Adventures with Benzodiazepines and SSRIs

[AmZ]

Would you feel that way if you had diabetes or a thyroid condition and needed medication to control that illness?

No, I'd feel fine about that.

It's more of a thing that, I feel like I have failed in being able to control my own mind... Plus couldn't even control my life enough to find what I want and not get myself in this situation in the first place. With something physical, the person didn't put themselves in that place, it's something they had no control of. (In most cases, unless we're talking about something that could be brought on themselves like high cholesterol because of a bad diet etc).

 

[David Baxter PhD]

No, I'd feel fine about that.

It's more of a thing that, I feel like I have failed in being able to control my own mind... Plus couldn't even control my life enough to find what I want and not get myself in this situation in the first place. With something physical, the person didn't put themselves in that place, it's something they had no control of.

Exactly the same applies to anxiety, or OCD, or depression.

 

[AmZ]

Exactly the same applies to anxiety, or OCD, or depression.

I know... And I have all of those things due to my own life decisions I have made and by a few made by others which has affected me. This medication I am taking is not due to my liver not working for example, it's because of my own paths that I have made in my life. Anyway, I'm not being dismissive, but lets not talk about the medication any more. I shouldn't have said anything in the first place because I know that as much as it was something I never thought I would get to, it was a last last resort that I have gotten to and will help me... Just a bit disappointed. Like I say, it makes me feel worse taking it if things (therapy and my life) are not moving in a good direction at least - I don't want the medication there just to cover over the feelings/issues...

Hopefully once things will get moving, I will feel better about being on the medication.

And I didn't say, but another reason as to why I am feeling worse is because my family went back to England after visiting for a month and all I have left here is my sister. She has a 2 week old baby and she has no time for me whatever. I don't expect her to and understand why she has no time, but now I just feel extremely bad because of it. The psychologist said that this 'separation anxiety' I have from my sister obviously was getting worse over time in all of the steps... her getting married and us not living together, watching 9 months of pregnancy and now a new born baby that stops herself from evening taking care of herself properly, let alone taking more than 2 minutes to speak to me on the phone.

Can't say that a mix of anxiety and depression is made much better by feeling totally alone.

 

[AmZ]

Hope everyone is having a nice weekend.

What a crazy roller coaster of emotions... Looking back at yesterday and how I felt just feels like it wasn't even me or something. Weird. It's not that I am sitting here now laughing and smiling, but wowza, yesterday was something else.

Same thing today, 4.35am (instead of 4.30am the previous 3 days!) waking up in the morning. Not sure why it's happening, but I have 3 possibilities

1. Just as I had the bad stomach for the first 2 weeks of this at 6-6.30am, I am now doing the same psychological thing of expecting to wake up at 4.30am so in turn, am doing so. If that's the case, as much as I can 'tell myself' that I don't want to do it, it's still happening!

2. It's the new medication. Started the medication 4 days ago. Since then have been doing the 4.30am waking-up-deal. Have been taking it about 9pm every night. Maybe it's something to do with the time I am taking it and after so many hours, it's causing me to wake-up for whatever reason.

3. I've been feeling pretty good during the day, anxiety-wise for the last few days or so, but still know that when I am asleep, it's at its worst! I take 1 Alprazolam when I go to bed (around 12am) so perhaps I'm waking up because I'm feeling anxious in my sleep, so is physically waking me up because of it.

Anyway, those are my hypothesis... No point in looking in to things too much so just going to get on with it. For starters, I took the Paxil at 7pm tonight instead of 9/10pm, so will see if that makes a difference. My 4 days of 10mg are over, so I am on 20mg as of tonight... Wish me good luck

 

[David Baxter PhD]

Good luck.

 

[Retired]

Wishing you well!

:support:

:goodluck:

 

[AmZ]

4am here... Have been trying to sleep for 5 hours now, laying in the dark, just tossing and turning and can't fall asleep.

It must be the Paxil, esp. now because I took 20mg for the first time.

What is the procedure here? Give it a few more days and see what happens?

I can deal with other side effects, but this is no good, I need to get up for work in the morning and I'm not even getting myself stressed out because of that, but my mind just feels totally awake and am going to be feeling shattered at work in the morning, 8 hours in front of a computer and 1 1/2 hours traveling each way on the bus, grr!

 

[Retired]

The medication may well require a period for acclimation, meaning your body and brain chemistry needs time, usually about two weeks, to reset itself to the new dosage.

Understanding that being unable to sleep is causing distress, you may want to contact your doctor as soon as convenient to report what you are experiencing. In the meantime, you may want to try the technique called square breathing. Many people find this technique helpful to slow down their mind and body when tossing and turning, unable to sleep.

It's done by inhaling for four seconds, holding your breath four seconds, exhale four seconds and pause four seconds before repeating the cycle. If you can do this about ten times, or even more, you may find it helps to settle down.

I have found it helps me when I'm agitated and cannot sleep

 

[Daniel E.]

Are you exercising daily?

 

[AmZ]

Thanks Steve.

Many people find this technique helpful to slow down their mind and body when tossing and turning, unable to sleep.

It's not that I even feel anxious or am having any thoughts or anything, I feel relaxed, just not tired. I still took the Alprazolam as normal when I got in to bed last night.

I actually saw you post about the square breathing technique before I had gone to bed last night and have been doing that on and off since trying to fall asleep tonight with no avail.

I never thought it was going to be all easy, but I don't really think it's do-able to possibly not sleep for the next week or two whilst my body adjusts.

Are you exercising daily?

Not daily, but I go to the gym twice a week and do a good cardio workout. I'm still active though on a daily basis and walk a lot, am fit and healthy etc, never had problems in sleeping before. Even when I'd gone to the gym the other day, I felt exhausted from it but still couldn't sleep because of the new medication.

---------- Post added at 04:50 AM ---------- Previous post was at 04:03 AM ----------

...meaning your body and brain chemistry needs time, usually about two weeks, to reset itself to the new dosage.

Just to clarify, I only started on the Paxil a few days ago. The psychiatrist said to take it with my evening meal, starting on 10mg for the first 4 days, then go up to 20mg, which was last night.

I guess there is no other answer here so just have to stick with it.

On the days I go to work, I'll just have to be tired - I sit in front of my boss at work so hope I don't nod off! On my days off in the rest of the week, I'm going to have to resist sleeping in the afternoon etc because I know that I am going to feel exhausted by the time even lunchtime comes, let alone the afternoon hours! (Plus of course it will make my nighttime sleeping worse also).

Ah 5am now... Always a bad sign to start to hear the busses starting to run and the garbage trucks outside.

 

[David Baxter PhD]

Always a bad sign to start to hear the busses starting to run and the garbage trucks outside.

Garbage trucks are never a bad sign. They're Nature's way of telling you you can stop worrying about critters getting into your garbage and making a mess.

 

[AmZ]

Garbage trucks are never a bad sign. They're Nature's way of telling you you can stop worrying about critters getting into your garbage and making a mess.

Haha. Right now, I'd prefer the critters than this.

6 hours and starting to get a bit frustrated now - Don't know what to do with myself... The sun is coming up but I have a potential 3 hours left of sleep before I need to get up for work. Gonna be a long day :hide:

---------- Post added at 08:38 AM ---------- Previous post was at 05:08 AM ----------

Managed to sleep from 7-7.30am.... Nice 30 minutes (!)
Woke up with {feeling sick} .
And now I need to go to work

---------- Post added at 04:26 PM ---------- Previous post was at 08:38 AM ----------

Sorry to do this.

If anyone has any words of wisdom or any advice they can offer, it would be greatly appreciated.

Had 4 days of starting on Paxil at 10mg, then upped to 20mg last night as per psychiatrist's instructions. Whilst I was on 10mg, I had some side effects but they were bearable asides from the least bearable was only managing to sleep a max of 4 hours a night.

20mg last night - Awful - Slept for 30 minutes (literally) all night, very sick in the morning, nauseous, sweaty, very bad headache, shaky, etc. Braved it and went off to work this morning. Lasted 2 hours there until I broke down crying to my boss telling him what the deal is and that I need to go home. (Feeling both physically and mentally BAD).

Spoke with psychiatrist and he has said to go back to 10mg in the meantime "until we next meet" - We don't have any appointments set, and they don't call me, so it's up to me basically as to when to call and ask to go and see him. Not sure how long to leave it, 4 more days, 7 more days? If I so badly couldn't take the 20mg vs. the 10mg, how long does it take people to adjust to the 10mg or at the beginning usually before going up some?

Now have 2 days off of work, which is good and bad. Good because I physically have no strength to go (4.30pm now, no appetite at all, can't eat anything and tired from the lack of sleep from the last 5 nights ), bad because I'm going to be at home for 2 days alone, last 2 days have felt very depressed (and mixed/lots of emotions) which is a 'new' thing for me. Now back at home, feel exhausted, but can't sleep during the day because then I'll not sleep at night again. 32?C heatwave outside which is not helping for various reasons also. Can't exactly go out for a nice gentle stroll without passing out. Can't go to the gym or be active really because the physical weakness. Many matters.

Lots of things are difficult and there is no real answer to solve all of my problems, and I know that... But trying my best here to make the 'best out of a bad situation'.

I look forward to the day where I can make a real positive post and not go back too much to the negative. I know that I need to wait for the medication to kick in, but that hasn't quite gone to plan so like I say, any advice would be much appreciated.
Thx.

 

[David Baxter PhD]

If my calculations are correct, you've only been on Paxil for about 5 days and weren't doing too badly with it until you increased the dose. See what happens now on the lower dose. If you're feeling okay, go back to see the psychiatrist in about a week. He may want you to try the higher dose of Paxil or he may switch you to something else. If you continue to feel bad even on the lower dose, go back to your psychiatrist earlier and ask for something else.

 

[AmZ]

Thanks DR.

Yes, I've only been on it for 5 days. 4 days at 10mg and 1 at 20mg.

I can't say that the 10mg was too great, but compared to last night with the 20mg, is still by far better. Instead of 30 minutes sleep, I slept for 4 1/2 hours max and just felt a bit nauseous and had a headache for the first couple of hours in taking in and in the morning also, nauseous and a headache, but bearable.

I'll go back to the 10mg and hope that my body will adjust over the next few days so that I can just sleep a bit more and then see about raising the dosage again. After taking the 20mg yesterday at 7pm, even now, my eyes are wide open hardly blinking and head is buzzing, and I only slept 30 minutes last night! Like some weird trip. (Or what I would imagine it to be). I'm actually due to take the 10mg in an hour or twos time, I guess nothing I can do that the fact my head is still buzzing from yesterday and now I'm going to put more of it in my system?

Just really want it to start working soon because over the last couple of days I've been very tearful and upset for the first time since this started, and the Alprazolam can't fix this... Before, I wasn't feeling this way, just the anxiety, so when I'd take the Alprazolam, it would calm my body down and bring me on a decent appetite in the afternoon... Yesterday and today are the total opposite.. My appetite has gone, and I think it's all that depression coming out of me finally (plus a build up of it through all of this saga).

 

[Retired]

The thing about SSRI's, the class of meds that Paxil belongs to, is that, as we have discussed, they require a period of time to reset neurotransmitters before they show signs of relief of symptoms.

Unlike when you take an aspirin for pain relief or even your alprazolam for anxiety relief, the effect is usually felt in about an hour, as soon as the medication clears the gut and enters the bloodstream.

Monitor your progress on the decreased dose and as you have correctly done, continue reporting your progress to your doctor.

If the exxagerated stimulation that is keeping you awake and ultra sensitive continues, your doctor may opt to change to a different SSRI/SNRI compound. Sometimes a particular compound affects individuals by stimulating adrenergic receptors in the brain, causing this kind of over stimulation response.

Although these meds are designed to be specific to serotonin receptors, they are not perfect and other neurotransmitters can be stimulated, causing unwanted side effects. Each compound varies in the degree it stimulates other neurotransmitters in each individual, which is why patience is often required to find the optimum match between patient and SSRI/SNRI medication.

We support you in your courage to work toward success in your treatment, so keep the conversation going. There is nothing negative in seeking support, because in doing so, you can benefit from the experiences and insights of others in answering your concerns. That is indeed, a positive step for you.

 

[David Baxter PhD]

Also, you may have already addressed this, but if you find you're not able to sleep well taking the Paxil at night, try taking it in the morning. It's not critical with this type of medication when you take it.

 

[AmZ]

Thank you for your such kind and helpful words Steve.

Trying to keep up my patience here. It's just 1. A horrible situation I've never been in and has been confusing and exhausting and 2. I'm just eager to get everything moving in the right direction in all ways, not just with the medication.

I spoke with my psychologist again and don't think it's going to work out with him. I explained again to him the reason as to why all of this started was because of suppressed thoughts, which them came out in physical problems/symptoms and that this is now something I feel that I need and want to explore in therapy. Not only to fix now my still negative and intrusive thoughts, but to also learn more for the future about myself and how my mind works so that I can be aware and be able to control it for the future. He still seems pretty adamant that we should just focus on the life changes I need to make and that's it, so that I will be happier and my anxiety and depression will 'finally' go away... I don't think his method is for me. I still have the negative and intrusive thoughts, and I feel that in still having them inside of me and not talking about them, is making me feel even worse. Like I said in the other thread, I felt worse coming out of the session with him than before I went in! Just made my stomach feel bad again which I know (by now) is the anxiety hitting. Not a good sign!

Also, you may have already addressed this, but if you find you're not able to sleep well taking the Paxil at night, try taking it in the morning. It's not critical with this type of medication when you take it.

Would you think it's OK to then 'skip' tonight and take 10mg tomorrow morning? I'd like to try this also instead. Anyway I had 20mg last night so I don't think it's a big deal not to have tonight if I'm going back to 10mg anyway. I don't think it's a big deal for me to decide to do this as my psychiatrist is one who likes to free the reigns a bit lol. The only problem with taking it in the morning is that you're meant to have it with food, no? Still having big issues in not eating until at least the afternoon, and today, not at all, woopsy... But I can have liquids, so maybe it'll be OK just with some chocolate milk? (Ah, it's a tough life )

 

[David Baxter PhD]

I spoke with my psychologist again and don't think it's going to work out with him. I explained again to him the reason as to why all of this started was because of suppressed thoughts, which them came out in physical problems/symptoms and that this is now something I feel that I need and want to explore in therapy. Not only to fix now my still negative and intrusive thoughts, but to also learn more for the future about myself and how my mind works so that I can be aware and be able to control it for the future. He still seems pretty adamant that we should just focus on the life changes I need to make and that's it, so that I will be happier and my anxiety and depression will 'finally' go away... I don't think his method is for me. I still have the negative and intrusive thoughts, and I feel that in still having them inside of me and not talking about them, is making me feel even worse. Like I said in the other thread, I felt worse coming out of the session with him than before I went in! Just made my stomach feel bad again which I know (by now) is the anxiety hitting. Not a good sign!

Perhaps you're jumping ahead too quickly... If it were me, my first priority would be to help you get your symptoms under better control. After that we could worry about where they came from. It rather sounds like that's what your psychologist is trying to do. Finding out where the symptoms originated is going to help you manage them, or in other words insight doesn't always translate into a cure.

Would you think it's OK to then 'skip' tonight and take 10mg tomorrow morning? I'd like to try this also instead. Anyway I had 20mg last night so I don't think it's a big deal not to have tonight if I'm going back to 10mg anyway. I don't think it's a big deal for me to decide to do this as my psychiatrist is one who likes to free the reigns a bit lol. The only problem with taking it in the morning is that you're meant to have it with food, no? Still having big issues in not eating until at least the afternoon, and today, not at all, woopsy... But I can have liquids, so maybe it'll be OK just with some chocolate milk? (Ah, it's a tough life )

The recommendation to take it with food is to help avoid stomach upset - milk or a liquid food replacement should be fine.

 

[AmZ]

Perhaps you're jumping ahead too quickly... If it were me, my first priority would be to help you get your symptoms under better control. After that we could worry about where they came from. It rather sounds like that's what your psychologist is trying to do. Finding out where the symptoms originated is going to help you manage them, or in other words insight doesn't always translate into a cure.

I may be jumping ahead too quickly, but not for the same reasons you mentioned. In the first session, I basically just told him about how all of this came about - The summing up of 4 weeks since this 'started', or emerged, should I say. In the second session, we weren't looking more in to where they came from but into where I am now going. I can't think of where I am going before I can clear up not only the last 10 years or so, but the last 4 weeks and my current state of mind which is causing part of the block as to why I can not move forward also. Makes sense?

His approach, it seems so far, is to focus just on the future and give me what feels like life coaching, like 'join this club' etc... But I still have an extremely lot of feelings and emotions that haven't come out, and that are every day, but just to the front of my own mind and staying there. In the session, every time I tried to talk about these, he said not to think about the negative things and focus just on the positives, let the medication work and get more proactive than I was before. In an ideal world, this is how I would do things also, but especially in my case where the suppressed thoughts were that far back and some still are, I think it would be good to process all of these and for him to help me how to change the way I think - I can't even understand it and control it, so I'd like the help in therapy to do so. He'd even said to me at the end of the last session "So we'll meet next Thursday and you can update me on progress of making friends and finding connections" - That is not what I want to do every week. I can do this by speaking with my Father on the phone about this once a week for free.

Back to your first line about jumping ahead, I'll go to the next session and again bring these things up with him and then see what he says. Maybe this has been his approach to start with and I of course don't want to sound like I am belittling him somehow or being disrespectful - Either we'll work out between us what I feel would be good for me and what he can do to help and if not, then I'll put it down to his approach not being suited to me and move on.

Does that make more sense and do you agree at all?

The recommendation to take it with food is to help avoid stomach upset - milk or a liquid food replacement should be fine.

Cool, so I'll do that. Couldn't possibly think of taking more of this stuff right now whilst my eyes can't even focus on the words I am typing on the screen! Tomorrow morning it is.

 

[Daniel E.]

"So we'll meet next Thursday and you can update me on progress of making friends and finding connections"

To play "devil's advocate," have you been working on that homework assignment?