Sertraline withdrawal

I found my way to prescription meds when I had my big phat breakdown of the century in 2019 (see previous posts for further detail). Antidepressants were the last-ditch resort: I was tentative about being on them and suffering intolerable side effects. I had some helpful advice from friends and family, but among them, there were very different accounts of how efficiently medication worked for them and what it was like to withdraw from the meds when there was no longer much, if any, need for taking them. There were quite a few horror stories about withdrawal: tales of constant stomach agony, ‘zapping’ sensations in the brain, sleep disturbances, depersonalisation and generally just feeling the clutches of depression strongly as soon as antidepressants were reduced/cut out, but I wasn’t super phased by this. In terms of foreseeing the inevitable withdrawal process further down the line, I didn’t really have the capacity to see beyond the end of each day, never-mind a hypothetical scenario months or potentially years down the line. So I made the executive decision based on where I was in that moment, sat in that barely-padded GP’s patient chair, and said yes to Sertraline.

When I was initially handed the prescription for that first pill packet, I was told that, at minimum, I would be taking this medication for at least a year. This accounted for the initial period of up to six weeks, wherein Sertraline gradually builds up in your system and starts to take effect, and the progressive withdrawal, which is done incrementally.

A year from the first prescription: that should have taken me to Spring 2020, however, as the world was burning down around us and I didn’t want to inconvenience very busy NHS staff with my minor ailment of medication reviewal, I let that preliminary deadline slide. Also, with the entire routine of existence as I previously knew it in the air, only mere months after I’d started to venture out of the house and “take control” of my life, I didn’t feel it was the right time to talk about taking the stabilisers off.

I was right to follow my gut.

I think, in a way, I was acclimatised to many elements of lockdown life and this therefore softened the blow of the first few months (I still obviously had “down days” but they could have been far, far worse). I could have dropped the Sertraline, on track with the trajectory my GP had set, and probably winged it last summer. However, because I was tentative about the timing and unsure about how the COVID-19 situation would pan out, I clung on out of caution. Others were optimistic without cause, but I feel quite lucky as I’m a huge critic of the Tory government and anticipated their ineptitude, so I wasn’t as upset or surprised as others when we’d end up 1 step forward and then 50 steps behind. While others mourned their freedoms, I hadn’t grown attached to the idea of them returning in the first place and quietly continued on, reading and drinking wine.

Alas, it eventually caught up to me and another round of restrictions, which felt like a bit of a slap from the universe, and other influences such as seasonal changes, hormones being out of whack and employment stress led to peaks of tension that significantly worsened my mental state. There’s been light relief in between these periods of angst and anger, so I can definitely say that my mental health has fluctuated a lot on the wild rollercoaster ride that has been life during COVID-19. I altered my dosage to reflect how I was feeling in certain periods, so I swung from the lowest dosage of 50mg all the way up to 200mg, dependent on whether the symptoms of my depression or anxiety were moderate or severe.

Towards the end of the year, my journey with Sertraline came to an end and entirely by (accidental) cold turkey. This was not the plan. Cold turkey is not medically advised because the risks are so high for relapsing or experiencing severe withdrawal symptoms, which usually leads to people ending up back at square 1 of mental illness: turning to all the wrong people and places for solace. But you see, the thing is, I really didn’t mean to do this. I mean of course I occasionally forgot to pop one, or maybe two, but always found myself returning to the routine in spite of minor slips. Then came a point where I’d gone more than two weeks without taking it and I decided I was at an interesting crossroads. I did call my GP at this point, mainly to flag that I had achieved this feat with no major differences felt physically or mentally, but also to query whether it was worth me continuing on my rogue-ish course of abstinence. After all, I’d already come quite far without Sertraline and it was promising to see that I hadn’t completely deflated without it or suffered the cruel symptoms of letting it go. The GP was 100% supportive of me ‘weaning’. This process essentially meant that I had to slowly take smaller dosages, dropping one step and waiting for around 3 weeks before dropping another and waiting that out for a few more weeks.

It was during the second dropdown phase that I felt the slow ascension into my natural more manic state, which involves hyperactivity, struggling to sleep and taking on a multitude of tasks at the same time (juggling until I go kaput!). I also experienced heartburn, a completely new and unprecedented symptom that I literally never experience, and a slight spike in my IBS/digestive issues. These were uncomfortable experiences, but tolerable as I reiterated constantly in my head that they were literally just products of weaning and not signs of actual mental deterioration. Was this challenging? Yes. But nowhere near the same level of challenging as the condition which led to me taking Sertraline in the first place.

I worked through it. Honestly, there have been a few occasions where I’ve felt low and my instinct has been to blame the withdrawal from Sertraline, but I’ve not felt it strong enough to warrant turning back to the drug as I’ve generally managed to handle the symptoms I’m experiencing with holistic or alternate treatments. I’m lucky to be in this position and know that this is generally a sign of recovery, as I’m able to manage myself in a small capacity and look forward to testing the waters even more when the pandemic comes to an end. In the meantime, I think I will continue to take things a day at a time and try to avoid drastic decisions regarding medication as it worked for me only in tandem with talking therapy/other avenues being explored.

The world is a very weird place at the moment and I think it’s justifiable that we humans feel out-of-sync and a little tested by our current circumstances. Like countless others, navigating the new territory of a global pandemic and trying to keep mentally afloat, I have generally tried to be a little kinder to myself even when I get unfavourable blips of madness or sadness. Sometimes things work out and sometimes they don’t, so we end up in these frustrating bubbles where it’s easy to overextend or to abuse our crutches (be they in substance form or otherwise). My one significant achievement from this pandemic will be the fact I was brave enough to commit to life for the foreseeable future without antidepressants, even if that’s challenging sometimes and even if this only happened initially by accident. I’m very privileged to be in this position and I sure as heck couldn’t imagine it at all a couple of years ago, so I’m grateful today and I’m going to actively celebrate this victory as it’s no small feat.

If you’ve been feeling a little poopy lately, as if you’re missing the spring in your step, I would definitely implore you to write a list of all the things (however big or small) you’ve persisted through this pandemic and take a long, hard look at how far you’ve come. Nothing is to be taken for granted. If you beat yourself up about your shortfalls, it’s equally as important, if not more so, to celebrate all that you have done, as these feats are a testament to your stamina and positive will. I am guilty of focusing on the negatives myself and it doesn’t make for a productive or kind headspace. All I can say is: don’t lose sight of the bigger picture!

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