Mother of all Lists — Antidepressant Withdrawal

Antidepressant Withdrawal

This week’s author wishes to remain anonymous, but their voice comes through loud and clear as she shares her ongoing experience of managing her mental health and the impact of the antidepressant medication she was prescribed.
In 2016 I couldn’t convince my GP to refer me to a psychiatrist.
Despite telling him I had nightmares, suicidal ideation, felt violent impulses toward myself and others, felt scared and unsafe, was unusually aggressive and violent, and was frequently smashing shit up at home.
I had visual disturbance, was dizzy and my skin felt like it was pulsing with an electric current.
My description of moods from agitation to total numbness and uncontrollable sobbing, the insomnia and the rage that terrified me, wasn’t enough to get a referral.
My partner rang the community mental health team, and I told them I was scared I had cyclothymia or bipolar, and that I had suicidal thoughts.
I received a prescription for diazepam, no further care.
Days after one of these doctors appointments I attempted to get out of a moving car on the M4. I couldn’t open the door, I kicked the windscreen a few times (it didn’t break) and kicked the rearview mirror off and the gear stick out of gear. I ended up in the backseat by the time my partner had pulled over to the hard shoulder.
I got out and appeared back ten minutes later sobbing and carrying a large stick, which I clutched all the way home.
I have no idea what happened. I was not in control. I had only a vague idea that I was even in a car going 70mph, or that I had just put my husband’s life and others at risk.
This was a couple of weeks after having stopped an anti-depressant, after a ‘slow’ taper that had taken a year.
I now believe I may have experienced psychosis, or something very close, brought on by withdrawal from the anti-depressant.
This wasn’t an isolated incident, but it was the worst, thankfully.
I should’ve gone to hospital, but I didn’t know how bad I was, I felt the doctors’ dismissal of me meant I was OK, that I was being over-dramatic.
Instead, I took two diazepam, and slept.
Then I started taking the anti-depressant again, for what the doctors called my ‘relapse of depression’. I took the lowest dose, out of exhaustion and fear, heartbroken I had failed to kick the habit.
My partner, desperate for help, was asked to stop calling the community mental health team.
No one mentioned withdrawal to me. It would take me the next few years of wondering and researching to work that out.
It troubled me that my ‘relapse’ involved entirely different and scarier symptoms than any ‘depression’ I had ever experienced.
How could I ‘relapse’ to a place I had never been?
Throughout this, and for months, I believed no one was willing to support or help me.
Everything became evidence of my worthlessness, I was hypersensitive to each little thing. Every word, action or lack of, was a deliberate communication of how hated I was.
I lost friends, and avoided family, I lost trust in people.
In recent times I’ve heard more and more friends and acquaintances say they’ve been prescribed anti-depressants, and as I open up about my experience, I’m always met with the same response. “I’m not going to take it for long”.
“I really hope you have the choice, I didn’t choose this” I think.
The 2018 Davies and Read report found around a 50% occurrence of withdrawal symptoms, depending on the drug.
I believe anti-depressants save lives and have saved mine.
But then again I believe they have been the cause of my suicidal ideation, multiple times.
SSRIs and SNRIs increase the risk of suicide, especially when first starting, and in my experience, when stopping.
When you’re exhausted by the fight, there is definitely a place for pills that give you respite.
But believe me when I say I never thought I’d be on them for long either, dependence was out of my control and the side effects of withdrawal have been insurmountable.
Not all anti-depressants are made equal, so research what you’re given.
It’s taken me years of wondering what’s wrong with me and feeling alone, and I’m ashamed to talk about it.
But this needs to be talked about, so if others are experiencing withdrawal, they might have a chance at recognising it, before it does them too much damage.
It’s not addiction. It doesn’t cause cravings and credit card debt. It’s dependence.
The effects of losing or lessening your dose, can create havoc with the nervous system.
Anti-depressants should not be a life sentence.
It took a long time for me to stabilise in 2016. Not least because, I’ve omitted to say up until now, I was working in a refugee camp, and the trauma of that really muddied the waters.
I didn’t take my own needs seriously, I thought I was experiencing secondary trauma from being witness to unfathomable human rights abuses and violence, which certainly contributed to my state of mind.
How could I be so selfish whilst witnessing so much suffering and violence?
My mind had great material to work with, and it appeared to me, I simply couldn’t cope, wasn’t tough enough.
I had no idea the withdrawal was a thing.
The suicidal ideation stayed with me for months, on and off, it felt like a possession.
Walking over a bridge, holding a bread knife, taking a pain killer… it told me everything was an opportunity.
When I eventually told my partner how I planned to kill myself, he did a deal with me to try a higher dose of the anti-depressant and asked me to wait it out. So I went up again onto my original ‘therapeutic’ dose, and life got much easier.
Three years later, and I’ve once again tapered down to a tiny dose and am terrified of what will happen as I get near to zero.
I recently dropped my dose by a single milligram, and after six weeks of spiralling depression, became agitated and had two days of suicidal ideation and feeling distraught. Caused by a single milligram.
I reinstated my previous dose and lost the suicidality within 48 hours.
The lower you get the worse the symptoms are, because apparently the first 10% of the dose of an SSRI/SNRI accounts for almost 90% of the effect on neurotransmitters.
I’ve ‘bridged’ to a different SSRI which has less occurrences of withdrawal, a method advised by the psychiatrist Dr David Healy.
It’s taken me over two years.
There’s been vertigo, headaches, anxiety and panick attacks, fatigue, depression, crying as a full-time occupation, agitation, anger, being-an-insane-irritable-bitch-all-of-the-time, and that old electric feeling in my skin.
Oh, and feeling almost constant DOOM.
There’s also the times between dropping doses, when I’ve stabilised and feel good, can concentrate, and feel sociable, which helps me know I am right; withdrawal is real.
I’m having to manage myself and my symptoms very carefully, I need a lot of solitude, a smaller life, less stressful work, and activities to calm my nervous system; run, yoga, nature, mindfulness, cold water and a shit tonne of sleep!
Three things have driven me to write about it now;
1. More and more friends and acquaintances telling me they’ve been prescribed an anti-depressant, especially women.
More honest information is needed to help people make informed choices about the complex pros and cons of medication, or to realise that their experiences may be caused by medication.
The information doesn’t exist in medical guidelines, because the pharmaceutical companies haven’t done the trials, but there’s plenty of anecdotal evidence out there.
2. A glut of celebrity accounts of mental health crisis, which I believe is crucial, and helps us all to speak honestly. But I can feel fucking hopeless for myself and others whilst reading anecdotes of inpatient support, or ongoing work with a team of psychiatrists and psychotherapists, which represent private health care.
Most of us rely on the NHS, and stories of surviving and thriving quickly become less inspiring when the reader realises they face many more barriers to support.
In fact, you’re much more likely to have a low income if you’re managing enduring mental health difficulties.
Most of us will simply never receive this level of care, and we need to speak about that, and provide signposting and advice that helps everyone.
3. I’m scared it’s going to happen to me again. I’m scared I’ll put my partner through it all again, and I can’t do that.
Part of both processing what’s past, and preparing for what’s still to come, is allowing myself to be honest about it, and try and move past the shame.
Why am I so determined to get off them?
Well, there’s the night sweats, vivid dreams, fatigue, lack of libido, no concentration, brain fog and memory loss, and other lovely life enhancing side effects of just taking this thing.
Because 2016 wasn’t a ‘one-off’.
I was originally prescribed the SNRI in 2009 for ‘treatment-resistant depression’, on the tail of a breakdown at age 22, which, funnily enough, occurred in the months after stopping an SSRI I had taken for a year.
The first 4 years on this new drug were a dream, but the latter seven have seen a host of mental health ups and downs, which I have frequently feared might end in bi polar.
Now I know withdrawal.
I can look back at the past several years and recognise that every crisis, every madness, has corresponded with a change to my medication brand, dose or consistency.
I never imagined it would take so many years, and so much horror, to claw myself away from this stuff, but now I know, I don’t want it in my body.
I’m a woman in my thirties, who would like the choice to have children as safely as possible.
Knowing the effects these drugs have had on my body and mind, I’m cautious of their effects on a baby inutero, the effect of withdrawal on a newborn, and the longer-term effects we don’t know about.
My original drug has seen a lot of court cases regarding birth defects and miscarriage, and yet no prescribing doctor has ever asked me if I plan to get pregnant.
I’m more comfortable now I’ve successfully switched to one which is licensed for pregnancy and has, relatively, the most amount of research for this.
This isn’t about any woman making the wrong choice.
If you’re suffering from mental health hell, then you’re already doing your best in a shitstorm of mental dis-ease, and the safest thing is undoubtedly to stay well.
BUT I do believe that choice needs to be enabled by doctors offering accurate and honest information, not the lack of it.
HELPFUL RESOURCES:
The Samaritans
Mind Charity
Rethink.org
NHS: ‘Every Mind Matters’