Waves, windows, withdrawal symptoms
Tapering can be very difficult These all need links to the paragraph in this text
Waves
Windows
Physical symptoms
Emotional symptoms
Mindfulness
Difficulty stopping antidepressants
Withdrawal? Or just a standard ailment?
Withdrawal symptoms
Tapering can be very difficult
Some patients have constant symptoms that slowly go away. However, the wave/window pattern seems to be more common.
Other ailments have “normal” timelines and symptoms. With a broken bone, everyone knows how long recovery is likely to last. Antidepressant withdrawal is different.
Each case is unique. The actual symptoms will vary from person to person, along with their length and severity. This can be very frustrating. People call it waves and windows.
At first, withdrawal is probably unremitting. After some time (which varies from person to person), symptoms begin to form into cycles. Times when symptoms aren’t as bad, and times when they are quite severe. There is no particular pattern.
Waves: when symptoms are more severe.
They can be physical, emotional or both. If you listen to your body, you will start to notice signs of withdrawals returning. Keep a detailed record of all that happens to you. Link to keeping a journal post Then you can learn from previous experience.
Some people suffer everything straight away. But there will probably be something that warns you to be ready for a wave. Then symptoms will develop. You may have anxiety or depression, become over-emotional, have migraines …
It can be helpful to break waves up into different parts. If we listen to our body and keep a detailed journal, we will learn from experience. Then we can separate the different parts of the wave.
After all that, we have to find ways of dealing with each part of a wave.
Windows: when things feel much better.
At first, it seems it’s all over. But sadly not. Windows and waves come and go in cycles. Most people find that the windows slowly, ever so slowly, get longer, and the waves get shorter.
A window is more than a time free of symptoms, although it is a huge relief to have time off from suffering. Windows are a chance to prepare yourself for the next wave.
Try to pay attention to how you feel and how you think, how you respond to things. Try to see how you normally react when you are feeling good. In a window, your mind will tend to focus on the positive.
If you can focus on the positivity you have during a window, it will be easier to think yourself into positivity during the next wave. It’s that mindfulness that you will need then. After a while, you can tell when a thought is out of character for you, and consciously dismiss it.
Physical symptoms
Remember: physical symptoms tend to warn you of new symptoms coming.
Pain
You can try everyday painkillers for joint pain, headaches, or dizziness.
Dizziness
Try to stay as still as possible until it gets better.
Emotional symptoms
During a wave, the anxiety, depression, and obsessions we experience are real. During a wave we are unlikely to be rational.
Self harm can seem rational. We are used to avoiding, suppressing dangerous, harmful thoughts. During a wave, these negative thoughts and impulses can rise to the conscious mind and seem rational.
To manage the emotional symptoms of a wave, we must be conscious of the difference between normal thought and the unnatural power of irrational thought. But that is not easy.
Mindfulness
Withdrawal consists of regularly recurring good and bad times. The more we can use mindfulness to cope with the bad, the shorter the waves become. Our minds often work in feedback loops. One thought leads to another, creating the pattern of our minds. Mindfulness allows us to shape the pattern to a certain extent.
Gradually, you learn to see what is just part of a wave, not your real thoughts and feelings. Eventually, you will reach a final window, and there will be no more waves. On that journey you will have developed patience, acceptance and mindfulness.
With thanks: Waves and Windows of Psych Drug Withdrawal by Npanth:
https://npanth.wordpress.com/2013/01/31/waves-and-windows-in-ssri-withdrawal/
Difficulty stopping antidepressants
Recently, awareness has at last been raised of the massive problems thousands of people suffer when trying to come off antidepressants. Things have improved. There is more awareness that you should never stop abruptly or make major, rapid changes to your dose.
You can read about it here, for example:
https://www.bbc.co.uk/news/health-37682355
https://www.bbc.co.uk/news/health-51834456
Withdrawal? Or just a standard ailment?
It is hard to tell whether it is withdrawal (aka discontinuation syndrome) or a standard health problem.
Withdrawal can look and feel like other major health and mental health disorders:
a bad fibromyalgia flare
multiple sclerosis
bipolar disorder
schizophrenia
GAD
MDD
depression
anxiety
and all the rest. Have a look at this article, which also offers a video: https://www.webmd.com/depression/guide/withdrawal-from-antidepressants
Withdrawal symptoms
This list is not exhaustive. Neither is the official list: #5.7 in the Eli Lilly package insert: https://pi.lilly.com/us/cymbalta-pi.pdf
restlessness: an extreme feeling of inner restlessness and inability to stay still (akathisia)
trouble sleeping, unusual dreams, nightmares
unsteadiness: dizziness, light-headed, lack of balance
blood vessel control: (massive?) sweating, flushing, poor toleration of hot weather
stomach problems: nausea, vomiting, cramps, diarrhea, loss of appetite, increase in appetite
strange sensations: pain or numbness; hypersensitive to sound; “brain-zaps” – a feeling that resembles an electric shock in your head
feelings: irritable, anxious, confused, mood swings, agitation, mania, paranoia, suicidal ideation
physical control: tremors, restless legs, uneven gait, poor coordination
fatigue
flu-like symptoms
sobbing
self-harm
visual disturbances: double vision, blurry sight, visual trailing
heart problems: palpitations, missed beats
tinnitus
blood pressure problems
fatty liver
Here are some sources to investigate:
https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants
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