![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by LyndaK on August 22, 2005, at 21:45:51
In reply to Re: Prozac Withdrawal - need advice - going off meds, posted by Velodog2 on August 19, 2005, at 15:37:38
Is it just the idea of being dependent on the drug that you don't like? Or is there some side-effect(s) that you don't like?
In my experience, going cold-turkey is the worst way to come off an SSRI . . . and it's really not a good way to see if you still need the drug, because a sudden, big change like that can throw you into a severe depression. I've experienced that myself when I went off an SSRI cold-turkey . . . vowed I would never do it again. I'm not currently on an SSRI, I'm on a different med., but I don't like the side-effects of it either . . . but I can live with them. I CAN'T live with severe, unrelenting depression. I do know that my choices for treatment are a whole lot better than the choices that existed for my mom when she was young . . . I'm thankful for that! I'm also hopeful that even more will be learned and even better treatments will be developed. In the mean time, I'll do the best I can with the treatments that are currently out there . . . no shame in that.
Let us know how you're doing.
Lynda
> Hi, I'm new to this board. I've been on Prozac almost continuously for about 8 yrs. and am trying to come off it. I'm about 4 wks into cold-turkey cut off and it's not been easy. I have very few physical symptoms. My worst problem is recurring depression - generally much worse than before I went on the drug. This has happened every time I have tried coming off it before, and I always cave and go back. I hate being dependent. Does anyone else experience a bout of depression while withdrawing? Does it resolve?
Posted by velodog2 on August 22, 2005, at 21:46:35
In reply to Re: Prozac Withdrawal - need advice - going off meds » Velodog2, posted by barbaracat on August 19, 2005, at 16:23:00
Thank you for the thoughtful reply. You asked the exact question on my mind as well: has the drug has altered my brain's structure and ability to compensate without the drug?
You also said:
> I'd like to say that your depression is returning because your receptors have not had time to upregulate yet after only 4 weeks. You're most definitely in withdrawal which is why you're feeling the depression and why it's worse.So my next question would be how long before I may be able to guess at the first answers? How long before the chemistry could be said to have stabilized?
It's not simple to say why I wanted to get off this stuff. I've never been comfortable with the idea that my happiness is simply a matter of proper dosage of a drug. My partner is exacerbating the situation by complaining of my mood swings and claiming that he 'can tell' when I've missed a dose, or tried to come off it in the past, although he doesn't in fact know if or when I've done those things. And so I spend more time worrying about whether I should be taking the daily instead of the weekly prozac, or maybe increasing the dosage, or switching to another ssri instead of thinking about should I be looking for a new job, or a new house, or a new partner ;-)? And the fact that I having been trying to make those decisions (the first two at least, the third is becoming a question now) is a factor as well. I don't seem to be able to get anywhere with the decision. I mean these questions are all about happiness right? Maybe I should just increase my dosage and stay right where I am. It just makes these things too complicated and I want it out of my life!
Posted by barbaracat on August 22, 2005, at 21:46:35
In reply to Re: Prozac Withdrawal - need advice - going off meds, posted by velodog2 on August 21, 2005, at 18:59:55
Whatever your reasons for wanting to quit a med, and there are as many philosophical as well as medical, there are two absolutes for which there are no exceptions: If you cold turkey an SSRI you will feel much worse than you can imagine. It will be like not putting oil in your car. You'll get along fine for a few weeks, then you'll start screaching and smoking and frying up. Until that oil gets replenished you should just park it. Rule no 2 is, just as you would not want to drive from Miami to Denver in that car, you do not want to make any life changing difficult decisions while your brain's 'oil reserves' are essentially depleted.
Everything will get on your nerves more intensely ,paranoia will reign, you'll also start looking and acting a little weird and intense and people will react to that and you'll get more irritable and paranoid. The kids that shot up their classmates? I believe it was every single one that abruptly stopped an SSRI.
As far as resenting that a pill would determine your happiness, this is a worthy philosophical issue - what would you be like without the pill? If you could truly get it out of your system and your neurochemistry back to ground zero, what are your chances of unadulterated happiness without the false overlay of medication?
If that's your main reason (forget your partner - it's really none of his business and if he doesn't like it, let him go though the mess of leaving, not you in your sensitized state), realize you're going to go through hell and back as your chemistry stabilizes and you will lose the ability to make an objective judgement about your state of mind.
What generally happens is that going cold turkey is usually so hard, so stressful, so provoking rage and despair because you're without your chemical reserves that you tend to make a royal mess out of your life during that time. You get sick from stress, you lose your job, you say and do things from irritability and paranoia. You can't pay your bills, you lose your friends. You create the conditions that would make anyone depressed. That's why people take it reeaalll slow and have plenty of support on hand for the rough times.
Your other question is the clincher. How long should it take? No one really knows. My feeling is that if it's just a matter of upregulating receptors and allowing for repair of neuronal damage, you should be at ground zero in about 6 months after the last pill. I don't see why it would take any longer than that, structurally speaking. Cells have turnover rates. They heal, they regroup. So, if it takes 6 months to stop your last pill (not uncommon), 6 months later you can begin accurately judging if from that point you're starting to feel cleared out and happier or if the misery is unrelenting.
Many of us want to be without meds but just don't know how, have not developed the life or social skills, are naturally too sensitive for this harsh world. I don't know of anyone who has ever quit and stayed quit. People seem to learn the proper skills while they're on the meds then forget them once they're off - a different personality takes over.
I don't think it's a matter a brain damage. I think we just revert back to those old habits seen out of the old lenses. Sometimes we simply grow past the old pains and have grown beyond the reasons we originally took the meds. I'm talking both psychological and neurochemical. Time can make a lot of difference hormonally. However, there are conditions that with time will intensify with or without drugs. My bipolar condition was increasing to becoming a constant in my life prior to going on lithium, so that's one example of where things got worse without drugs.
But there will be an adjustment, no matter what. So, go slow and maybe you do need to try something different, or an augmentor. Just don't cold turkey it. - Barbara
>
> You also said:
> > I'd like to say that your depression is returning because your receptors have not had time to upregulate yet after only 4 weeks. You're most definitely in withdrawal which is why you're feeling the depression and why it's worse.
>
> So my next question would be how long before I may be able to guess at the first answers? How long before the chemistry could be said to have stabilized?
>
> It's not simple to say why I wanted to get off this stuff. I've never been comfortable with the idea that my happiness is simply a matter of proper dosage of a drug. My partner is exacerbating the situation by complaining of my mood swings and claiming that he 'can tell' when I've missed a dose, or tried to come off it in the past, although he doesn't in fact know if or when I've done those things. And so I spend more time worrying about whether I should be taking the daily instead of the weekly prozac, or maybe increasing the dosage, or switching to another ssri instead of thinking about should I be looking for a new job, or a new house, or a new partner ;-)? And the fact that I having been trying to make those decisions (the first two at least, the third is becoming a question now) is a factor as well. I don't seem to be able to get anywhere with the decision. I mean these questions are all about happiness right? Maybe I should just increase my dosage and stay right where I am. It just makes these things too complicated and I want it out of my life!
Posted by SLS on August 22, 2005, at 21:46:35
In reply to Re: Prozac Withdrawal - need advice - going off meds, posted by Velodog2 on August 19, 2005, at 15:37:38
Hi.
The more gradually you withdraw an antidepressant, the less likely you are to relapse.
At this point, it would be difficult to judge whether you are experiencing a temporary depressive rebound from going "cold turkey" or actually relapsing, in which case you will need to return to the Prozac.
I know if it were me, after 4 weeks, I would return to the Prozac, wait a few months, and try to taper gradually. If the depression returns under these conditions, it might indicate that you will need to return to Prozac until perhaps a completely new treatment can produce an actual cure. This may or may not occur in our lifetimes. Do what you need to in order to function and feel better.
- Scott
Posted by SLS on August 22, 2005, at 21:46:35
In reply to Re: Prozac Withdrawal - need advice - going off meds » Velodog2, posted by SLS on August 22, 2005, at 20:30:55
> Hi.
>
> The more gradually you withdraw an antidepressant, the less likely you are to relapse.I found an article on Medline that calls into question this traditional assertion.
I still can't help but to have trepidations regarding the abrupt discontinuation of an antidepressant and a subsequent increased risk of relapse. This study was a retrospective review of previous work rather than a prospective investigation involving the direct control of subjects. I am probably wrong in doubting their results, though. Despite this, I can't see any advantage in stopping Prozac abruptly and experiencing a discontinuation withdrawal syndrome unless it is otherwise necessary.
The article helps lay the groundwork for answering any questions you might have regarding your need to continue with treatment. It would be important to take into account your history of depression as it has unfolded during your lifetime. A high degree of recurrence or chronicity indicates the likelihood that there will be a need for indefinite treatment.
- Scott
------------------------------------------------1: Harv Rev Psychiatry. 1998 Mar-Apr;5(6):293-306. Related Articles, Links
Discontinuing antidepressant treatment in major depression.Viguera AC, Baldessarini RJ, Friedberg J.
Consolidated Department of Psychiatry, Harvard Medical School, Boston, Mass., USA.
Maintenance treatments in bipolar disorders and schizophrenia are securely established, and their discontinuation is associated with high but modifiable risk of early relapse. The benefits of long-term antidepressant treatment in major depression and the risks of discontinuing medication at various times after clinical recovery from acute depression are not as well defined. Computerized searching found 27 studies with data on depression risk over time including a total of 3037 depressive patients treated for 5.78 (0-48) months and then followed for 16.6 (5-66) months with antidepressants continued or discontinued. Compared with patients whose antidepressants were discontinued, those with continued treatment showed much lower relapse rates (1.85 vs. 6.24%/month), longer time to 50% relapse (48.0 vs. 14.2 months), and lower 12-month relapse risk (19.5 vs. 44.8%) (all p < 0.001). However, longer prior treatment did not yield lower postdiscontinuation relapse risk, and differences in relapses off versus on antidepressants fell markedly with longer follow-up. Contrary to prediction, gradual discontinuation (dose-tapering or use of long-acting agents) did not yield lower relapse rates. Relapse risk was not associated with diagnostic criteria. More previous illness (particularly three or more prior episodes or a chronic course) was strongly associated with higher relapse risk after discontinuation of antidepressants but had no effect on response to continued treatment; patients with infrequent prior illness showed only minor relapse differences between drug and placebo treatment.
Publication Types:
Review
Review, TutorialPMID: 9559348 [PubMed - indexed for MEDLINE]
Posted by barbaracat on August 22, 2005, at 23:22:01
In reply to Re: Prozac Withdrawal - need advice - going off meds, posted by SLS on August 22, 2005, at 21:22:35
Prozac has the longest half life and the least likelihood of causing the extremely uncomfortable withdrawals found in, say, Effexor. In fact, a dose of Prozac is routinely added to a discontinuation routine to smooth out the transition.
So if there's some way you can be assured of support, honest evaluation of your behavior, and maybe some benzos to get through the hard parts because you will be a little crazy for a while, it might be worth it to just get it over with.
Again, I'm going to suggest the 6 month range revue. Because you're dickering with powerful chemical homeostasis, you're going to be on a roller coaster, but if you can simply tolerate it you'll eventually come a time when you'll be able to make a clear headed decision of what to do. Not through any philisophical head machinations or ethical moral dilemmas or what anyone else thinks - how you feel. My suggestion would be if you're in misery and it's lasted more than 6 months past discontinuation, you very likely need a med. And why that would be - damaged brain structures or just a genetic disposition is immaterial. Quality of life is the goal.
It will be an interesting ride, my friend, but if you look at it with a sense of curiosity instead of dread, it could be very enlightening. - Barbara
> > The more gradually you withdraw an antidepressant, the less likely you are to relapse.
>
> I found an article on Medline that calls into question this traditional assertion.
>
> I still can't help but to have trepidations regarding the abrupt discontinuation of an antidepressant and a subsequent increased risk of relapse. This study was a retrospective review of previous work rather than a prospective investigation involving the direct control of subjects. I am probably wrong in doubting their results, though. Despite this, I can't see any advantage in stopping Prozac abruptly and experiencing a discontinuation withdrawal syndrome unless it is otherwise necessary.
>
> The article helps lay the groundwork for answering any questions you might have regarding your need to continue with treatment. It would be important to take into account your history of depression as it has unfolded during your lifetime. A high degree of recurrence or chronicity indicates the likelihood that there will be a need for indefinite treatment.
>
>
> - Scott
>
>
> ------------------------------------------------
>
>
>
> 1: Harv Rev Psychiatry. 1998 Mar-Apr;5(6):293-306. Related Articles, Links
>
>
> Discontinuing antidepressant treatment in major depression.
>
> Viguera AC, Baldessarini RJ, Friedberg J.
>
> Consolidated Department of Psychiatry, Harvard Medical School, Boston, Mass., USA.
>
> Maintenance treatments in bipolar disorders and schizophrenia are securely established, and their discontinuation is associated with high but modifiable risk of early relapse. The benefits of long-term antidepressant treatment in major depression and the risks of discontinuing medication at various times after clinical recovery from acute depression are not as well defined. Computerized searching found 27 studies with data on depression risk over time including a total of 3037 depressive patients treated for 5.78 (0-48) months and then followed for 16.6 (5-66) months with antidepressants continued or discontinued. Compared with patients whose antidepressants were discontinued, those with continued treatment showed much lower relapse rates (1.85 vs. 6.24%/month), longer time to 50% relapse (48.0 vs. 14.2 months), and lower 12-month relapse risk (19.5 vs. 44.8%) (all p < 0.001). However, longer prior treatment did not yield lower postdiscontinuation relapse risk, and differences in relapses off versus on antidepressants fell markedly with longer follow-up. Contrary to prediction, gradual discontinuation (dose-tapering or use of long-acting agents) did not yield lower relapse rates. Relapse risk was not associated with diagnostic criteria. More previous illness (particularly three or more prior episodes or a chronic course) was strongly associated with higher relapse risk after discontinuation of antidepressants but had no effect on response to continued treatment; patients with infrequent prior illness showed only minor relapse differences between drug and placebo treatment.
>
> Publication Types:
> Review
> Review, Tutorial
>
> PMID: 9559348 [PubMed - indexed for MEDLINE]
Posted by SLS on August 23, 2005, at 8:22:10
In reply to Re: Prozac Withdrawal - need advice - going off meds » SLS, posted by barbaracat on August 22, 2005, at 23:22:01
I find six months to be unacceptable to leave someone suffering acutely in the hope that the body will somehow come to produce a NEW homeostasis different from that which for so long has remained dysregulated. You are dickering around with someone's mental health and perhaps disposing them to suicide.
One thing that I believe ought to be considered is the potential for someone to develop a resistence to responding to medication the longer they go without it.
Regarding Prozac and discontinuation syndrome, if the long half-life of this drug produces minimal withdrawal symptoms, how would this change one's perspective when trying to account for the reappearance of severe depression 40 days post discontinuation?
Depressive rebound?
No.
Relapse.
Indefinite treatment is probably indicated.
- Scott
Posted by Velodog2 on August 23, 2005, at 8:37:38
In reply to Re: Prozac Withdrawal - need advice - going off meds » SLS, posted by barbaracat on August 22, 2005, at 23:22:01
Well thank you for all of the great information! I find all of this fairly confusing, including my motivation for going off the stuff. That has hurt my chances of staying off in the past, since my resolve weakened as soon as the going got tough. There seems to be so little we know for sure, including what this stuff does for/to us and I feel like a largish lab rat.
But my mood has been ok for the last few days - even pretty good yesterday. It doesn't mean much yet, other than if I can get a break like this on occasion, I may be able to get to what has become the magic 6 month point where I can make a valid evaluation. I intend to continue to try to make it cold turkey (strange expression, that).
As far as I can tell from my vantage point within the box, my main problem with depression prior to prozac was fairly frequent but relatively short episodes that would effectively screw up my life. However when I was convinced to go on the drug by my psychologist I was struggling mightily with with some major life upheaval caused by a ruptured lumbar disc which had ended my bicycle racing lifestyle as well as dealing with my first gay love affair. That situation has long since been adapted to, but I guess it was the periodic depression that has kept me on the stuff. I wonder if I ended up back in that mode if I would decide to go back on? Or would I be better able to manage it now?
And yes, I have managed to really piss off several of my friends, my Mother, and of course my partner over the course of the past month. But I haven't lost any of them yet.
I like the idea of looking at the journey as an adventure and will try to keep that in mind. I wish I could be sure of more support, but that may not happen. My partner told me last night that he wants me to go back on. I told him that he will not decide for me what drugs I take. I can't really say that it's none of his business - it is indeed as it affects both of our lives, and he does certainly suffer when I suffer. He's been taking Zoloft for 2 years now, because his job is stressful and he suffers from anxiety (He has one of those 'helpful' general practicioners who apparently give the stuff out at halloween) and has no qualms about using chemical aids without attempting other solutions. As an aside, I prefer his personality without the drug as being more interesting and engaging than with it. The more I consider this, the more apparent it is to me that he is what is pushing my desire to get off the prozac over the edge by attributing my every mood swing to the drug.
Well thanks again for the support. I will keep you up to date and hopefully my ramblings about my experience will help some of you somehow as well.
Posted by SLS on August 23, 2005, at 8:57:29
In reply to Re: Prozac Withdrawal - need advice - going off meds, posted by Velodog2 on August 23, 2005, at 8:37:38
Hi Veldog2.
I am more than happy to be wrong when it means that someone can regain their health and live free of medical treatment. What a blessing.
I hope your depression remains intermittent and mild. I was under the impression that things were more severe and chronic. It is possible that much of your depression has been related more to the situational and psychological rather than the biological. It is *extremely* healthy to look forward to the journey you have ahead of you. Self-improvement and growth is often very difficult and require much work. The pay-off can be huge, and I hope your endeavor pays-off big. I wish you nothing but good health and happiness.
Good luck with your continued abstinence from psychotropics.
- Scott
Posted by AnnieT on August 23, 2005, at 12:39:04
In reply to Re: Prozac Withdrawal - need advice - going off meds » Velodog2, posted by SLS on August 23, 2005, at 8:57:29
I am new to this board and am also struggling with Prozac withdrawl. I've been on it (somewhat consistently) since 1990. Last Oct., fed up with having no feelings about anything, I went cold turkey. I was ok for about 3 weeks and then began having manic behavior. It scared me so much that I went back on the drug. Again fed up with the "Zombie" feeling, I stopped taking the drug about a month ago. My manic feelings have returned (high energy, not eating much, feeling invinceable, staying on the computer for hours on end, drinking excessively and high sexual drive) Before Prozac, I never experienced any of these things. I originally went on the drug to help with mild depression and anxiety. I'm determined to stay off Prozac and "tough out" this mania stuff. I do LOVE having feelings again, including sexual enjoyment. My poor husband has seen me go through these episodes and I know that our relationship has been strained because of it. I don't know if life without Prozac is do-able long term. I do know that I'd like to try it.
Posted by barbaracat on August 23, 2005, at 13:05:47
In reply to Re: Prozac Withdrawal - need advice - going off meds » barbaracat, posted by SLS on August 23, 2005, at 8:22:10
Scott,
I agree with you. Leaving someone twisting in the wind for 6 months is cruel but that's not what I was even hinting at. I was giving an 'outer limits' guideline to shoot for based on my own attempts, sometimes more successful than others, in discontinuing a med and this was in response to Veldog's question. If I were feeling miserable - tolerably miserable, not suicidal after 6 months, chances are homeostasis has occured and things aren't going to get better as a result of being over withdrawal. Sometimes it takes alot less time, especially if suicidal ideation starts creeping in, but a person generally has sense enough to make that call and I certainly sensed that Veldog would do the right thing.It's a guideline I've used with myself. I keep a journal which has proved very useful in tracking just how things really are going over time. Sometimes after deciding to stop a med, it's taken a week to throw in the towel because I knew my life would suffer. Sometimes after 6 months I could determine that I was doing just OK but the limping along wasn't acceptable and I needed to visit my pdoc. Other times I found I was doing pretty good and set my goals to the next 6 month marker. Getting off a med is hard and it's not always clear when the withdrawal rollercoaster ride is over. If a person wanted a ballpark figure to determine 'ground zero', six months is a reasonable goal. I wasn't suggesting it as a sentence to white knuckle through.
I didn't get the impression that our friend was in a bad place in any way, just the opposite in fact. I got the impression that Veldog was more curious as to what would happen once the expected ups and downs of withdrawal were over and was ready to give getting off the med a try.
We try to help each other on this board, Scott, and sometimes our own history/experiences influence what we say. I appreciate the fact that you would be concerned enough to voice your alarm, but you and I have traveled together on this board long enough to know that I'm not likely to advise someone to do something harmful to themselves. I feel confident that if Veldog were really suffering at the 2 month mark, he/she would not be moaning 'oh, uhhhgh, can't give up, BarbaraCat says I've got 4 months to go'.
If Veldog decides to go off meds and decides to do it cold-turkey (which I strongly suggested not to do), then we have to trust there's enough of a good reason, he/she has enough common sense, we add our own experience and advice as a way of offering help and support. As for dickering with someone's mental health, I certainly don't have the influence or power to do so and care enough to not do so, but if it appeared that way then know that it was not intended. Peace, Barbara
> I find six months to be unacceptable to leave someone suffering acutely in the hope that the body will somehow come to produce a NEW homeostasis different from that which for so long has remained dysregulated. You are dickering around with someone's mental health and perhaps disposing them to suicide.
>
> One thing that I believe ought to be considered is the potential for someone to develop a resistence to responding to medication the longer they go without it.
>
> Regarding Prozac and discontinuation syndrome, if the long half-life of this drug produces minimal withdrawal symptoms, how would this change one's perspective when trying to account for the reappearance of severe depression 40 days post discontinuation?
>
> Depressive rebound?
>
> No.
>
> Relapse.
>
> Indefinite treatment is probably indicated.
>
>
> - Scott
Posted by ed_uk on August 23, 2005, at 14:36:52
In reply to Re: Prozac Withdrawal - need advice - going off meds, posted by Velodog2 on August 23, 2005, at 8:37:38
Dear VD2,
Please keep posting on p-babble and tell us how you do.
Kind regards
~ed
Posted by Velodog2 on August 23, 2005, at 15:03:02
In reply to Re: Prozac Withdrawal - need advice - going off meds » Velodog2, posted by SLS on August 23, 2005, at 8:57:29
Thank you for the well wishes.
As I said, assuming that I could return to a pre-medicated state, whether or not I would stay off of the drug would depend upon how much of the periodic depression I was willing to put up with and/or how well I was now able to deal with it.
Possibility two which has been discussed is of course that I have become permanently dependent upon the drug to maintain acceptable levels of neurochemicals. So far I'm hopeful this isn't the case.
In reference to your earlier post, my (very cursory) understanding of addictive response is that it includes adaptation or building of tolerance that I interpret as the body adapting to the presence of the drug by re-adjusting itself to try to maintain pre-drug setpoints. Thus if you suddenly remove this crutch it has become accustomed to, it would fall down, perhaps only temporarily. In that scenario a bout of perhaps extra-deep depression with withdrawal makes sense to me. I'm sure there's more to addiction that that however.
Mike> Hi Veldog2.
>
> I am more than happy to be wrong when it means that someone can regain their health and live free of medical treatment. What a blessing.
>
> I hope your depression remains intermittent and mild. I was under the impression that things were more severe and chronic. It is possible that much of your depression has been related more to the situational and psychological rather than the biological. It is *extremely* healthy to look forward to the journey you have ahead of you. Self-improvement and growth is often very difficult and require much work. The pay-off can be huge, and I hope your endeavor pays-off big. I wish you nothing but good health and happiness.
>
> Good luck with your continued abstinence from psychotropics.
>
>
> - Scott
Posted by velodog2 on August 23, 2005, at 22:16:48
In reply to Re: Prozac Withdrawal - need advice - going off meds » Velodog2, posted by ed_uk on August 23, 2005, at 14:36:52
Whoops. Got home tonight to find a charming note from my partner informing me that he was done, and gone. Anyone care to place bets on how long I stay off of prozac now? Ironic, since going back on it was what he wanted.
Posted by ed_uk on August 24, 2005, at 13:52:12
In reply to Ante up. New card dealt., posted by velodog2 on August 23, 2005, at 22:16:48
I'm really sorry. How are you coping?
Ed x
Posted by barbaracat on August 24, 2005, at 13:56:48
In reply to Ante up. New card dealt., posted by velodog2 on August 23, 2005, at 22:16:48
Ahhh, poo. What a crummy thing to happen. Good, bad, it's always rough to end a relationship. But I've gotta say - a note? just a note? No face to face honest give you a chance to talk? Tsk tsk.
How long has it been without the Prozac? A little over 4 weeks, right? It sounded like you were doing OK, depressed but still determined. This is just a thought, so take it for what it's worth. With this new outcome, leaving a note and splitting, it would seem that your partner may have had this in mind for a while and whatever the reason, your being on meds or not, he was thinking about it, planning it. This was in the airwaves, so to speak, you can't help but pick up on it and feel the anxiety and unclarity of something that doesn't feel right.
It will be interesting to see how you feel without those uncertain bad vibes in your energy space. Yes, the split will have it's own heartaches. But maybe the subliminal dissatisfaction and vague threats aimed your way was affecting you more than you realized.
It would be helpful to separate out the different streams of what must feel like a jumbled mass of feelings. There might be a tiny bit of relief in there as well and if so, grab onto it and let that relief grow. Because it's too easy to thrash ourselves for what we did wrong. That's where the downward spin starts so hopefully you can pull yourself back from going there.
About the Prozac, you'll know what's best for you. There's no need to white knuckle it though massive pain. It seems like you've got a bunch of processing to do about your life circumstances, and on one hand you don't want to sublimate or blunt that process, on the other you don't want to go into a tailspin where you can't handle anything. I wish the best for you and that you can find a balanced path through all this upheaval. - Barbara
> Whoops. Got home tonight to find a charming note from my partner informing me that he was done, and gone. Anyone care to place bets on how long I stay off of prozac now? Ironic, since going back on it was what he wanted.
Posted by Velodog2 on August 24, 2005, at 14:39:40
In reply to Re: Ante up. New card dealt. » velodog2, posted by barbaracat on August 24, 2005, at 13:56:48
You perceive much Barbaracat, all correctly. I am in a lot of pain right now, of course. I was quite committed to the relationship and have been through this too many times in the past (from one side or the other) to shake it off lightly.
However, so far I would say that I have not fallen into what I would consider depression. I am extremely sad, angry, anguished, etc. - all normal stuff - but not depressed, yet. The danger time is ahead when the shock wears off and I have to look at and evaluate and make decisions about my life.
Also interestingly (to me) is that I am feeling this one somewhat more intensely (the feelings listed above) than what was essentially the same situation 1.5 yrs ago when we split for a couple months, but then got back together, and when I was on Prozac. That's not necessarily bad -increased intensity of feelings is a double edged sword.
I have a rather simplistic theory that my depression is either a reaction to, or a coping mechanism for, an impasse in problem solving. Not being able to perceive an answer to a significant problem in my life often seems to initiate depression. As I said, it is simplistic and I don't believe it is more than a small piece of the puzzle.
I have an appt. with the dr. tomorrow to refill the prescription however, so I will have it on hand. I don't intend to use it until I feel actual persistent depression. I don't want to dull my feelings at a time when I may need to make decisions about my life. After all, deciding what you want is all about what you feel. Conversely, I don't want to make decisions when I am depressed either. Which is exactly what you said Barbaracat.
Thank you all again for the support - my need has increased quite significantly. I may need to find a psychologist before this is over.
Mike> Ahhh, poo. What a crummy thing to happen. Good, bad, it's always rough to end a relationship. But I've gotta say - a note? just a note? No face to face honest give you a chance to talk? Tsk tsk.
>
> How long has it been without the Prozac? A little over 4 weeks, right? It sounded like you were doing OK, depressed but still determined. This is just a thought, so take it for what it's worth. With this new outcome, leaving a note and splitting, it would seem that your partner may have had this in mind for a while and whatever the reason, your being on meds or not, he was thinking about it, planning it. This was in the airwaves, so to speak, you can't help but pick up on it and feel the anxiety and unclarity of something that doesn't feel right.
>
> It will be interesting to see how you feel without those uncertain bad vibes in your energy space. Yes, the split will have it's own heartaches. But maybe the subliminal dissatisfaction and vague threats aimed your way was affecting you more than you realized.
>
> It would be helpful to separate out the different streams of what must feel like a jumbled mass of feelings. There might be a tiny bit of relief in there as well and if so, grab onto it and let that relief grow. Because it's too easy to thrash ourselves for what we did wrong. That's where the downward spin starts so hopefully you can pull yourself back from going there.
>
> About the Prozac, you'll know what's best for you. There's no need to white knuckle it though massive pain. It seems like you've got a bunch of processing to do about your life circumstances, and on one hand you don't want to sublimate or blunt that process, on the other you don't want to go into a tailspin where you can't handle anything. I wish the best for you and that you can find a balanced path through all this upheaval. - Barbara
>
>
>
> > Whoops. Got home tonight to find a charming note from my partner informing me that he was done, and gone. Anyone care to place bets on how long I stay off of prozac now? Ironic, since going back on it was what he wanted.
>
>
Posted by barbaracat on August 24, 2005, at 20:46:17
In reply to Re: Ante up. New card dealt., posted by Velodog2 on August 24, 2005, at 14:39:40
Well, just know that we're here for you. Sometimes just the act of writing helps process the pain and results in some clarity, and you might even get some useful advice here and there from us.
It's a good thing you're going to have the Prozac on hand, kind of like a safety net. You might also talk to your doc about some benzos. I think I mentioned I like lorezapam. It's a good chill pill when things start feeling anxious and revved up and can offer some relief from the withdrawal symptoms, if you still decide that's what you're going to do.
It's good you're feeling anger. It's a higher more active vibration than the paralysis of depression. Hopefully you can use it's energy to keep you out of the pit and motivate you on to new enthusiasms and activities. Hopefully you can mourn without unnecessary despair. All fine lines, but you seem to me like you have a depth of spirit and a will to health that will get you through this and come out stronger. My thoughts are with you. Breaking up is hard to do. - BarbaraCat
> You perceive much Barbaracat, all correctly. I am in a lot of pain right now, of course. I was quite committed to the relationship and have been through this too many times in the past (from one side or the other) to shake it off lightly.
>
> However, so far I would say that I have not fallen into what I would consider depression. I am extremely sad, angry, anguished, etc. - all normal stuff - but not depressed, yet. The danger time is ahead when the shock wears off and I have to look at and evaluate and make decisions about my life.
>
> Also interestingly (to me) is that I am feeling this one somewhat more intensely (the feelings listed above) than what was essentially the same situation 1.5 yrs ago when we split for a couple months, but then got back together, and when I was on Prozac. That's not necessarily bad -increased intensity of feelings is a double edged sword.
>
> I have a rather simplistic theory that my depression is either a reaction to, or a coping mechanism for, an impasse in problem solving. Not being able to perceive an answer to a significant problem in my life often seems to initiate depression. As I said, it is simplistic and I don't believe it is more than a small piece of the puzzle.
>
> I have an appt. with the dr. tomorrow to refill the prescription however, so I will have it on hand. I don't intend to use it until I feel actual persistent depression. I don't want to dull my feelings at a time when I may need to make decisions about my life. After all, deciding what you want is all about what you feel. Conversely, I don't want to make decisions when I am depressed either. Which is exactly what you said Barbaracat.
>
> Thank you all again for the support - my need has increased quite significantly. I may need to find a psychologist before this is over.
> Mike
>
> > Ahhh, poo. What a crummy thing to happen. Good, bad, it's always rough to end a relationship. But I've gotta say - a note? just a note? No face to face honest give you a chance to talk? Tsk tsk.
> >
> > How long has it been without the Prozac? A little over 4 weeks, right? It sounded like you were doing OK, depressed but still determined. This is just a thought, so take it for what it's worth. With this new outcome, leaving a note and splitting, it would seem that your partner may have had this in mind for a while and whatever the reason, your being on meds or not, he was thinking about it, planning it. This was in the airwaves, so to speak, you can't help but pick up on it and feel the anxiety and unclarity of something that doesn't feel right.
> >
> > It will be interesting to see how you feel without those uncertain bad vibes in your energy space. Yes, the split will have it's own heartaches. But maybe the subliminal dissatisfaction and vague threats aimed your way was affecting you more than you realized.
> >
> > It would be helpful to separate out the different streams of what must feel like a jumbled mass of feelings. There might be a tiny bit of relief in there as well and if so, grab onto it and let that relief grow. Because it's too easy to thrash ourselves for what we did wrong. That's where the downward spin starts so hopefully you can pull yourself back from going there.
> >
> > About the Prozac, you'll know what's best for you. There's no need to white knuckle it though massive pain. It seems like you've got a bunch of processing to do about your life circumstances, and on one hand you don't want to sublimate or blunt that process, on the other you don't want to go into a tailspin where you can't handle anything. I wish the best for you and that you can find a balanced path through all this upheaval. - Barbara
> >
> >
> >
> > > Whoops. Got home tonight to find a charming note from my partner informing me that he was done, and gone. Anyone care to place bets on how long I stay off of prozac now? Ironic, since going back on it was what he wanted.
> >
> >
>
>
Posted by Velodog2 on August 31, 2005, at 10:03:41
In reply to Re: Ante up. New card dealt. » Velodog2, posted by barbaracat on August 24, 2005, at 20:46:17
Hey all
I'm hanging in, although the weekend was pretty much horrible. Treated to the new 'ex' coming by to get the rest of his stuff saturday am, and being able to watch him drive away for the last time. Had to call a friend to come over after that as I completely lost it and actually started to hyperventilate. Otherwise I've hit a few moments of depression, but It's not a problem yet. Mostly sadness, anger, panic, etc.I'm thinking that half of the pain is coming from the life upheaval. I need to make a new life and the sooner I can get a direction established the sooner I can start recovering. My primary care physician gave me a couple of references for counselors, but they were pretty much dead ends (and turned out to be marriage counselors anyways, which I'm not sure is most appropriate here as the relationship is already dead).
What is the best way to go about finding a DECENT counselor in my area? How many 'kinds' are there? I know of psychologists and psychiatrists, and then I guess there are various levels under those as well. I just need someone to help me make sense of my mess of feelings and help me pick the most reasonable next step!
Anyone?
Mike
Posted by barbaracat on August 31, 2005, at 12:47:11
In reply to Holding on - need counselor, posted by Velodog2 on August 31, 2005, at 10:03:41
Hi Mike,
What a difficult time this is for you, but not unexpected. Breaking up is miserable, scary, you think the world is coming to an end and in a way, the one you knew is. You will heal, but right now you need a life raft.You didn't say whether you restarted the Prozac. I know you wanted to see how things really were without the drug, but this may not be the time to muscle through when you need all the help available. Life gets weird enough in the best of circumstances when a person is rebalancing chemically. If you're hyperventilating, sure sign of major stress and important to get that under control. A mild tranquillizer could go a long way to keep things from spinning into panic. Ugh. Hate panic.
So, there are plenty of kinds of counselling therapists, basically and simplistically divided into two camps, psychoanalytic/depth where past issues are examined, family of origin dynamics explored. You'll find Freudian psychoanalysis, Jungian depth therapy, Gestalt in here and the time frame is usually long and ongoing.
The other is a present day goal oriented focus, the primary example being Cognitive Behavioral Therapy where you recognize and label thoughts and behaviors that contribute to depressive feelings. The timeframe is usually 10 sessions. Sometimes you'll find therapists who combine aspects of both.
There are also spiritually oriented therapists that put more of an emphasis on integrating what's going on from a transpersonal basis.
Insurance companies generally aren't going to pick up the tab for long-term therapy so the kind you're going to most likely encounter from a main-stream medical standpoint will be the Cognitive, or CBT, or derivations of it (Dialectical Behavioral is another good one). This kind would be more likely to focus primarily on what's going on in your life now and what you're going to do about it and so would probably be the one to go for. You need quick tools to call on to get you through the day and CBT types of therapy provide that.
Even if very relevant to your present situation, depth therapy can be intense and you don't need to dive into your past and stir additional stuff up on top of present day issues. Later on when you're out of crisis and ready to deal with your deep unconsious, depth therapy can't be beat. Ideally, you can find someone who is skilled in both goal oriented and depth therapy and can apply whichever focus is needed for a particular session.
There's also group therapy which can be extremely helpful down the line, but probably not when you're in the midst of a meltdown. Being in a group where you know you're not alone in your feelings is a great comfort. Kinda like this board, but right now you need more.
Also subspecialties, such as Eye Movement Desensitization Repatterning, or EMDR, hypnosis, breathwork, bodywork. But these are generally tools used within the framework of the 2 main categories. It's good to know, however, if a therapist has these additional tools in their bag of tricks.
How you find someone is to look in the yellow pages under Psychotherapists. There will sometimes be a referral service. Sometimes you get a hit on someone and call them and see what they offer and how they feel to you. There will also be clinics listed (sometimes under a separate yellow pages section) with a number of therapists. There's usually an intake person who gets a brief history from you on the phone and suggests a good fit. As you've seen, not all turn out to be good fits.
You can also call the main office of a hospital, explain that you're looking for a therapist and you'll be connected with some department that can offer suggestions.
If you're inclined towards the transpersonal approach or even a religious affiliation, call a church or organization and ask for suggestions. Sometimes the person won't be a clinical psychologist per se but will be trained anyway. I gravitate towards New Thought and Buddhist philosophy and have found some wonderful therapists who gear their work within that context instead of a purely secular one. I've found them by calling Unity churches, Buddhist meditation halls, going to metaphysical bookstores and looking on the bulletin boards or publications. Sometimes these bookstores just provide a haven to hang out in, whether you're spiritually inclined or not.
You can also call the psychology department of colleges, briefly say what you're looking for to the receptionist who will most likely put you in contact with someone to get a referral from.
In other words, there's no sure way to find a DECENT therapist but there are plenty of ways to be directed to those whom other's think are good. Sometimes you have to kiss a bunch of frogs. But you usually know pretty quickly which ones are frogs or at least not quite right for you. Kind of like looking for a roomate. Sometimes you get lucky right away and sometimes it takes a little more footwork.
When I mentioned in a previous post that it's important to have your support system ducks lined up before stopping an AD, this was a big part of it. But you'll find someone and finding someone will provide a sense of purpose that will provide a good distraction and focus. Hang in there, Mike. It will get easier. - Barbara
> Hey all
> I'm hanging in, although the weekend was pretty much horrible. Treated to the new 'ex' coming by to get the rest of his stuff saturday am, and being able to watch him drive away for the last time. Had to call a friend to come over after that as I completely lost it and actually started to hyperventilate. Otherwise I've hit a few moments of depression, but It's not a problem yet. Mostly sadness, anger, panic, etc.
>
> I'm thinking that half of the pain is coming from the life upheaval. I need to make a new life and the sooner I can get a direction established the sooner I can start recovering. My primary care physician gave me a couple of references for counselors, but they were pretty much dead ends (and turned out to be marriage counselors anyways, which I'm not sure is most appropriate here as the relationship is already dead).
>
> What is the best way to go about finding a DECENT counselor in my area? How many 'kinds' are there? I know of psychologists and psychiatrists, and then I guess there are various levels under those as well. I just need someone to help me make sense of my mess of feelings and help me pick the most reasonable next step!
>
> Anyone?
> Mike
Posted by Velodog2 on September 1, 2005, at 7:43:54
In reply to Re: Holding on - need counselor » Velodog2, posted by barbaracat on August 31, 2005, at 12:47:11
Well I'm hoping that the crisis/panic phase is behind me. I feel relatively in control, and to me that's the most important thing to warding off depression. If I prove incapable of making decisions that need to be made to move my life forward, I will be in danger. That is the reason I would like a counselor/therapist. I guess I was hoping for advice on avoiding the frogs, but other than a recommendation for someone specific, I suppose there is no option but trial and error as you said.
So no, I'm not back on Prozac. I feel like I have come so far, I hate to give it up now. And although I know the withdrawal wasn't the only or even primary reason the relationship failed, I feel like it contributed at least to the timing, and thus it feels like I have paid a very steep price for this independence. And although I may be wrong, I still don't believe I feel significantly depressed. I do have alprazolam that I have begun to use sparingly which has helped.
I'm not even sure my primary therapy need is for depression. Again, I just want help making rational sense of my life, sorting out the emotional responses from the real needs. But I feel that if I could get better at doing that, I could avoid some depression problems in the future. Again I recognize I could be wrong. But it looks like the goal-oriented therapy would be fine. Definitely want nothing to do with 'spiritual' or religious associations. I look at religion as just another form of addiction, and given my particular 'lifestyle' (ugh, hate that word) one that seems fueled too much by hatred and judgement.
I'm off to the yellow pages.
Thanks again for your help Barbaracat. Your posts are perhaps more beneficial than you know.
Mike
> Hi Mike,
> What a difficult time this is for you, but not unexpected. Breaking up is miserable, scary, you think the world is coming to an end and in a way, the one you knew is. You will heal, but right now you need a life raft.
>
> You didn't say whether you restarted the Prozac. I know you wanted to see how things really were without the drug, but this may not be the time to muscle through when you need all the help available. Life gets weird enough in the best of circumstances when a person is rebalancing chemically. If you're hyperventilating, sure sign of major stress and important to get that under control. A mild tranquillizer could go a long way to keep things from spinning into panic. Ugh. Hate panic.
>
> So, there are plenty of kinds of counselling therapists, basically and simplistically divided into two camps, psychoanalytic/depth where past issues are examined, family of origin dynamics explored. You'll find Freudian psychoanalysis, Jungian depth therapy, Gestalt in here and the time frame is usually long and ongoing.
>
> The other is a present day goal oriented focus, the primary example being Cognitive Behavioral Therapy where you recognize and label thoughts and behaviors that contribute to depressive feelings. The timeframe is usually 10 sessions. Sometimes you'll find therapists who combine aspects of both.
>
> There are also spiritually oriented therapists that put more of an emphasis on integrating what's going on from a transpersonal basis.
>
> Insurance companies generally aren't going to pick up the tab for long-term therapy so the kind you're going to most likely encounter from a main-stream medical standpoint will be the Cognitive, or CBT, or derivations of it (Dialectical Behavioral is another good one). This kind would be more likely to focus primarily on what's going on in your life now and what you're going to do about it and so would probably be the one to go for. You need quick tools to call on to get you through the day and CBT types of therapy provide that.
>
> Even if very relevant to your present situation, depth therapy can be intense and you don't need to dive into your past and stir additional stuff up on top of present day issues. Later on when you're out of crisis and ready to deal with your deep unconsious, depth therapy can't be beat. Ideally, you can find someone who is skilled in both goal oriented and depth therapy and can apply whichever focus is needed for a particular session.
>
> There's also group therapy which can be extremely helpful down the line, but probably not when you're in the midst of a meltdown. Being in a group where you know you're not alone in your feelings is a great comfort. Kinda like this board, but right now you need more.
>
> Also subspecialties, such as Eye Movement Desensitization Repatterning, or EMDR, hypnosis, breathwork, bodywork. But these are generally tools used within the framework of the 2 main categories. It's good to know, however, if a therapist has these additional tools in their bag of tricks.
>
> How you find someone is to look in the yellow pages under Psychotherapists. There will sometimes be a referral service. Sometimes you get a hit on someone and call them and see what they offer and how they feel to you. There will also be clinics listed (sometimes under a separate yellow pages section) with a number of therapists. There's usually an intake person who gets a brief history from you on the phone and suggests a good fit. As you've seen, not all turn out to be good fits.
>
> You can also call the main office of a hospital, explain that you're looking for a therapist and you'll be connected with some department that can offer suggestions.
>
> If you're inclined towards the transpersonal approach or even a religious affiliation, call a church or organization and ask for suggestions. Sometimes the person won't be a clinical psychologist per se but will be trained anyway. I gravitate towards New Thought and Buddhist philosophy and have found some wonderful therapists who gear their work within that context instead of a purely secular one. I've found them by calling Unity churches, Buddhist meditation halls, going to metaphysical bookstores and looking on the bulletin boards or publications. Sometimes these bookstores just provide a haven to hang out in, whether you're spiritually inclined or not.
>
> You can also call the psychology department of colleges, briefly say what you're looking for to the receptionist who will most likely put you in contact with someone to get a referral from.
>
> In other words, there's no sure way to find a DECENT therapist but there are plenty of ways to be directed to those whom other's think are good. Sometimes you have to kiss a bunch of frogs. But you usually know pretty quickly which ones are frogs or at least not quite right for you. Kind of like looking for a roomate. Sometimes you get lucky right away and sometimes it takes a little more footwork.
>
> When I mentioned in a previous post that it's important to have your support system ducks lined up before stopping an AD, this was a big part of it. But you'll find someone and finding someone will provide a sense of purpose that will provide a good distraction and focus. Hang in there, Mike. It will get easier. - Barbara
>
>
>
> > Hey all
> > I'm hanging in, although the weekend was pretty much horrible. Treated to the new 'ex' coming by to get the rest of his stuff saturday am, and being able to watch him drive away for the last time. Had to call a friend to come over after that as I completely lost it and actually started to hyperventilate. Otherwise I've hit a few moments of depression, but It's not a problem yet. Mostly sadness, anger, panic, etc.
> >
> > I'm thinking that half of the pain is coming from the life upheaval. I need to make a new life and the sooner I can get a direction established the sooner I can start recovering. My primary care physician gave me a couple of references for counselors, but they were pretty much dead ends (and turned out to be marriage counselors anyways, which I'm not sure is most appropriate here as the relationship is already dead).
> >
> > What is the best way to go about finding a DECENT counselor in my area? How many 'kinds' are there? I know of psychologists and psychiatrists, and then I guess there are various levels under those as well. I just need someone to help me make sense of my mess of feelings and help me pick the most reasonable next step!
> >
> > Anyone?
> > Mike
>
>
Posted by barbaracat on September 1, 2005, at 11:49:40
In reply to Re: Holding on - need counselor, posted by Velodog2 on September 1, 2005, at 7:43:54
Yes, I hear you on the Prozac and agree totally on the need to avoid panic and stress, so good for you that you're taking the Xanax as needed. That's the situation with me too. If I can manage to keep stress from getting out of control and thoughts of looming doom, I can manage just about anything. Important to regulate your breathing too cause an imbalance of oxygen and CO2 in blood pH caused by disorganized breathing can easily trigger a panic attack
As far as how to avoid the frogs, well, you pretty much know after the first or second session if they're going to help or not. It's a little more obvious with psychiatrists, in my opionion, because so many pdocs today are medication managers and have no interest or skill in getting into the emotional trenches with someone. They just don't respond to your pain and maintain a professional aloofness that makes you feel like sh*t when you're in need of human kindness. This is not true of all pdocs, of course, but I've met far too many who come off as sociopaths.
With psychologists, there are the various schools with their various methods, but when all is said and done, the healing takes place in the level of compassion offered and the ability to help you access your own inner knowing. Someone who doesn't have any obvious agendas (against a lifestyle choice or promoting fundamentalism of any kind or obvious pathologies). There's got to be a click, you have to feel safe and also in the presence of someone who has wisdom and experience and knows how to listen, but also has the forthrightness to call you on your crap.
The best therapist I ever had in my long career with this stuff was a Jungian analyst who I saw for 3 years. That was back when insurance wasn't so cheapskate. We explored some very deep and dark places because I was ready to go there to understand how my hellacious chilhood was ruining my here and now. But she was also very practical and could offer direction in mundane things. A wise and skilled guide whom I trusted with my life. A mutual love and respect was a potential at the start and blossomed with time. The most valuable thing I learned with her was to not be afraid of the scary places inside me and to honor my feelings as being there for a good reason. I had a tendency before seeing her to beat myself up badly because I was feeling bad - talk about a vicious circle.
I've had a few really awful ones and one that comes to mind was a guy that wasn't too long out of school, was kind of tweaky and twitchy, and kept wanting to steer the session to 'well, now it's time to talk about your inevitable sexual projections onto me'. He should be so lucky!
Another was a born-again Christian who insisted my depression was a product of demonic possession. He even arranged an exorcism for me. He had me so friggin' terrified and seeing demons everywhere I came out of it a wreck. In other words, he had a major agenda but I had no idea before hand. Didn't expect someone like him to be associated with a major university hospital.
Another had an anger problem, took my issues personally and would do things like kick his desk when I didn't do my 'homework' cause I was too damn depressed. Another pdoc told me he should have been a vet because he hated people. Got outta there quickly.
You have to realize that most folks who go into this career do so because they have their own wounds they're trying to work through, and some are healthier than others.
Sometimes these things aren't immediately obvious so your first and second sessions should include you probing them mercilessly, cause they usually will avoid answering real personal questions after that.
Within your lifestyle community (jeez how lame, but you know what I mean), there must be organizations and advocacy groups that are hooked up with therapists. By all means, find someone who has no agenda whatsoever here because it will influence the relationship.
When I said spiritual orientation, don't get me wrong, I am not religious. Far, far, far from it. What I meant was that in my own case, my interests and questions usually veer into the existential realms and so I appreciate someone who also has a leaning that way. I don't do well with purely behavioristic methods but appreciate someone who can at least grok that there is more that goes on here than meets the narrow visual spectrum of the senses. I also appreciate a psychotherapist that has a good grasp of what's going on at the neurochemical level too.
Keep me informed. Considering you're maintaining so well while coming off an SSRI says quite alot about your strength and determination. You'll do fine. And your partner? I can't presume to know the story, but anyone who writes a note and splits has got a few choice issues to bring to therapy himself. - Barbara
> Well I'm hoping that the crisis/panic phase is behind me. I feel relatively in control, and to me that's the most important thing to warding off depression. If I prove incapable of making decisions that need to be made to move my life forward, I will be in danger. That is the reason I would like a counselor/therapist. I guess I was hoping for advice on avoiding the frogs, but other than a recommendation for someone specific, I suppose there is no option but trial and error as you said.
>
> So no, I'm not back on Prozac. I feel like I have come so far, I hate to give it up now. And although I know the withdrawal wasn't the only or even primary reason the relationship failed, I feel like it contributed at least to the timing, and thus it feels like I have paid a very steep price for this independence. And although I may be wrong, I still don't believe I feel significantly depressed. I do have alprazolam that I have begun to use sparingly which has helped.
>
> I'm not even sure my primary therapy need is for depression. Again, I just want help making rational sense of my life, sorting out the emotional responses from the real needs. But I feel that if I could get better at doing that, I could avoid some depression problems in the future. Again I recognize I could be wrong. But it looks like the goal-oriented therapy would be fine. Definitely want nothing to do with 'spiritual' or religious associations. I look at religion as just another form of addiction, and given my particular 'lifestyle' (ugh, hate that word) one that seems fueled too much by hatred and judgement.
>
> I'm off to the yellow pages.
>
> Thanks again for your help Barbaracat. Your posts are perhaps more beneficial than you know.
> Mike
> > Hi Mike,
> > What a difficult time this is for you, but not unexpected. Breaking up is miserable, scary, you think the world is coming to an end and in a way, the one you knew is. You will heal, but right now you need a life raft.
> >
> > You didn't say whether you restarted the Prozac. I know you wanted to see how things really were without the drug, but this may not be the time to muscle through when you need all the help available. Life gets weird enough in the best of circumstances when a person is rebalancing chemically. If you're hyperventilating, sure sign of major stress and important to get that under control. A mild tranquillizer could go a long way to keep things from spinning into panic. Ugh. Hate panic.
> >
> > So, there are plenty of kinds of counselling therapists, basically and simplistically divided into two camps, psychoanalytic/depth where past issues are examined, family of origin dynamics explored. You'll find Freudian psychoanalysis, Jungian depth therapy, Gestalt in here and the time frame is usually long and ongoing.
> >
> > The other is a present day goal oriented focus, the primary example being Cognitive Behavioral Therapy where you recognize and label thoughts and behaviors that contribute to depressive feelings. The timeframe is usually 10 sessions. Sometimes you'll find therapists who combine aspects of both.
> >
> > There are also spiritually oriented therapists that put more of an emphasis on integrating what's going on from a transpersonal basis.
> >
> > Insurance companies generally aren't going to pick up the tab for long-term therapy so the kind you're going to most likely encounter from a main-stream medical standpoint will be the Cognitive, or CBT, or derivations of it (Dialectical Behavioral is another good one). This kind would be more likely to focus primarily on what's going on in your life now and what you're going to do about it and so would probably be the one to go for. You need quick tools to call on to get you through the day and CBT types of therapy provide that.
> >
> > Even if very relevant to your present situation, depth therapy can be intense and you don't need to dive into your past and stir additional stuff up on top of present day issues. Later on when you're out of crisis and ready to deal with your deep unconsious, depth therapy can't be beat. Ideally, you can find someone who is skilled in both goal oriented and depth therapy and can apply whichever focus is needed for a particular session.
> >
> > There's also group therapy which can be extremely helpful down the line, but probably not when you're in the midst of a meltdown. Being in a group where you know you're not alone in your feelings is a great comfort. Kinda like this board, but right now you need more.
> >
> > Also subspecialties, such as Eye Movement Desensitization Repatterning, or EMDR, hypnosis, breathwork, bodywork. But these are generally tools used within the framework of the 2 main categories. It's good to know, however, if a therapist has these additional tools in their bag of tricks.
> >
> > How you find someone is to look in the yellow pages under Psychotherapists. There will sometimes be a referral service. Sometimes you get a hit on someone and call them and see what they offer and how they feel to you. There will also be clinics listed (sometimes under a separate yellow pages section) with a number of therapists. There's usually an intake person who gets a brief history from you on the phone and suggests a good fit. As you've seen, not all turn out to be good fits.
> >
> > You can also call the main office of a hospital, explain that you're looking for a therapist and you'll be connected with some department that can offer suggestions.
> >
> > If you're inclined towards the transpersonal approach or even a religious affiliation, call a church or organization and ask for suggestions. Sometimes the person won't be a clinical psychologist per se but will be trained anyway. I gravitate towards New Thought and Buddhist philosophy and have found some wonderful therapists who gear their work within that context instead of a purely secular one. I've found them by calling Unity churches, Buddhist meditation halls, going to metaphysical bookstores and looking on the bulletin boards or publications. Sometimes these bookstores just provide a haven to hang out in, whether you're spiritually inclined or not.
> >
> > You can also call the psychology department of colleges, briefly say what you're looking for to the receptionist who will most likely put you in contact with someone to get a referral from.
> >
> > In other words, there's no sure way to find a DECENT therapist but there are plenty of ways to be directed to those whom other's think are good. Sometimes you have to kiss a bunch of frogs. But you usually know pretty quickly which ones are frogs or at least not quite right for you. Kind of like looking for a roomate. Sometimes you get lucky right away and sometimes it takes a little more footwork.
> >
> > When I mentioned in a previous post that it's important to have your support system ducks lined up before stopping an AD, this was a big part of it. But you'll find someone and finding someone will provide a sense of purpose that will provide a good distraction and focus. Hang in there, Mike. It will get easier. - Barbara
> >
> >
> >
> > > Hey all
> > > I'm hanging in, although the weekend was pretty much horrible. Treated to the new 'ex' coming by to get the rest of his stuff saturday am, and being able to watch him drive away for the last time. Had to call a friend to come over after that as I completely lost it and actually started to hyperventilate. Otherwise I've hit a few moments of depression, but It's not a problem yet. Mostly sadness, anger, panic, etc.
> > >
> > > I'm thinking that half of the pain is coming from the life upheaval. I need to make a new life and the sooner I can get a direction established the sooner I can start recovering. My primary care physician gave me a couple of references for counselors, but they were pretty much dead ends (and turned out to be marriage counselors anyways, which I'm not sure is most appropriate here as the relationship is already dead).
> > >
> > > What is the best way to go about finding a DECENT counselor in my area? How many 'kinds' are there? I know of psychologists and psychiatrists, and then I guess there are various levels under those as well. I just need someone to help me make sense of my mess of feelings and help me pick the most reasonable next step!
> > >
> > > Anyone?
> > > Mike
> >
> >
>
>
Posted by gracieplatt on October 5, 2005, at 20:58:33
In reply to Re: Prozac Withdrawal - need advice - going off m » Velodog2, posted by LyndaK on August 21, 2005, at 0:49:34
I stopped the 40mg Prozac I was on for the last 2 years about 5 weeks ago. I think I weaned..I first skipped a day, then after about 3 days, skipped another, then after a week, skipped 2 and so on...maybe it's considered cold turkey, but I was fine for about 4 weeks. This past weekend, my anxiety level went sky high. I'm lightheaded, feel like I'm short of breath, and my dreams are vivid and awful..today I took a short nap which was more like a LSD trip...it was about screaming at my husband, being anxious and woke up in a sweat, shaking and crying. I'm afraid of what's ahead. Any thoughts on what to expect and for how long? Before Prozac, I was on Lexapro which was awful, but I did get off that before being put on the Prozac, and that didn't seem half as bad as getting off Prozac.
I just don't want to hurt myself or anyone else. I found myself yelling at my dogs today, and even hit one for not listening, which I have never done. I have a 13 week old puppy who decided to play with a towel I was using, and I literally ripped it out of her mouth and flung her to the floor. I'm SO scared of what's to come. I do take Xanax, so I took 1mg. after waking up, about 7P, then another at 9PM. I feel a lot better, but is there anyone out there who has run the gamut and can advise me of what to expect, how long it will last, and whether I should continue reading my Bible everytime I get these feelings come over me.
Thanks.
Gracie
Posted by barbaracat on October 6, 2005, at 0:57:20
In reply to Re: Prozac Withdrawal - need advice - going off m, posted by gracieplatt on October 5, 2005, at 20:58:33
I have a very strong feeling you should not be taking an SSRI type med without a corresponding mood stabilizer. This might be lithium, depakote, or on the natural side, high doses of L-taurine. I say this because your experience is similar to the one I had, especially the 'trippy' part. This is a giveaway of too much serotonin and/or norepeninephrine.
You may have bipolar disorder (I do and was surprised to find this out) and antidepressants will exacerbate the weirder symptoms of this disorder. It's more common than anyone realizes.
Lithium was my saving grace. For me, taking an antidepressant without lithium is a sure recipe for panic, clenching jaws, psychosis, and bizarre behaviors that are fascinating only to myself. Not everyone can take lithium but if you are bipolar, you cannot take an SSRI without a mood stabilizer. Period. I would stake large amounts of honor (which I have) and money (which I do not have) on this irrefutible fact. Another way of looking at it is this: there is a chemical component to depression which ADs serve well, and an electrical component which ADs make worse if the electrical frequencies of your symptoms mesh with the disorganized frequencies of bipolar disorder. If this makes sense to you, you're on the right track.
You can get L-taurine in a health food store and 1 G am and pm would be a good place to start. Don't expect your pdoc to be familiar with it since it's in the realm of orthomolecular medicine. Until you find the right mood stabilizer L-taurine will do in a pinch, both before and after (Margot Kidder of Superman fame uses it as her mainstay of bipolar maintenance).
Start researching mood stabilizers and Bipolar II disorder. This is not to say you don't need an antidepressant - I certainly do. But an AD without a needed mood stabilizer is bad trip city. If you have a savvy pdoc, he/she will know where to go from here. But don't take their word as Gospel. Do your own research and become informed. Go to www.psycheducation.org for tons of info on this subject. - Barbara
> I stopped the 40mg Prozac I was on for the last 2 years about 5 weeks ago. I think I weaned..I first skipped a day, then after about 3 days, skipped another, then after a week, skipped 2 and so on...maybe it's considered cold turkey, but I was fine for about 4 weeks. This past weekend, my anxiety level went sky high. I'm lightheaded, feel like I'm short of breath, and my dreams are vivid and awful..today I took a short nap which was more like a LSD trip...it was about screaming at my husband, being anxious and woke up in a sweat, shaking and crying. I'm afraid of what's ahead. Any thoughts on what to expect and for how long? Before Prozac, I was on Lexapro which was awful, but I did get off that before being put on the Prozac, and that didn't seem half as bad as getting off Prozac.
> I just don't want to hurt myself or anyone else. I found myself yelling at my dogs today, and even hit one for not listening, which I have never done. I have a 13 week old puppy who decided to play with a towel I was using, and I literally ripped it out of her mouth and flung her to the floor. I'm SO scared of what's to come. I do take Xanax, so I took 1mg. after waking up, about 7P, then another at 9PM. I feel a lot better, but is there anyone out there who has run the gamut and can advise me of what to expect, how long it will last, and whether I should continue reading my Bible everytime I get these feelings come over me.
> Thanks.
> Gracie
Posted by barbaracat on October 6, 2005, at 13:10:08
In reply to Re: Prozac Withdrawal - need advice - going off m » gracieplatt, posted by barbaracat on October 6, 2005, at 0:57:20
Hi Gracie,
I went back and re-read your post and realized your symptoms were due to coming off Prozac, not being on Prozac. L-taurine will help you anyway because it acts as an anticonvusant. Some of those sharp electric zap feelings and swoopie dizzies respond well to L-taurine. Some people find that 5-HTP or L-tryptophan replenishes stores of serotonin and helps with the withdrawal.Expect to want to bite everyone's head off for around 2 months while you're detoxing. Take alot of Vitamin C and drink alot of water to flush it out faster. A real good product is Emergen-C which you can get a Trader Joe's, health food stores, some super stores. Full of Vit C and all the minerals you need right now, plus it tastes good. Two packets a day in water.
Xanax is a great idea, or a longer lasting benzo. I personally like lorazepam cause it causes less tolerance. Anything to soothe that savage beast.
When I was coming off zoloft I was incredibly paranoid/sensitive/enraged about everything and everyone. I'd tail car drivers who offended me for miles out of my way just so I could flip them the bird. I got so furious at my husband one time that I punched the wall instead of him - good thing too because I punched a hole clear through it (knew those karate lessons would come in handy eventually). I also punched and screamed at a dog (wasn't even my dog) for constant barking. This really woke me up because I'm an animal rights proponent and would be the first to report someone who struck an animal. Luckily, that Barbara the Terrible energy was eventually released back to where the volcanoes and tornados could make use of it.
A sad fact is that just about every one of the school shootings the past few years were committed by kids who had been on SSRIs and suddenly stopped. It's as though all those feelings of rage don't go away while you're taking the med, but build up and lie in wait until the lid comes off the pot, so to speak.
Things will eventually subside but realize that you're in a delicate spot, have compassion for what you're going through, and don't make any major decisions during this time. Sticking up little notes around the house and in your car like 'This too shall pass' or 'Breathe!' or 'No major decisions today!' really help. When you're in the midst of these things, you forget that it's not you and it's not them - it's coming off the drug.
Do whatever you can to healthfully soothe your nervous system. Walks rather than aggravating type exercise, get to sleep early and get at least 8 hours, stay away from alcohol and especially stay away from diet sodas and anything with aspartame (really aggravates things), and lots of water. Your poor body is going through alot and you want to make things easy for it. Reading the Bible and praying, you bet. Good luck and hang in there. - Barbara
This is the end of the thread.
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