Withdrawal from Fluoxetine (Prozac)

So I’ve tried to keep it as quiet as possible to avoid A) second guessing everything and B) other people blaming everything on meds withdrawal. 

Now I’m not going the whole hog. I started on 10mg about 13 months ago, then I went up to 20mg for about 3 months. But then I was so spaced out and couldn’t remember the simplest thing (the name of my sister’s dog for example), it just couldn’t continue. I have a demanding job that definitely requires not being half asleep at my desk. I figured three months was long enough. 

So 8 weeks ago I dropped down to 10mg again. Nothing happened for 4 weeks, which I understand is due to the long half-life of fluoxetine. But then things started to change. For about three intense days I had absolutely uncontrollable anger. Honestly, if someone coughed, or I couldn’t get my jumper on quickly, it became the world’s greatest atrocity. I only realised it might be a withdrawal thing after I’d spent an evening yelling at my boyfriend and realised I couldn’t find an actual reason. Thank goodness I ran out of steam. 

Thankfully, that didn’t last long. My periods changed yet again. My sex drive has completely and utterly disappeared. It’s very obvious to me as I’ve always been a once a day kind of girl (where I can!). It’s really sad because things I know would have sent me wild just didn’t even register. Yet again my boyfriend demonstrates his ability to go to hell and back for me. I guess it must be true love. 

Other than those things, and a growing nausea first thing in the morning, I’m doing ok. 

I’m definitely more down than I was, but honestly? I’m so used to depression this doesn’t feel so bad. I feel the way I’m used to feeling but with a damn sight more positivity than before fluoxetine. 

It’s been an interesting lesson so far. One thing is for sure: when I make the decision to come off fluoxetine completely it won’t be lightly. 

And I really do want to come off the meds some day. They’ve changed my life, but I want and hope that I can hold onto the feelings and thoughts I’ve had sometimes since starting them and maybe just maybe… I can stay on an even keel. It’s not happened before. Who knows? It won’t be any time soon. 

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Assumptions 

Sharing your mental health woes with others has benefits, but the one thing that is guaranteed to set me into a spiral, is the assumption that I’m having an irrational bout of anxiety when I’m actually trying to make a valid point in a discussion/debate/argument. I mean, being honest maybe I have a hard time keeping my emotions in control when I feel passionate about my point, but it doesn’t mean the point I’m making isn’t valid. 

I admit wholly that I can be irrational and get upset easily, and I’m way too sensitive to criticism… but actually I’m also intelligent, I read a lot, watch a lot of documentaries and keep up with current affairs. I have some valid opinions and knowledge to add. 

It must be hard for others distinguishing between something that’s about to tip me over the edge, and they’re a damn sight better at seeing it in me than I am, but the frustration at not feeling heard is infuriating. 

Of course, then there’s the complex question of: is it because I need their validation? So many questions. It’s a big mass of spaghetti in my head and it’s hard to see what’s what. 

Lifestyle changes

You read a lot about a good diet and exercise being beneficial for mental health. Maybe it’s even some of the reason mental health illness seems to be on the rise these days. I don’t know. All I know is, when I’m feeling down and lethargic and forgetting reality, it doesn’t even occur to me to exercise. In fact, it sounds like torture. I notice days when I’m feeling more positive I naturally move more – scurrying around the house tidying, walking up to the shop, finding reasons to go up and down the stairs at work. It’s chicken and egg, which causes the other? All I can say for definite is the willpower required to try something – and actually stick to it – is a massive challenge for anyone struggling mentally. 

Plus, when I was near enough to work that it was a 40 minute walk each way, rather than the 30 minute drive it is now, I honestly wasn’t feeling at all good mentally. I suppose that’s the truth: it’s not just one thing that helps. It’s a many-pronged attack from all angles. Just got to keep trying. 

Oh, and don’t forget to be kind to yourself. That’s the bit I’m worst at. 

Shout out to my ex

I keep hearing this song on the radio. I dislike the idea that I would somehow be grateful that my ex ‘made me what I am’. He changed my life when he met me and certainly changed my life again when he left me. But he would never get my thanks: he is a coward. 

I loved him deeply, I was utterly in love with him, I was going to grow old with him and do all the things that people in love do. But I gave him all I had, and he took it. We are both equally to blame in that respect. He will always be a coward  to me because he waited until he found the arms of another woman before he admitted the truth that it was over for him. 

I was with him for 11 years, naively believing  it would be forever. But it wasn’t. It’s been almost four years. It took more than a year for the divorce and name change to finalise. He still haunts my thoughts, unexpectedly, when I’m least prepared to deal with it. 

I still care about him. Not in that I really care what he’s doing, or what he thinks of me.. it’s something else. Maybe it’s just the memories and knowing that I gave so much of myself to someone. It’s hard to accept that for all that effort and life, I’ve barely seen or contacted him since. It feels like the biggest failure of my life. Yet through failure comes new beginnings. 

The harder life is, the sweeter the rewards when it is good. I finally learnt what it meant to stop planning and obsessing (oh don’t get me wrong, it’s a battle), and to actually just savour those little moments. So now, if I want to watch the birds and feel the sun on my face, I will. If I want to cuddle a soft toy, I will. If I want to sit in the weirdest place in the house and babble to myself for an hour, I will. I feel so comforted and free in those moments. With my ex, I lived a very restricted life with an incredibly strict reign on displaying my emotions. It’s no surprise I struggle constantly with my emotions. But through my own hard work, and the incredible patience of my boyfriend, I’m now more free to display those emotions without fear of repercussions. I’m more me. I’m more pleasant to live with. I’m enjoying my life so much more. 

Shout out to my ex? No. 

Shout out to my boyfriend and all those who care about me and are still in my life.

Shout out to me. I didn’t give up. 

Undiagnosed 

So the title of this blog makes it pretty clear. The only diagnosis of mental illness is in my head(!)

Aside from my experience aged 14, I’ve pretty much kept going without seeking help. The first time I actually asked for help from a doctor was the day after I crashed my car. My ex had left me three months previously and my parents had just split up. I was 27.

So I’m there in the doctors. “I’ve just crashed my car and I think I need some help. Mentally. I’m not doing so good”. He asked me to fill out a standard questionnaire. Upon review of my answers, he frowned. “You don’t really fit the score for depression, here you’ve indicated that you rate highly for enjoyment of activities for example”. I looked back at my answers. I had answered as highly and positively as was possible for those kind of questions. But I was having a great time. A really, really great time. I didn’t feel depressed, I didn’t feel anxious. I just had an incredible desire to do many reckless things (and was doing them), was hardly sleeping, and was seeing and thinking all sorts of things that weren’t real. I just shrugged. 

He suggested he sign me off sick from work for two weeks, maybe I might want to look at some counselling, and did I want anti-depressants? I gladly took the sick note (I had been falling asleep at my desk and making big mistakes anyway), but rubbished the other suggestions and off I went. 

My sister was the only person at that time who knew how erratically I was behaving. It’s hard to go into any detail because it’s pretty damn embarrassing, but let’s say areas of recklessness included driving dangerously, walking around alone in unsafe places in the dark, going to random guys houses who I had met online, drugs, sexual promiscuity, spending money I didn’t have, and a general disregard for consequences of anything. Over the next 6-8 months this continued, and to my shame included drink-driving at one point. I can’t emphasise enough that I had never done any of these things before, and went against the morals and values I had been raised with. I had been a sensible, rational person, but something else was in charge and was keeping my foot firmly away from the brakes.

It was almost two years later I went to a doctor again. This time I was with my boyfriend (who I loved deeply), lashing out at him and I was thoroughly and utterly miserable. This time there was no doubt I met every criteria for depression. I was signed off sick, to my shame I quit my job, and started taking Sertraline. During the first three weeks I suffered many of the common side effects, plus some of the less common ones. My left eye puffed up and remained that way for several days, I became terrified to leave the house, and was rather obsessed with the colour blue. 

I went back to the doctors and said I couldn’t continue. He frowned, and asked if I was having trouble sleeping. “Well yeah I guess that’s one of the things”, I said, somewhat surprised by the question as it was the least of my worries. “Right we will switch you off Sertraline and try Mirtazapine”. I went along with his advice. 

Within 24 hours of taking it, I could barely stay awake. I was drinking coffee at work (a new job), taking caffeine tablets at the weekend, and sleeping at any opportunity I got during the day. For someone used to 6 hours being a good nights sleep, this was unprecedented. I couldn’t function. I went for a walk with my boyfriend and had to sit down after a few minutes. I was absolutely beyond exhausted. After I’d had a near miss on the drive to work, I rang the doctors for advice. I’d been taking it about a week. Their advice was “just stop taking it”. I asked if I should taper off somehow, their response was negative. All in all I had spent approximately 8 weeks on anti-depressants and they had made things so much worse. I was completely put off seeking any further help, and it was almost a year later I went back to the doctor. 

I’d moved house so I was with a different doctor this time. After telling him my previous experiences, and confessing that my lashing out at my boyfriend was starting to escalate (to his absolute credit he is still here, loving and caring for me more than ever), I was prescribed Fluoxetine. This time I got lucky. The side effects consisted of extreme nausea and dizziness for about two hours after taking it, this lasted several weeks, then all side effects stopped. My periods did change quite a bit, but I persisted. The lashing out stopped. After about six months it finally had the effect I’d been hoping for. I felt like a child. Someone turned on the colours again for me, and instead of every day being an epic battle to the finish line, it was, somehow, just living a day. The sleep I was getting, plus no longer wanting to die, plus no longer in a rage/guilt cycle with my boyfriend, was magical. 

I went back for my six month review and the doctor asked if I felt like I used to before I became depressed. I looked at him with dumb surprise and answered honestly, “I haven’t felt this way since before puberty”. He blinked at me and prescribed me another six months worth. 

So here I am, 13 months after starting fluoxetine. I’m not too sure I like the idea of this long term relationship, but it has changed my life. By fluke, rather than careful assessment and diagnosis, I am where I am now. 

Supposedly I’m on a waiting list for an NHS psychotherapy team assessment, after I told the doctor the absurd anxiety I am living with (scanning every room, obsession with knowing every detail, paranoia and seeing things I know not to be real). The fluoxetine definitely shifted my main depressive symptoms but did little for the rest. It’s enough for me that fluoxetine is my success story. 

New Year

Today I want to post a message to show you how positive I can feel when the beast in my head calms down for a bit. 

I love my life. 

There. Said it. And it’s true! I don’t think it’s been helpful when engaging with health professionals but it’s honestly how I feel! Life is a massive struggle every day and I’m exhausted all the time. But I love the life I have. 

I am so thankful for my amazing boyfriend, sister and all my family and friends. Those scarce few who know my struggles but also those who continue to bring moments of happiness to my life through our shared experiences, through my enjoyment of their happiness. 

I’m thankful for having a home, a job and people who care about me. I have the freedom to make choices each day and it’s great! A lot of days I’m too burdened by the beast to make the choices I might like to when I’m feeling okay. But that, in itself, is okay!

Since starting fluoxetine, the days where I can feel this positivity and logical assessment of the good things I have going for me, now outweigh the days where I don’t. It’s nice to know the real Sarah is the one who knows, who has reason and logic, who can see the magic that life can offer. It’s so intense when I feel good that I often ‘scrunch’ myself up and giggle and feel tears flowing. I love those moments when I’m in my boyfriend’s arms and just giggling away like a small child. There’s no freer feeling than letting that emotion out. 

I’m actually having a really hard day today at work, and I’m exhausted. But I do love my life. 

Appearances can be deceptive

It was a real battle to post that previous message. It feels like I’ve committed now. I’ve actually written down in words one of the many things that haunts me and needs to be kept buried in order to maintain my carefully constructed outward appearance to the world. 

My ex and my current boyfriend have seen me at my worst. But that’s behind closed doors. My sister has an idea of some of the demons I face, and has been incredibly supportive, especially during the breakdown of my marriage. I leaned on her a lot, and though I hate myself for that, I really needed it. 

After the 14-year-old incident, the front has only faltered a couple of times. Once, I was so overwhelmed I went off sick and quit a job within a few weeks of starting. It was absolutely the right thing for me to do at the time, and led to getting some help, but I am bitterly ashamed at letting myself and everyone down. 

I’ve never been diagnosed with any mental health illness. I’ll talk about my struggles to get through to health professionals in a separate post. But I consider that whatever my brain is doing, whatever label I may or may not be able to have placed on me, no matter what illness I suffer from, or none at all, I’m a high functioning one of them. Somehow I’m that stubborn that even when being awake is a struggle I’ve kept going. I believe fear of shame is the only thing that keeps me in a relatively ‘normal’ state within society. It’s hard to admit shame is what keeps me going, but I’m afraid to let go of that shame lest I lose all my control and do whatever the hell I want. I know me well enough to know I certainly couldn’t hold down a job, a home or a relationship, and indeed if it wasn’t for my sister I would have found out what happens when I let go. 

Her golden rule: “never do anything you wouldn’t be able to tell me about”.

I’ve kept it about 95%. It’s enough.  You’re truly my hero. Thank you, I love you.