Unable to relax like before

[Hello20]

Has anyone that has come off ADs and been off for long enough to start feeling mostly normal again noticed they cant relax like they used to when on ADs?

[agtaylor]

5 hours ago, Hello20 said:

Has anyone that has come off ADs and been off for long enough to start feeling mostly normal again noticed they cant relax like they used to when on ADs?

I’m curious about this too. I’ve only been off about 6 months this time, but I feel like I can’t really even enjoy just sitting and watching TV like I used to. It’s definitely gotten better than when I first CTd, but I’m hoping it will continue to improve. 

[Hello20]

@agtaylor

Relaxing and watching TV is exactly what I'm talking about with unable to relax. I'm about 14 months off.

[jon1]

I still can't relax when watching TV, off for 2/12 years.

 

It has improved in some respects, though.

 

More recently, over the last six months or so, I've found it more difficult to concentrate and follow TV shows than I used to. It's the same with reading books. A year ago I had no problem, but now I'm finding my mind is wandering after a couple of pages.

[Hello20]

@jon1 @agtaylor

I've noticed that all of us noting we can't relax while watching TV since being off have all come off Lex@pr0.

[Hello20]

@jon1

How is your sleep? Do you have early morning waking still?

[jon1]

51 minutes ago, Hello20 said:

@jon1

How is your sleep? Do you have early morning waking still?

 

It varies. I go through short periods where I wake earlier (although I'm nowhere near as 'wired' as I felt at the beginning of withdrawal), but I also have periods where I sleep like a baby and can barely wake up in the morning!

 

I quit caffeine about a year ago, and that made quite a big difference to my sleep.

[Ariel]

1 hour ago, jon1 said:

More recently, over the last six months or so, I've found it more difficult to concentrate and follow TV shows than I used to. It's the same with reading books. A year ago I had no problem, but now I'm finding my mind is wandering after a couple of pages.

 

@jon1

Same. 

Sometimes I wonder whether it's at least partially a matter of habit. Like maybe my brain/mind is deconditioned and I could just retrain it to read? I don't know. 

A few months back I made an effort to read fiction and successfully read a number of novels in a short period of time. I was amazed that it was possible. 

And then I sort of lost interest again and haven't been able to get back into it since. 

I experience similar waxing and waning with being able to follow television programming and movies, both in terms of concentration and interest. 

It's hard to tell whether these could be oscillations of anhedonia and other WD-related cognitive-emotional issues, or whether it's something else. 

When in doubt i usually err on the side of anything being WD, and try to accept and be patient, trusting that it will all sort itself out eventually. 

 

[jon1]

1 minute ago, Ariel said:

 

@jon1

Same. 

Sometimes I wonder whether it's at least partially a matter of habit. Like maybe my brain/mind is deconditioned and I could just retrain it to read? I don't know. 

A few months back I made an effort to read fiction and successfully read a number of novels in a short period of time. I was amazed that it was possible. 

And then I sort of lost interest again and haven't been able to get back into it since. 

I experience similar waxing and waning with being able to follow television programming and movies, both in terms of concentration and interest. 

It's hard to tell whether these could be oscillations of anhedonia and other WD-related cognitive-emotional issues, or whether it's something else. 

When in doubt i usually err on the side of anything being WD, and try to accept and be patient, trusting that it will all sort itself out eventually. 

 

 

Personally, I feel like a lot of it is down to low/fluctuating levels of dopamine.

 

Dopamine is responsible for alertness, concentration, and all sorts of neurological processes. Low levels are also the primary cause of anhedonia.

 

Dopamine doesn't seem to be talked about that much here, but some SSRIs do appear to have a significant downstream effect on it. It also explains why there's so much crossover in symptoms between SSRI withdrawal and benzodiazepine and alcohol withdrawal.

 

Here's a summary of dopamine, which I think sums it up perfectly.

 

“Dopamine acts on areas of the brain to give you feelings of pleasure, satisfaction and motivation. Dopamine also has a role to play in controlling memory, mood, sleep, learning, concentration, movement and other body functions.”

 

https://www.healthdirect.gov.au/dopamine#:~:text=of the brain.-,What is the role of dopamine%3F,movement and other body functions.

[Ariel]

47 minutes ago, jon1 said:

Personally, I feel like a lot of it is down to low/fluctuating levels of dopamine.

 

Dopamine is responsible for alertness, concentration, and all sorts of neurological processes. Low levels are also the primary cause of anhedonia.

 

Dopamine doesn't seem to be talked about that much here, but some SSRIs do appear to have a significant downstream effect on it. It also explains why there's so much crossover in symptoms between SSRI withdrawal and benzodiazepine and alcohol withdrawal.

 

Here's a summary of dopamine, which I think sums it up perfectly.

 

“Dopamine acts on areas of the brain to give you feelings of pleasure, satisfaction and motivation. Dopamine also has a role to play in controlling memory, mood, sleep, learning, concentration, movement and other body functions.”

 

Thanks for this @jon1

I hear you, and I tend to agree. 

 

On principle I try not to speculate about mechanisms/levels of individual neurotransmitter action as it pertains to me and my state at any given time, esp. in WD. The whole-system dynamics are so complex and interrelated, whatever is actually going on is far beyond what I am capable of knowing and understanding. I am wary of falling into traps of simplified thinking about this or that neurotransmitter, as I associate such reductions with insidious precedent such as the chemical imbalance myth and serotonin theory of depression, etc. The history of psychiatry and so-called medical science abounds with that sort of poor reasoning and I am trying to free myself of such tendencies!

 

That being said, it's not uninteresting to think about, and like I said, I get where you're coming from. 

I'm not sure there's much we can do about it though, other than accept that this is part of a larger healing process and surrender to the awesome mystery and power of nature, and be patient. 

 

I do try to implement some pop-neuro-sci brain hacks (!) around not abusing one's dopamine pathways (whatever that actually means!) and going gently on the most notorious dopamine stimuli (you know, the big baddies mentioned as being addictive) to not aggravate anything, quasi-dopamine-detox-adjacent-ish haha 

But ultimately, it seems to me, that the incredible neuroplasticity of our brains affords us the opportunity to consciously teach/retrain ourselves to learn new/better/desirable habits, which is made possible by, among other neurotransmitters, dopamine signaling. By which I mean, it's my understanding that our deliberate behavior can exert positive influence on learning, habit formation, and facilitating healing/neurogenesis, as well as stimulating healthy brain activity. 

 

I find it important to insist to myself that we do have some agency (I don't always believe this, but I insist anyway, and it's one of those fake it till you make it things), so as not to give in to the temptation of throwing up my hands and lapsing into WD-induced learned helplessness. 

 

Know what I mean? 

How do you (addressing anyone reading this, I welcome your input and responses) navigate the tension between WD circumstances beyond our control and inquiring into the possibilities of our own agency?

[jon1]

I've reached the stage where I don't attempt to do anything anymore. I'm just letting my brain and body heal at its own pace. I don't take any supplements (invariably, they make me worse) or any of the normal techniques like meditation, etc. I did for the first couple of years, but it made no difference.

 

My only rule is I only eat natural whole foods—nothing chemical or man-made, like additives, sweeteners, vitamins, etc.

 

Not actively trying to do anything has helped. Although sometimes I do wonder if it's a chicken and egg thing. It's hard to judge if I occasionally feel a bit better because I've stopped trying to fix myself, or if I've stopped trying to fix myself because my brain has healed a bit, and is making me feel a bit better. My head hurts! 😁

 

It was actually my therapist who put the dopamine idea in my head. She deals with a lot of alcoholics and told me it was striking how my symptoms were almost identical to many of those she's seen who've been through PAWS from alcohol.

 

She said that even for people who don't drink much (2-3 drinks a week), it takes the brain at least 6-9 months to restore dopamine to normal levels after stopping alcohol. For heavy drinkers (1 1/2 bottles of wine a week or more), it's around two years.

 

So, considering how powerful SSRIs are, it's no wonder the effects linger for such a long time.

 

[Ariel]

32 minutes ago, jon1 said:

It was actually my therapist who put the dopamine idea in my head. She deals with a lot of alcoholics and told me it was striking how my symptoms were almost identical to many of those she's seen who've been through PAWS from alcohol.

 

She said that even for people who don't drink much (2-3 drinks a week), it takes the brain at least 6-9 months to restore dopamine to normal levels after stopping alcohol. For heavy drinkers (1 1/2 bottles of wine a week or more), it's around two years.

 

Wow, that blows my mind! 

2-3 drinks a week -> 6-9 months to restore dopamine to normal levels?!!

I've never been much of a drinker but most people I know drink way more than that (and wouldn't consider 1.5 bottles of wine a week to be heavy drinking!).

 

I didn't know PAWS from alcohol is a thing. I thought it was about getting sober and maintaining abstinence forever after.

Although I did recently listen to an interesting podcast episode about naltrexone and The Sinclair Method of alcohol use disorder recovery, which sounds a bit different. 

 

32 minutes ago, jon1 said:

I've reached the stage where I don't attempt to do anything anymore. I'm just letting my brain and body heal at its own pace. I don't take any supplements (invariably, they make me worse) or any of the normal techniques like meditation, etc. I did for the first couple of years, but it made no difference.

 

My only rule is I only eat natural whole foods—nothing chemical or man-made, like additives, sweeteners, vitamins, etc.

 

Not actively trying to do anything has helped. Although sometimes I do wonder if it's a chicken and egg thing. It's hard to judge if I occasionally feel a bit better because I've stopped trying to fix myself, or if I've stopped trying to fix myself because my brain has healed a bit, and is making me feel a bit better. My head hurts! 😁

 

@jon1

 

So you don't try to read or play music (unless you feel like it) or force yourself to do things to practice concentration/focus?

If you don't feel motivated around a specific behavior, do you just refrain? 

 

 

[jon1]

10 minutes ago, Ariel said:

Wow, that blows my mind! 

 

2-3 drinks a week -> 6-9 months to restore dopamine to normal levels?!!

I've never been much of a drinker but most people I know drink way more than that (and wouldn't consider 1.5 bottles of wine a week to be heavy drinking!).

 

I didn't know PAWS from alcohol is a thing. I thought it was about getting sober and maintaining abstinence forever after.

Although I did recently listen to an interesting podcast episode about naltrexone and The Sinclair Method of alcohol use disorder recovery, which sounds a bit different. 

It was an eye-opener for me too!

 

Apparently PAWS is the leading cause of relapse. The lack of dopamine means people feel miserable, fatigued, sick and lack any enjoyment in life. They assume it’s because life is dull without alcohol - rather than a withdrawal symptom - and so start drinking again.

 

It’s almost a mirror image of people who start taking antidepressants again, because they mistakenly think their withdrawal symptoms are what life is like off the drugs.

 

Alcohol is very bad. The media tends to focus on it’s effects on the liver and other organs, but it really does a number on the brain too, even at low levels. And yes, 1 1/2 bottles of wine a week is heavy drinking. When she told me I had to look it up to double check! Way too many people drink way too much, and are probably unaware of it.

 

Frustratingly, a lot of people going through alcohol PAWS are put on antidepressants. Which means they then have to go through another set of withdrawals at a later date. Out of the frying pan into the fire.

 

 

10 minutes ago, Ariel said:

So you don't try to read or play music or force yourself to do things like that to practice concentration/focus?

 

If you don't feel motivated around a specific behavior, do you just refrain? 

 

I do still read and listen to music, etc. But only when I feel like it, and as soon as I lose focus, I stop. Some days I’ll do more than others.

 

If don’t feel like doing something, I won’t. If I try and force myself, it rarely works, and only ends up in making me frustrated and reinforcing negative memories.

 

That said, I still keep up certain routines, even if I don’t feel like it. Stuff like talking to my parents via video every week, and walking to the shops. Sometimes it’s very difficult, but they’re the sort of things that I’m in control of, so I feel a sense of accomplishment when I do them.

 

[Hello20]

On 6/8/2024 at 11:35 PM, jon1 said:

 

It varies. I go through short periods where I wake earlier (although I'm nowhere near as 'wired' as I felt at the beginning of withdrawal), but I also have periods where I sleep like a baby and can barely wake up in the morning!

 

I quit caffeine about a year ago, and that made quite a big difference to my sleep.

@jon1Did you ever suffer from early morning waking regularly in withdrawals?

Do you still have any symptoms if you don't mind me asking?

[jon1]

18 minutes ago, Hello20 said:

@jon1Did you ever suffer from early morning waking regularly in withdrawals?

Do you still have any symptoms if you don't mind me asking?

 

Hey @Hello20,

 

Yes I did. It still happens occasionally, but nowhere near as much as it did for the first couple of years. I'd usually wake at around 3-4am and feel like I'd had a coffee. Then be unable to sleep.

 

I quit caffeine a year ago, and that seemed to be a turning point, but I don't know if that was just a conicence, as it had been improving anwyay.

 

Yes, I still have plenty of symptoms and my life is still restricted. I still go through 'waves', but they do seem to be less intense than they used to be.

 

I've been completely off my SSRI since January 2022, so 2 1/2 years.

[Hello20]

5 minutes ago, jon1 said:

 

Hey @Hello20,

 

Yes I did. It still happens occasionally, but nowhere near as much as it did for the first couple of years. I'd usually wake at around 3-4am and feel like I'd had a coffee. Then be unable to sleep.

 

I quit caffeine a year ago, and that seemed to be a turning point, but I don't know if that was just a conicence, as it had been improving anwyay.

 

Yes, I still have plenty of symptoms and my life is still restricted. I still go through 'waves', but they do seem to be less intense than they used to be.

 

I've been completely off my SSRI since January 2022, so 2 1/2 years.

Thanks for that @jon1 my main issue is the early morning waking exactly as you described it and what you have said gives me hope but I've noticed you were only on meds for about 2 years were I was on for like 10 to 12 years. ive also spoken to a lady that has had early morning waking for like 4 years which doesn't give me confidence my issue will resolve.

Thank you for your information.

[jon1]

I'm sure it will eventually @Hello20. We're all different, and it's almost improssible to know how long it will take our brains to heal.

 

Counting tapering time, I was on escitalopram for just under 3 1/2 years. I have read that SSRI's change the brain very quickly, within weeks, so I'm not sure if the length of time on the drugs is always indicative of how long it will take to reover.

 

In the end, I've just resigned myself to the idea that when it happens, it happens!

[AGlassDarkly]

@Hello20 Hi there. 30 years on/off SSRI use here. Been 2 years free of all the wretched meds now. Echo pretty well all of your observations and experiences of PAWS. I too went through a few months where I simply couldn't read books (a lifelong passion) at all. Likewise with winding down, say watching TV for example: it felt like my mind was restlessly wandering in another time/space no matter how hard I 'tried' to re-direct it. Ditto the 3am cortisol jump-start waking, and lying in a thin sleep. To end on a positive note – my trend has been broadly one of slow improvement, but with definite and frustrating setbacks (waves) to keep me on my toes!  As I progress further along the recovery path I think I'm leaning toward @jon1 's philosophy:

 

Quote

In the end, I've just resigned myself to the idea that when it happens, it happens!

…mainly because for me no one thing seems to make any real difference either way! 

 

[Gonzo]

I also have this early morning anxiety pike issue and I think it's related to trauma. During the morning obviously is when the work/school starts for most people, and since I was very little I have abandonment trauma for different reasons which always got triggered during the morning, that means lots of anxiety early during the day. My mind learned that during the morning is when I leave home and attachment gets disrupted so I don't feel safe. Also work/school is already and obviously stressing for lots of people per se. When we are taking psych drugs we don't have to face none of this, we live in autopilot mode, numbed. When I quit Sertraline all my emotional issues and trauma came back roaring but I wasn't able to make sense of them until now, close to 4 years later. Just my 2cents.

[Hello20]

@Gonzo

I don't suffer from anxiety when waking anymore but just wake up early. I pretty much feel back to normal but still have a few psychological issues but can handle them. I worry about the early morning waking will be my normal now because i was talking to a lady on another site and she has had it for 4 years. Did you get to a point and feel pretty much normal and had issues that healed?

[Gonzo]

So, I haven't fully healed yet, I'm now dealing with my original trauma. My issues are mostly trauma related now. If I had had the help I needed earlier, which I don't have, I wouldn't have these issues and this anxiety. So if it's trauma related and you have help and are not afraid to get into it, it can take much less time. I don't feel normal because I haven't healed.