Losing my mind off my antidepressants
September 9, 2022 8:59 AM   Subscribe

I took SSRIs for seven years for anxiety. I tapered off over 6 months. 3 months after my last dose, I’m an emotionally unstable mess and I’m questioning every aspect of my life. I’m really struggling to figure out what’s withdrawal, what’s the real me, and who the hell I can go to for help now.

Early 30s cis female here. I never saw a psychiatrist. I’ve struggled with garden-variety anxiety since childhood and got the meds from my GP in 2015. They never really helped beyond the first few months but my doctor cautioned to stay on them for 1 or 2 years and then there never was a good time to go off of them. I managed my own taper because my doctor said that “cutting back over a few weeks is good enough” and I suspected that was too fast.

Ever since I got down to 5mg (I was on 20mg Lexapro) I’ve been a mess. I mean I still have my job and my health. But I struggle with: insane levels of anxiety unlike anything I’ve known before, massive mood swings, hysterical crying spells on a near-daily basis, and losing my sense of self. Like I literally don’t know who I am anymore or what I am doing with my life. Pre-meds and on-meds, I felt like a generally strong, confident woman with a strong sense of self who just struggled with stress/anxiety sometimes.

I’ve been with my partner for 5 years and we live together. We used to be very happy. He’s a good and loyal guy who had stuck by me but I question the relationship constantly and am always wondering if I am miserable in the relationship, or just miserable. We argue a lot now and I know my moods are very difficult for him. Almost every day I think about breaking up and then dissolve into tears at the thought of losing him.

My friendships now feel strained and I don’t know who to lean on anymore. I no longer feel like I have a stable sense of anything. I will often feel very sure of something and then change my mind completely in a week. I no longer trust my own perceptions of anything. I am lucky to have a job that is very easy for me so I am managing, but I worry they will pick up on it soon. I am terrified of the future and just constantly terrified. I have nightmares and trouble sleeping almost every night.

I’m in therapy but I’m still struggling. My therapist thinks I have BPD symptoms, but I don’t feel that’s who I used to be. My doctor just tells me to go back on the meds, because this is a sign that I have a chemical imbalance that they corrected, but I never had these symptoms before the medication and I am afraid of making things worse. Seeing a psychiatrist where I live is impossible (I could maybe get a referral to see one in six months to a year). I look on websites like Surviving Antidepressants where people are struggling years after going off their meds, but I am skeptical of them too. Basically I don’t know what to believe, what to do or who to trust. I feel the medical establishment refuses to acknowledge the downsides of the meds, while the people talking about med withdrawal online often seem unhinged and conspiratorial.

I guess I’m just looking for something to help me decide what to do. Stick it out or go back on the meds. I wish I had some kind of authority to trust. I am just miserable and looking for hope. I eat well, I exercise, I cut back on caffeine and alcohol, I spend time outside with my dog but nothing seems to help.
posted by anonymous to Health & Fitness (19 answers total) 3 users marked this as a favorite
 
seems to me, medication might be necessary for you. it is for me.

i suggest seeing a qualified mental health provider as opposed to a gp. i see an NP. maybe a psychiatrist or np is just the thing.
posted by j_curiouser at 9:10 AM on September 9, 2022 [9 favorites]


this is going to seem possibly really dismissive but...go back on the meds? Like, this is really a no-brainer. You say you weren't like this before the meds but you also weren't like this ON the meds. The hard part of treating anxiety disorder is that anxiety makes you anxious about the treatment.

You don't explain why you wanted to get off the drugs, and you took them for SEVEN YEARS so clearly they were not causing you a high level of suffering, it seems? It is extremely common for people taking psychiatric drugs to feel like they "stopped working" or like they are no longer needed when in fact they are working extremely well--it's just that patients often feel substantially BETTER at first but eventually the person just feels normal, with normal ups and downs. It is very easy to forget how one felt beforehand, as well, because it can be very hard to reconcile that internal experience with a more balanced one.

All in all it sounds like your doctor has been expressing their opinion that this is a drug you need--advising you not to quit it immediately, and now suggesting you go back on it. Your therapist also seems to be expressing that you are in a mental health crisis (even if you disagree with their diagnosis). You seem to understand that you are in a mental health crisis.

If you cannot get in to see a psychiatrist for a long time then the best time to start getting on the list is today. But in the meantime, seriously, go back on yer dang meds.
posted by We put our faith in Blast Hardcheese at 9:17 AM on September 9, 2022 [25 favorites]


I'd say the first order of business is to go back on the meds. It does seem like they were either helping to correct something, or that the withdrawal is too difficult to face without the appropriate support, which it sounds like you don't have right now. Then go ahead and make your appointment with a psychiatrist for 6 months to a year from now. You can talk to the psychiatrist about intentionally ramping down, if that's what you want to do. But it sounds like your status quo before tapering off was working ok, so I'd say get back to that baseline and re-evaluate from there.
posted by Ragged Richard at 9:21 AM on September 9, 2022 [11 favorites]


I've been on the one and only SSRI I've been prescribed for some 10 years now and it makes me feel normal, as if I wasn't even taking it, and there's no way I'm going to stop it or switch.

I'm MUCH LESS ANGRY about little things on the SSRI and I'm MUCH MORE SOCIAL to boot.

GO BACK ON THE MEDS and don't look back. And trust your doctor.
posted by qsysopr at 9:42 AM on September 9, 2022 [7 favorites]


Sorry to hear you're going through this. At risk of becoming a chorus, yep, consider going back on the meds.

I've taken them at various times in my life. Once, a few years ago, I was taking them, and was a couple of years on from the really bad spell I'd had that led to me taking them that time around. I was pretty content on them, but got chatting about it with someone at a party who made a scornful comment about how I needed to get off them now the initial difficulty had passed. She even told me they were "just a crutch". I wish I'd told her where to go, but instead that comment ate at me, I thought maybe it was time I did without them, and I weaned off them. Six months later I had probably the biggest mental health crash yet. Had to get back onto meds (not simple in itself) and suffered wholly unnecessarily. I've been taking the new meds now for 8 years, my docs are happy for me to stay on them and refer to me being "settled on them" and I agree.

You say you didn't feel like this before you were on them, but you presumably felt bad in some way (hence going onto them)? And you say they didn't work after 2 years but you sound like you were in a pretty good place, relatively speaking. There's no shame in taking them. There shouldn't be shame in taking them. And they might not solve all your problems, but it sounds like they were doing a good job of giving you a reasonable bedrock where the real mental chaos went away and your symptoms were manageable.

I've also had a doctor tell me before it was fine to taper off over a few weeks. She was wrong. Maybe it's medically fine but it was shite to live through, physically and mentally. I wouldn't do it again.

FWIW, I've had an illuminating experience with mental health in recent years as a result of long covid. When I've had anxiety/depression before, it's come on kind of slowly, or maybe with an inciting incident that then gathers speed. But it takes a while. Which always makes me feel like my "What am I doing, my life is all wrong and I won't be happy until I sort out all of the ways that it's wrong" thoughts are absolutely correct, that meds are just a crutch and the real answer lies in sorting out my life.

With long covid, I've discovered that when I have a physical/energy crash, all those thoughts appear overnight, with the same force. My life is a vale of tears and suffering. Then I have enough quality rest, and they go away again, pretty much overnight. It's such a revelation to discover that such intense feelings, the loss of sense of self that you describe, the questioning of everything in my life, can kick in for 24 hours or so as the result of some kind of physical issue, and not as the result of complex and difficult to solve life issues.

It's totally possible that there are also difficult to solve issues in your life, but you'll be better able to work through those when your mental health is stable.

If you do feel like coming off them again one day in the future, you now know that it would be worth trying it very, very slowly. Like reduce by a quarter of a pill a week or something. Make it a year-long project and see how that goes. Or just stay on them.

Going back on them doesn't have to be a failure. It's a learning process, you shouldn't feel a sense of inadequacy or lack if you go back on them - you tried something important, and you've learned from it, and now you get to make a new decision that will improve your life. You deserve to feel functional (you deserve more than that, but that's a very minimum that you deserve, whatever it takes).
posted by penguin pie at 9:44 AM on September 9, 2022 [12 favorites]


Adding to the chorus here; I'm going to be on a baby dose of Citalopram for the rest of my life. I tried going off of them a couple of times, both under my doctor's supervision, and he noted 'horriffic results' both times.

One convo, between my fellow Leftist doc and I, when I went off of them:

"I need to go back on the SSRI. I just screamed obscenities at a row of riot cops, while standing on my porch in my underwear, at midnight."
"Well, that does sound like your jam."
"It is - but I usually do it in a more organized fashion, and with Jail Support set up."

It sounds trite, but if you can't make your own seretonin, it's OK to use store bought.
posted by spinifex23 at 9:50 AM on September 9, 2022 [25 favorites]


I'm wondering when these new symptoms started relative to the taper/withdrawal.If this is withdrawal, it suggests that the taper was too quick. The point of the gradual taper is to avoid the withdrawal symptoms by allowing the body to gradually adjust at each reduction with minimal symptoms. If it's not withdrawal, then your brain chemistry has changed over the years and needs medication to stay stable.

My suggestion is to get back onto the medication at a dose that makes you feel normal, stay for there a few months. In the meanwhile, get on the list to see a psychiatrist and when you meet them ask them for their support in trying to taper off again - more slowly - with regular checkins on how things are going. There might also be an option to shift to different related med that has less withdrawal problems so first you do a relatively quick cross over to the new med and then you taper off of that one. The kind of thing an expert would know (and a GP wouldn't)

I'm sure there is a part of that figure that if you spent so much time getting to this point and it is just withdrawal, maybe you would be better of just toughing it out until it resolved. But you've been doing that for a while and the impact on your daily life is horrible. Taking a pill, feeling normal and then spending a lot more time tapering off seems like a better overall quality of life.

If I understand you, you decided to taper off because it seemed like the meds weren't doing any good. If you take my advice - restart the meds and taper more slowly it will become more apparent if the meds were actually helping more than you thought or if you just needed to give your brain more time to adjust.
posted by metahawk at 9:54 AM on September 9, 2022 [3 favorites]


Is there a reason you went off the meds other than "to see what happened?" Because my knee-jerk reaction is also "go back on your meds, after three months this isn't withdrawal, it's what you are currently like without your meds and it sounds really painful for you, you don't have to live like this!" But I wonder if there's a piece here we're missing about why being on meds wasn't working for you. If there were side effects, expense, etc. that made being on meds really difficult for you, that's a different scenario than "I wanted to try going off them, I've tried it, it sucks."

I think whatever else you do, you should go ahead and get on that psychiatrist referral waitlist. Maybe in six months to a year you'll be doing a lot better one way or another and you won't need it anymore, and then you can step aside and let someone else move up the list, but give Future You the option, and get on that waitlist. You aren't feeling totally comfortable with what either your therapist or GP are telling you, and it's pretty reasonable to line yourself up to get another opinion even if you can't get it right away, or to get help doing a more supervised taper again at that point, or whatever you and that psychiatrist decide makes sense based on where you are at that time.

For whatever it's worth so you can balance this in your "whether to take this person's advice" column, I was on meds for a couple of years in my twenties, off them for another decade or so, and then went back on and expect to stay on them forever now. They're very clearly a net good in my life. I don't think that's true for everyone by any means, but I do think it's true for some people and maybe it's true for you.
posted by Stacey at 9:55 AM on September 9, 2022 [2 favorites]


How were you doing during the rest of this taper? Because if it's only been since you've been on the 5mg dose that you've been having these side effects, then why not jump back up to the last dose you were stable on and sit there for a while so that you can be in a good headspace to reassess?

I assume you have a good reason to want to go off the meds, but there's no reason that you have to totally cold-turkey it now when you're feeling so awful. It's not a failure, either--you tried this using your best judgement and it was harder than you expected. Going forward, you'll have this experience to help you decide what kinds of supports you need to manage your relationship with meds and that's really valuable! One of the hardest things with psych drugs is that they can be very individualized in their actions and side effects so choosing what works best for any one person is quite difficult.

Also, just as an aside which may not be applicable to you at all, but it may be worth your while, if you are hesitant At All about your diagnosis, to do some independent research about what the current science says about its presentation. Women in particular are prone to be Dx'd with anxiety/depression without a proper differential to identify potential comorbidities (eg, neurodivergence), which makes it very difficult to then get appropriate treatment/support (statistically, and also from personal experience). Good luck!
posted by radiogreentea at 10:05 AM on September 9, 2022 [2 favorites]


I have been through something similar and had access to experts in this field + have a medical background.

I agree with everyone saying the short/medium term solution is to go back on the meds to try to re-stabilize, that's good advice. Even though a lot of people on surviving-antidepressants are unhinged, the website's advice of: "Go on the last dose you felt stable at and stay there until you feel better before trying to go down again" is the standard advice you would get from an expert psychiatrist in this area.

It could be that you just didn't realize how much it was stabilizing you, it could be permanent or long term "withdrawal" from a long-term physiological dependency, it could be something no one understands. ALL of those are possible. No one can definitively say which it is but regardless that standard advice of resuming and re-stabilizing is good first try for all the scenarios. If it makes things worse after a month or two you stop and try something else.

You're functioning in a situation with a lot of ambiguity and there aren't any good solid answers to your questions about what is actually happening. The fact that your skeptical and all sides seem to be offering inadequate explanations reflects that and I think demonstrates your (IMO) accurate awareness of the actual situation.

While I don't think anyone has the authority or expertise to tell you what's happening definitively, finding a provider who seems knowledgeable in the area of more complex ambiguous med cases and isn't going to pretend they know what's going on but is going to offer good strategic advice for things to try would help long-term.
posted by Res0ndf7 at 10:44 AM on September 9, 2022 [4 favorites]


Uuuuuugh this is why GPs shouldn't hand out antidepressants but I digress. Go back onto the meds at the last dosage that was effective for you and get onto that psychiatry waiting list TODAY. If it's possible and you have the money, go private. An expert may not have a perfect solution but just having some more insight on the situation will help you, I think.
posted by kingdead at 11:04 AM on September 9, 2022 [3 favorites]


I have been taking medication for twenty years. I tried to stop taking anti depressants two years ago. I felt EXACTLY like you do now. I wanted to stop taking tablets but I became so ill that I simply couldn’t cope with my life. Just grit your teeth and start taking your medication again. You will feel well again.
posted by resurgem at 12:07 PM on September 9, 2022 [3 favorites]


You’re describing exactly what I experienced withdrawing from Lexapro, except longer. I was on Lexapro for only 6 months and did a short taper. The symptoms lasted for about 3-4 weeks. So makes sense they are longer for you.
posted by haptic_avenger at 12:59 PM on September 9, 2022


You sound like me at your age, early 30's. I'm now in my mid-40's. If I could go back in time, I'd tell early-30's me to "for the love of god, just go back on the meds and STAY on them already." Lots of unnecessary suffering during those years.
posted by storminator7 at 5:08 PM on September 9, 2022 [4 favorites]


You probably wouldn't still be having physical withdrawal symptoms from Lexapro three months after stopping taking it.

No matter where I am in my life or my self-perceived happiness, going off my anti-depressant - Venlafaxine - makes me an uncontrollably-sobbing mess for days. Sometimes I think I'm ready to go off it but I'm perfectly OK with taking it for the rest of my life just to avoid the inevitable meltdown even if I sometimes think 'I've been in therapy for 30 years, I should be over this now'.

Pre-meds and on-meds, I felt like a generally strong, confident woman with a strong sense of self

You're at least seven years older than you were pre-meds. Life changes, your body changes, it's quite possible you're more aware of your own emotions and body than you were then. You have a long-term partner now and it's likely that your relationship has changed your perspective.

I don't see any good reason for you to "stick it out" and not restart your meds. It sounds like your life and relationships have gotten drastically more stressful and that going back on Lexapro would be a really easy fix that would mitigate a lot of your agony.
posted by bendy at 6:38 PM on September 9, 2022 [4 favorites]


Replace "Lexapro" with glasses, and mental wellbeing with being able to see things. There's nothing wrong with needing to wear glasses to see as well as you want to. There's nothing wrong with needing to take medication to feel how you want to.

It might help in your decision-making to set aside whatever part that thinks I "should" not have to take these to feel well. That doesn't change the decision. You shouldn't suffer for the sake of feeling you "should" be able to feel fine without the meds.

Psychiatric medications are weird. The 'chemical imbalance' notion your doctor mentioned has now been substantially complicated, if I recall correctly. We don't know how, why or when they work - it's a lot of trial and error. The best ones help less than half of people, and we cannot predict who those will be. Your doctor may or may not have anything useful to say about it. The best psychiatrists I have seen have openly acknowledged this and left the final decision in my hands, having provided what information they could.

Keep in mind that if you have generalized anxiety, it will attach itself to anything - your relationship, the medication. Things my anxious mind says are incontrovertible facts are often not. The anxiety is probably feeding on itself.

If you're not already, and whether or not you start then again, it's worth tracking your moods and anxiety to give a reality check to the anxious mind. I like the app Daylio for this.
posted by lookoutbelow at 12:10 AM on September 10, 2022 [3 favorites]


What works for me is 1 hour of vigorous exercise every morning before work. I’m a swimmer, although I’m sure any vigorous exercise would work. Helps keep my mental nasties at bay. As in, it’s pretty hard to phase me on days where I got my swimming in. If I have to skip it for a day, the difference is noticeable.

Look at it this way — you’ve already weaned off the meds, which was a lot of hard work. You can always go back on them if you need to. But since you’re already off them, why not take this opportunity to try out some new coping skills?
posted by panama joe at 1:44 PM on September 10, 2022 [1 favorite]


One other thing – taking them again now doesn't mean you have to take them forever. If it helps you to feel better, you would then be in a position to put your mental energy into change your environment and habits in ways that help you and try again another time.
posted by lookoutbelow at 2:21 PM on September 10, 2022 [1 favorite]


Hi. I can relate to the trauma of trying to get off psych meds. While my situation may not seem to entirely relate to yours, I think you might find a different take from what some other people are saying.

I'm bipolar and have been taking anti-psychotics for 20+ years. Side effects of my meds include massive weight gain, brain fog, tremors, and increased risk for a number of physical problems. I wanted to get off this drug, and after a couple of too-quick attempts, my p-doc had a compounding pharmacy make a liquid form for me so I could titrate down in very small doses. Some people take up to a year to wean themselves off their med.

All that being said, I got down to 1mg of my drug, but started getting manic, and had to go back up to 15mg. I'm feeling good again, but really, really want to get off this drug. I will most likely try again. There is something very human in wanting to feel your own sense of self, of being, and not the chemically altered feeling that is just not right to some of us.

Good luck on your journey.
posted by furtheryet at 2:39 PM on March 25, 2023


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