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ADMIN NOTE: Topic Summary added. SEE ALSO: Stabilising After a Reduction - What Does That Mean? Withdrawal Normal Description ___________________________________________________________________________________________ Key Study - Waves and Windows in SSRI Withdrawal Windows and waves occur in a stair-step pattern, with a general upwards trend. After a year, a little better. Awful Alto: I've experienced waves. I'll have a window when I feel better, then a wave, which feels as bad as ever, except a little different. Over time, the windows have gotten more frequent and longer and the troughs not as deep, and shorter. So, on average, I've gotten slowly better. Kind of like 1 step forward and 5 steps back, then 2 steps forward and 5 steps back, then 3 steps forward and 4 steps back, then 2 steps forward and 3 steps back, then 3 steps forward and 3 steps back....uh, where was I? Waves mean your nervous system is struggling to heal. It moves in the right direction for a bit then falls back a bit. This is normal. You can view the "better" part of the wave as when your nervous system is finding its balance. These periods will get longer and more frequent as time goes on. Rather than damaged receptors, I've found it more accurate to visualize post-acute withdrawal syndrome as autonomic dysregulation. The effects are generalized and when the nervous system is under stress, symptoms can reappear -- and go away again, as is common with autonomic issues. Our nervous systems are so complicated they repair themselves in patches. Some parts recover then the whole thing needs to re-balance again. Rinse and repeat. The windows are part of the pattern of healing. They are when your autonomic (and other) systems are working in harmony. Withdrawal Cycles vs Other Cycles Alto: There are regular biological cycles, daily, monthly, seasonally etc, and there are the waves from withdrawal syndrome. Withdrawal syndrome can exacerbate some normal cycles, e.g. early morning cortisol, menstrual symptoms, or seasonal sadness. Waves from withdrawal syndrome can also come out of the blue and have no apparent relationship to any other biological pattern. Fast Tapering and Waves Alto: If you are tapering too fast and get withdrawal symptoms, they may fluctuate in a windows and waves pattern. This leads a lot of people to ignore the warning signs of going too fast. If you continue to taper, withdrawal symptoms probably will get worse. It's the nature of withdrawal symptoms to fluctuate, because the nervous system is trying to correct itself. It's important to treat yourself gently. You may not be able to handle difficult situations that you've always handled before. Focus on stress reduction. Learning how to protect your nervous system from abrasive people is a good skill and will serve you well in the long run. Being pushed to take care of ourselves is, I guess you could say, one of the benefits of this awful condition. The Importance of Flowing with the Waves JanCarol: There was a DIRECT CORRELATION between how hard I worked during my window / hypo-mania, and HOW LONG and DEEP my ensuing depression was. If I got to washing the dog and mowing the lawn, it might be 3 weeks or more before I'd see the light of day. This is a cautionary tale: when in a window, learn to relax and flow. Don't push. I know, things aren't getting done, and you are tired of it - but if you push too hard, the wave will crash deeper. See entire post - Flow with the Waves Video Healing from Antidepressants: Patterns of Recovery Members' Theories on what Windows and Waves are all about Healing: I have heard of people having long-lasting setbacks even very far out. It's extremely upsetting. In some cases, it seems like the setback is triggered by stressful life events. My theory is that, even after we have healed a lot, we are still very fragile for a time after that. If life happens to be fairly smooth, we can function pretty well, but if life hands us a big stressor or two, we become really autonomically dysregulated. We're still more sensitive to conditions than we will be when we have healed further. Eventually.....eventually.....we heal even more, become more robust, and stressful life events can no longer knock our nervous systems off balance so easily. Jemima: Because antidepressants change brain functioning by destroying serotonin receptors, recovery goes in fits and starts as these receptors regenerate. (From what I've read, this is my understanding of what getting back to health after withdrawal is all about.) Starlitegirlx I have a theory that it's a healing process where our body is adapting and adjusting to not having the meds. Pain or hellish days come into play, then we feel better for a bit until our body finds a new way to heal and recover which triggers the pain/suffering cycle again. The body knows how to heal from just about anything, but often we interfere or things interfere with it (like stress, other meds or other health issues that compound one another). I like the idea of trusting in my body and believing it knows how to find its way back to its wellness. Bad days are awful but if they mean my body is going through some kind of adaption as it heals, I feel they are worth enduring. Like when you are tired and just want to go home but traffic and bad weather slow you down and frustrate you. Those things pass and you will get home eventually. So accepting the traffic/ bad weather as par for the course makes the journey home easier on you emotionally. It’s a simple analogy but it holds the truth of what is happening – there are storms and delays when we just want to be home (well again). Recoveries are rarely as smooth and linear as we would like. I think it has to do with how the body has to adapt to a new status quo. Any healing is change which brings about a new status quo. So maybe this new status quo throws the workings of our systems off balance - and that's why we have waves. The body is saying 'wait, this is different than it was. Adjust! Adjust! Then as it adjusts we have the suffering we call waves. Those adjustments are probably system stressors, and we all know how sensitive we are to stressors. I think it's why windows get longer as we progress and have healed more. The adjustments we need to make are less because we are closing in on our original normal so the healing isn't as dramatic. Like how a cut stings, then the scab forms and it hurts and tends to itch. That's a healing cycle. At the end, the itch is minor - like how some people who are further into recovery have less dramatic and shorter wanes. A clear description of the healing pattern ADMIN NOTE Original post: In other words, when you go through a period of symptoms getting worse, and then that draws to an end, is it followed pretty obviously by a period of new gains? Are you now better than you were before the wave? People have reported this pattern. I have never been able to discern it clearly in myself, but I'm open to the possibility. What is your experience of this yourself? Or observation of others? Or opinion?
Kittygiggles posted a topic in Introductions and updatesIntroduction Hi everyone. I have been lurking here since last year but decided to start my thread as my waves are getting more frequent. I am trying to stabilize at 20mg of generic Prozac (fluoxetine) daily, and have been taking it for 6 months. I thought stabilization was finally happening in January this year but waves are now weekly. I am here to see if anyone can shed light on why my horrible waves are more frequent now. I've read “The windows and waves pattern of recovery” (http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/). Maybe I'm missing something? I'm not feeling very bright since WD hit me! Wave and window frequency Stabilization seemed to work right away and my intense waves were about every 14 to 21 days (3 to 4 weeks). Last month and this month, waves have increased frequency to about every week and last 2 to 5 days, with a window inbetween. Currently working on a graph based on my daily notes to visualize my stabilization journey. WD waves This is how I recall them now but I will update this description when I consult my notes next during a window. A headache and dizziness accompany a vice-like tightness around my head. I then get intensely irritable, depressed, and quite sleepy. I then get akathisia, mostly in the legs. I have tried pushing through it but I find it very hard to concentrate on anything and I just can’t bring myself to talk or interact with anyone. Any conversation or touch terrifies me and I just have to dismiss myself and apologize to whoever is around me at the time and hope they don’t take my sudden departure personally. I then go to sleep. When I wake, I feel better but the wave is still there. I tend to get better over the next day or two, only for the cycle to repeat as mentioned above. Aside from sleeping the only relief I get, for but a moment, is when my rescue cat comes home and deigns to grace me with her presence on the bed next to me or in my chair. This WD has meant that I can no longer keep many commitments, I can only work on a casual basis (i.e. I put in a few hours a day in a window), and my relationships have become skeletal. My life is slowly falling apart and I am now dependent on my partner. She is understanding of my withdrawal, having been on SSRIs herself but luckily avoided a protracted WD. Sadly though, I just feel so guilty and frustrated at how I am now a slave to this window and wave cycle, and largely a useless partner. Windows (something positive) I am myself: productive, fairly positive, happy, thoughtful of others, and able to tackle my anxiety properly. I still live in fear of waves but I am learning to try not to ruminate on them. I feel a willingness to connect with people. I am starting to put too much pressure on myself to do everything during a window and that is leading to problems. To be fair to myself though, my waves are iatrogenic and I must forgive myself for feeling wretched, even during a window, because SSRI withdrawal is the worst thing I’ve ever experienced and it has ruined my life. Why are my waves more frequent? I will share some of my hypotheses below regarding why my waves are more frequent. If anyone has any thoughts please let me know, I’d love to hear them. I’ve learned so much from SA already. As mentioned in my signature I am working on compiling all the daily data I have into a graph so I can get a better picture of my stabilization journey (and what proceeded it). I don’t know when that will happen as my windows are now spent doing all the things I put off in my waves and just improving my loosening grip on the good things in life. I know though that I have to finish this data processing as soon as I can in case the waves merge into one big, long one. 1. My SSRI history during the last two years is peppered with ignorant tapering attempts, maybe it is catching up with me? 2. The optimist inside me is hoping that the frequency is increasing because it could be a pattern that occurs prior to a period of flatter frequencies (perhaps the ebbs and flows of homeostasis). I am perhaps just fantasizing but I imagine that if the frequency increases so much, like in a radio wave, the peaks and troughs (waves and windows) will be indistinguishable, which could be what homeostasis looks like. I am laughing at this hypothesis as I can see I am desperate for some good news XD 3. Maybe my reinstatement/stabilization dose was a little too low (considering I was on 40mg daily for the longest time) and I am catching up with the WD that it would have caused in recent months. If this is the case, I can’t see any benefit in updosing now anyway. Sure, it could always get worse but I think it would definitely get worse if I start guessing at an updose level. I could be wrong. 4. Some of my family wish to visit me later this month for a few days. I haven’t seen them in years. They planned it during one of my windows in December and I felt positive about it all. I also felt optimistic that given about 6 months of trying to stabilize, my waves would be a thing of the past, or a rarer occasion. I tried to get them to postpone but they can’t change their plans without losing all their money. I don’t want them to stop their holiday for me but as the reason for travelling is to see me, I have warned them that I may be in bed, only able to talk to them for a few minutes. I hope I have a window when they are here but I think I’ve had a huge amount of stress about the visit because I just don’t need the guilt I will undoubtedly feel when I am only able to see them for a few minutes. In other words, perhaps stressors and other factors in my life are making waves more frequent. My expectations for stabilization and my tapering plan I didn’t expect stabilization to take this long but after reading “After reinstating or updosing how long to stabilize” (http://survivingantidepressants.org/index.php?/topic/4244-after-reinstating-or-updosing-how-long-to-stabilize/?hl=%2Bhow+%2Blong+%2Bstabilize) I realize it could take a long time, maybe years based on how much damage my ignorant tapering did in the past. When I stabilize (I suppose I have to believe that I will) I plan to do an SA taper, spanning years, with water titration (I have done a few trial runs of it and it’s very easy to get accurate doses this way). I have the syringes ready but it could be a long time before I get to use them! My current plan is to keep plodding along at 20mg until I can get a more stable window and wave frequency. I don’t expect my waves to disappear completely but this increase in frequency means I am questioning things and hope that someone out there may have an idea about what’s happening and what I may expect to happen for the next 6 months. Lifestyle As for my lifestyle, I am healthy, eat well, and exercise most days. I take some supplements but I don’t think they’ve made much of a difference either way. I will list them later when I can manage it but they include B12, magnesium, and fish oil. Sadly, during waves I mostly lie in bed as it provides me some relief. One of the side effects from fluoxetine is sleepiness and lethargy, which I've always had, so that contributes to me lying about a lot. It took so much out of me to write this but I am glad I did it now! Good luck to you all and I wish you the best, regardless of what stage of withdrawal and recovery you are. Kittygiggles