Meta symptoms of SSRI withdrawal


SSRI withdrawal causes many symptoms, both physical and emotional.  In some cases, the emotional symptoms can combine to create larger symptoms, meta symptoms.   Renewed or new depression is one of the most common symptoms of withdrawal.  Depression is an inward emotion.  It forces the patient to examine themselves in an overly critical manner.  In that compulsive self examination, other symptoms can emerge.  It’s not the healthy self examination of mindfulness or self awareness, it is an uncontrollable focus on the negative.  The patient doesn’t see themselves in a mindful light, but through the dark lens imposed by the depression.  Even joyful memories are seen in that distorted way.

Regret and Guilt

The depression of withdrawal forces the mind to pick negative aspects out of any event and focus itself on that exclusively.  That single minded focus creates regret in the patient.  Many times, it is out of proportion to the event itself.  Regret and guilt are very similar to each other.  They feed on each other.  Withdrawal pushes the mind to see guilt in places that the patient normally wouldn’t.  Withdrawal depression narrows the focus of the mind to see only the negative in an event.

I only remember a few things from my 10th birthday.  My parents had organized a party for me and invited several friends to come over.  I had wanted toe clips for my bicycle for a long time, and was very happy that I got them for my birthday.  Being 10, I wanted to install them on my bike right away.  During withdrawal, the nature of that memory changed.  Instead of remembering the happiness of the event, I focused on the fact that my parents scolded me for installing toe clips instead of playing with my friends.

Compulsive memories

One of the symptoms of SSRI withdrawal is renewed memories.  While taking the drug, memories are largely suppressed.  Many patients report that they do not have a good sense of what happened to them while they were on the drug.  They know the larger arc of events, but many of the details are missing.  The emotional nature of memories is likewise suppressed.  During withdrawal, the emotional tie to memories is reawakened.  It doesn’t happen in a linear way, though.  Instead of recalling memories in an associative way, where one memory reminds you of another, memories flood into the conscious mind without context.  It can be profound or trivial, the only commonality is that the memory is not recalled, it is imposed on the mind.  It is a sign that the mind is reordering itself, cataloging memories and emotions into a new order.

For more than a month I couldn’t get the image of a fast food restaurant out of my mind.  I ate lunch there 2-3 times a week for a year, 4 years ago.  The restaurant didn’t have any particularly strong memories associated with it for me.  Every time I tried to go to sleep, though, the image of that Wendy’s just wouldn’t leave my mind.  There was no guilt or other emotion associated with the image, I just couldn’t see anything else when I closed my eyes.

Fear of relapse

At first, withdrawal is unrelenting and overwhelming.  The symptoms occur continuously.  As time goes by, symptoms begin to break up.  Withdrawal becomes a cyclical thing.  There are times when symptoms are severe, and times when they are light.  People call them Windows and Waves.  A window is a period where symptoms are lighter, waves are times when symptoms are more pronounced.  There is an inevitable fear that arises from feeling better.  It’s not intuitive to an outside observer, but it is a real phenomenon for the person going through it.  Withdrawal creates a mental relativism where the way you feel at the moment feels like a permanent state.  Combined with uncontrollable negative self examination, waves begin to feel “realer” than windows.  That breeds a distrust of windows.  There is always the fear that a window is just a prelude to another wave.  Windows and Waves are closely connected, they are part of the cycle of recovery in SSRI withdrawal.  There is some validity to that fear of relapse in the beginning.  Windows will revert to waves, just as waves will break up into new windows.  As time goes by, the windows become longer and the waves become shorter.  There is no point in time that the patient can point to when the severity of waves falls below the level of awareness.  It’s one of the subtleties of withdrawal that progress can only be measured once it has occurred.  You just realize one day that you haven’t experienced a wave in a long time.  The last window has just extended longer than the others, with no wave afterwards.  The fear of relapsing into a wave lingers, though.  It becomes one of the central thoughts during recovery.  Slipping into a wave feels like getting sick, just mental instead of physical.  It begins with a subtle feeling of instability.  It then progresses into more profound feelings of despair.  Waves are very difficult to deal with.  The entire context of the mind has been altered.  There is little memory of feeling better, just the emotions associated with the wave.  So, when the wave breaks up into a window, there is a legitimate fear of the next, seemingly inevitable, wave.  The inevitable thing about withdrawal is that recovery will happen, though.  Many people have experienced prolonged feelings of despair, even suicidal ideation, and recovered themselves in the end.

The best way to deal with the window/wave cycle is to recognize that it is occurring.  It’s difficult to think of waves as temporary phases in recovery.  Somehow, it’s easier to believe that the windows are the temporary phases.  Being mindful of the cycle between windows and waves helps.  Just as windows are temporary in the beginning of withdrawal, waves likewise become temporary as recovery progresses.  Think of the last time you started a new job.  At first, all the new information felt overwhelming.  It’s easy to think that you will never absorb it all.  You quickly become accustomed to the new routine, though.  Eventually, the daily tasks lose their overwhelming quality and become easier to accomplish.  Withdrawal is similar in some ways.  At first, it’s very hard to believe that it will ever end.  Eventually, you begin to reclaim yourself, and it gets easier the longer you do it.

15 Responses to “Meta symptoms of SSRI withdrawal”

  1. jon rees Says:

    I have been on a variety of SSRIs for nearly ten years now for obsessive compulsive disorder. At one point I realized that my emotions were dead, and I wanted to laugh and cry and experience life again. I also make a living with my brain as a PhD analytical chemist, and I needed my clarity and acuity back in my brain. Therefore, I began tapering off of Luvox CR 4 months ago, and have been free of the drug for 4 weeks. The clarity of mind, when it is there, is remarkably refreshing. I had forgotten what it was like to be free to think again. However, I am still experiencing the waves described in your post, and can only hope that they wane with time. I want to be me again, the way I was before the buffet of SSRIs were pushed my way. The fear of relapse is very real, and lurking around the corner. I am assuming this will be a months long process as my brain recovers from the assault of SSRI use, yet I take it one day at a time. The more mileage behind me, the less steep the road becomes. If you too are on the road to recovery from SSRI use, I believe it will be worth it.

    If you are thinking of going off of your SSRI, consider one thing. Read the list of effects that SSRIs cause in your body (I refuse to call them “side effects”). Here is a short list from the paxil insert: “anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania.” Aren’t these lists of symptoms you were taking the SSRI for in the first place? When you meet with your psychiatrist or psychologist (or most often both), are you treating your “illness” or are you treating the effects of the drug? How can you tell the difference.

    I would never give medical advice, and I am sure there is a disclaimer somewhere, but SSRIs don’t have to ruin your life. With good support such as that which npanth provides, I believe we can become SSRI free. I have read some of the other posts that npanth has written, and find them quite accurate and helpful. I wish luck to all, and at this time especially me!

    • npanth Says:

      Isn’t it amazing to feel that clarity return? I was astounded at the ways I changed when I got entirely off Paxil. I became creative and thoughtful in a way that I had completely forgotten about. It’s a bit insidious how the drug steals that away from us. When I reinstated on Paxil, it really felt like a blanket was lowering over my mind. It was like the description in Daniel Keye’s Flowers For Algernon. I could feel my mind slipping away into that grey fog again. As I’ve tapered, it has been slowly lifting, again. I can’t wait until I get off Paxil, again. It will be for good, this time. I need to taper slowly to avoid symptoms, though. It’s a Faustian bargain, but I think I will get the better of it in the end.
      It’s very hard to tell the difference between symptoms that are caused by the drug, withdrawal, and a pre existing condition. There will always be some doubt about some of them. the best way to approach it is to try to be mindful about the causes of what you’re feeling. If you can’t find a trigger to explain what you’re feeling, then it is most likely caused in some way by the drug.
      I never did more than a cursory study of the insert on my Paxil before I tried to stop taking it. I know I should have been more careful, but how many things in our lives do we take on faith or trust? My doctor said I needed this drug, put a prescription in my hand, and I started taking it. I didn’t start to question it until 10 years later. It didn’t dawn on me that many of the problems I had been struggling with for years were caused by the drug itself. The steady, clock like depression faded away. The excess weight faded away. I realize now that Paxil made profound changes to my personality and cognition. The drugs mask their effects on the mind, though. While the patient is taking it, they don’t realize that many of their symptoms are iatrogenic. I assumed that Paxil was keeping my steady depression from becoming chronic. I didn’t realize that Paxil itself was causing it.
      “The more mileage behind me, the less steep the road becomes” Indeed, that’s so true of the way that withdrawal works. I hope you feel better soon.

  2. Mimi Says:

    If not for places like this and people willing to reach out to others, I am sure that I would have taken my life by now. The hell of mental illnesses such as depression, anxiety and PTSD along with all the others is incomprehensible to those that have never experienced it. Even health care workers (especially health care workers) are the worst. I have heard disparaging remarks so often from them that I actually began to feel that it was my fault. One pain management physician in East Tennessee actually told me to loose some weight and work out and I would be cured.. This was while I was sitting on his exam table with tears pouring down my face and shaking like a leaf. My minister told me that it was my lack of faith. I went thru the roller coaster of doctors and drugs for about 7 or 8 years.
    I am very, very fortunate that I was able to finally remove the stressors from my life and finally begin a 4 month wean off Lexapro. 3 weeks into being totally off and I am in the throes of withdrawal. Worst headaches I can imagine as I never had them before. Mentally I feel okay but physical symptoms are very present. I do have much anger and intolerance for stupid people. I am older and do not have small children to worry about so I can s pend the day in bed with headache if I need to. GI issues come and go. I am quite sure that I would never touch this stuff again as long as I live. Please consider very carefully all of your options and look long and hard for a good doctor before you give up and go on drugs that mess with your brain. As I hopefully recover from this hell, I will pray daily for each and every one of you. Don’t give up. In the past there was no place to go for help and uplifting and understanding. Now you can come to all of us here and feel at least that you are not a freak or dead beat or some such. May God Bless us al.l

  3. Dan Says:

    Glad I found this site! I went cold turkey off Lexapro 20mg about 3 weeks ago. I hadn’t noticed any symptoms, have been sleeping better and am mentally sharper, more energetic. But my temper! It’s like the alarm on my BS meter was reset from 10 to 0.1. No patience. I’m a teacher, so patience is a vital part of my job. Getting out and running helps a lot, but I have moments when I feel like one of those cartoon characters with steam coming out of my ears! I’m hoping it will pass soon, I don’t want to slip up and lose my temper at work.

    • Pajama Diva Says:

      I hope you’re feeling better by now. I’m currently going through this. Little things like my dog following me around the house make me want to scream at him. This is definitely NOT me.

  4. James Says:

    I was 16 when I got on SSRIs and now i’m 24. I feel as if another person has taken control of my body for 8 years and learned new things my old emotional self could never handle but it has hurt so many relationships in the process. My development and how i learned what the world was was through this lense. Im now weening and realizing what it is to feel actual emotions for people and a sense of empathy i did not have before.The worst thing is the overhwelming sense of dread that does not disappear and is not related to anything. It makes me search my memory banks for every hurtful thing I have done to others and remember the horrible things i looked up on the internet when i was on them. Is it healthy to remerge these feelings so i can get them off my chest? Will it make the dread lessen or make it worse during withdrawal? or should I block things out until its all over (which is very hard to do)? Everything was faked that I did to appear normal and now im realizing why people act the way they do. Ive said so many things that people reacted to so negatively and I had no idea why. Conspiracies , death metal and death videos are what made me feel ANYTHING while on the drug. I’m feeling very alone and a lot of my friends have abandoned me because they associate my depression with their own and how their able to deal with it. So i’m labeled as weak. Your articles have really inspired me to stay MINDFULL and back up from the uncontrollable rage. And have given me a good way to explain to people without sounding self righteous. I almost cried when I read your story. Not sure if it was from withdrawl but no one has seemed to relate the problems so realistically.

  5. wren Says:

    Hi. I just want to thank u for ur brillant article. There is so little written about the emotional symptoms of wirhdrawal. I d been on sertraline for 15 years for severe depression. I decided to come off it a few months ago. I was only on 75 mg and am now down to 25mg. I ve had no physical withdrawals but the emergence of my emotions is a rollercoaster. Anxiety and anger is through the roof. I feel as if my armour has been taken away and the world is so hard. Sensitivity is hard to deal with. At times i would prefer to be back to being numb. It was a lot easier but then its amazing to have so many feelings. Its really frightening and i ve have worried that i may be an absolutely awfully made person who is far too over emotional for this world and may need anti depresants for life to make me fit in and be normal. But your article has given me strength to carry on and that this may not be the permanent me. I just hope i dont lose too many people in the process. I know my boyfriend is finding me tough.

    • Anne Says:

      Hi Wren,
      I can so relate to how you are feeling (or at least how you were feeling when you posted in June…I hope things may have become easier for you). I also have recently tapered my antidepressants after 20 years for extreme depression. Like you, I am extremely hypersensitive and feel like a skinned rabbit (in a spotlight) much of the time… My anxiety is through the roof. I am appreciating the ability to weep again, however, after so long feeling numbed by the ADM. It’s such a 2 edged sword, isn’t it? To continue on ADM (armour in tact) or to find ways to live well with extreme sensitivity…Right now I’ve decided to work on the latter. Good luck to us all!

      • Jon Says:

        Hi All,
        I posted here a long time ago, but still get updates when others make a comment. For many years I was taking very high doses of paxil for OCD. With just a little bit of research, I found that in reality the majority of people taking SSRIs for OCD do not respond in a satisfactory manner. There is no “serotonin imbalance” in OCD (or depression). I was fed a bill of goods when I started taking paxil, the doctor emphasizing the “benefits” and downplaying the “side effects”. I believe SSRIs work for OCD by emotional numbing. You think you feel better because the downs are not so down, not realizing that the ups are no so up either. You still have OCD, you just don’t care so much. You are not so stressed about OCD, but you are not so jubilant when your child walks for the first time, you cannot grieve properly when a loved one passes, and you don’t cry when the dog in the movie dies. These are lost years for me, as memories are created by the magnitude of the emotion. I want to go back and shake the doctor that first prescribed these numbing agents to me.

        However, I have been able to wean off of the high doses. I haven’t taken any SSRIs for 3 years now. It was hard for 2-3 months, but I was able to shake out all of the side effects of withdrawal. It is most definitely doable. Don’t be afraid to wean slowly. Often SSRIs are prescribed for chronic anxiety (actually they are prescribed for many, many things), so you may feel some anxiety return. I believe eating right can help you immensely. Get rid of caffeine. This can be hard, but will help so much. Eat things at the ends of the store. Fruits, vegetable, whole grains, a little bit of meat. Do not drink sodas. Stay away from sugar.

        I believe life will return in grand fashion. It doesn’t do much good to dwell in the past. Learn lessons, move on, and try to help a brother or sister through your experiences. I have been so very down through SSRi withdrawal, but made it through. You can too.

  6. Pajama Diva Says:

    Thank you for your words of wisdom and encouragement. I knew I was experiencing irrational rage but didn’t know why.

  7. Paula Says:

    Seroxat has to the Devils drug in disguise!2 weeks thru it after tapering off it,an I feel like am in Alice in wonderland story book.every thing you all say is so true…me for one isn’t going to be beat by this drug!we can all do…💞

    • Jon Says:

      Hang in there Paula. You will make it. Be very, very patient. You are making the right choice!

      • Paul Says:

        Thank you john…I feel like am losing my mind!i feel like a snail with-out a shell.i tapered from 40ml,30ml,20,ml,10ml them nothing all in 4 weeks!this drug is mind bending stuff…am still going to work (don’t know how).i just need to keep going.thank you for your support john

    • australiaclivia Says:

      If you run into problems, it isnt a relapse, it is withdrawals. They can hit even 12 months after tapering too quickly. if you need help.

  8. australiaclivia Says:

    Thankyou so much, after 10 years, to actually find the old me, again, coming back, is just wonderful. Struggles still to come, I lost everything on that damn effexor, but I can see glimpses of a life still worth living on the way. As for tapering, dont do as I did, be wise, taper over 2-4 years, 10% drops, and spare yourself the agony of withdrawals.

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