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!

PERSONAL BLOG: Quietly disappointed, 2021 begins

The accompaniment to a very strange NYE.

It’s that time of year again: the time for reflection and for the sincere, albeit misguided, art of resolution-making for the year ahead.

Has this worked in the past? Not really, but then again, I’m not in the habit of ritualistically practicing what I preach or staying motivated for consistent periods of time. The problem is more likely to be with me than it is with the spiritual practice of reflection and setting manageable goals for the year ahead, so, with that in mind, I’ve decided to give it another go, if only to get my affairs in order and truly gain some closure from what can only be described as the never-ending shit-show that was 2020.

It’s a tough exercise: lamenting the mistakes and shortcomings of 2020, as well as looking back fondly on the few things I’ve managed to achieve in spite of the global pandemic, which has essentially pulled the rug from beneath my feet, not to mention millions of others. This is because there has been overwhelmingly negative events to look back upon and because a lot of the memories I would have created with loved ones were wiped out by the virus (thanks again, COVID-19).

I’ve never felt like this at the beginning of a new year before.

Usually I can find a way to focus on the parts of life I’m most grateful for or the positive attributes of the world. However, I realised last night, on the cusp of 2021, that just I don’t feel very good at the moment and it is especially hard for me to be receptive to gratitude or positive things happening. I would love to decipher why that is, specifically, so that I could try and fix it. Only, how I feel is complicated because it has no sole cause and is more likely due to a combination of various factors such as: Sertraline withdrawal, underlying depression/anxiety resurfacing in a Sertraline-free body, hormones, having no personal space and the big one, COVID-19. The destroyer of dreams, the taker of good times.

NYE itself was no reassurance. Like countless others with no option to go out or be with loved ones, I stayed in. I was generally okay in the company of my incredible friends, but the evening culminated in me crying at midnight, not the good type of crying, and having to take a moment to check myself. Even though I was in a situation where literally dozens of friends and family were virtually plugged in and trying to celebrate with their heads held high, my instinct was to crawl into a dark hole and be alone, because alone was exactly how I felt. I couldn’t feel their joy even though I really wanted to.

I fought through this and made the effort to stay sociable for a while, knowing that cutting myself off would likely make everything worse, before spending a considerable amount of time thinking dark things and toying with the idea of calling Samaritans, all while dressed up and drinking a bottle of champagne in the dining room on my tod. Eventually I decided that the best way to not feel so lame, aside from having my stomach pumped, was to go to sleep in order to turn the bad thoughts off. I ended up sleeping for about 12 hours and waking up this afternoon feeling even more deflated.

I have learned that as a person, I am very good at burning the candle at both ends and taking on commitments with a vivacity, as if I’d die without inhumane amounts of stress on my shoulders. As of recent years, I am excelling at also being so burnt out and incapable of positive thought, that I am immobilised completely by anxiety and can spend long periods of time literally doing nothing. It seems I am good with extremes, but severely lacking with the ability to balance.

Being at home for the last 9 months, left to my own devices in an environment with 4 other strong personalities, has been challenging. It has meant that I am neither progressing nor deteriorating in measurable terms: I’m just not moving at all, which has actually felt even worse. For a person who is so used to being really high or really down, the prospect of repetition, routine and static has been a massive shock to the system.

Presently, my living situation leaves much to be desired. This is not because I hate my family or I’m ungrateful for all that I have, including this roof above my head, but the reality of the situation is that I am now a grown adult living like a responsibility-less child in a place where personalities clash all the time, and with about the same seismic impact as a bout with one of the Klitschko brothers.

It was once a haven, when I was really poorly last year, but it’s now a nightmare for me: I sleep in a bunk-bed in a room I share with my sister, and overhead is an over-heaving loft of disregarded artefacts, weighing down upon the house, which has clutter crammed into every possible cranny. We have not one of everything, but dozens of spare duplicates, lost in the ether and about as much use to us as a Tory government during a global pandemic. As a person who is eager to transition into a plant-based diet with cleaner, more eco-friendly modes of living and a minimalistic space of my own some day, my main instinct is to gut the whole place out and start afresh, but sadly, I am fighting against very stubborn and dark forces, which makes this an impossibility.

On a less dismal note, and accepting that there are some things beyond my control, I think I would like to work harder at focusing on the things which are in my control.

Firstly, there’s the realisation that this isn’t my house to change and everyone here has their own issues as much as I do. And as much as there may be evident signs of trauma up in my grill every day (girl, we hate to see it), it certainly isn’t my place to diagnose or assist in other people’s journeys to better themselves, particularly if they have no desire whatsoever to embark on that path and are content living in oblivion. It may be an inconvenience which has an impact on me, but it is truly not my problem.

Secondly, I am in control of my fitness and clean-eating habits, of which I currently have none. On the plus-side, I literally have nothing to lose and everything to gain from the moment I pull my finger out and make a conscientious effort to try, in whatever capacity I can, on a day-to-day basis. Amen hallelujah, brother.

Thirdly, I would like to convert my frustrations at this current, temporary living situation into a real, tangible effort at making my vision of my own future home into a reality. There’s much saving to be done, many decor mood-boards to be made, dog shelters to be perused and other logistical obstacles to be overcome, so I’ve got plenty to keep me occupied, on that front.

Fourthly, though my mental health is pretty good at making this feel like it isn’t the case, I am in control of how I talk about myself and how I view myself as a person. In this moment, I would like to give myself kudos for actually just being alive right now, as there have been several times over 2020 where the black dog has pushed me into that dingy corner and made me seriously question mortality. I’m going to go full Snoop Dogg mode and thank myself for getting here, because ultimately, it’s all on me.

There are many more to note, but I think I’ll keep those in my notepad and perhaps this year, I won’t beat myself up for not hitting impossible targets by choosing not to make impossible goals and targets in the first place.

Disclaimer: In the time it’s taken me to write this, I’ve gone from feeling like a used Kleenex to actually pretty decent, which is a welcome change and a promising start to 2021, despite all the bad juju I’ve had in the last 24 hours. This is the power of writing and self-reflection. This was intended to be a private rant in a shelved Word document, but instead, it is my first statement to the world of 2021. It is an honest and tired account of a person who doesn’t quite know what she’s doing in life, but she’s come to terms with that and most other imperfections she carries, so I think that’s worth some celebration in itself.

I hope that whoever reads this is armed with the knowledge that struggle is inevitable and mental health is a rollercoaster that doesn’t necessarily correspond with what’s happening in the world. It could be the brightest day with the nicest encounters, but that doesn’t mean you feel it as such, if your head isn’t in that place. I am currently going through a bad patch, but I believe everything will be okay because it has to be okay and, even if you don’t feel this right now, know that I am believing on your behalf and that you’re never alone. Here’s to clawing our way through 2021 in the same way we did 2020 ❤