I am sure I'm not the only who, when experiencing an on-going discomfort, becomes almost addicted to googling symptoms and information about what I'm going through.
Currently I am experiencing anti-depressant withdrawals - this can happen when you abruptly stop taking anti-depressant medication, or fail to wean yourself off them for long enough. Pretty silly situation to end up in for someone who studied psychology, has spent years researching mental health and mental illnesses, has also been on anti-depressants and anti-anxiety medication a number of times previously, and also mentions "make sure you see your doctor if you want to come off your medication" to anyone who asks me about medication... I know.
Well I'll explain how I got myself into this situation, but first I want to give you a little more information about Anti-Depressant Withdrawals - the summarised google search edition.
What are Anti-Depressant Withdrawals? What are the symptoms? What can I do?
I want to start by saying that the research says Anti-Depressants are not addictive drugs, I know the term "withdrawals" is something we typically associate with drug/habit addictions (smoking, hard drugs etc). When you experience Anti-Depressant Withdrawals, also referred to as Anti-Depressant Discontinuation Syndrome, you do not crave the anti-depressant - this is a major differentiating factor.
Why does it happen?
Anti-depressants work by restoring function to the brain. They work by changing the amount of neurotransmitters ("chemical messengers") that are produced in the brain and how they are received by receptors. For example, our brain produces serotonin - the chemical, or neurotransmitter, that is responsible for mood stabilisation and feelings of happiness. It also helps with sleeping, eating and digestion. After our little serotonin neurotransmitter has transmitted its neural impulse (its "message"), it is generally absorbed by the body.
SSRI's (Selective Serotonin Re-uptake Inhibitors - a common type of anti-depressant) prevent the body from absorbing that serotonin neurotransmitter, which means there are more serotonin messengers circulating our body. As one theory of depression suggests that a possible cause is depleted serotonin levels, the increased serotonin levels in our body should restore balance and lead to increased happiness levels, and better ability to stabilise mood (among other benefits).
Your body becomes used to the new levels of serotonin, which is why anti-depressants can take a little while to start working, and why you do need to be taper off them. A sudden stop can leave you very depleted in serotonin and lead to some nasty side effects.
What are the symptoms?
Harvard (www.health.harvard.edu), and many other medical website, list the symptoms as follows:
Digestive. You may have nausea, vomiting, cramps, diarrhea, or loss of appetite.
Blood vessel control. You may sweat excessively, flush, or find hot weather difficult to tolerate.
Sleep changes. You may have trouble sleeping and unusual dreams or nightmares.
Balance. You may become dizzy or lightheaded or feel like you don't quite have your "sea legs" when walking.
Control of movements. You may experience tremors, restless legs, uneven gait, and difficulty coordinating speech and chewing movements.
Unwanted feelings. You may have mood swings or feel agitated, anxious, manic, depressed, irritable, or confused — even paranoid or suicidal.
Strange sensations. You may have pain or numbness; you may become hypersensitive to sound or sense a ringing in your ears; you may experience "brain-zaps" — a feeling that resembles an electric shock to your head — or a sensation that some people describe as "brain shivers."
NOTE: You may not experience all of these symptoms, and you can experience them in varying levels. I can attest to this, because if I was currently experiencing everything on this list, I'd be a proper mess right now. Some medications are associated with worse symptoms too.
Also note, I have come off anti-depressants before and not experienced a single symptom. About 1 in 5 people who stop taking anti-depressants will experience a level of Anti-Depressant Withdrawal.
What can I do?
So as I've been desperately researching, looking for relief, I had a bit of chuckle when I reached the "Treating Anti-Depressant Withdrawal" section of one site that said: The best way to treat antidepressant withdrawal is to avoid it altogether and continue taking the medication.
If you don't laugh you'll cry right? It was a little too late for that because I'd been experiencing symptoms for around 2 weeks (as I began tapering myself off my medication, but I'll get to that). One thing I didn't know (but should've really) was that each medication has a different half-life, some take longer to leave the body and some are associated with more severe side effects.
So I found this little gem while I was researching:
Hardest to stop Anti-Depressants (drumroll please.......)
escitalopram (Lexapro) < the one I am on currently
Ok, makes sense... So how come last time I stopped taking Anti-Depressants (and I stopped abruptly that time, as in, I forgot and realised I hadn't taken my medication in over a week) I felt completely fine, and this time has been SUCH a struggle?
The best thing to do is to see your doctor and organise a schedule to slowly taper off your medication, that process can take longer than you think. Trust me.
Yesterday was one of the more difficult days I have experienced. Being in a level of pain and not exactly knowing what is happening is hard to deal with because you don't know if you should be panicking or not. Honestly, it was a "perfect" storm. A combination of a few things that led me there so I'm going to back it up a little.
Just over a month ago I had a virus and was prescribed medication to treat it. The doctor incorrectly prescribed me an antibiotic, which should've been an antiviral drug. I took the antibiotics for a while and didn't get any better, so I was then prescribed the correct antiviral and began taking that.
The antibiotics interfered with my antidepressants (which can happen) and, alongside being sick, I started to experience withdrawals from my antidepressant medication. Which was just fab.
I have been taking Escitalopram for just under a year, it takes about a month to adjust to the medication, and during that adjustment period you can experience some nasty side effects such as your depressive symptoms actually getting worse. I then had to weigh up how I was going to go about dealing with the current situation. I didn't know if my medication had completely stopped working, or it was just "muted" until the antibiotics had left my system.
Would've been a great time to see a doctor then.
Don't be like me.
I decided I'd begin my own form of a taper-down, as I had done this before successfully and, well, I'm an idiot.
Instead of returning to my regular dose I began to take the same dose every 2 days, then after a week I took it every 4 days. The withdrawal symptoms were "tamed" during this time but they weren't gone completely.
While this was going on, and it is SO important to look at lifestyle and life events when considering matters relating to your mental health, I was undergoing some huge changes.
Taking antidepressants helps to alleviate some of the symptoms of depression (the smoke) and a lot of the time, the cause of those symptoms (the fire) is something to do with our lifestyle, our past experiences, trauma etc. (Honestly, read Lost Connections by Johann Hari). Our lifestyle dictates how well our brains works - this includes our activity and movement, our diet, having meaningful connections with people, our alignment to purpose in life - these things make up our mental HEALTH and help us to function in an optimal way.
The Time Everything Was Fine
That time I forgot to take my anti-depressants for a week, I was working in a job that I LOVED, I was surrounded by people I really cared for (and who cared for me), I was training every morning and genuinely loved it, I was seeing changes in my body and felt my body functioning like a well-oiled machine, I hadn't touched alcohol in over 4 months and I was aligned my purpose of helping people. It had been about 4 months since I had come out of a really long (perfectly fine) relationship, but the relationship I had with MYSELF had never been better!
I was on my way to work after a training session where I really pushed myself, I was experiencing a HUGE rush of dopamine, driving with a great song pumping and I realised it had been a week since I had taken my medication and I had never felt so happy. I actually cried from happiness, I didn't think I could ever love life as much as I did in that moment.
It came down to lifestyle.
But, dropping everything and building our perfect lifestyle isn't just something that can happen over night for everyone. I believe that anyone can work to build a perfect lifestyle, it takes time. And that lifestyle that we believe will create the perfect environment for our mental health to thrive isn't always what we think it is.
Ask me a few years before if I thought my perfect lifestyle would be working full time in a gym and I would've laughed. I could go and work full time in a gym right now and not have the same experience. Our perfect environment changes and this is why it is such a struggle to reach that point.
Anyway, I could write a whole blog about that.
At that time I was taking a different medication too , and one that I experienced mild side effects on while I was taking it (it reacted badly to alcohol and I experienced a general numbness of all feelings). The medication I have just come off however, I didn't experience any side effects while I was taking it, but the withdrawals have been something else...
THIS TIME (Everything Was/Is Not fine)
Life right now, it is good. Seb and I just got engaged and our relationship is, honestly, one that I didn't even know was possible. I pinch myself everyday.
I was thinking about coming off my medication prior to the trip, my mental health is the best it has been in a LONG time, and had been so for months, we have left a very stressful/traumatic period behind us which was the main catalyst and trigger for my depressive symptoms. I wanted to do this the right way but...
When we got back from our engagement trip, I got sick and our celebrations had to be cancelled. Instead of being surrounded by the people I loved most I was really sick in bed and my antidepressants suddenly stopped working. This led to a pretty severe comeback of my depressive symptoms and, alongside being dragged into some petty drama that ended up explosively triggering some past traumas, I felt really lonely & and disappointed.
I'd also been struggling a bit financially, between working for myself, reduced jobs and chasing invoices, I felt like I was always busy and not having the income to justify it. I began the job search process just before I went away and was completely invested in a role I had interviewed twice for. The recruiter ended up being shockingly unprofessional (to say the least, everyone I have spoken to about this is genuinely shocked) and the whole thing ended up being a huge waste of time.
I thought I was coming back from my trip to an awesome new job and some great times with friends and family, but it wasn't so.
So I began the job search process again with very little energy and very little self-belief. I did end up finding a great new opportunity, the hours and the commute would be long and, as Murphy's law would have it, the workload from my own clients suddenly increased in a big way.
I went from working my own hours/schedule, to being sick and having my antidepressants stop working, to deciding to taper off themselves, to working 60+ hour weeks (6 days a week) with limited sleep and not even enough time to get outside for a walk. My nutrition really slipped up too.
See the MONUMENTAL difference between lifestyles at both times? I believe this played a huge role in WHY it has been such a difficult experience this time around.
I have been enjoying this new role and, as I always do, have completely thrown myself into 110%. I've been pushing through the withdrawal symptoms, the worst being BRAIN ZAPS. If you haven't experienced them - this is what it is like (for me):
It is like a sporadic electric shock in your brain that sends a shock through your entire body. This week they've gotten progressively worse, they generally happen when I move my eyes too quickly or when I hear a loud sound or something touches me, to the point where I'll experience pins and needles for 10-20 seconds. My vision can black out or feel "lagged" for a few seconds, I explained it to Seb as a "Strobe light" sensation in my brain. It is very unpleasant.
My immune system had been compromised and I wasn't sure if I was getting a cold, or whether the drained feeling was coming from being overworked & not sleeping well. I woke up with a cough and a throat full of ulcers.
This coincided with it being that time of the month for me, so at the height of my withdrawal symptoms (Saturday - yesterday), I was painfully bloated and quite emotional. I had the absolute worst cramps of my life yesterday, and because of the brain zaps being triggered by unexpected sounds or feelings, when the cramps were at their worst, I had this bizarre sensation in my brain. I could literally feel my brain pulsating and I didn't know what the fuck was happening to me. I also was supposed to be at one of my best friend's 30th birthday dinner, so I was overrun with guilt for missing this (particularly as a huge issue with my experience of depression is the feeling of always letting people down).
I didn't know if I should or even could go to the hospital. I didn't know what issue was a symptom of what. I was dizzy, nauseous, disoriented and in a lot of pain, and I really just needed to be curled into a little ball. I didn't know how to even explain what was going on, so I just waited it out.
I'm feeling a little better today, I am honestly so glad this happened on the weekend so I had time to rest and shut the world out for a moment. I've been taking it easy, I'm not in so much pain today (I think it was honestly just really unfortunate timing, when it rains it pours right?)
I am going to focus on getting moving, I am going to make sure I don't overexert myself this week and actually focus on moving my body and looking after my nutrition.
IF YOU ARE GOING TO STOP TAKING YOUR DEPRESSION MEDICATION:
- See your doctor and organise a plan (actually do it, don't be like me)
- Before you do, make sure you have consistency in your lifestyle
- Self-care is the fundamentals (reducing stress, moving more, eating better, prioritising time for the things that create happiness in your life - ie. quality time with people you genuinely care for, and genuinely for you).
- Create a good balance that promotes optimal mental health before coming off your medication.
- Over-working yourself at the detriment of your mental health is not glamorous, it is reckless.
Medication (for depression*) is meant to keep you emotionally balanced while you create the long-term changes that will help you be the happiest version of you. We need energy and focus to create this life, and this is pretty impossible when we are depressed. Taking medication alone is not a "cure" but it does help. Speak to a professional.
* Some mental illnesses require on-going medication, there is no issue with this. I am not talking about BPD or Bipolar Disorder, I am talking about my experience with depression. Some types of depression are caused by chemical imbalance in the brain, and are not so much lifestyle-related. Seeing a professional for YOUR diagnosis and treatment is the most important thing!
I just wanted to share my experience, because other than medical websites detailing the base level overview of what Anti-Depressant Withdrawals look like. But this is how it looked for me.
And even though in the past, accidentally forgetting medication for a few days just led to flu-like symptoms, this has just proved the importance of seeing a doctor. It is best to avoid it altogether because you don't know how your body is going to react. You can't predict what is going to be happening in your life and how mentally strong you are going to need to be.
You don't need to go through the above, medication saved my life and helped me get back on track and happy again (I am still happy now, I know this will pass).
Just be smart about it.
Love & strength,
PS. Please get in contact with a Mental Health Professional if you are experiencing depression, or if this article has left you feeling triggered in any way. Our mental health needs to be treated with seriousness, and there are resources to help.
LifeLine Australia (24 Hours/7 Days): 13 11 14