Waves and Windows in SSRI Withdrawal

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Tapering off of an SSRI can be very difficult.  It’s not like other ailments that have defined timelines and symptoms.  When a doctor treats a broken bone, there are long established milestones in recovery.  SSRI withdrawal is different.  Each case seems to be unique, with different length and severity of symptoms.  One of the frustrating parts of withdrawal is the way that symptoms fluctuate over time.  People call them waves and windows.  At first, withdrawal is unremitting.  There seems to be no respite from the symptoms.  After some time, which varies from person to person, symptoms begin to break up into cycles.  There are times when symptoms aren’t as bad, and other times when they are quite severe.  It’s not a universal pattern.  Some patients find that they have constant symptoms that slowly go away.  The wave/window pattern seems to be the majority, though.

Waves

Waves describe those times when symptoms are more severe.  Symptoms can be physical or emotional.  It feels like getting sick.  When you start to get a cold, you can feel little changes that presage the illness.  A sore throat or headache, then the full symptoms of the cold start in a day or two.  A wave has similar precursors.  Usually, physical symptoms are the first sign that a wave is coming.  A stiff neck, headaches, and dizziness are some of the symptoms.  A day or two later, the emotional symptoms become more pronounced.  These symptoms include obsessive or compulsive thoughts, depression, or anxiety.  It can be helpful to break waves up into different parts.  Knowing that each part of a wave is coming, and what to expect next, can make the whole process easier to handle.  The reason we’re so adept at knowing the cycle of a cold is that we’ve had them off and on all our lives.  we’re aware of the subtle changes in our bodies that tell us that we’re getting sick.  In the same way, it takes some experience before you can separate the parts of wave from each other.  It takes still more time to develop ways of dealing with each part of a wave.

Physical symptoms of a wave are hard to mitigate.  There isn’t much you can do about general joint pain, headaches, or dizziness.  You can try analgesics like aspirin or ibuprofen, but those aches are fairly resistant to those kinds of pain killers.  Dizziness is likewise difficult to deal with.  Withdrawal dizziness isn’t just something that happens when you stand up or spin around.  It’s hard to believe that you can feel dizzy when you lie down, but it happens in withdrawal.  Try to stay as still as possible until it gets better.  Try to use the physical symptoms as a sign that there are new symptoms coming that you need to deal with.

There isn’t really any way to avoid the emotional symptoms of a wave.  There is no way to “suck it up and get over it”.  Our minds create our reality in a fluid way.  The anxiety, depression, and obsessions of a wave are just as real as the screen in front of you.  The fact that our rational mind would recognize that it’s not real or overblown doesn’t mean much when you’re experiencing it.  That’s the essence of a wave.  It’s not rational or thoughtful.  Obsessive thoughts can be about almost anything from the benign to the surreal.  Self harm can suddenly seem like a rational idea.  In normal thought, the entire spectrum of emotions are right below the surface.  When you’re cut off in traffic, you have several choices.  You can ignore it, respond verbally or visually, speed up, slow down.  Even the psychotic is present in that moment.  We’ve become so accustomed to suppressing psychotic thoughts that we don’t even realize that the idea of ramming the other car didn’t rise up to our conscious minds.  In withdrawal, those thoughts that would normally be dismissed without a thought gain the same weight in our conscious minds as socially acceptable thoughts.  The only way to mitigate the emotional symptoms of a wave is to be mindful of the difference between normal thought and the unnatural power that irrational thought has in a wave.  It’s very hard to pick apart which thoughts are your normal responses and which ones are caused by the wave.  They mingle together in a chaotic way.  That’s what makes your reactions to a window just as important as your reactions to a wave.

Windows

Windows are periods of time when symptoms are not as pronounced as they were before.  At first, it feels like it’s over… you beat withdrawal, you’re free.  That’s the cruel joke of SSRI withdrawal.  Windows and waves are intertwined together.  The way withdrawal works for most people is that the windows slowly, ever so slowly, get longer, and the waves get shorter.  A window is more than a vacation from symptoms, though.  It is a huge relief to have some time off from feeling miserable.  Savor the good times in withdrawal, because that is what you have to look forward to in recovery.  More than relief, though, windows are an opportunity to prepare yourself to deal with waves in a better way.  Try to pay attention to how you feel.  Examine the way you think, the way you respond to things.  Try to recognize the way that you automatically choose responses and thoughts.  Emotionally, a window is a return to the normal way of parsing thoughts.  Instead of allowing all thoughts to rise to consciousness, you mind is automatically tuning out undesirable thoughts based on your personality.  Paying attention to the process during a window makes it easier to impose that same kind of structure during the next wave.  It’s that mindfulness that you’ll need during the next wave.  After a while, you can tell when a thought is out of character, and consciously dismiss it.

Withdrawal is a process of alternating good times and bad.  The more you’re able to mitigate the bad with mindfulness, the shorter the waves become.  Our minds often work in feedback loops.  One thought leads to another through association, creating the pattern of our minds.  Mindfulness allows us to shape the pattern to a certain extent.  The more you can recognize that a harmful thought is just part of a wave, and not a normal part of your normal mind, the faster you’ll get to the next window.  Eventually, that last window becomes reality, and the next wave never comes.  The mindfulness you’ve developed getting there will remain, though.

 

32 Responses to “Waves and Windows in SSRI Withdrawal”

  1. MindyS253@aol.com Says:

    James, I hate this so much.. the waves I get,….. are awful,, thank you from the bottom of my heart for this article . It is a life saver…… best… mindy

  2. Catherine sebelin Says:

    Hi , been off the meds now this will start week 7 . Yesterday and today are so bad, I was hoping by this time to really see some progress. My doc said 3 month, hope I can make it to that point. I am hoping that he is pretty well on target at this point. Anything you can tell me will be so helpful. I am trying so hard to stay on track but , days like today make it so difficult, I guess I just head reassurance at this point. Thank you so much for your time on this matter

    • npanth Says:

      The length of time that withdrawal symptoms are at their worst varies from person to person. I think it depends on a lot of factors. The dosage you weaned off of, how long you were taking it, your personal sensitivity to meds.

      My doctor dismissed the idea that Paxil could cause withdrawal symptoms and gave me a rather precipitous tapering plan to get off 40mg/day of Paxil. Instead of the two month schedule he gave me, I decided to extend that to 5 months. That was too fast, too. Now, I taper 10% of my previous dose, and only taper when I feel stable enough to do it.

      The best way to taper off of an SSRI or benzo is to do it very slowly, much slower than the official schedules that most doctors or therapists provide. It’s frustrating, because I had to become medically non compliant with my doctor to start tapering properly. When I went to him with my ultra slow tapering plan, he just gave me the same tapering plan he originally gave me. It felt like he thought that he was coddling a difficult patient who was working out a delusion. After seeing the failure of his plan, and the effectiveness of slow tapering, I’m starting to think that the delusion is his, not mine. That, in itself, is a serious disconnect from the unquestioning trust I’ve had in doctors my whole life.

      • Catherine sebelin Says:

        Thank you so much for the reply. I think I was a little vague on my question. I have been totally off meds since December 30, 2012. I am now starting 7 weeks . Yes I weened off in two months, and my dose was 12.5 mg while taking it. That’s what worked for me. I guess I am sensitive to meds since I only needed that amount to work. I am taking fish oil ( no brain zaps) vitamin b12 vitamin b6 folic acid , vitamin d3 with calcium. This has helped tremendously , but still have major issues. My doc said to figure on at least 3 months, for issues to resolve. I hope he right, get bad depressive episodes , hoping this will pass , normally very happy even with aches and pains. I respect your knoeledge on this and feel your the one I want to count on for the answers. Knoeledge is everything and you have it. Thank you so much again for hearing me out and being concerned.

        • npanth Says:

          I don’t mean to frighten you with this post. It frightened me when I first heard it. I know that the times involved in slow tapering can be very daunting when you’re feeling withdrawal symptoms. It’s not as bad as it seems, though. Yes, it does take a long time to get off these drugs, but it really is worth it in the end. Also, symptoms are not uniform for the whole time you’re tapering. It is the sudden change in dosage that seems to cause symptoms to be so severe. Even if you do a rapid taper, things do tend to smooth out as time goes by.

          A 10% reduction plan starting on 1-1-2013 with a starting dose of 12.5mg/day would run for about 18 months. The amount of time that people need between tapers does vary, though. The schedule is an approximation I started tapering from 40mg/day in June of 2011. I’m down to 6mg/day right now (2-11-2013) Since I tapered too quickly at first, that slowed down my tapering schedule. I had to reinstate and stay at 10mg/day for several months before I was stable enough to start tapering again.

          I’ve met many people who get symptom relief from supplements like fish oil or vitamins. They didn’t seem to help me very much, but I won’t discount them based on my own experience. If they are helping with symptoms that’s great. Anything that helps minimize the symptoms can’t be bad. I would stick with vitamins and fish oil, though. I’m a little hesitant about some of the other supplements like 5-htp or tryptophan precursors. Those compounds act on the brain in similar fashions as SSRI. It seems like that may be substituting one problem for another. Since the brain is adjusting to the lack of Serotonin reuptake, taking another compound that blocks neurotransmitter reuptake may prolong the problem.

          • Catherine sebelin Says:

            Thank you very much on your information. I’ll just hang in there and keep plugging away and lots of praying. All things do come to pass. Again thank you

          • npanth Says:

            Hang in there. Withdrawal sucks, but it is a finite crisis. Even if it takes longer than you think it will, it’s shorter than you thought it could be when it’s done.

  3. Deborah Davis Says:

    Came to your site by way of searching for success stories in weaning off Paxil onto anther SSRI. I have been on an SSRI (Prozac for 4+ years and then Paxil for nearly 12) for a bit over 16 years. The started them after dealing with 3 years and chronic insomnia (likely due to depression) with Ambien following open heart surgery in my early 30s. The open heart surgery in the early 90s was for an aortic aneurysm that was felt to be a birth defect. Drs. I saw when the insomnia started in the months following the surgery recommended ADs but at that point in my life I felt depression was a character flaw. I was so wrong. After 3 years of the insomnia which I just couldn’t take anymore (serious thoughts of suicide) I finally relented and started taking an AD (Prozac). Those drugs “saved” my life over those years. I’m a now a low level executive and very physically active (love cycling). Over the following 15 years, in two separate attempts to discontinue an SSRI (first on the Prozac and the 2nd on the Paxil thinking I didn’t need them; again I was so wrong). I was unsuccessful. It’s likely that I need to be on something regardless and of course the withdrawal makes it only worse. There is a very strong family history of depression and obsessive worry.

    In July of this past year after starting a new senior role at a new company, I experienced a “breakthrough” in anxiety that just 7 months later I now characterize as experiencing withdrawal symptoms. I had slightly feared over the previous year the 20 mg of Paxil just wasn’t as effective as it had been but it wasn’t stopping me from being quite functional albeit I was in a less stressful environment during that time. In July with the breakthrough anxiety from the new role, in working with a PDoc, I increased my Paxil to 30 mg and within 6-8 weeks was balanced and functioning well. In late January quite by accident, for 5 days I took 45 mg of Paxil versus my standard 30 (thought they were 20 mg tabs and continued taking 1.5 tabs a day without realizing the pharmacy had given me 30 mg tabs instead of 20 mg). So I’m experiencing withdrawal from the 45 mg. One PDoc I was able to get into right away (meaning he’s not very good) told me the withdrawal would take 4-5 weeks given I was taking amounts above 30 mg. My pharmacist and a 2nd PDoc whom I saw yesterday (Dr Greenman rated one of the best in the Phoenix area) said the withdrawal should only take about 9 days. I’m now at 16 days and not doing very well. I’ve used excuses to work from home over the last week and half. I super commute flying from my home in Phoenix on Mon. morning and working in the greater Denver area from Mon-Thurs. I typically fly back Thursday night.

    My current symptoms are ringing in the ears, at times extreme anxiety (but when your life seems to be falling apart some of that is warranted), and insomnia; either unable to fall asleep or stay asleep. Dr. Greeman is most concerned about getting sleep regulated over the coming 2 weeks and seeing how I re-stabilize at the 30 mg . To help with the sleep I’m taking Trazadone to fall asleep if necessary (25 mg – likely need to go to 50) and when I wake up after 2-3 hrs (which I think occurs in part due to the very active dreaming) I’m now adding 1.75 mg of Ambien to fall back asleep. This morning I of course feel a bit drugged, a bit less of the anxiety but of course very depressed.

    I have a 3rd PDoc appointment on Friday (another best of Phoenix; a Dr. Aubrey Joseph) to get his opinion. At that point I’ll have 3 opinions and my own of course given what I’ve learned about the severity of the withdrawal these drugs can cause. What I do know is that the depth of the anxiety and the physical symptoms I have experienced coming off Paxil are far in extreme to what I remember during the three years following the surgery and the withdrawal from Prozac. I don’t recall having real full blown panic attacks until withdrawal or breakthrough with Paxil.

    Given how I feel today, regardless of whether the withdrawal from the Paxil was to supposed to take 9 days or in reality it was going to take 28+ days; I don’t anticipate getting back to the relatively carefree balance I felt before the inadvertent mis-dosaze. I think the Paxil is waning and some type of breakthrough of withdrawal anxiety was inevitable. Given my history and how relatively easily I’ve been treatable in the past Dr. Greenman feels this is a “bump” in the road and that managing this episode is highly doable. We’ve talked about likely needing to wean from Paxil onto another SSRI. I know this is just borrowing time; but I’m willing to make the tradeoff if it works. He talked about the standard approach of tapering from Paxil while ramping up on the new SSRI which will likely be Zoloft. I’m also pretty sure I won’t be able to do this without very noticeable performance issues at work. Which will mean taking a short term leave – at which point the “cat will be out of the bag” about my depression/anxiety and I’ll likely have to resign because finding a suitable role that allows me to work remote is unlikely although I do work for a very good company? I’m very sad about this. I actually really like what I do and like the company I work for but the level of responsibility/stress given my mental handicap may be undoable. I’m still embarrassed about my handicap with depression.

    I’ve been reading many of the boards over the last 2 weeks but haven’t posted on any of them because they didn’t seem as knowledgeable as this one. James, I am extremely grateful for your site.

    I welcome constructive comments from all. I will continue to post in that it may help someone else, who at some time in the future may come to this site and will may get comfort or benefit from my story/experiences.

  4. kate Says:

    Just wanted to say thanks for your very helpful posts on withdrawal from SSRIs. I’m about half way through slowly weaning off sertraline – started by introducing half-tablets one day a week, increasing to seven, now I’m missing out days – and have started noticing that I have less control over my moods. Anger and tearfulness seem to come out of nowhere and I can’t shake them off, even if my ‘rational’ mind knows it’s not how I’d normally react. I was starting to worry that this was just what my moods were going to be like until I read your blog.

    I’m planning on maintaining my current dose for a few weeks to give my brain more time to adjust but, in the mean time, do you have any tips/resources I could use to help me to practice mindfulness? Are there things I could tell myself (e.g. mantras) or other techniques you’d recommend?

    Thanks

    • c1clista Says:

      Kate;

      I apologize for not responding sooner. I didn’t see your post until this morning. I can only share with you my personal experience as well as what I’ve read regarding tapering off short-acting SSRIs which I believe sertraline is.

      First if you are not working with a compassionate and knowledgable PDoc to act as your guide in tapering I strongly encourage you do so. Find someone that doesn’t go strictly by the drug company’s literature or what they learned in school but someone who has worked with real-world patients tapering off SSRI or NSRIs. The good ones are frequently hard to get into quickly but they are worth it. Plus they will be there for you if you need a little additional help once you’re off the SSRI.

      Short acting SSRIs are supposedly in and out of your system in less than 24 hrs. That’s why it will likely be better for you to cut each days dosage by the same small amount (10% seems typical) versus experience a 50% reduction one day a week or every other day of a week. That’s a lot of ups/downs. Make the taper a gradual linear slope. I would definitely stay at your current dose but keep it the same every day. When you’re feeling confident, then go down in dosage (small cut) but keep it consistent every day, until you are ready for the next taper. Give yourself months to do this. You don’t need to be in a hurry.

      As far as mantras go, reminding yourself that you’re experiencing withdrawal symptoms and not necessarily emotions/feelings that would be normal for you off of an SSRI is likely the easiest one. I actually try to compartmentalize the negative thoughts and label them withdrawal and focus as much as I can on the good thoughts that know I’m going to be better and that it’s just a matter of time. And beyond that, for me at least, is distracting myself and not ruminating (which is my weak point) on the situation. Although certainly not easy, focusing on work tasks, house tasks and getting some level of exercise are all things that help. Don’t set those bars too high – just enough to get through the task/goal and feel a sense of accomplishment.

      Also – do not underestimate the affect not keeping your blood-sugar staple throughout the day will have. During tampering it seems the central nervous system is hyper sensitive to this. I have to make sure I eat something (banana, yogurt, peanut better) a nice combination of carbs and protein every 3-4 hours. Because once the blood sugar drops it will feel just like a panic attack or increased depression.

      Hang in there you’re on the right path. Take it slow and easy and find a good guide to lead and support you through it.

      Best
      Ciclista

      • npanth Says:

        I second what Ciclista said. Many doctors recommend large dosage drops and skipping days while tapering. That worsens withdrawal symptoms. Make slow, steady tapers and don’t skip days. Instead of following a calendar schedule to plan your tapering, go by how you feel.. After each taper, wait until you have gone through a couple cycles of windows and waves before tapering again. The last wave before a taper should be so mild that you barely feel it.
        It’s very hard to describe how mindfulness helps in withdrawal. It’s a very subjective and personal thing to examine your thoughts. It begins with recognizing that a series of thoughts are obsessive or outside you normal thoughts. Then, try to replace that thought with something else, or dismiss it each time it floats to the surface of your mind. It doesn’t work in the beginning. Withdrawal creates obsessive thoughts of such power that they are very hard to control. In combination with a slower tapering schedule, though, mindfulness can have a big impact on your quality of life. I hope you feel better soon.

    • aza Says:

      Hope you’re feeling better now. From my personal experience, If these feelings are still continuing avoid mantra meditation or meditating on a single object, otherwise known as Samadha meditation. Long blocked feelings are now coming to the surface and you don’t need Samadha meditation to avoid dealing with them. The best thing for your condition is Vipassana (Insight) meditation. This will help you to experience those feelings in a controlled and systematic way and then release them. It is an effective purification process. Just Google “Vipassana” and enjoy the journey. Goodluck Kate!

      • npanth Says:

        Thanks aza, I’ve been reading about different techniques for myself and when others ask for advice. I’ll read up on Vipassana.

  5. mkgardengirl Says:

    I am writing to thank you from the bottom of my heart for helping me through the hell I’ve experienced with SSRI withdrawal. Had been on rather low-dose (10 mg) Celexa for close to 10 years and I tapered even more slowly than my FP doc suggested, although in retrospect even that was too fast. Of course I didn’t know then what I know now. My last dose was in early July of last year. For the first few weeks I didn’t really have any problems at all and I figured “Wow, that was pretty easy.” Then I slowly began to notice an increase in irritability (toward everything) and a huge tendency to get teary-eyed over things that normally wouldn’t affect me at all…..even paintings and commercials on TV. I thought it was curious, although I didn’t really relate it to the med withdrawal at that point. Then came some bouts of sadness, nervousness and insomnia. It wasn’t until mid November that I got blind-sided by a bout of depression worse than anything I’d had before, which seemed to alternate with episodes of over-the-top anxiety. This is the point at which I started researching SSRI withdrawal, as these symptoms were totally new to me. I couldn’t believe all the info I found on it, but no website described with absolute clarity the specifics of the process like yours did. As I read through the website, all I could think was “This is EXACTLY what I’m going through.” And you know all too well how helpful that type of discovery is. I experienced the windows and waves and have been noticing a definite leveling-off in degree of the symptoms over the past several weeks. Of course I’m hoping at 7+ months out that I’m beginning to exit the worst of the withdrawal period……..but I’m not convinced yet and I have prepared myself for yet another return of these nasty symptoms. Now, however, I know what is happening and I know I can handle whatever this miserable process sends my way…..thanks to you. I also want to encourage others going through this to hang in there because it may be a long time, but it does get better and you will feel so much stronger when you begin to heal. Again, thank you so much for all the wonderful help, understanding and support.

    • npanth Says:

      Thanks so much. I’m glad it helped. I’m starting to think that the fear of having another wave is a meta symptom of withdrawal. In a weird way, we almost become accustomed to the symptoms… even start to rely on them a little bit. That would sound insane to someone who hasn’t gone through it, but it’s true. After the chaos of withdrawal, there’s a (comfort isn’t the right word) to having something happen regularly, even if it’s bad.

      Like you, I more than doubled my doctor’s schedule, but found that it was way too fast. That fear of reverting back to a wave does fade away slowly. I noticed it after I had gone through a couple of short waves. 7-8 months after reinstating and starting a sloooow taper, my waves have become much milder than they were before. It took me a long time to recognize the bigger pattern between waves and windows and realize that the waves were getting shorter/milder, and the windows were getting longer/better. I needed a lot of intrinsic reassuring that the pattern would continue, and not revert back to the unrelenting wave I went through for so long.

      I think it’s the same process that causes depression in social anxiety. A person feels awkward in social settings, which causes frustration, which leads to depression. In a similar way, withdrawal waves cause and lead to depression, which causes fear of relapse. The difference is that it’s caused by drug withdrawal, not a normal mental process. It’s very hard for doctors to tell the difference between normal anxiety and withdrawal anxiety in the short time they have to consult with patients. So, it falls back on the patient to figure it out for themselves. It’s too bad, we don’t have the advantage of experience and training to deal with this sort of thing, but the current medical world just doesn’t account for that kind of in depth diagnosis.

      • mkgardengirl Says:

        That is exactly right. I find it offensive that almost all of the advice from the medical community implies that if you experience these horrible, protracted withdrawal symptoms it’s simply because you’ve done something wrong…..if you had weaned correctly in the first place you should be fine. And if you’re not fine then you are most likely having a recurrence of the original depression/anxiety/whatever. The denial is very widespread and very alarming. Given the cavalier way in which these drugs are dispensed, I would think there has to be a huge epidemic of people encountering these withdrawal symptoms. I sure hope the medical world is paying attention.

        • npanth Says:

          The similarity between withdrawal symptoms and other psychiatric problems compounds the problem. When a doctor who only talks to each patient for a few minutes tries to make a diagnosis, they don’t have enough information to recognize withdrawal. My doctor actually told me that I had a new psychosis when I went to him in withdrawal. His only answer was a new prescription for new drugs. If I had followed his advice, I’d be on a fistful of pills by now. I didn’t start the new prescription. I can see how patients who go to their doctors for help during withdrawal wind up in ever darker spirals of drug use. Instead, I’m steadily improving.

          Doctors have more faith in the pills than they do in their patients, to the detriment of both. Patients trust doctors less, and doctors dismiss their patients.

  6. full report Says:

    Hi! I’ve been reading your blog for some time now and finally got the courage to go ahead and give you a shout out from Dallas Texas! Just wanted to say keep up the good work!

  7. read this Says:

    Heya i am for the first time here. I came across
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  8. mkgardengirl Says:

    Just a follow-up to my last post in February. Still experiencing the waves and windows with regularity. In my case the waves seem to vary in intensity rather than showing a steady decline. Very much enjoy the windows when they choose to make an appearance, although my tendency is to get too hopeful that I’m finally getting past this only to have my hopes dashed when a wave hits all over again. This has been very difficult. I am now 11 months out from a way-too-rapid taper from Celexa, which I took at the same (rather low) dose for close to 10 years, and I have not reinstated or taken anything else to alleviate the symptoms. Not sure I would have had the nerve to go through this had I known what a long and difficult road withdrawal is, but I really am committed to staying off these drugs. I am not a fan of the medical community and the treadmill you get caught up in when you visit the doctor (they want to do a test for everything, and the test shows some abnormality that requires more tests and on and on until your whole life becomes visiting the doctor). When I was prescribed Celexa, my FP announced that I would have to visit him twice as often or he wouldn’t renew the script. Celexa did work well for me, but it was these endless office visits (aka padding the FP’s wallet) that made me want to quit taking it. I realize that may sound strange to a lot of people, but it’s just me. Anyway, I continue to find your website immensely thoughtful and helpful, especially in realizing that I’m not alone in experiencing these withdrawal symptoms for a protracted period of time. Misery loves company, I guess. Thanks again, with all my heart.

    • npanth Says:

      Thanks, gardengirl. I think that knowing that it’s not a solitary struggle to get off an SSRI is very helpful. It doesn’t necessarily help with the individual symptoms, but it is good to know that you’re not alone. The way my doctor kept saying that I had a new problem, the way others told me to just get over it… It felt like I was the only one who ever experienced this. It took a bit of searching, but it turns out there are a lot of people who have trouble with these drugs. Who knows, we may represent the majority. I’m beginning to think that at the least, we represent a significant percentage of people who wean off SSRI. We’ll get through it, and be better off in the long run, I’m sure of it.

      • mkgardengirl Says:

        Yes and, as you’ve noted several times, there is actually a silver lining because the coping mechanisms you use to get through the withdrawal will be very valuable down the road. The ‘mindfulness’ you talk about has really helped me to realize how hard I need to work on improving how I respond to things. My go-to reaction nearly always involves a lot of negative self-appraisal. I was never truly aware of that until I started applying the mindfulness to my feelings during the waves and windows. It was actually quite shocking to see how tough a self-critic I’ve always been. Probably a large part of what led to the mild depression and, hence, the Celexa. This is priceless in learning to deal with life without meds.

        It will be interesting to see how this all plays out. I agree that we probably represent at least a significant percentage of people trying to wean off these things. At what point will doctors be forced to address the fact that their cash cow antidepressants are causing perhaps even worse problems than they’re solving?

        • npanth Says:

          It really is something to realize how much more thoughtful I am about my own behavior. Just today, I realized that I was paying much more attention in the office. I stopped myself from interrupting other people’s conversations with some witty thought that popped into my head as I walked by. When I was on Paxil, I would have interrupted. I had no sense of how annoying it would be to other people. It was a great feeling. I had a sense that mindfulness was just a means to the end of getting through withdrawal. Instead, it’s a framework I use everyday, now.
          I think that antidepressants will follow a similar path as ephedra or other drugs. It will take a series of accidents and tragedies to bring the problems of the drugs to light. There have been many such tragedies, but it hasn’t reached that critical point, yet. The profitability of SSRI is much higher than that of ephedra, so it will probably take many more tragedies, unfortunately.

  9. Jill Kronenwetter Says:

    Thanks so much for this information. I wish I would have found this 3yrs ago after my adverse reaction to one 10mg. dose of citalopram. It would have helped me more quickly to understand what to expect in my recovery. Was doing pretty good as of December 2012 but I’ve since had a relapse in symptoms do to some supplements I tried to take and found my nervous system was still to sensitive to tolerate them. So now I’m back having waves and windows again. But this and support groups are giving me hope to keep hanging in there and keep fighting the good fight. Thanks again!

  10. ChrisW Says:

    This site is helping me so much, thank you. I have been off SSRI’s for almost 2 months now and I think I’m still feeling withdrawal effects. I was on SSRI’s for ~8 years, then in April I had to change doctors 3 times in as many months who kept changing my dosage and/or medication entirely (during a bad period, lexapro was starting to lose its effect). I was given one day off Lexapro then was started on 50mg of Zoloft. This was horrible, I cut it to 25mg myself after a month. Then I started going to ANOTHER doctor that I knew outside of the medical world, and he tapered me off Zoloft for 2 weeks, then was supposed to start back on Lexapro. I didn’t start back on the Lexapro, I thought 2 weeks was long enough to taper, I now realize that I’ve basically gone off cold-turkey. I went back to my doctor yesterday complaining about depressive episodes and a detachment from reality this far from stopping medication, and was prescribed 30mg of Cymbalta with the idea of taking the next 2 years to taper off. At about 3pm yesterday I had a massive headspin and a minor panic attack, then 2 minutes later felt like I was completely back to normal, now today I’m detached again, memory is messed up and doesn’t feel chronological and I feel like I’m a passenger in a body that is on auto-pilot, but I still have enough mindfulness to type this. This is terrifying. I’m yet to start this new medication because I’m afraid of going through all of this again. Would you rough it out? Or take the meds? I’m losing faith in doctors, but at the same time am too busy with life to take the next 6 months off.

    I hope this finds you well.

    • npanth Says:

      I’m a proponent of reinstating after a fast taper. It gives the brain a chance to adjust slowly to lower doses of the drug. SSRI Mae structural changes to receptors in the brain that regulate mood/cognitive transmitters. It takes a while for the brain to reorganize around the lack of drug. It’s not brain damage, although it does feel like it at times. Your brain adjusts itself every day. SSRI just make bigger changes than normal function does. So, it takes longer for the brain to change things back.
      Reinstating and doing a slow taper allows for a pretty normal life. When I was touching it out, the symptoms would last for weeks. Now that I’m doing a slow taper, symptoms only last a few hours. Instead of being overwhelming, now I can go to work, go out with friends.
      It’s very hard to go back on the drugs. When I reinstated on Paxil, I could feel myself getting dumber and slower as it took hold again. I could function, though. That Paxil cloud has been lifting ever since, too. Every time I taper, I feel a little more like my old self. It makes it hard to stick to the very slow pace I’ve set for myself. It important to keep the symptoms to a minimum, though. I know I’ll get all the way off Paxil eventually, and that’s the most important thing for me.
      Go slow. It sounds like they med flipped you a bunch of times, and that can really mess you up. I’m glad the post helped.

      • Mike Says:

        It’s been 2 years today since my 6 m taper from Lexapro that I took for 6 years for Gen Anx. Ironically, I’m having a terrible wave of anxiety, no energy and no appetite. Can somebody tell me that this is going to end?

  11. Pauline Rouse Says:

    Am I correct in saying that you come from near Lollipop Farm. My son lives near there, would it be possible to meet up when I come over in April.

  12. laurenmonroecosmetics Says:

    Fabulous article! This has really helped me get through my current withdrawl from Luvox. I have great results with Luvox, but would like to be off of it for a while to start a family. I just started week 2 of withdrawl after tappering off Luvox for four weeks. I feel the dizziness, headaches, and emotional inconsistencies. Additional symptoms have been confusion, memory loss and troule concentrating. These things all happen in waves and windows. I am hopeful after reading this article, that the windows will become more frequent.

  13. Ian Brown Says:

    Hi. Been on SSRI’s, starting with Prozac, on and off for about 18 years after a prolonged period of high stress and emotional battles that left me with a breakdown and depression. That’s all in the past though and I decided for a number of reasons that now was the time to come off Cipralex after an extended period. Feeling fine etc I weaned off slowly over several weeks and stopped just over two weeks ago. Well – the agitation, brain zaps (on eye movement), restlessness, restless legs at night and other withdrawals (which I wasn’t expecting) have really calmed down now which is great but I’m now suddenly getting alternate days of feeling very horny(!!) and crying like a baby at the slightest thing or nothing in particular! Found this site after some searching (there doesn’t seem to be anything “official” in the medical world). It describes things very well. The “waves and windows” scenario is an accurate description and has really helped with the ups and downs of symptoms so far. Is it a general concept used for other withdrawals? Drugs, alcohol…? Also explaining that the mind or brain has to readjust its own receptors and chemical balances – and takes time. I guess the best thing is to accept the symptoms, embrace them and not to be frightened of them. Thanks

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  15. Beast Says:

    Ask your doctor to switch you to Prozac then withdraw from the Prozac instead. Prozac has the longest halflife and is easier to stop taking


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