here and now, with what's right in front of us, rather than analysing and looking for root causes. And you may be right. But then, why do we get ill in the first place, if not for deep-rooted causes and events that lie long buried in the past? Obviously genetics may have some role to play in our getting ill, but I've never met a mentally ill person who didn't have difficult issues in their past or problematic cognitive patterns.

 

It seems to me that, if one is to address one's illness, one has to be willing to look at its root causes and origins. I've done the 'deal with the here and now' approach, principally through CBT and partly with psychotherapy. It does work, but only up to a point. At the end of the day, you really have to look as a little deeper. The problem is that, during withdrawal, one's CNS is so fragile and dysfunctional, that all the problems that get unearthed during psychoanalysis can get magnified to overwhelming proportions. 

 

A final thought is that many of us who are ill have had trouble working and earning money throughout our lives. Our illness has left us poor. We are therefore severely restricted in the amount and type of talking therapy we can access. The more you need talking therapy, the less likely you are to be able to afford it. I would love to be able to try different therapists and different therapies until I find the one that works best for me, but I can't afford it. 

 

I hope your med-free life is getting better. It sounds like you've been through quite rough time what with all those meds and then the withdrawal. I hope you are well now, or at least getting there.

20mg Fluoxetine daily for 13 years. I did two tapers (both before I found this site). The first, about three years ago, was by breaking open the capsule and reducing the amount of powder. I did that for about 8 months. My doc then told me this was wrong and that, if I wanted to taper, I should use the liquid form. I then went on to the liquid form at full dose and started to taper again. This second taper took about a year, ending in about May this year. Since then, due to bad withdrawal, I have reinstated to 2mg and am just about coping, but not exactly thriving.

 

Update: November 2015: upped reinstatement dosage to 4mg on advice received here. Since then, periods of feeling OK alternating with deep pits of suicidal despair, but the former are just about winning out over the latter. Was seriously considering going back on at full dosage for good, but have so far managed to resist that temptation. 

 

Update Feb 2016: feeling OK, although still not immune from waves of despair and deep depression. Reduced the 4mg by 10% with the aim of eventually getting back down to zero again, which I will be doing very, very, very slowly. Also taking 100mg 5HTP daily, which helps a little.   

 

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Some very interesting thoughts on this thread.

 

It seems to me that the helpfulness of anything during wd is dependent on both the person and the practitioner and their approach. I've never done psychoanalysis, nor had any interest in doing it..so can't comment on it's efficacy when emotions are heightened.

 

I can though, say that decades of a lot of therapy on a sensitized nervous system (from trauma and PTSD, not wd) got me nowhere. Yes, I understood the source of most of my problems. But it did nothing to help them. But even worse, it exacerbated nearly everything I went in with...plus, left me feeling a failure, because it didn't help..it harmed.

 

For myself, I've come to realize that healing is in my own hands...that it's up to me to find ways to deal with the life-long patterns that were a result of my crappy childhood. That means finding different, healthier, creative ways to cope when emotions and thought patterns arise...and doing my best to live in the healthiest way possible, in order to reduce the amount of things that come up. This has been far more successful for me than any therapy that I did.

 

Talking about things to me isn't an answer...especially talking to people who really don't get it. I've paid my last penny to any therapist in my lifetime. The last thing I need is being more connected to my problems...I know those in spades. What I need is healthier ways to work with the challenges and I never found therapy gave me that. It made me focus more and more on what was wrong, not what was right or good in me.

 

Over the years, I've also had better outcomes from working through the body--massage, craniosacral therapy, Reiki, acupuncture, naturopathic therapy, and now, chiropractic. In these things though, it takes a skilled, listening, and sensitive practitioner--not easy to find.

 

But the core of my healing is the things I do for myself..as listed in my signature. I don't go looking for problems and use practices to "fix". My intention is healing..and whatever that means. Sometimes, it's very hard going. But it's empowering to be your own healer, not dependent on others, and ultimately, be able to give oneself what is most needed.

 

For years, I bought into the notion that we "need other people in order to heal". That led me down a path of a lot of wounding and disappointment. Now, when I work with a practitioner, it's to support what I'm already doing...not so they can fix or heal me. Before and after treatments, I do my own practices..

Remeron for depression. Started at 7.5 mg. in 2005. Gradual increases over 8 years, up to 45 mg. in 2012.Began tapering in June 2013. Went from 45 to 30 mg in the first 3-4 months. Held for a couple of months.Started tapering by 3.75 mg every month or 2, with some longer holding periods. Eventually went down to 3.75 mg. about April 2014. Stopped taking Remeron August 2014. Developed issues with histamine a week after stopping--symptoms reduced through diet and a few supplements. Currently having issues with a few foods. Most of the histamine intolerance has resolved or is at least, in remission.

Current Medications:

Current Supplements: Cannabis (CBD and THC), Vitamin C, D, Quercetin, CoQ10, Tart Cherry, Probiotic, Phytoplankton oil, magnesium, Methyl B. What has helped me most: spending time in nature, qi gong, exercise, healthy diet, meditation, IV vitamins, homeopathy, massage, acupuncture, chiropractic, music, and cuddling my cats..

My introduction: http://survivingantidepressants.org/index.php?/topic/8459-mirtazapine-withdrawal-freespirit/#entry144282

Please note: I am not a therapist or medical practitioner. Any suggestions offered come solely from my personal experience in recovering from childhood trauma, therapy, and AD use. Please seek appropriate care for yourself.

 

“After a cruel childhood, one must reinvent oneself. Then re-imagine the world.”
Mary Oliver
 

 

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Bonpensiero, withdrawal symptoms are not caused by whatever brought you to psychiatric drugs in the first place, but dealing with them, as with any illness, can indeed force us to confront certain habits of thinking about ourselves that may impede healing.

 

Getting to the historical root causes of "depression" or whatever might be possible when one is experiencing withdrawal syndrome, but if it is too painful -- tipping one into excessive rumination about disappointments, for example -- it can exacerbate withdrawal.

 

While in withdrawal, one should be focusing on self-care and minimizing stress. Going through a lot of emotional upheaval may be best postponed for a time when one's nervous system is more stable.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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