Honza

Honza: Poor stress tolerance and hypersensitivity after citalopram withdrawal

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Hi all, I'm new here and would like to thank everyone for sharing their experience and helping others. I wish every one of you success on your path to recovery!

My story and symptoms:

2 years ago I tapered off citalopram/escitalopram, because after 6 years taking it I built tolerance to it, as well as some unbearable sinusitis-like side effects. I was prescribed this drug for GAD treatment (for details see my signature below)

During the 5th year on citalopram I started to feel its antidepressant effects slowly vanish, and I also noticed I couldn't handle much stress anymore. Actually, my working name for this problem is "impatient stress" and it's one of the most unpleasant symptoms.

I would describe the feeling as a mix of impatience and stress without any apparent stressor. I rush to finish whatever I'm doing, but my muscles are clenching and I'm feeling strong physical and emotional unease, sometimes to the extent it feels I'm going to faint or have a heart attack. Kind of stress over-reaction to even simple tasks like chores. My body and mind force me to stop, although there is no apparent stressor.

2 years after getting off meds, this poor stress tolerance doesn't seem to get better, in fact it seems to be worse these days.

I try to help my body deal with this artificial stress by supplementing vitamin C and magnesium, but it doesn't seem to have much effect (although it probably does help a bit)

Somehow related to this is perhaps my extreme sensitivity to stimulants (tea, coffee, even chocolate). Even small doses make me agitated and anxious next day. At the moment I seem to be even more sensitive than I was a few months after withdrawal. Maybe it's because now I tend to really avoid stimulants as much as I can, which is probably making me more sensitive to them... But is my body going to readjust if I never expose it to such substances? Or is it better to avoid all stimulants and wait if my brain heals from hypersensitivity over time? What's your experience?

For example, last week I tried two adaptogenic herbs (ashwagandha, rhodiola) for just a few days, in very small doses. Although I only ingested one capsule of rhodiola (which is 1/2 of recommended daily dose) it made me feel like a new person for two days in row! I felt great and focused.

The next morning I had an erotic dream (which I normally don't have) and just when the dream got too exciting, I woke up with a terrible spike of agitation, which pretty much resembled the stressed-out feeling, but much more intense and terrifying. It only lasted a second, but it felt like I was losing my mind, as if I'm going to faint or vomit. Extremely unpleasant feeling. (It wasn't a panic attack though, these are completely different. I'm also familiar with these morning cortisol surges, but this was more like a momentary shock.)
I could feel my heart beating strong. I never experienced such a strange shock and I was quite scared. Perhaps the single small capsule of Rhodiola (which apparently is a MAOI) messed up neurotransmitter levels too much?

I would love to know what's your experience with hypersensitivity to stimulants following SSRI withdrawal. Did stimulants also trigger anxiety for you? Did you register any change over time?

For the last 4 months I seem to be having some kind of anxiety episode triggered by emotional stress and accidental ingestion of green tea. The anxiety is getting worse every day, my sleep is getting shorter and shorter, giving rise to more anxiety. Is there a way to escape this vicious circle?

Sometimes I have pinkeye. Not sure if it's something to worry about, I guess it's linked to sleep problems.

There's also this sharp "pulling" sensation which I get from time to time in my hands or legs. Feels like if my veins were being pulled into body, shortened. Anyone experienced this?

Just recently I started to have occasional chin twitches, although very subtle, hardly noticeable. I hope they'll go away once I manage the anxiety and bodily tension.

And the last problem is lower back pain which I have ever since I discontinued SSRI, which makes me think that the physical damage to my back was done probably much earlier, but the pain has been temporarily suppressed by SSRI. Is it possible? Or maybe my lower back isn't damaged that much, but the elevated stress hormones intensify pain signalling in the body. I came to this hypothesis because last week, when I was in better mood for two days, the back pain almost vanished.

I've practiced daily meditation for 2 years since withdrawal, I underwent 6 week CBT course, tried fasting, self-help books, supplements, etc. Meditation and CBT provided some help and I'll definitely keep using them. But still... these days I feel so anxious, sensitive, unstable... scared. Since I cannot handle any work load, I had to leave my job. I moved to my family's house, and recently I applied for disability pension (I hope I'll need it just for a few years). Everything has turned upside down for me. I feel I'm doomed to suffer for the rest of my life. I'm worried every day that the taper was too fast (I was so stupid to rush it), and I'm afraid my brain will never recover from the dependency on SSRIs, which terrifies me so much!

Can you please help? Any ideas what might be happening with me in regards to the poor stress tolerance? What is actually going on there? Your experiences regarding any of these symptoms will be much appreciated! Do you think the damage is permanent? It's been 2 years now.

Thank you!


PS: As I'm rereading this post, it all seems so negative... But there are positives also - I'm no longer depressed these days. The depression transformed into anxiety 4 months ago, and although that's not necessarily a great thing one would desire, at least I know something is going on and I can feel motivated again.

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Hey Honza!

 

Congratulations on escaping Citalopram.  It was good of you to see the tolerance and walk away - instead of trying to increase it or add drugs to it.

 

I'm sorry it's still a struggle after 2 years.  That's not uncommon, to still be struggling with Sleep & anxiety.  It's awesome that you meditate and CBT and all that practice - that's a great start!

 

Pink eye is usually caused by hand-eye contact - bringing bacteria / virus from your hand to your eyes.  If you can refrain from touching your eyes, or wash your hands more frequently, this might help. 

 

Or it might be a histamine imbalance.  Do you have allergies?  Do you eat wheat or dairy?  Some foods cause high histamine reactions, you can learn more here:  Histamine Food Intolerance

 

To take your stress response to the next level - I would recommend a physical meditation, like walking meditation, yoga, tai chi, Pilates, or even more vigorous martial arts.  Weightlifting is good for stress reduction, especially slow lifting combined with breathing.

 

When you learned meditation, have you learned much about breathing?  Breathing is the key to anxiety.

 

And light - may be a key to sleep.  Do you get some sunlight every day?  Walking in the sun every day (I mean:  every day!) is an excellent mood stabilizer, and helps reset your melatonin clock.  And even if it is cloudy, daylight is better than indoor light for this.

 

I'll throw you a few links to see what you think, see if you can find anything here which might help you.

 

Important Topics about Symptoms Including Sleep Problems

 

http://survivingantidepressants.org/index.php?/topic/33-early-morning-waking-with-panic-or-anxiety/

 

Dr. Claire Weekes - Recovering from a Sensitized Nervous System

 

I hope you see the sun today!

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Hi there Honza, 

today, I can really feel with you and exactly understand your worries. Today I keep these constant nagging thoughts and fears in my head that I´ll never fully recover and that I might have damages my system forever. I quit SSRI about a year ago and after going through hells of WD I can defenitely see tons of positive changes. BUT - there are still waves and symptoms that I´d soooo love to be gone for goof finally!! Sometimes I feel so tired of having to deal with this crap all the time and I long to be a person that never has known such horrible psychological "madness". Specially stresswise I can totally relate to what you are saying. Generally I´d say I can handle my life pretty well now but I am absolutely sress sensitive and the things that are stressing me out are often things ..well, yu can´t avoid as a human being. Of course I can do my best to keep stress down at work, reduce working hours, whatever - but sometimes I get stressed meeting friends or being in a very busy street - well no one can avoid those things at all times. 

 

What is GAD?

 

I do think that AD´s have a horrible, long lasting impact on us and that it takes a long time to heal. And speaking for myself I think that I am an overly sensitive person and I guess I would be even withought ever having been on meds. I also think that I´d be on a better path if I had found a way to deal with my troubles without ADs as my troubles have doubled since I started taking any.

 

I guess that we are impatient, because of course we don´t want these symptoms. And we feel like that 1-3 years is really enough time of suffering. But compared to the many years that we have influenced our brain with these toxic substances - we need to be more EVEN MORE loving and patient with ourselves. BELIEVE ME! I KNOW HOW HARD THIS IS! Some days I just want to scream at all this misery and unfairness - but all of that doesn´t help. 

 

You say that after a long phase of depression you went into anxiety - since your off meds, have you ever had times of release where you had no symptoms at all? Because if so - this is prove that it doesn´t always HAVE TO BE this way, and that things are slowly improving. 

 

Reading through my answer I have to say it sounds quite negative as well :D I am sorry for that! I guess we´re both having a bad day ;) 

The question I always ask when confronting myself when having these horrible "will I always be that way-thoughts" is: If so, what´s my alternative? 
Medication defenitely not. So there is simply no way other than acceptance and learning to deal with it. 

What kind of meditation are you practising? I meditate every so often as well and I absolutley find it very helpful (though on days like these, as you say, it´s helpful but no resolution). 

I hope you´re feeling better soon and that you can see a more positive side to all of this!

Best, 
Pepita

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Ahoj Honzo,

 

welcome to SA! I was wondering if I ever run into a fellow citizen here. I believe you will get much useful information here. Take care!

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Or it might be a histamine imbalance.  Do you have allergies?  Do you eat wheat or dairy?  Some foods cause high histamine reactions, you can learn more here:  Histamine Food Intolerance

 

To take your stress response to the next level - I would recommend a physical meditation, like walking meditation, yoga, tai chi, Pilates, or even more vigorous martial arts.  Weightlifting is good for stress reduction, especially slow lifting combined with breathing.

 

When you learned meditation, have you learned much about breathing?  Breathing is the key to anxiety.

 

Thank you so much JanCarol!

your post gave me like 150% relief when I first read it! For a moment all the anxiety and fears went away, as there was a spark of hope.

 

Histamine - I had my blood histamine levels checked back in 2015 and they were pretty low - 2.6 nmol/L in the reference interval 1.8-9.0. But maybe that itself doesn't prove I don't have histamine food intolerance. I'll research this more.

 

Meditation - started to meditate daily in 2015 in order to address the anxiety and dread during tapering off. The more anxious I was, the more I practiced meditation - and it worked pretty well. After some 6 months I underwent S. N. Goenka's Vipassana meditation retreat and started meditating 2 hours every day... but after 1 year I couldn't keep up with it any longer, since my lower back started to hurt. So these days I meditate only occasionally, 1 hour in a lying position, but that's not nearly as powerful (although it still provides a great relief)

 

 

And light - may be a key to sleep.  Do you get some sunlight every day?  Walking in the sun every day (I mean:  every day!) is an excellent mood stabilizer, and helps reset your melatonin clock.  And even if it is cloudy, daylight is better than indoor light for this.

 

Good point, JanCarol. I try expose myself to daylight as much as I can, I also bought blue-blocking glasses which I use in the evening in order to help regulate my circadian rhythm. The thing is - my sympathetic system is way too active since the anxiety started, and what's probably waking me up so early is cortisol surges. No matter how exhausted I am, I still wake up around 3am, and sleep pills don't seem to help too much either.

 

What I should mention is that after tapering off, for a period of 18 months the only symptom I was experiencing was moderate depression.

Then one day, after a series of stressors (exams, illness and death of a relative, etc.) the depression was fairly quickly replaced with anxiety. That was 4 months ago, and the anxiety and agitation are getting worse, leaving me with little to no sleep. My memory and concentration are very poor, I cannot focus on simple tasks. Often I forget what I was just about to do. I try my best to calm down my hyperactive sympathetic system (meditation, supplements, CBT) and regain my sanity, but it keeps getting worse and I don't know what to do. Actually last few weeks I've been so agitated I couldn't practice any meditation - it was impossible, my mind was racing with unpleasant obsessive thoughts that kept coming back. I'll have an appointment with another CBT psychotherapist soon, but not sure if CBT can help enough. Maybe melatonin would provide some relief? I guess it's a matter of escaping the vicious circle. I just hope to somehow calm down my sympathetic system before the agitation turns into chronic fatigue syndrome.

I was born a sensitive person, but wasn't nearly this sensitive before going on meds. I truly hope my CNS will desensitize over time. Thank you for the link to Dr. Claire Weekes, I'm going to buy the book. I also found Ashok Gupta's Amygdala Retraining and Annie Hopper's Dynamic Neural Retraining System, but not sure how much they can help. Have you ever heard of them?

 

 

Hi there Honza, 

today, I can really feel with you and exactly understand your worries. Today I keep these constant nagging thoughts and fears in my head that I´ll never fully recover and that I might have damages my system forever. I quit SSRI about a year ago and after going through hells of WD I can defenitely see tons of positive changes. BUT - there are still waves and symptoms that I´d soooo love to be gone for goof finally!! Sometimes I feel so tired of having to deal with this crap all the time and I long to be a person that never has known such horrible psychological "madness". Specially stresswise I can totally relate to what you are saying. Generally I´d say I can handle my life pretty well now but I am absolutely sress sensitive and the things that are stressing me out are often things ..well, yu can´t avoid as a human being. Of course I can do my best to keep stress down at work, reduce working hours, whatever - but sometimes I get stressed meeting friends or being in a very busy street - well no one can avoid those things at all times.

 

Thank you for your soothing words of compassion, Pepita. I think we all are on the same boat. It's good to see I'm not alone going through this hell, and I'm happy to hear that you can see things changing for better!

Yes, I can totally relate to what you're saying about stress sensitivity.

Maybe the above retraining programs would help you?

I wonder... do you think this stress sensitivity is changing for you somehow? Was it any different let's say 6 months ago?

 

 

What is GAD?

 

Generalized anxiety disorder

 

 

You say that after a long phase of depression you went into anxiety - since your off meds, have you ever had times of release where you had no symptoms at all? Because if so - this is prove that it doesn´t always HAVE TO BE this way, and that things are slowly improving.

 

There were few days of near-euthymia, yes, but that was more than 4 months ago, before the anxiety started - since then it's getting worse and I don't know what to do to reverse this progress and start healing. I'd like to believe the body is slowly healing on its own and it's just a matter of time and surviving these horrible waves. But I don't know... watching my anxiety getting worse, I'd like to help my body somehow.

 

 

The question I always ask when confronting myself when having these horrible "will I always be that way-thoughts" is: If so, what´s my alternative? 

Medication defenitely not. So there is simply no way other than acceptance and learning to deal with it. 

What kind of meditation are you practising? I meditate every so often as well and I absolutley find it very helpful (though on days like these, as you say, it´s helpful but no resolution).

 

For me, medication is not an alternative either. I can see what harm it can do to myself and other people.

As far as meditation goes - see my first reply to JanCarol.

 

Thanks again to both of you for your help.

 

Take care!

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Ahoj Honzo,

 

welcome to SA! I was wondering if I ever run into a fellow citizen here. I believe you will get much useful information here. Take care!

 

Zdravím! Thanks Aelius, I already did actually. Loads of useful information. I wish you good luck on your road to recovery!

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I have to agree with JC that some meditation walking , yoga or weight training would be excellent as well as tai chi and /or pilates. Extreme sensitivity to stimulants is to be expected. Most of us suffer from this to some degree in W/D. 

 

So, you're 2 yrs off ? What do you feel is helping? How is the meditation?  

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Hi there, 

oh yes, stress sensitivity has changed a lot! In the beginning of my WD I was happy if I managed to go to the supermarket and that was enough stress for one day. Only the thought of meeting friends somewhere in a public place or to go to a party/restaurant whatever would rise my adrenalin/fear/stress...all of that improved LOOOOOTS...I can sort of lead a normal life now. Sure, some days it gets really hard to go on with daily business or to attend meetings, whatever but at least I CAN! 

So it definitely got better by far! 

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I have to agree with JC that some meditation walking , yoga or weight training would be excellent as well as tai chi and /or pilates. Extreme sensitivity to stimulants is to be expected. Most of us suffer from this to some degree in W/D. 

 

So, you're 2 yrs off ? What do you feel is helping? How is the meditation?  

 

AliG, my biggest fear is: "What if my over-reactive fight-or-flight mechanism (stress response) will stay like this forever? My taper was fairly quick. I'm 2 years off, and I'm still unable to handle any stress. Even smallest things can kickstart my fight-or-flight mechanism."

The fact that I'm 2 years off makes me worry even more that the stress response will never return to normal. I'm scared.

 

Anyway, what often helps me when my body entered the fight-or-flight mode, is still meditation. But not every time I'm able to calm myself down to stay still. In these situations I'll try the walking meditation that you and JC mentioned.

When anxiety strikes, I also find it helpful to use slow breath technique or some self-talk "You've been there many times, this too shall pass. It's just anxiety tricking your mind, it's harmless."

 

 

Hi there, 

oh yes, stress sensitivity has changed a lot! In the beginning of my WD I was happy if I managed to go to the supermarket and that was enough stress for one day. Only the thought of meeting friends somewhere in a public place or to go to a party/restaurant whatever would rise my adrenalin/fear/stress...all of that improved LOOOOOTS...I can sort of lead a normal life now. Sure, some days it gets really hard to go on with daily business or to attend meetings, whatever but at least I CAN! 

So it definitely got better by far! 

 

That's great, thanks for giving me a bit of hope! For me it's been 2 years and no improvement in stress tolerance, but it's good to see people actually getting better with time.

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Hey there - yes my recovery came more or less "fast" but I was on a small dosage compared to many others and quite short term - so you can be sure - it will get better:) It only seems like forever to us 

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Honza. None of us really know the answer to that question. A lot of us have over reactive fight /flight mode. It comes with the territory. It seems that your meditation is helping to a degree. If it is I would persevere but maybe you could ramp it up a notch or two with some other exercise - be it yoga/ pilates / weight training and/ or whatever else interests you.

 

Take it easy to start with , if you do. As always start small and work your way up in intensity. 

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