YANMPsychD
May 7, 2019 7:03 PM Subscribe
Until recently, I was on low dose Zoloft and had been for years. I’m afraid to be on it and afraid to stay off. Help?
I have a therapist and a psychiatrist and see them regularly. I’ve talked about this with my therapist recently, but am still ruminating.
Essentially I’ve been on either 25mg or 50mg of Zoloft for about five years. Every doctor tells me this is a “baby dose,” but I feel I’ve benefitted from it. It quiets my mind/gives me space from my thoughts and helps me sleep. The dose is low enough that the side effects aren’t that bad, though I do notice them, mostly in the form of slightly upset stomach and slightly dampened sex drive.
A few months ago I got a new therapist and was making big strides. Getting better at boundaries, more productive at work, just really feeling better than I ever had. I got the bright idea to stop taking Zoloft (since therapy helped me so much, I thought maybe it had never been a chemical thing, just cognitive/behavioral). I stuck it out for about a week, had terrible brain zaps, mood swings (I honestly still feel somewhat traumatized by how bad my mood was), etc., and went back on it.
Fast forward a month or two and I still wanted to try to quit; I was sick of feeling so tired and having a sensitive stomach, plus I was just feeling down overall, like my bad feelings were lessened but I never felt joy. I stuck with it this time (though it was again horrible!!) and now I have been off it for about three weeks.
Not sure it’s an improvement! I feel like I just... have so many thoughts. And lots of negative thoughts. Fancy that. I’m much better at dismantling them now than I was before I started medication, but I feel a bit like I’m white-knuckling it, like I’m watching television with my face an inch from the screen. It’s hard to take a step back and get perspective. I don’t feel super sad (nor do I feel joy), I just feel like I’m processing emotions constantly, all day long, and getting quite mentally exhausted. I realize it’s only been three weeks... so I don’t know if this is really me, or Withdrawal Me. But it basically sucks.
I do feel a bit more engaged with life, mostly because I HAVE to be (I am having so many thoughts!). I feel pretty dumb now, as all the negative thoughts I had about medication before I started taking it are coming back... because guess what, I’m a negative Nancy again. It’s hard to confront the fact that despite how much I’ve grown in terms of healthy coping skills etc., I’m still this anxious, depressed person underneath the pills.
Basically I was not listening to doctors and decided I could just wing it from here on out... and I feel like I could, but like it’s highly unpleasant and I don’t even want to. At this point I’m not sure if whether I start taking it again it will work right away or take the usual 4-6 weeks. Also, I’ve been reading many articles lately about how long term SSRI use isn’t well understood, etc., and I’m just generally freaking out that I’m somehow damaging myself irreparably by taking the “easy way out.” Technically I could just try to exercise every single day and fight through the onslaught of shitty feelings. But I don’t want to. :(
My questions are basically: Have you gone through something like this, and what did you decide to do? Should I stick with the no drugs lifestyle for awhile— is this a rebound effect? And how do you handle anxiety about medication if you are an anxious person who treats their anxiety with medication?
Also in case you’re worried, I have a psychiatrist appointment next week where I will discuss all this. I’m just trying to process my thoughts in advance so I can talk to them confidently.
I have a therapist and a psychiatrist and see them regularly. I’ve talked about this with my therapist recently, but am still ruminating.
Essentially I’ve been on either 25mg or 50mg of Zoloft for about five years. Every doctor tells me this is a “baby dose,” but I feel I’ve benefitted from it. It quiets my mind/gives me space from my thoughts and helps me sleep. The dose is low enough that the side effects aren’t that bad, though I do notice them, mostly in the form of slightly upset stomach and slightly dampened sex drive.
A few months ago I got a new therapist and was making big strides. Getting better at boundaries, more productive at work, just really feeling better than I ever had. I got the bright idea to stop taking Zoloft (since therapy helped me so much, I thought maybe it had never been a chemical thing, just cognitive/behavioral). I stuck it out for about a week, had terrible brain zaps, mood swings (I honestly still feel somewhat traumatized by how bad my mood was), etc., and went back on it.
Fast forward a month or two and I still wanted to try to quit; I was sick of feeling so tired and having a sensitive stomach, plus I was just feeling down overall, like my bad feelings were lessened but I never felt joy. I stuck with it this time (though it was again horrible!!) and now I have been off it for about three weeks.
Not sure it’s an improvement! I feel like I just... have so many thoughts. And lots of negative thoughts. Fancy that. I’m much better at dismantling them now than I was before I started medication, but I feel a bit like I’m white-knuckling it, like I’m watching television with my face an inch from the screen. It’s hard to take a step back and get perspective. I don’t feel super sad (nor do I feel joy), I just feel like I’m processing emotions constantly, all day long, and getting quite mentally exhausted. I realize it’s only been three weeks... so I don’t know if this is really me, or Withdrawal Me. But it basically sucks.
I do feel a bit more engaged with life, mostly because I HAVE to be (I am having so many thoughts!). I feel pretty dumb now, as all the negative thoughts I had about medication before I started taking it are coming back... because guess what, I’m a negative Nancy again. It’s hard to confront the fact that despite how much I’ve grown in terms of healthy coping skills etc., I’m still this anxious, depressed person underneath the pills.
Basically I was not listening to doctors and decided I could just wing it from here on out... and I feel like I could, but like it’s highly unpleasant and I don’t even want to. At this point I’m not sure if whether I start taking it again it will work right away or take the usual 4-6 weeks. Also, I’ve been reading many articles lately about how long term SSRI use isn’t well understood, etc., and I’m just generally freaking out that I’m somehow damaging myself irreparably by taking the “easy way out.” Technically I could just try to exercise every single day and fight through the onslaught of shitty feelings. But I don’t want to. :(
My questions are basically: Have you gone through something like this, and what did you decide to do? Should I stick with the no drugs lifestyle for awhile— is this a rebound effect? And how do you handle anxiety about medication if you are an anxious person who treats their anxiety with medication?
Also in case you’re worried, I have a psychiatrist appointment next week where I will discuss all this. I’m just trying to process my thoughts in advance so I can talk to them confidently.
I've been on low dose zoloft, and later wellbutrin. I quit both because I hated the side effects and they kind of...stopped working after a while, though the side effects got worse. Now I'm on lamotrigine and I feel much better. No bad side effects at all. Per my psychiatrist, SSRI's will sometimes just 'quit on you'.
If you're finding it hard to cope, find a different med. Its tempting to quit when things are going well, but as you've seen, it can have not great results. You shouldn't have to white-knuckle through life. Find something that works for you, and not just bouncing around different SSRI's. There's other options out there. I know it's hard to try new meds...but if you need it, just do right by yourself. Its scary to change things up, but it's so worth it.
Best of luck.
posted by ananci at 8:05 PM on May 7, 2019
If you're finding it hard to cope, find a different med. Its tempting to quit when things are going well, but as you've seen, it can have not great results. You shouldn't have to white-knuckle through life. Find something that works for you, and not just bouncing around different SSRI's. There's other options out there. I know it's hard to try new meds...but if you need it, just do right by yourself. Its scary to change things up, but it's so worth it.
Best of luck.
posted by ananci at 8:05 PM on May 7, 2019
I take 200 mg of Zoloft every day. I have been taking it for at least 20 years. For me it wound up being a fairly simple decision: Take the medication I need so that I can live my life as I choose. Or don't take medication and let my issues dictate what I could or couldn't do.
One of the reasons I don't stop taking it - I had the opportunity to go back many years later to the psychiatrist who basically saved my life when I was 15. I asked him about the differences between treatments in the late 1960s when I was seeing him before and what was available now. He said the difference was amazing. He cautioned me that, at that time, when people stop taking an SSRI or similar medication, it may not work if they need it again
I take Zoloft for panic disorder. My panic disorder is clearly neurochemical. If I don't take Zoloft I have panic attacks, period. I don't want to stop because Zoloft is relatively benign and I don't want to go back to having panic attacks on a regular basis. They first tried Prozac, but it makes me sicker than being pregnant did. It took at least two weeks to get it out of my system.
I first developed full blown panic disorder in 1988. They put me on a tricyclic. Dry mouth. Really dry mouth. While my sister did just fine on a tiny dose, I had to take 100 mg. I could hardly talk my mouth was so dry. I went through multiple on and off cycles. I hated having to take a medication. Every time I stopped I wound up back on the edge of the mental health cliff, ready to give up. Doctors have told me I cannot have a panic attack that lasts for a day. I beg to differ. Well, maybe not 1 panic attack, but a succession of them. I am lucky because I am not associative - I never connected panic attacks to any particular circumstance. If I don't take Zoloft, I have panic attacks. Even with Zoloft, if I experience unusual stress, I still have the occasional very rare panic attack. Probably the only person who would realize I am having a panic attack is my ex. As long as it is an isolated event, I know what it is and just keep on going.
In the early 90s, I decided to enroll in an accelerated degree program to get my bachelor's. The first time, I got so stressed out I had to withdraw. At that point I decided if I had to take a medication so that I could do what I wanted to do, I would. At that time, it felt as if Zoloft mostly let me actually be who I am, and not a rabbit in a dog kennel. So I make that decision and never looked back.
I have been blessed with some wonderful therapists. I have also had a few useless ones. My panic attacks are NOT caused by a cycle of thoughts. The most helpful things for me have been interesting when I look back. First I took some meditation classes at the Berkeley Psychic Institute. Next I happened to work with a wonderful person who was doing some very effective personal development work in the 90s. One of those programs led me to the realization that "IT simply isn't about what's wrong with me." That realization/insight led to me starting a career in consulting, flying into strange places late at night, learning the details of a software module the night before so that I could train my clients on it the next day....getting kicked off projects, etc. Just do it. It was not about what was wrong with me. Getting that deep down really changed my life. Also having insights and unfolding them in my life has been amazing. When you have an insight you can never go back to being who you were before. I have moved on to studying the work of Sydney Banks and I am considering starting a 3 Principles group.
Also, the "so many thoughts" is common among people with ADHD. My mind is never quiet. Never. I was amazed when my daughter told me that her best friend actually has times when her mind is quiet. I cannot imagine. And ADHD, when undiagnosed is often comorbid with other issues.
Only you can really know what will work for you. Be easy with yourself and listen to your inner self. I wish you the best possible future.
posted by Altomentis at 8:11 PM on May 7, 2019 [3 favorites]
One of the reasons I don't stop taking it - I had the opportunity to go back many years later to the psychiatrist who basically saved my life when I was 15. I asked him about the differences between treatments in the late 1960s when I was seeing him before and what was available now. He said the difference was amazing. He cautioned me that, at that time, when people stop taking an SSRI or similar medication, it may not work if they need it again
I take Zoloft for panic disorder. My panic disorder is clearly neurochemical. If I don't take Zoloft I have panic attacks, period. I don't want to stop because Zoloft is relatively benign and I don't want to go back to having panic attacks on a regular basis. They first tried Prozac, but it makes me sicker than being pregnant did. It took at least two weeks to get it out of my system.
I first developed full blown panic disorder in 1988. They put me on a tricyclic. Dry mouth. Really dry mouth. While my sister did just fine on a tiny dose, I had to take 100 mg. I could hardly talk my mouth was so dry. I went through multiple on and off cycles. I hated having to take a medication. Every time I stopped I wound up back on the edge of the mental health cliff, ready to give up. Doctors have told me I cannot have a panic attack that lasts for a day. I beg to differ. Well, maybe not 1 panic attack, but a succession of them. I am lucky because I am not associative - I never connected panic attacks to any particular circumstance. If I don't take Zoloft, I have panic attacks. Even with Zoloft, if I experience unusual stress, I still have the occasional very rare panic attack. Probably the only person who would realize I am having a panic attack is my ex. As long as it is an isolated event, I know what it is and just keep on going.
In the early 90s, I decided to enroll in an accelerated degree program to get my bachelor's. The first time, I got so stressed out I had to withdraw. At that point I decided if I had to take a medication so that I could do what I wanted to do, I would. At that time, it felt as if Zoloft mostly let me actually be who I am, and not a rabbit in a dog kennel. So I make that decision and never looked back.
I have been blessed with some wonderful therapists. I have also had a few useless ones. My panic attacks are NOT caused by a cycle of thoughts. The most helpful things for me have been interesting when I look back. First I took some meditation classes at the Berkeley Psychic Institute. Next I happened to work with a wonderful person who was doing some very effective personal development work in the 90s. One of those programs led me to the realization that "IT simply isn't about what's wrong with me." That realization/insight led to me starting a career in consulting, flying into strange places late at night, learning the details of a software module the night before so that I could train my clients on it the next day....getting kicked off projects, etc. Just do it. It was not about what was wrong with me. Getting that deep down really changed my life. Also having insights and unfolding them in my life has been amazing. When you have an insight you can never go back to being who you were before. I have moved on to studying the work of Sydney Banks and I am considering starting a 3 Principles group.
Also, the "so many thoughts" is common among people with ADHD. My mind is never quiet. Never. I was amazed when my daughter told me that her best friend actually has times when her mind is quiet. I cannot imagine. And ADHD, when undiagnosed is often comorbid with other issues.
Only you can really know what will work for you. Be easy with yourself and listen to your inner self. I wish you the best possible future.
posted by Altomentis at 8:11 PM on May 7, 2019 [3 favorites]
My questions are basically: Have you gone through something like this, and what did you decide to do? Should I stick with the no drugs lifestyle for awhile— is this a rebound effect? And how do you handle anxiety about medication if you are an anxious person who treats their anxiety with medication?
I was on 50 mg Zoloft for five years. In getting on it I was motivated enough to take it to ignore the side effects of both decreased sleep quality and suppressed libido. I stopped taking it because I found a therapist who helped me understand the patterns that were causing my anxiety. I quit, using tapered doses to do so, and experienced brain zaps and the re-emergence of strong good and bad feelings. Nobody warned me that the Zoloft withdrawal symptoms suck as much as they do or would last that long. I think it took at least six weeks for them to fade and then I still had to do the work of applying my newly learned coping methods to all those... feelings! And thoughts! I So many thoughts... and such loud thoughts! I did not realize, until I got off it, how much it regulated my emotions into a calm blandness. I decided to stick with it. The brain zaps were awful, but they did finally go away. I tried getting back on it once. This was not successful. I found the side effects to be not worth it. Instead, I exercise every day. For me exercise is an effective means of seeing through thoughts that seem all-powerful, along with the mental toolkit I acquired in therapy. I am willing, though, to take the "long way" in dealing with my anxiety because my anxiety, when compared to what others go through, is really not all that onerous. It is tedious, and it has negatively impacted my life. But I do not have, say, panic attacks as described above. I understand that exercise and mental toolkits are not enough for people with truly severe anxiety. Just how bad is your anxiety? You and your therapists/doctors have to decide.
I don't know if you should stick with a no-drugs lifestyle for a while. SSRIs affect everyone differently. You might want to hold out a little longer and see if you start to feel better. But if you decide to get back on them, then that is what works for you and that is okay.
posted by Armed Only With Hubris at 6:49 AM on May 8, 2019 [2 favorites]
I was on 50 mg Zoloft for five years. In getting on it I was motivated enough to take it to ignore the side effects of both decreased sleep quality and suppressed libido. I stopped taking it because I found a therapist who helped me understand the patterns that were causing my anxiety. I quit, using tapered doses to do so, and experienced brain zaps and the re-emergence of strong good and bad feelings. Nobody warned me that the Zoloft withdrawal symptoms suck as much as they do or would last that long. I think it took at least six weeks for them to fade and then I still had to do the work of applying my newly learned coping methods to all those... feelings! And thoughts! I So many thoughts... and such loud thoughts! I did not realize, until I got off it, how much it regulated my emotions into a calm blandness. I decided to stick with it. The brain zaps were awful, but they did finally go away. I tried getting back on it once. This was not successful. I found the side effects to be not worth it. Instead, I exercise every day. For me exercise is an effective means of seeing through thoughts that seem all-powerful, along with the mental toolkit I acquired in therapy. I am willing, though, to take the "long way" in dealing with my anxiety because my anxiety, when compared to what others go through, is really not all that onerous. It is tedious, and it has negatively impacted my life. But I do not have, say, panic attacks as described above. I understand that exercise and mental toolkits are not enough for people with truly severe anxiety. Just how bad is your anxiety? You and your therapists/doctors have to decide.
I don't know if you should stick with a no-drugs lifestyle for a while. SSRIs affect everyone differently. You might want to hold out a little longer and see if you start to feel better. But if you decide to get back on them, then that is what works for you and that is okay.
posted by Armed Only With Hubris at 6:49 AM on May 8, 2019 [2 favorites]
ug. I am going through this very same struggle as you right now. Been on Lexepro for 2 years, decided things are in a different place now and I'm ready to reset. And, shit has it ever felt like a bad week.
All this is to say - it's tough.
posted by rebent at 10:49 AM on May 8, 2019
All this is to say - it's tough.
posted by rebent at 10:49 AM on May 8, 2019
Great advice you're getting above from people with personal experiences in the matter. Just in case you hadn't seen these, this has been written about on several occasions in the New Yorker and in the NY Times:
https://www.newyorker.com/magazine/2019/04/08/the-challenge-of-going-off-psychiatric-drugs
https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html
https://www.nytimes.com/2019/03/05/health/depression-withdrawal-drugs.html
posted by jasper411 at 11:23 AM on May 8, 2019
https://www.newyorker.com/magazine/2019/04/08/the-challenge-of-going-off-psychiatric-drugs
https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html
https://www.nytimes.com/2019/03/05/health/depression-withdrawal-drugs.html
posted by jasper411 at 11:23 AM on May 8, 2019
please tell me you tapered off the meds and didn't quit cold turkey. you could still be experiencing withdrawal.
i've been on meds of various types for 20 years. there were a couple times i decided i wanted to see what life was like off them, if my depression was "just me" or was situational. let me tell you i realized pretty fast that it's just me. and that i will need drugs for the rest of my life.
you need to make the decision for yourself if you prefer the way you feel without the meds or the way you feel on the meds, and if the side effects are a worthwhile trade off for that.
there are certainly other meds you can try. though the cycling on and off and cross-tapering is its own hell.
posted by misanthropicsarah at 1:59 PM on May 8, 2019
i've been on meds of various types for 20 years. there were a couple times i decided i wanted to see what life was like off them, if my depression was "just me" or was situational. let me tell you i realized pretty fast that it's just me. and that i will need drugs for the rest of my life.
you need to make the decision for yourself if you prefer the way you feel without the meds or the way you feel on the meds, and if the side effects are a worthwhile trade off for that.
there are certainly other meds you can try. though the cycling on and off and cross-tapering is its own hell.
posted by misanthropicsarah at 1:59 PM on May 8, 2019
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At this point, I'm mostly very glad I went off it. I feel much more stable. However, there are times when my anxiety is triggered and I feel like crap (health anxiety is a big thing for me) and I think, 'hm, should I do the Zoloft again?' but I don't want to. I DO take clonazepam here and there and have that fear of running out, because my doctors don't like to prescribe it. Also, yeah, you're not supposed to take a lot of benzos, etc., I know, and I don't.
But anyway, everybody's mileage is obviously different. But I think maybe you might want to give being off it a much longer trial before deciding what you want to do. Let me say that I am a mental health professional but NOT with a medical degree and have NO professional expertise in psychopharmacology and am NOT making any professional recommendations to you whatsoever! I am just relating my personal experience,; I have no answers for anybody and am just experimenting for my own body.
Good luck - I know that awful feeling -- better with, better without, what am I supposed to do?? it sucks. Just remember you can always go back on the drug or another drug that might work better for you.
posted by DMelanogaster at 7:19 PM on May 7, 2019