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"What if" thinking and catastrophizing


O2bhappy

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I have been off Prozac for 10 months and yesterday I started having "what if" thinking.  I used to get this a lot during a panic attack, but thankfully I haven't had it in a year or so.  At the time it happened I wasn't doing anything. It came out of no where.  It was like all the sudden I thought "what if" something happens to me.  I had this wave come over me yesterday with the exact same thought.  Is this part of withdrawal?  How should I handle these thoughts and/or feelings when they happen?  Any suggestions would be wonderful. 

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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Yes, it is part of withdrawal, to have ruminative thoughts, health anxiety, all kinds of thoughts that are anxiety-related.  The best thing is to observe and then let them float on by. Don't give the thoughts power.  Say to yourself "this is withdrawal and it will pass." 

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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SG-

 

Is this a symptom that will pass over time?

 

I will focus on letting the thought go. Thank you for the advice.

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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I came across this thread recently, O2bhappy, and it really is good for ending those catastrophizing type thoughts:

 

"Change the channel" -- dealing with cognitive symptoms

 

Mindfulness is really good for helping with this, too. If you click on the below link, there's a section called MEDITATION AND MINDFULNESS that might be helpful. SquirrellyGirl's comment "Don't give the thoughts power" is a very important concept that's practiced in mindfulness. 

 

Non-drug techniques to cope with emotional symptoms

 

Another thing I like to do is instead of going "What if (insert the bad thing)" replacing it with "What if (insert something GOOD)".

 

It's weird the way withdrawal always makes us go to the dark side. From reading the Success Stories, it's very likely life is going to be better than ever after we heal.

 

So also check out the Success stories: Recovery from withdrawal when you're having those thoughts. 

 

 

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Shep -

 

Thank you for all the information that you have provided me.  I greatly appreciate it.

 

I know that you have been dealing with a lot during your withdrawal.  I am feeling very scared right now like this wave won't pass.  I feel like I am at a braking point and cannot get pass this and it is really scaring me.  I am having a hard time channeling the channel right now.  I agree that the withdrawal makes you go to the dark side.  I had a huge meltdown early because I feel like I cannot handle it anymore.  What do you do if you get to this point?

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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I like what the mindfulness sages say, O2b. They say "be quiet". 

 

That's it - "be quiet".

 

This is the stage where you get to really "practice" these non-drug coping skills. If you can, get away from whatever is causing the meltdown, re-group for a few minutes, get back into a state of mindful observance, or what I now call "Beautiful Detachment", and simply not engage in other people's drama. Their movie doesn't have to be your movie, especially if it's making you feel bad. You have enough weight to carry with withdrawal - you don't need that. 

 

And if you are the one causing the drama - and I caused a lot of my own drama over the years - then that's something you can work on, too. The same coping skills work both ways. 

 

What kind of coping skills are you practicing? These are the things you need to define and then subscribe to them. That way they are on call whenever you're distressed. They become automatic and every time you have a stressful situation, you can be grateful for the opportunity to practice. 

 

This is a bit of a "mind shift" that takes you away from the drama and into your own state of peacefulness. It takes a great deal of practice in mindfulness (or in whatever type of coping skill you choose), but it's the practice element of withdrawal that makes it automatic. 

 

This journey doesn't have to be so dark. Let these skills act as a light and you'll come out the other side golden. 

 

 

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Hi O2b-- melt downs are no fun. I've had a number of them throughout my taper. There were always warning signs that they were coming and my wife always said she was expecting them when they happened.  Although wrenching to go through they always ended up being cathartic, a big release of pent up frustration.  I would feel very drained for a few days after each one, but that was followed by a definite improvement in my baseline WDnormal level.  Even though I didn't look forward to them, it got to the point that I was pleased when they happened because it was a sure sign of improvement.  Over time they grew less intense and less frequent, until now they are no problem.

 

Instead of being scared, view it as your body letting off steam and regrouping.  Then you can be relieved that it happened and prepared for the next one, if it should come. 

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Shep -

 

I think I am the one probably causing my own drama because I cannot stop dwelling on how I am feeling.  Some days are easier for me to "defused" my thoughts but that becomes very difficult during a wave.  I love your term "beautiful detachment."

 

One thing I notice I do is I always go back and say "what if I was still on Prozac, would I be feeling this way."   How do you stop that thinking.  At the time I went off Prozac I was basically forced off it because my body could not adjust to the different Prozac generic I was taking.  I had wanted to go off it, but I wanted to be the one to make the decision and to be able to taper, but that wasn't in the cards for me.  I know it is a blessing that I am off the medicine, but sometimes I wish I was still on it because life seemed easier.  I know that I had side effects while taking it and I even believe I had Prozac pop-out but I guess being drugged made it easier to deal with things.  It was a year ago that my generic formula changed and all this started happening to me.  It started with nausea and tremors.  I stopped the Prozac August 27th, 2015 and then in November was hit with major withdrawal.  I am just drained from it.  I know I shouldn't complain because everyone has their struggles and probably most are worse then me.  I just want to feel better.

 

Thank you for listening to me and responding to my post.  I greatly appreciate your help and suggestions you have given me.  I admire all that you have been through and how you have such a great attitude getting through it. 

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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brassmonkey -

 

Thank you for your suggestions on how to view my meltdown.  I will "try" and remember to view them as a sign of improvement.  I think my meltdowns happen because I feel so bad, or I am just done feeling bad.  I see everyone else out enjoying their lives and here I sit feeling sick.  All I keep saying is I want to feel better, but who doesn't.  I sometimes find myself resenting my friends because they are not having to deal with the hell that I am experiencing.  I know that everyone has things going on in their lives but I am just tired of always feeling sick.  This isn't the person that I am but it is certainly the person I have become during withdrawal.  I miss the happy go lucky person I was while taking Prozac.  My husband tells me that I wasn't happy on Prozac and that I was drugged.  It scares me when I read how long some people have been in withdrawal.  It hasn't even been a year yet for me and I am done with withdrawal.

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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Shep -

 

I think I am the one probably causing my own drama because I cannot stop dwelling on how I am feeling.  Some days are easier for me to "defused" my thoughts but that becomes very difficult during a wave.  I love your term "beautiful detachment."

 

One thing I notice I do is I always go back and say "what if I was still on Prozac, would I be feeling this way."   How do you stop that thinking.  At the time I went off Prozac I was basically forced off it because my body could not adjust to the different Prozac generic I was taking.  I had wanted to go off it, but I wanted to be the one to make the decision and to be able to taper, but that wasn't in the cards for me.  I know it is a blessing that I am off the medicine, but sometimes I wish I was still on it because life seemed easier.  I know that I had side effects while taking it and I even believe I had Prozac pop-out but I guess being drugged made it easier to deal with things.  It was a year ago that my generic formula changed and all this started happening to me.  It started with nausea and tremors.  I stopped the Prozac August 27th, 2015 and then in November was hit with major withdrawal.  I am just drained from it.  I know I shouldn't complain because everyone has their struggles and probably most are worse then me.  I just want to feel better.

 

Thank you for listening to me and responding to my post.  I greatly appreciate your help and suggestions you have given me.  I admire all that you have been through and how you have such a great attitude getting through it. 

 

Hi, O2b. I think it's a blessing you're off the medicine, too. And next month, you'll be able to celebrate an entire year off! That's a great accomplishment. 

 

As far as your thoughts about "what if I was still on Prozac," please note that the prognosis for having a happy and healthy life on these drugs is very poor. Consider this article on tardive dysphoria:

 

https://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria

 

So keeping a realistic viewpoint can help. Knowing the truth about these drugs really helps me with these kind of "what if" thoughts. The concept of depression being a chemical imbalance was debunked a long time ago (and it never was proven in the first place). We have so many healthier options. You may feel that you didn't have much control in how you came off the drug, but you definitely have control over the non-drug coping strategies you pick up on this journey. That's the real take away from this experience. Use this experience to your advantage and make this time count for something. That's another way of taking control and making time pass without it feeling like such an empty and wasted experience. It doesn't have to be. 

 

The root of a lot of "what if" thinking comes from thinking we don't have any control. But learning to back away from your thoughts and simply let them pass is powerful. Don't let this time pass without picking up some of these skills. That would be the real tragedy.

 

I know it's hard to keep focused on this when you're in the thick of it and withdrawal is sending all of these neuro emotions your way, but better times are ahead. 

 

Sending healing vibes your way. 

 

 

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I think I am the one probably causing my own drama because I cannot stop dwelling on how I am feeling.  Some days are easier for me to "defused" my thoughts but that becomes very difficult during a wave. 

 

This was me yesterday - ruminating on old hurts and things I cannot change. Sometimes, I'm successful at distracting myself, but often, I just have to let it run it's course. If I don't fight it, but just understand what is happening without (re)acting on it, it lessens within a day or two. It's incredibly hard to be *inside* the storm and not feed the monster. For whatever it's worth, know you aren't alone.

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Shep -

 

Thank you for reminding me that being off Prozac is a blessing, sometimes I need to be reminded.

 

Thank you for sharing that article about tardive dysphoria.   When I first started down the path of withdrawal I had tremors that could be seen in my hands.  That has gone away.  I am now experience internal shaking, which of course makes me feel more anxious.  Is internal shaking considered  tardive dyskinesia.  Is the internal shaking a withdrawal symptom that will go away over time? 

 

When I started having my panic attacks back in the late 90's my doctor told me I had a chemical imbalance and he put me on Paxil.  I went off that after a year.  Not knowing I was probably in withdrawal I ended up on Prozac a year later.  Since I thought I had a "chemical imbalance" I stayed on the medicine.  I wish I had know better. 

 

I have been working on my coping techniques.  I started to do meditation.  I found an app that I like and have been slowly introducing myself to the practice.  I do feel better after I so a session of meditation.   I also find myself doing deep breathe techniques.  I agree that this can be a learning experience instead of what I am making it out to be.  I know the tools that I am using now will only benefit me in the future. 

 

Thank you for the healing vibes.  I am sending them right back to you. 

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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It's incredibly hard to be *inside* the storm and not feed the monster.

 

 

I never thought about it like that before but that is EXACTLY what I do.  I feel like I am my worst enemy during a wave.  I need to learn to be better at distracting myself and when I am distracting myself I need to not continue to focus on how I feel.  I am not good at not focusing on what is going on with my body, I think that is what sent me into panic attacks.  I am learning to accept what is happening by saying it's just a withdrawal symptom and it will pass. 

 

I am glad to know that I am not alone, but it doesn't make it any better.  I feel bad for everyone who is suffering from withdrawal. 

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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I have been off Prozac for 10 months and yesterday I started having "what if" thinking.  I used to get this a lot during a panic attack, but thankfully I haven't had it in a year or so.  At the time it happened I wasn't doing anything. It came out of no where.  It was like all the sudden I thought "what if" something happens to me.  I had this wave come over me yesterday with the exact same thought.  Is this part of withdrawal?  How should I handle these thoughts and/or feelings when they happen?  Any suggestions would be wonderful. 

I had a conversation with an NLP practitioner today and he mentioned "what if" thinking.  It's not a term I'd heard before but he nailed it when explaining what has been happening with me (extreme and unfounded anxiety).

 

I'm waiting on an appointment so I don't have a magic answer but the way he explained it was that the "what if" question is that it's coming from a worst case scenario voice.  The best case scenario has been silenced for some reason.

 

When I was struggling with side effects of the medication I found a helpful resource that had a thought diary.  It asked:

 

- what you are doing

- what you are feeling

- what you are anxious about

- how sure you are of this (1-10)

- what is the evidence for this?

- what is the evidence against this?

- now re-rate how sure you are of it (1-10)

 

Invariably I had no evidence of the worst case scenario.  It was all speculation.  It was hard to take but this process made me challenge the initial conclusions I had jumped to.  There's emerging theory that as humans we are predisposed to remember bad things, to focus on negative experience more than positive.  This tool might be something that could help you out.

2000-2009 Effexor instant release, 37.5mg, 75mg and at one point 150mg. Stopped in early 2009

 

17-Mar-2016: beta blockers (Propanolol then Atenolol then tapered with Propanalol, 15 days total)

 

21-Mar-2016: 75mg Venlablue extended release (2x37.5mg/day) for 25 days
Tapering:15-Apr-2016 1x37.5mg Venlablue extended release capsule in the morning for 7 days; 1x25mg capsule for 2 days

 

24-Apr-2016 zero for 10 weeks

 

03-Jul-2016: reinstated on a quarter pill (9.375mg) twice a day [tried one day lowering to 8mg but felt terrible so stayed on 2x9.375 since]

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CallMeAl -

 

Thank you for sharing the thought diary.  I am going to write that information in my journal.  I had a therapist once ask me what was my worse case scenario when I would have these thoughts.  They were usually something silly and probably were not going to occur.  I have struggled with this for years.  It comes from my experiences with panic attacks.  I think the internal shaking I am experiencing with withdrawal is making it worse because it seems to be predisposing me to more anxiety.  My body constantly feels like it is in a fight or flight struggle. 

Discontinued Fluoxetine cold turkey after taking it for 12 years. Stopped taking Fluoxetine in August 2015.

My current withdrawal symptoms: Itchy skin, smell hallucination, hot flashes, night sweats, insomnia, and anxiety. 

Synthroid for hypothyroidism.

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  • Altostrata changed the title to "What if" thinking and catastrophizing
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Bumping! Have you had a habit of mind where you work yourself into a panic over "what-ifs"? What are your methods for managing a tendency to catastrophize?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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For me, the question should be when have I ever not had a habit of working myself up over what-ifs. I am the queen of what-if thinking. This was great for my earlier career when I was tasked with doing a lot of risk assessment, but not so much otherwise, for obvious reasons. 

 

As would be expected, the what-ifs get really bad when I'm in the throes of my withdrawal symptoms and I start to catastrophize about having all sorts of serious medical conditions or that I'm never going to feel better. Recently, this community has been very helpful with those thoughts; I have read over and over that my symptoms are normal and that I am going to get better, and this has become a mantra that I try to use as much as possible. I have to force myself to come back to the present and then remind myself about what I've read here. I guess it's a form of mindfulness for me. It's hard work, though, and takes a lot of practice. Mindfulness is a newer concept for me and it doesn't come easy, especially when my withdrawal brain is actively trying to fight against it.

 

The other thing that I find helpful is just writing things down. I feel like this forces me to organize my racing thoughts, and in doing so, I'm usually able to see that things aren't as bad as they were in my head. This also gives me something to refer back to in the future so I can remind myself that most if not all of my what-ifs never actually come true. I don't follow a specific format when I write; I just try to grab my thoughts as they pass by and put them into paragraph form. I try to visualize that I'm pulling the thought out of my head and moving it onto the paper so I can leave it there. 

 

 

1999 Sertraline 100(?)mg ~6 months 
2001 Effexor XR 75mg ~3 weeks
2001 Citalopram 60mg > 2012 40mg > 2015 30mg > 2017 20mg > 2019 15mg > 2021 10mg > May 2022 5mg

2023: 13-Apr Started 1/2 liquid 1/2 tablet > 5-Jun 4.5mg > 3-Jul 4.05mg > 1-Nov 3.85mg

2024: 3-Jan Finished cross over to all liquid > 9-Jan 3.47mg > 6-Feb 3.12mg > 5-Mar 2.81mg

 

Supplements: magnesium and fish oil

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