What are the long-term effects of antidepressant use? How do they impact mental health and overall well-being? Explore the complexities and debates surrounding this crucial issue.

The Rise of Antidepressant Prescriptions: A Concerning Trend

In the past decade, prescriptions of selective serotonin reuptake inhibitors (SSRIs), the most common type of antidepressant, have doubled in the UK. With more than 70 million prescriptions dispensed annually, the use of these medications has seen the “greatest rise” of any drug in recent years, according to NHS research. This surge in antidepressant usage raises important questions about the long-term implications of such widespread reliance on these drugs.

The Withdrawal Conundrum: Facing the Challenges of Discontinuing Antidepressants

The experience of Sarah, who struggled to stop taking Seroxat after 14 years, highlights the profound difficulties individuals can face when attempting to withdraw from antidepressants. The severe withdrawal symptoms, including anxiety, loss of appetite, and a sense of disconnect from oneself, can be deeply distressing and challenging to overcome. This raises concerns about the true nature of “dependence” on these medications and the long-term consequences of prolonged use.

Debating the Long-Term Impacts: Weighing the Benefits and Risks

While some experts believe antidepressants can be “transformative” in helping individuals navigate critical periods of their lives, others, like Dr. Joanna Moncrieff, a consultant psychiatrist, suggest that the drugs may be contributing to a rise in mental health disability claims. The complex interplay between the underlying conditions and the long-term effects of the medications makes it challenging to determine the true impact of these drugs on mental health and overall well-being.

Symptom Misattribution and Disbelief: The Challenges Faced by Patients

Patients who experience persistent side effects long after discontinuing antidepressants often face skepticism and disbelief from healthcare providers. As Professor David Healy argues, GPs may be more inclined to trust the information provided by pharmaceutical companies rather than the firsthand accounts of their patients. This mismatch between patient experiences and medical understanding can lead to further frustration and a lack of adequate support.

Navigating the Complexities: The Need for Increased Awareness and Research

The long-term effects of antidepressant use remain a complex and often misunderstood issue. With limited research into the long-term impacts, healthcare professionals and patients alike face significant challenges in accurately assessing the risks and benefits of these medications. Addressing this knowledge gap through increased research and greater awareness of the potential long-term consequences is crucial for ensuring informed decision-making and better patient outcomes.

Seeking a Balanced Approach: Weighing the Risks and Benefits of Antidepressant Use

As the use of antidepressants continues to rise, it is essential to maintain a balanced perspective on the role of these medications in mental healthcare. While they can provide valuable support for individuals struggling with depression and anxiety, the potential long-term effects must be carefully considered. A nuanced understanding of the complex interplay between the underlying conditions, the medications, and their long-term impacts is necessary to ensure that patients receive the best possible care and support.

Conclusion: Toward a More Comprehensive Understanding of Antidepressant Use

The experiences of individuals like Sarah, as well as the ongoing debates among experts, highlight the need for a more comprehensive understanding of the long-term effects of antidepressant use. By continuing to explore this crucial issue through research, open dialogue, and a patient-centered approach, healthcare professionals and policymakers can work towards developing more effective and informed strategies for managing mental health challenges and supporting long-term well-being.

‘I don’t know who I am without it’: the truth about long-term antidepressant use | Depression

Sarah never planned to take antidepressants for 14 years. Three years after she began taking them, when she was 21, she went to her GP and asked to stop: 20mg of Seroxat a day had helped her live with anxiety and panic attacks, but she began to feel uncomfortable about being on medication all the time. Her doctor advised her to taper down her medication carefully.

At once, “I was a mess,” she says. “I thought I was losing my mind. My appetite completely went. I lost the best part of two stone. I was anxious constantly. My mouth was dry. It was difficult to sit and be calm.” She became withdrawn, refusing to see friends, and remembers asking her mother to get her a couple of boxes of paracetamol, thinking, “I’m going to have to take all these tablets, because I can’t live like this.”

Sarah’s doctor encouraged her to go back up to 20mg. “Within a week, I was much better. I feel anger when I look back. That wasn’t me relapsing, that was withdrawal. But I was so unwell, I didn’t stop to think, ‘I’ve never had this before.’ I truly thought it was me. Now the only reason I am on the drug is because I am dependent upon it. And that is not good enough.”

Prescriptions of SSRIs (selective serotonin reuptake inhibitors), the most common type of antidepressant, have doubled in the past decade. There are now more than 70m prescriptions dispensed in the UK in a year, the “greatest rise” of any drug in the last year, according to NHS research. But while the side-effects of starting and then withdrawing from these drugs are reasonably well known (the patient information leaflet accompanying the SSRI Seroxat is six pages long), there is very little research into the long-term effects of using antidepressants.

Last year, an all-party parliamentary group began hearing evidence as to whether there is a link between a measurable rise in mental health disability claims – 103% between 1995 and 2014 – and that in antidepressant prescriptions. (Claims for other conditions fell by 35% in the same period.) “We need to have a serious rethink about current levels of prescribing, because it may well be that the drugs are in fact contributing to the disability burden,” Dr Joanna Moncrieff, a consultant psychiatrist and senior lecturer at University College London, told the committee.

Reports both anecdotal and clinical have included side-effects such as constant pain, an altered sense of smell, taste or hearing, visual problems, burning hands and feet; food or drug intolerances and akathisia (the medical term for a deep inner restlessness). When a patient begins tapering down their dosage, these effects are generally ascribed to the drug leaving their system; if it is long after withdrawal is supposed to be over, however, patients are often disbelieved (according to the drug companies, withdrawal should take just two weeks for most people, though they acknowledge that for some it can be months).

Professor David Healy, director of the department of psychological medicine at Cardiff University and author of 22 books on psychopharmacology, believes that antidepressants are overprescribed. “If you go into your average doctor – if you’ve been off the drug for half a year or more – and you complain [of a range of symptoms] and say, ‘I think it’s caused by this pill I was on’, he or she would say, ‘It’s been out of your body for months. You’re neurotic, you’re depressed. All we need to do is put you on another pill.’”

GPs, Healy says, are “relying on your word, and if it’s a choice between believing what you say and relying on what drug companies say to them, they [tend to] believe the drug companies”. Healy, who has been a consultant for, and expert witness against, most of the major pharmaceutical companies, has long argued that long-term side-effects are routinely ignored or misunderstood.

But many experts believe these drugs do more good than harm. “Most of the people I see who have moderate to severe depression benefit from them,” says Daniel Smith, a professor of psychiatry and researcher into bipolar disorder at the University of Glasgow. For some, medication can be no less than “transformative. It can get them through a really critical period of their life.”

However, when it comes to long-term impact, especially after a person stops taking SSRIs, Smith says it can be hard to work out which symptoms relate to the drug use and which to the underlying conditions. “There’s obviously an issue of cause and effect. How can we be certain the SSRI caused it? Depression affects libido and sexual interest. How much [of the reported effects] is depression and/or anxiety symptoms coming back?”

By 2003, worldwide sales of Seroxat, manufactured by GlaxoSmithKline, were worth £2.7bn. Photograph: Alamy

SSRIs have been around for more than 40 years, but grew in popularity in the late 1980s and 90s after pharmaceutical company Eli Lilly launched fluoxetine, otherwise known as Prozac. Time magazine put the drug on its cover twice, asking, “Is Freud finished?” and describing SSRIs as “mental health’s greatest success story”. In 2001, a landmark report on a clinical trial into paroxetine (sold as Paxil in North America and Seroxat in the UK), called Study 329, concluded that it demonstrated “remarkable efficacy and safety”. Study 329 led directly to a massive increase in prescriptions: by 2003, worldwide sales of Seroxat (manufactured by GlaxoSmithKline) were worth £2.7bn.

But concerns were raised about the study –the US food and drug administration (FDA) officer who reviewed the data disagreed with the findings, calling it a failed trial – and in 2015 the British Medical Journal published a re-evaluation. Seven authors went through as many of the thousands of individual case reports as they could, and found not only that “the efficacy of paroxetine… was not statistically or clinically different from placebo”, but that “there were clinically significant increases in harms, including suicidal ideation and behaviour”. The original study reported 265 adverse reactions; the BMJ found 481. The re-evaluation also found that psychiatric responses were grouped together with “dizziness” and “headaches”, rather than given their own category. In 2003, the UK banned the use of Seroxat by anyone under 18; and in 2004 the FDA required a “black box warning” on all antidepressants, its strictest level of patient warning.

“Patient safety is our number one priority,” a GlaxoSmithKline (GSK) spokesperson tells me. “We believe we acted responsibly in researching paroxetine, monitoring its safety once it was approved and updating its labelling as new information became available.”

It’s more reliably predictable that they’re going to get rid of sexual function than get rid of depression

Many SSRI users report blunted emotions, even long after they have ceased taking pills, and an impact on sexual function. “They should be called anti-sex drugs rather than antidepressant drugs,” says Jon Jureidini, a child psychiatrist of 30 years’ standing, a professor of psychiatry and paediatrics at the University of Adelaide and co-author of the BMJ study, “It’s more reliably predictable that they’re going to get rid of sexual function than it is that they’re going to get rid of depression.” Again, some people find this persists long after they cease taking the drug. One person I spoke to, Kevin, had taken Prozac for six months when he was 18; now 38, he hasn’t had an erection since.

Last September, Healy and colleagues published a further examination of the data gathered for Study 329. This data followed the trial participants for six months after they started taking paroxetine (the “continuation phase”) and while they were tapered off it. GSK, which in 2004 published a clinical study report, had argued that “the long-term safety profile of paroxetine in adolescents appears similar to that reported following short-term dosing”. Healy and co, however, concluded that the “continuation phase did not offer support for longer-term efficacy”. More alarmingly, they found that the taper phase, when patients were being taken off the drugs, was the riskiest of all, showing a “higher proportion of severe adverse events per week of exposure”. This, they said, opens up the risk of a “prescribing cascade”, whereby drug side-effects are thought to be symptoms, so are treated with further drugs, causing further side-effects and further prescriptions – thus increasing the risk of long-term prescription drug-dependency.

In October, the British Medical Association published its response to a two-year fact-finding exercise into long-term use of psychoactive drugs. It noted that while benzodiazepines, z-drugs, opioid and antidepressants are “a key therapeutic tool”, that their use can “often lead to a patient becoming dependent or suffering withdrawal symptoms… the evidence and insight presented to us by many charity and support groups… shows us that the ‘lived experience’ of patients using these medications is too often associated with devastating health and social harms”; it was therefore, the report concluded, a “significant public health issue”.

The BMA made three key recommendations: first, and most urgently, that the UK government establish a 24-hour helpline for prescribed drug dependence; second, that it establish well-resourced specialist support units; and third, that there should be clear guidance on prescription, tapering and withdrawal management (they found the current approach to antidepressants, in particular, to be inconsistent: too many patients were suffering “significant harm”). There are also increasingly urgent calls for studies into long-term effects that are not funded by drug companies, because, Moncrieff says: “We don’t have very much data. This research is really important, but hasn’t been done. It’s a massive blind spot. It’s extraordinary – or maybe, given the pressures and interests at work, not extraordinary at all – that it hasn’t been filled.”

In March this year, members of the BMA, along with MPs and researchers from Roehampton University, went to parliament to lobby Public Health England, armed with research estimating that there are 770,000 long-term users of antidepressants in England alone, at a cost of £44m to the NHS per year (a figure that does not account for the cost of GP appointments, or the impact of side-effects, withdrawal effects and disability payments).

“I think you have to adopt a very conservative approach,” says psychiatrist Jon Jureidini. “These are brain-altering drugs, and our overall experience with brain-altering drugs of all kinds is that they tend to have a detrimental effect on some proportion of people who take them long term. All we know about the benefits is from short-term symptom-reduction studies. The careful prescriber needs to say, ‘Well, in balancing the likely benefits and harms, I need to be very cautious about how much benefit I’m expecting, and I need to be very generous about the possibility that the harms might be more than they appear to be.’”

Quite a few long-term users, such as those I spoke to below (and who wished to be anonymous), would agree.

‘Tapering off is the hardest thing I’ve ever done’: Sarah, 32; has taken Seroxat for 14 years

I was prescribed Seroxat when I was 18, the year I started university. I grew up with a disabled sister, so things at home were very stressful, and I had a history of anxiety and panic attacks. I had counselling, but the problems persisted, so I went back to the GP. I don’t remember everything that was said, but there was no conversation about side-effects.

Within the first two weeks of starting Seroxat, I remember I was sitting in the front room watching TV when out of nowhere I had this intense feeling of heat, like an electric shock. It started in my hands, went all the way up my arms and through to my head.

The GP said it was probably just my body getting used to the drug. And after a few weeks the weird sensations did ease off. I had a fabulous time at university. I still had panic attacks, and there were certain situations I would avoid – as I still do – so it wasn’t a wonder drug, but there were no major problems.

But in 2006 I tried to come off it. There were a couple of Panorama documentaries about the side-effects and I was starting to become concerned. The GP said, “That’s fine, but do it gradually, over three weeks.”

I thought I was losing my mind. I was going to work, but it was difficult to get through the day. My mouth was so dry

I immediately became incredibly unwell. I thought I was losing my mind. I was going to work, but it was difficult to get through the day. My mouth was so dry, I was constantly drinking water. I had bizarre thoughts – not hallucinations – that were frightening or distressing. I had a strong sense of detachment from reality.

Eventually, the doctor said, “Look, you coming off is obviously not working: we need to get you back to 20mg.” Within a week I was much better.

A few years later, when I realised my mental health was getting worse, even though I was on the medication, I started to do some research, reading case studies about withdrawal. I find it so offensive when a GP says, “This is who you are.” I didn’t have these symptoms 10 years ago. I didn’t have this sense of detachment. I saw various psychiatrists. They just kept saying, “The drug is safe, you need to be on it.” A couple of others told me the reason I was having these problems was because I wasn’t taking enough. Another said, “If you were diabetic, you’d take insulin and you wouldn’t have an issue. Why are you so bothered about taking this drug?”

I’ve been on it since I was 18, so I don’t know who I am without it, as an adult. Who knows? I might have all kinds of problems, but I need to know I’ve tried. Tapering off is the hardest thing I’ve ever done. It’s taken me three years just to get from 20mg to 5mg. I’m no longer with my partner – we were together for six years. I believe Seroxat has played a part: it affected my moods, it made my anxiety worse and, by necessity, I’ve had to be selfish, really. I don’t want to say all my problems are to do with Seroxat, because they’re not. But I do believe that it has caused me harm.

‘I don’t have much of an interest in interacting romantically or physically with the opposite sex’: Jake, 24; took SSRIs for eight years

I had been dealing with symptoms of OCD and anxiety for a lot of my childhood. It’s in my family, affecting two siblings and one parent. I was prescribed Zoloft when I was 12; I took a variety of SSRIs, Zoloft to Prozac to Lexapro, and then two others, for eight years.

Did they help? You know, I can’t really tell you, because I got through school. I got high marks, I had a lot of friends. So, in that sense, they must have helped. That’s the thing: for people with major depression, it’s easy to say, this has a measurable effect. But I kept taking them just because that’s what I’ve always done.

I went to university right out of school. I did very poorly. I had a bit of a breakdown, isolating myself, not sleeping. I was still on medication. I came home and enrolled at a community college. That was my worst period – I was very depressed. And I started to think, “I’ve been on these medications a long time. I’m not doing well – why not get off them?” I don’t recommend this at all to anyone, but I stopped going to a psychiatrist and took myself off.

Prozac. Photograph: Getty Images

For months I had trouble sleeping. I was jittery. I had brain zaps. My anxiety was pretty ramped up. I would feel numbness in my extremities – generally my arms. My psychiatrist told me these were just normal withdrawal symptoms, and they’d be gone in four to six weeks: “Anything you feel beyond that is your anxiety and depression returning. ” Basically, if you still feel anything beyond this window that the medical community has established, it’s all in your head.

Eventually I went back to school full-time, and I remember doing OK, feeling somewhat better.

I’ve now been drug-free for four years. What’s lasted are the sexual side-effects. They were definitely worse in withdrawal than they had been on the drug, even though I didn’t really realise or understand it at the time, primarily because I started to take SSRIs at 12. While my brother took the same medicine over the same period and had a normal sexual life, I had a lack of sexual interest. I had erections, and I have regularly masturbated my entire life. But I don’t have much of an interest in interacting romantically or physically with the opposite sex.

I didn’t even start thinking about sex until a couple of years ago. It’s almost like I woke up one day and thought, “OK!” I started getting these windows – days or weeks – when normal sexual feelings would appear. But they’re new to me and I don’t know what to do about them. And because I don’t know what to do, I get anxious, and the anxiety kills any feeling – and then I’m anxious because I’ve lost all my feeling.

Online, I’ve come across a big asexual community. Some also took antidepressants; I think there are a lot of people like me out there. I’d like to think that if I keep going to counselling and sleeping and eating properly, I can rectify these things.

In the end, it’s about pros and cons. If you’re lying in bed and can’t get up, is it better to function? If it was up to me, I’d say that, barring extreme circumstances, nobody under 18 should be prescribed these things. Your brain develops around them. Drug companies should be thinking of the long-term effect on people who can’t even consent.

‘If I missed a dose, I’d get shocks down the side of my body’: Chris, 43; has been taking Seroxat for 26 years

I was originally prescribed Seroxat for mild anxiety about my GCSEs. It was 1991, about the time GlaxoSmithKline released Seroxat. I was one of the first people to be given it.

I was prescribed 20mg, the basic dose, to start with. It helped me: I got through school, I went to uni, I went to work. But I had side-effects from the off: profuse sweating, low libido. I’m quite a placid person, but I became aggressive. I never suffered, in the beginning, with the suicidal thoughts that people talk about now, but what I did notice was that if I missed a dose – especially after eight years of taking it – I’d get shocks down the side of my body. I’d be nauseous, my limbs would become weak. I’d be in a constant state of confusion and was very impatient. I couldn’t communicate well with people. I said this to the doctor, and he said, “We’ll up the dose to 40mg.” That was 1998.

I tried to go back to 20mg, but my words became slurry, so the doctor put me back up to 60mg

The 10 years after that weren’t too bad. I managed to work, as a sales rep, for 18-20 years. But by 2012, by which time I was up to 60mg, I had tried on numerous occasions to withdraw. I tried to go back to 20mg, but my words became slurry, so the doctor put me back up to 60mg.

By the time I was 38, even that wasn’t enough. I tried to take my life. The doctor wouldn’t prescribe a higher dose. I couldn’t do my job, I couldn’t concentrate, I couldn’t drive. A psychiatrist once said to me that coming off Seroxat is harder than quitting heroin. That really hit home.

I have now been unable to work for four years. I’m still seeing a psychiatrist. I’ve also been diagnosed with fibromyalgia: constant tiredness, aches in the neck, and in the lower back and lower limbs. I’m 43 and still live with my mum and dad.

I also have no libido. Since the age of 30, I have had no feelings in that regard whatsoever. I have had relationships, but they’ve all failed. I haven’t been in a relationship for 10 years, which is a long time to go without sex, but I just don’t get the urge.

I don’t really have emotions, to tell you the truth. The drug takes your emotions away. I’m sort of existing, not living.

And when the drugs do work…

‘I wanted to be able to feel good when good things were happening, bad when bad things were happening’

By Simon Hattenstone

I suppose I was a depression snob. A purist. Why should I take antidepressants? Yes, there was something rubbish about crying all the time, not functioning, being unable to answer simple questions because of the fug in my head. But, hey, at least I was true to myself.

My depression went back to my late teens. I didn’t like to think of myself as depressive, because depressives were losers. And I didn’t think I fitted the bill: I was pretty funny and able, and I could get girlfriends. I guess most depressives don’t think they fit the bill.

It might have been genetic. My dad had paralysing depression, and so did his father. As a young boy, I’d spent three years off school with encephalitis – an inflammation of the brain that is often fatal. Survivors are often left with depression.

I remember as a teenager being on holiday in Greece with friends. The weather was gorgeous, and I thought, “Why can’t it piss down, because then at least I’d have a reason to feel this way?”

That is what I always craved – objectivity. To be able to feel good when good things were happening, to feel bad when bad things were happening. I hated the fact that my feelings rarely correlated to what was going on in my outer world.

In my 20s, I got by. I held down a good job, fell in love, had kids, made friends, had a pretty good life. But things came to a head when my best friend killed herself. I’d find myself weaving in between traffic wondering what the impact would be like. I took a period off work and gratefully accepted my Prozac prescription.

Things had changed since I first rejected them. Prozac looked cool (lovely green-and-white pills) and rock bands wrote great songs about it (even if REM’s Shiny Happy People was supposed to be dystopic). After telling people I was off work with depression, I ended up feeling like a priest at confessional. It turned out that virtually everybody I knew was a depressive and pilling their way out of it; now it was “our secret”.

I would try to come off the pills and felt rubbish again – not more rubbish than before, but the same. So I returned

Initially, Prozac made me feel sick. And then magically, after a couple of weeks, I felt lighter, as if something had been lifted. I could hear questions properly, answer logically, enjoy a sunny day.

My partner said I was transformed. Occasionally, I would try to come off the pills and felt rubbish again – not more rubbish than I had before, but the same. So I returned, and after a while, I thought, “What’s the point of even thinking about coming off the pills if they make life work for me?”

There are times now when I wonder if I weep and fret and withdraw too much, and whether I’m becoming immune to the Prozac. But on balance I think not, because life is still so much better than it was.

If Prozac was no longer working for me, would I stop taking it? Probably. Would I stop taking antidepressants full stop? I doubt it. I’d simply look for another super pill.

Are you a long-term user of antidepressants? Tell us about your experiences

• If you are affected by the issues raised in this piece, contact the Samaritans here.

• This article was amended on 8 May 2017 to clarify that paroxetine is sold as Paxil in the US and Seroxat in the UK, not the other way around as stated in an earlier version.

Ask Dr. Rob about OCD

We’ve all had times when we focused on a particular thing — something the boss said at work, a song that played in your head all day, or an important upcoming event. And we’ve all had the experience of feeling compelled to do something just one more time — making sure the oven is off or checking just once more that the front door is locked. While these experiences are common and normal, imagine they were persistent, consuming, and debilitating — that’s what Obsessive-Compulsive Disorder (OCD) is like.

What is obsessive-compulsive disorder?

OCD is a condition in which a person experiences recurring and uncontrollable thoughts and behaviors that disrupt normal function, reduces quality of life, or both. The condition gets its name because the recurring thoughts (obsessions) lead to repeated behaviors, called compulsions. It’s relatively common, affecting about 1% of the population; about half of cases develop during childhood or teenage years.

The cause of OCD is unknown. However, a number of risk factors have been identified, including:

• a history of OCD in a parent, sibling, or child, especially if the relative developed the disease as a child
• prior history of physical or sexual abuse
• recent Streptococcal infection (though most strep infections do not cause or worsen OCD)
• certain brain abnormalities (as demonstrated by MRI or other imaging tests).

I’m constantly washing my hands and cleaning things. Do I have OCD?

Symptoms and signs: Some people with OCD have both obsessions and compulsions while others may be bothered more by one than the other. Symptoms may improve and worsen over time. Many people with OCD realize their thoughts are not rational but are able to reduce their anxiety about the obsessions only if they perform the repetitive behaviors.

Common obsessions include:

• needing to have things in a particular order
• anxiety about germs or being unclean
• intrusive thoughts about aggression, religion, or sex.

Common compulsions include:

• repeated handwashing or cleaning things
• rearranging objects over and over to get them in perfect order
• rechecking that something’s been done properly such as repeatedly packing a repacking a suitcase.

What test is used to diagnosis OCD?

Diagnosis: While some of the thoughts or behaviors experienced by people with OCD occur normally in healthy people, OCD should be considered when these thoughts and behaviors are:

• uncontrollable
• getting in the way of normal functioning
• taking up considerable time (for example, an hour or more each day)
• relentlessly present.

Doctors have specific tests and criteria they rely upon to make the diagnosis.

My teenage son was just diagnosed with OCD. Will he have this condition for the rest of his life?

Expected Duration/Prognosis: While OCD can be lifelong, the prognosis is better in children and young adults. Among these individuals, 40% recover entirely by adulthood. Most people with OCD have a marked improvement in symptoms with therapy while only 1 in 5 resolve without treatment. OCD may cause lifelong social and developmental problems when it begins in childhood. For example, young people with OCD may have difficulty socializing with their peers, establishing friendships and relationships, and may struggle in school. Later, they may be unable to keep a job.

OCD is common in my family. How can I prevent myself from having this condition?

Prevention: There is no known way to prevent the development of OCD. However, avoiding certain stressful situations may prevent triggering of symptoms and treatment may prevent worsening of symptoms.

Is there an effective treatment for OCD?

Treatment: Standard treatment for OCD includes psychotherapy, medication, or both. Most of the time, treatment is effective. Many people with OCD also have an anxiety disorder or depression so treatment choices may be determined in part by the presence or absence of these other conditions.

Certain “self-help” treatments can be beneficial, such as becoming more aware of “triggers” and how to avoid them and using relaxation techniques, yoga, and massage to lessen anxiety associated with OCD.

Psychotherapy often includes forms of cognitive-behavior therapy such as:

• education about OCD and how cognitive behavioral therapy can help.
• exposure and response prevention in which a person is exposed to situations that trigger symptoms while learning that no harm will follow if refraining from the compulsive behavior. For example, a person may be exposed to their opened front door and encouraged to lock it only once. While this may cause distress (due to the inability to recheck and relock the door repeatedly), over time, the lack of harm associated with this may lessen the need to relock the door repeatedly.
• cognitive therapy intended to help people with OCD to reassess their mistaken beliefs about their obsessions. For example, talking about how locking the door once is adequate to protect the house and how refraining from repeated locking is unlikely to result in a break-in.

Medications that may be effective for OCD include:

• fluoxetine
• fluvoxamine
• sertraline
• clomipramine
• venlafaxine
• risperidone.

While medication therapy can be effective, side effects are common and it can take some time to identify the most effective and well-tolerated drug.

Deep brain stimulation (DBS) is an investigational approach for people with severe symptoms of OCD that does not improve enough with medications or psychotherapy. With DBS, electrodes are implanted by a surgeon into specific areas of the brain allowing the application of electrical impulses to stimulate or inhibit those areas. For reasons that are not entirely clear, this approach can be effective for people with OCD.

The Bottom Line

OCD is a common and potentially debilitating condition in which a person experiences recurring and uncontrollable thoughts and repetitive behaviors that interfere with normal functioning. The condition may be caused by abnormal brain function, it can run in families and may be triggered by infections or other environmental factors. Treatment is usually effective and includes psychotherapy, medications, or their combination.

— Robert H. Shmerling, MD

Robert H. Shmerling, MD, is associate professor of medicine at Harvard Medical School and Clinical Chief of Rheumatology at Beth Israel Deaconess Medical Center in Boston where he teaches in the Internal Medicine Residency Program. He is also the program director of the Rheumatology Fellowship. He has been a practicing rheumatologist for over 25 years.

To learn about the latest and most effective treatment approaches, including cognitive behavioral therapies, psychotherapy, and medications, buy the Harvard Special Health Report Coping with Anxiety and Stress Disorders.

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Does Sertraline (Zoloft) Work for OCD?

Does Sertraline Work for OCD?

Sertraline, or Zoloft, is one of the most common medications that is used to treat OCD. Earlier in the history of OCD treatment, an older type of antidepressant medication called Anafranil was commonly prescribed for OCD. Anafranil (which is a serotonin reuptake inhibitor, not a selective serotonin reuptake inhibitor) can come with some nasty side effects, which has led physicians to start prescribing SSRIs like sertraline for OCD instead.

SSRIs like sertraline, like we discussed before, affect the way our brains work. Specifically, it increases the amount of serotonin in the brain. This is what is thought to improve both OCD symptoms as well as symptoms of mood and anxiety disorders.

Sertraline has been found to be very effective in treating OCD symptoms in both adults and children. Medications like sertraline have been found to reduce OCD symptoms by about half. In fact, SSRIs like sertraline have been found to be equally effective as Anafranil, but with less side effects. Sertraline, or any medication, is most effective for OCD when taken in conjunction with receiving a type of therapy like Exposure and Response Prevention.

The FDA has approved the use of sertraline, along with 4 other SSRIs, for the treatment of OCD in the United States; it’s approved and available in the U. K. as well.

Sertraline for OCD-Related Depression

It’s also important to consider OCD’s high comorbidity rate with depression. Over half of people with OCD also experience symptoms of depression. For anyone living with OCD, this won’t come as a surprise to you; living with intrusive thoughts and the constant urge to perform compulsions, day after day, wears you down after a while. It’s no shock that depression follows soon after.

This may be another reason why sertraline and other SSRI medications are so effective for the treatment of OCD. Like we talked about above, the medication is effective for specifically treating OCD symptoms like intrusive thoughts and fear. But it’s also effective for treating depression; studies have consistently found that sertraline is a safe and effective antidepressant drug.

If you suffer from co-occurring OCD and depression, sertraline might be able to help you find relief from both.

Frequently Asked Questions About Sertraline and OCD

We at Impulse Therapy understand it’s scary to start a new treatment or medication — but being equipped with information can help. Here is some information about the most frequently asked questions about sertraline and OCD. Keep in mind that this blog isn’t intended to replace medical advice, and you should talk over any concerns or questions you have with your medical provider.

Q: Will I experience side effects with sertraline (Zoloft)?

A: Unfortunately, whether or not someone experiences side effects with any medication depends on each person. There are many common but mild side effects associated with sertraline, along with some rare, serious ones. Many people who take sertraline will experience at least one of the side effects that we listed above.

If there’s a specific side effect you’re worried about, talk to your doctor. There are certain things you shouldn’t do because they’ll increase your risk of side effects; for example, don’t take herbal depression remedies like St. John’s Wort while you’re taking sertraline.

Your OCD thoughts may be worrying about whether or not you will experience side effects with this or any other medication, and that’s a typical symptom of the disease. Unfortunately, neither this blog or any other can tell you with absolute certainty whether or not you will experience side effects.

Q: How long does Zoloft take to work for OCD?

A: Typically, people start seeing results within 4 to 6 weeks of starting to take sertraline.

Q: Which is better for OCD: Prozac or Zoloft?

A: Both Prozac (fluoxetine) and Zoloft (sertraline) are different types of SSRI antidepressants, which mean they affect the brain in the same ways. Studies have shown that most SSRIs, including Prozac and Zoloft, have a similar level of effectiveness for both depression and OCD. In short, whether Prozac or Zoloft is better for you will depend on your specific situation. Talk to your doctor to figure out which to start with.

Q: Can Zoloft cause bad thoughts?

A: An increase in suicidal thoughts is a rare but serious side effect of any SSRI medication, including sertraline. The risk, although still small, is higher for people under the age of 25. This can be understandably scary for someone with OCD, especially suicide OCD, who already worries about having suicidal thoughts come on out of nowhere.

Talk to your doctor or therapist about these concerns. We can not provide you with reassurance here that you definitely, one-hundred percent won’t experience this side effect, because reassurance only makes OCD worse. Some ERP exercises around this intrusive thought may also be helpful.

Q: Will Zoloft stop obsessive thoughts?

Yes, sertraline has been shown to reduce obsessive thoughts and the associated fear and anxiety for people with OCD. It’s generally prescribed for adults with OCD, but it’s also approved to treat children and adolescents with OCD as well.

A Generation Grows Up With Antidepressants

In her bestselling 1997 memoir Prozac Nation, Elizabeth Wurtzel was already expressing concern about the long-term effects of her new antidepressant: “I can’t help feeling that anything that works so effectively, so transformative, has got to be hurting me at another end, maybe sometime further down the road. I can just hear the words inoperable brain cancer being whispered to me by some physician 20 years from now.” But 15 years after Wurtzel’s memoir, Prozac is no longer considered to be so transformative—or even so effective. According to the research of Harvard Medical School’s Irving Kirsch, selective serotonin reuptake inhibitors (SSRIs), the broad category of drugs including Prozac, Zoloft, and Lexapro, are more effective than placebos only in cases of severe depression.

But 10 percent of the American population continues to take them because the message from psychiatrists and from the culture more broadly is, “Why not?”

We still don’t have a conclusive answer about whether antidepressants work, or about their long-term effects. Tentative hypotheses suggest that feedback mechanisms could permanently alter serotonin levels in the brain, but unsurprisingly, pharmaceutical companies are not eager to fund this kind of research. There is also another reason for the startling lack of long-term safety studies: the Federal Drug Administration doesn’t require them. A mere two years of proven safety is sufficient.

Wonder drugs or not, it is now considered culturally acceptable to take SSRIs indefinitely. Psychiatrists often prescribe them without an endpoint, and this attitude toward prescription has changed the way depression is conceptualized. Only two weeks of symptoms are required for a diagnosis, but then—somewhere along the line—depression becomes a lifelong disease that requires lifelong drug treatment. When it comes to therapy, insurance companies are moving in the opposite direction, often paying only for short-term treatment. So we are left wondering: does depression last forever, or can it resolve itself in 20 sessions? Can the drugs do the trick?

From William Styron’s Darkness Visible to Andrew Solomon’s The Noonday Demon to Wurtzel’s famous memoir, there has been no scarcity of books on depression. But 25 years since the birth of Prozac, we’ve reached that rare moment when it seems possible, and even necessary, to do something new with the genre: to take stock of the experience of a generation that has grown up with antidepressants. In Coming of Age on Zoloft: How Antidepressants Cheered Us Up, Let Us Down, and Changed Who We Are, Katherine Sharpe writes about people like herself: people who have never known a world without SSRIs.

After 20 minutes with a psychiatrist at her college counseling center, Sharpe left with a prescription for an antidepressant, which she continued to take for the next 10 years. Millions of people could say the same, and Sharpe states outright that her own story is neither dramatic nor unique. Rather, its value lies in its similarity to the experiences of so many other young adults born in the 1980s and 1990s.

Instead of a traditional, individual-focused narrative, Coming of Age on Zoloft is a collective memoir, of sorts. Sharpe weaves her own account together with the stories of her peers—a group interpreted quite broadly as anyone from the ages of 18 to 40, but also quite narrowly as white, upper middle class, and highly educated. Most of the book’s subjects are struggling with the same existential questions: Am I a different person on antidepressants? Is life without antidepressants somehow more authentic?

These questions are especially pertinent and confounding when they are asked by people who began taking SSRIs in adolescence. While adults can make an informed decision about whether they want to subscribe to the narrative that SSRIs will restore them to their pre-depression selves, adolescents have not yet fully developed the personalities that could serve as points of comparison. The self on antidepressants becomes the only self they know.

Sharpe intersperses her interviews with a history of antidepressants, placing valuable emphasis on the creation of that narrative of self-restoration and the strategic way pharmaceutical companies have marketed these drugs. “The story of the invention of modern antidepressants and the invention of depression as we know it go hand in hand,” Sharpe explains. There is a widely accepted but never conclusively proven idea that depression is caused by a chemical imbalance in the brain. The rise of this biomedical model of depression was used by “big pharma” to reassure consumers that SSRIs were designed to treat a disease not unlike, say, diabetes. The key date in the story is 1997, when the FDA removed the regulation against direct-to-consumer advertising, making it possible for large numbers of people to go to the doctor specifically to request SSRIs.

The idea of a psychopharmaceutical as a quick fix is nothing new, but the ease with which antidepressants are now prescribed is carrying over into yet another, more troubling class of drugs: atypical antipsychotics, designed to treat diseases like schizophrenia. Sharpe mentions the rise of these drugs as a means of managing childhood behavior problems, but she doesn’t discuss the fact that they are increasingly used in the general population to supplement antidepressants, often with serious side effects.

After 25 years, the chemical treatment of depression may just be getting started. And if SSRIs are changing who we are, we’re still figuring out how.

Book review: Coming of Age on Zoloft.

One of the interesting and inescapable features of our knowledge-building efforts is just how hard it can be to nail down objective facts. It is especially challenging to tell an objective story when the object of study is us. It’s true that we have privileged information of a particular sort (our own experience of what it is like to be us), but we simultaneously have the impediment of never being able fully to shed that experience. As well, our immediate experience is necessarily particular — none of us knows what it is like to be human in general, just what is is like to be the particular human each of us happens to be. Indeed, if you take Heraclitus seriously (he of the impossibility of stepping in the same river twice), you might not even know what it is like to be you so much as what it is like to be you so far.

All of this complicates the stories we might try to tell about how our minds are connected to our brains, what it means for those brains to be well, and what it is for us to be ourselves or not-ourselves, especially during stretches in our lives when the task that demands our attention might be figuring out who the hell we are in the first place.

Katherine Sharpe’s new book Coming of Age on Zoloft: how antidepressants cheered us up, let us down, and changed who we are, leads us into this territory while avoiding the excesses of either ponderous philosophical treatise or catchy but overly reductive cartoon neuroscience. Rather, Sharpe draws on dozens of interviews with people prescribed selective seratonin reuptake inhibitors (SSRIs) for significant stretches from adolescence through early adulthood, and on her own experiences with antidepressants, to see how depression and antidepressants feature in the stories people tell about themselves. A major thread throughout the book is the question of how our pharmaceutical approach to mental health impacts the lives of diagnosed individuals (for better or worse), but also how it impacts our broader societal attitudes toward depression and toward the project of growing up. Sharpe writes:

When I first began to use Zoloft, my inability to pick apart my “real” thoughts and emotions from those imparted by the drug made me feel bereft. The trouble seemed to have everything to do with being young. I was conscious of needing to figure out my own interests and point myself in a direction in the world, and the fact of being on medication seemed frighteningly to compound the possibilities for error. How could I ever find my way in life if I didn’t even know which feelings were mine? (xvii)

Interleaved between personal accounts, Sharpe describes some of the larger forces whose confluence helps explain the growing ubiquity of SSRIs. One of these is the concerted effort during the revisions that updated the DSM-II to the DSM-III to abandon Freud-inflected frameworks for mental disorders which saw the causal origins of depression in relationships and replace them with checklists of symptoms (to be assessed in isolation from additional facts about what might be happening in the patient’s life) which might or might not be connected to hunches about causal origins of depression based on what scientists think they know about the actions on various neurotransmitters of drugs that seem to treat the symptoms on the checklist. Suddenly being depressed was an official diagnosis based on having particular symptoms that put you in that category — and in the bargain it was no longer approached as a possibly appropriate response to external circumstances. Sharpe also discusses the rise of direct-to-consumer advertising for drugs, which told us how to understand our feelings as symptoms and encouraged us to “talk to your doctor” about getting help from them, as well as the influence of managed care — and of funding priorities within the arena of psychiatric research — in making treatment with a pill the preferred treatment over time-consuming and “unpatentable talk-treatments.” (184)

Sharpe discusses interviewees’, and her own, experiences with talk therapy, and their experiences of trying to get off SSRIs (with varying degrees of medical supervision or premeditation) to find out whether one’s depression is an unrelenting chronic illness the having of which is a permanent fact about oneself, like having Type I diabetes, or whether it might be a transient state, something with which one needs help for a while before going back to normal. Or, if not normal, at least functional enough.

The exploration in Coming of Age on Zoloft is beautifully attentive to the ways that “functional enough” depends on a person’s interaction with environment — with family and friends, with demands of school or work or unstructured days and weeks stretching before you — and on a person’s internal dialogue with oneself — about who you are, how you feel, what you feel driven to do, what feels too overwhelming to face. Sharpe offers an especially compelling glimpse at how the forces from the world and the voices from one’s head sometimes collide, producing what professionals on college campuses describe as a significant deterioration of the baseline of mental health for their incoming students:

One college president lamented that the “moments of woolgathering, dreaming, improvisation” that were seen as part and parcel of a liberal arts education a generation ago had become a hard sell for today’s brand of highly driven students. Experts agreed that undergraduates were in a bigger hurry than ever before, expected by teachers, parents, and themselves to produce more work, of higher quality, in the same finite amount of time. (253)

Such high expectations — and the broader message that productivity is a duty — set the bar high enough that failure may become an alarmingly likely outcome. (Indeed, Sharpe quotes a Manhattan psychiatrist who raises the possibility that some college students and recent graduates “are turning to pharmaceuticals to make something possible that’s not healthy or normal.” (269)) These elevated expectations seem also to be of a piece with the broader societal mindset that makes it easier to get health coverage for a medication-check appointment than for talk-therapy. Just do the cheapest, fastest thing that lets you function well enough to get back to work. Since knowing what you want or who you are is not of primary value, exploring, reflecting, or simply being is a waste of time.

Here, of course, what kind of psychological state is functional or dysfunctional surely has something to do with what our society values, with what it demand of us. To the extent that our society is made up of individual people, those values, those demands, may be inextricably linked with whether people generally have the time, the space, the encouragement, the freedom to find or choose their own values, to be the authors (to at least some degree) of their own lives.

Finding meaning — creating meaning — is, at least experientially, connected to so much more than the release or reuptake of chemicals in our brains. Yet, as Sharpe describes, our efforts to create meaning get tangled in questions about the influence of those chemicals, especially when SSRIs are part of the story.

I no longer simply grapple with who I can become and what kind of effort it will require. Now I also grapple with the question of whether I am losing something important — cheating somehow — if I use a psychopharmaceutical to reduce the amount of effort required, or to increase my stamina to keep trying … or to lower my standards enough that being where I am (rather than trying to be better along some dimension or another) is OK with me.

And, getting satisfying answers to these questions, or even strategies for approaching them, is made harder when it seems like our society is not terribly tolerant of the woolgatherers, the grumpy, the introverted, the sad. Our right to pursue happiness (where failure is an option) has been transformed to a duty to be happy. Meanwhile, the stigma of mental illness and of needing medication to treat is dances hand in hand with the stigma attached to not conforming perfectly to societal expectations and definitions of “normal”.

In the end, what can it mean to feel “normal” when I can never get first-hand knowledge of how it feels to be anyone else? Is the “normal” I’m reaching for some state from my past, or some future state I haven’t yet experienced? Will I know it when I get there? And I can I reliably evaluate my own moods, personality, or plans with the organ whose functioning is in question?

With engaging interviews and sometimes achingly beautiful self-reflection, Coming of Age on Zoloft leads us through the terrain of these questions, illuminates the ways our pharmaceutical approach to depression makes them more fraught, and ultimately suggests the possibility that grappling with them may always have been important for our human flourishing, even without SSRIs in our systems.

5 Zoloft Side Effects You May Not Expect

November 18, 2020 – Drug Facts – 0 Comments

Zoloft is a popular medication that is used to treat depression and anxiety. The generic name of Zoloft is sertraline hydrochloride, an SSRI (Selective Serotonin Reuptake Inhibitor) that works by increasing the level of serotonin or “feel-good hormone” in the brain.

When a person takes Zoloft, it could help improve mood, appetite, energy, and sleep. It has been shown to be an effective mode of treatment for people with depression, social anxiety, and panic attacks.

Unlike benzos, however, Zoloft is not a drug that provides instant effect. It could take up to six weeks for a user to feel that the drug is working. Because of this, it is not unlikely for people to become dependent on Zoloft and keep on taking it even if they do not need the drug any longer.

There are also other people who confuse Zoloft with other anti-anxiety drugs like Xanax and Klonopin. There is a misconception that Zoloft could give similar effects so they try to abuse Zoloft or use the drug recreationally. Doing so can be dangerous because while Zoloft can be a safe treatment for people who have a legitimate prescription, abusing Zoloft or taking it longer than necessary could lead to serious side effects.

Below are just five of the side effects that a person taking Zoloft could experience.

1. Gastrointestinal problems

People who are taking Zoloft can frequently have gastrointestinal problems such as constipation, indigestion, bloating, nausea, and diarrhea. These are some of the most common side effects of taking this antidepressant medication. According to Dr. James Murrough from the Icahn School of Medicine at Mount Sinai, people on Zoloft can experience changes in their gastrointestinal function because there is actually a lot of serotonin in the GI tract. If you are experiencing these symptoms persistently, you should consult with your doctor to see whether the dosage should be lowered until your body becomes accustomed to the medication.

If you are taking Zoloft without a prescription, it is important to note that doing so could affect your gut even after stopping the drug.

2. Sexual Disorders

Another common side effect of taking Zoloft is having sexual disorders. Some examples of how Zoloft has affected users include lack of sex drive, inability to maintain an erection in men, delayed or failure in ejaculating, and difficulty in reaching orgasm. These problems reportedly affect 1/3 of patients taking Zoloft but this figure could be more as not all Zoloft users are comfortable in discussing these with their doctor. Some patients, however, may need a change in medication if these sexual side effects are bothering them.

3. Weight Gain

Do you know that up to a quarter of people taking antidepressant drugs including Zoloft experience weight gain of around 10 pounds? While this may be advantageous to people who have lost weight due to their depression issues, this could be an unexpected side effect for people who are trying to maintain weight or those with obesity issues.

According to studies, the weight gain was not initially noticed during clinical trials that were 8 to 12 weeks in length and it seemed that the weight gain generally occurs with long-term use (six months or more). If you are dependent on Zoloft and you are taking it longer than what was recommended, this could be a side effect you could experience.

4. Psychiatric Symptoms

Depression and anxiety are two of the most common psychiatric conditions experienced by Americans today. If you have these conditions, your doctor could prescribe you Zoloft as a first-line of treatment. But do you know that it is also possible for you to experience more adverse psychiatric symptoms brought about by Zoloft use?

There have been reports of Zoloft users experiencing mood changes, behavioral changes, increased depression, agitation, memory loss, impulsiveness, and hallucinations after taking Zoloft.

Another psychiatric side effect that should be carefully monitored in people taking Zoloft is having suicidal thoughts, especially in adolescents. If you are taking Zoloft and you experience suicidal thoughts or your psychiatric symptoms become more severe, contact your doctor immediately.

5. Drug Overdose

Because Zoloft is a popular drug used to treat depression and anxiety, some people have the misconception that it is a benzodiazepine like Xanax. People who are used to abusing Xanax because it could give them instant relaxation and calmness think that abusing Zoloft will provide the same effect.

However, because Zoloft is an SSRI that is effective only after a longer period of use, it will not give an instant effect. It can take weeks before a depression patient can feel the positive effects delivered by Zoloft. People who are abusing Zoloft may not be aware of this and it is possible for them to increase the dosage of the drug or mix it with other substances, thinking it will be more effective. Taking too much Zoloft and combining it with other substances could lead to a drug overdose.

If you or a loved one is struggling with substance abuse, help is available.

Contact Lighthouse Treatment Center today.

My experience coming off medication | Mind, the mental health charity

In 2004 I had a breakdown. I was a very busy vicar working in the middle of two large council estates, was a governor at various schools, and had a young family and a wife who had just recovered from depression, partly because of a very stressful job in Palliative Care as a Cancer Nurse Specialist.

I had been diagnosed with an underactive thyroid, irritable bowel syndrome and a hiatus hernia and life crashed. I was totally stressed, dealing with difficult problems and difficult people. As the above physical symptoms surfaced, so did the hidden depression.

“I felt like I couldn’t share how I felt with anyone except my spouse.”

My depression goes back to my childhood and teenage years. My parents divorced when I was very young and I never knew my father. My mother wasn’t maternal and packed me off to boarding school, which I hated. I was desperate for love and a father figure, and I was sexually abused. Although I eventually had counselling, I found that nothing could shift the depression.

Added to all of this was the burden of – as a vicar – being someone that people put on a pedestal. I felt like I couldn’t share how I felt with anyone except my spouse, who, in my case, did understand only too well. Over the years I have also been able to confide in my golfing buddy whose wife has had episodes of serious anxiety and depression. 

After my breakdown I was put on Citalopram and was off work for three months. I probably should have been of work for longer, but I dragged myself back and continued to take my medication. I struggled on over the years, but in 2009 I was forced to take early retirement. We moved house and I continued my part-time role as Chaplain to Worcester Warriors Rugby Club, but life was an effort.

“What I really needed was a doctor to look at my history and help me through a gradual withdrawal.”

In 2011 I found a new lease of life as I began an Elvis Presley Tribute Act, but I was still on Citalopram and wanted to come off it. What I really needed was a doctor to look at my history and help me through a gradual withdrawal.  

This summer, after fifteen years on Citalopram, I went back to the doctor. They told me to come off Citalopram, which they felt was no longer right for me, and to start taking a low dose of Sertraline. Sertraline was not right for me either, so after a few weeks I returned and said I wanted to come off everything. The doctor was very kind, but didn’t seem to understand this area. She agreed but said that if I couldn’t cope to try Duloxetine. When I asked what the side effects were they were exactly the same symptoms I was already experiencing, so I decided not to take it and start the process of coming off my medication altogether. 

What no one told me was what happens when you come off Citalopram after so many years. I experienced a number of symptoms during the weeks I was coming off it, including: 

• brain zaps (electric shock-type feelings in the head) 
• headaches 
• irritability and mood swings 
• fatigue 
• suicidal thoughts 
• dizziness and blurred eyesight 
• depression and anxiety 
• sleep changes and strange dreams 
• memory problems.

I found these side effects horrendous. My doctor told me that that they would pass in a few weeks, but for me they lasted much longer, and I am still getting some of them now.  

However, I am finding ways to survive this process of withdrawal. It’s difficult to want to do anything, but I am forcing myself to do the following: 

• Take regular exercise. I walk the dogs, swim, play golf and do gardening. 
• Eat healthily. 
• Get enough sleep. 
• Take the right vitamins. 
• Find forums that make me realise I am not alone. 
• Pray, hard as that has been at times.

One of the hardest things over the years has been the feeling that I failed by having to be on Citalopram. I battled depression for years before going onto Citalopram and in those days very little was understood about it.  

Unless they’ve had depression, people just don’t understand, so it can be a lonely walk. Recently the Worcester News did a front page article on my story and many of the comments online were completely insensitive and hurtful. 

“I would’ve liked more information and support when I did make the decision to come off my medication.”

I think medication along with good counselling and other support can be good to get a person up and running, but for me, I believe I was taking medication for too long when it wasn’t right for me. I also would’ve liked more information and support when I did make the decision to come off my medication, especially about the side effects of withdrawal.  

I decided to share my story partly because I am still going through the effects of coming off my medication. There’s not much light yet, but I believe that eventually there will be.

Antidepressant Pfizer Zoloft – “Zoloft helped …”

Hello! Hope the review will help you. Zoloft is not just a cure, it is a hope and a fight … against panic attacks.

I will not describe the form of the medicine, lay out instructions – all this is on the internet.

I came to Zoloft via Rexetin (Paxil), to Rexetin via Grandaxin, to Grandaxin via Afobazole, to Afobazole via Corvalol, Valerian and Phenazepam. At the heart of the pyramid of tranquilizers and antidepressants is the moment that divided my life Before and After.Sound familiar? Are you on the verge of taking antidepressants (AD) or not? I’ll try to be helpful.

Because I already had the experience of taking and canceling AD Reksetin, then I looked at Zoloft doomed, they say, it is necessary. I had phenazepam to cover up and a week to get used to, without going out, where I waited for fears, suffocation, weakness in the legs, dizziness, fainting, and all together the diagnosis: panic attacks, socio- and agorophobia. Of course, on Reksetin I already felt better, but during the period that I lived without him, the symptoms returned, but to a lesser extent.Zoloft advised me to see another neurologist, to whom I turned with complaints of headache. He himself, by his own admission, on Zoloft

As always when taking blood pressure, I started with a small dose, with a quarter. After 6 days, it changed to 0.25. In a week by 0.75 and after another one and a half weeks by 0.50, i.e. on a full pill. Feels like I was nagging the first days of admission, excitement, but panic did not reach for phenazepam. In principle, everything went without any special problems, Zoloft was tolerated much easier than Rexetin and others like him (there is experience of taking amitriptyline, fluoxetine).Zoloft has a cumulative effect and after a month and a half I felt better, I was relieved, I got a mood, a smile, the lump that was strangling my chest left, I began to be careful, and then it is not easy to go out to cafes, supermarkets, and this is not easy, alarmists will understand me less headaches. steel, the miracle did not happen, but it became easier for me to endure it. Having achieved remission, I drank Zoloft for 6 months. Cancellation was also easier than on resetin. I went down the ladder. Those. on gradually decreasing the dose. It was shocking, there was excitement, but I understood that it was in my head and it should be so…the last crumb of zoloft was drunk on Friday and canceled … the panic did not return !!! but … it was like that on Rexetin … for a week the body learns to live without artificial seratonin, learns to live by its emotions and he does not really like it … This week after the cancellation, we need to keep from emotional breakdowns, tears, causeless anger, psychosis … novopassit or phenazepam to help us. And patience, understanding of our loved ones. Better, isolation. That no one would provoke. Just a week! After a year, I can say with confidence that Zoloft saved me, gave me a decent life with its joys, with cycling, cars, treats in a cafe, dating, traveling…If you have been prescribed HELL! If you do not see any other way out, do not wait, then you will regret the lost time … They reproached me, they say, you will ruin your health with antidepressants)) HA! Yes, I’d rather live up to 50 years a positive, full life on Zoloft than die an old wreck with a web of fears. BUT THIS WILL NOT HAPPEN during the treatment, I did not find any changes in the body, except for positive ones.

Order Zoloft 50mg 28 pcs tab (Pfizer) in the online pharmacy

Pimozide. With the combined use of sertraline and pimozide, an increase in pimozide levels was observed with its single administration in a low dose (2 mg).Increases in pimozide levels were not associated with any ECG changes. Since the mechanism of this interaction is unknown, and pimozide has a narrow therapeutic index, the simultaneous administration of pimozide and sertraline is contraindicated.

MAO inhibitors. Severe complications have been noted with the simultaneous use of sertraline and MAO inhibitors (including selectively acting selegiline and with a reversible type of action of moclobemide, as well as linezolid). Perhaps the development of serotonin syndrome (SS) (hyperthermia, rigidity, myoclonus, lability of the autonomic nervous system (rapid fluctuations in respiratory parameters and CVS) changes in mental status, including increased irritability, pronounced agitation, confusion, which in some cases can turn into a delirious state or to whom).Similar complications, sometimes fatal, occur when MAO inhibitors are prescribed during treatment with antidepressants that inhibit the neuronal uptake of monoamines, or immediately after their withdrawal.

LS, depressing the central nervous system, and ethanol. The combined use of sertraline and substances that depress the central nervous system requires close attention, and the use of alcoholic beverages and preparations containing alcohol during treatment with sertraline is also prohibited. There was no potentiation of the effect of ethanol, carbamazepine, haloperidol or phenytoin on cognitive and psychomotor function in healthy people, however, the combined use of sertraline and alcohol is not recommended.

Indirect anticoagulants (warfarin). When administered together with sertraline, there is a slight but statistically significant increase in PT (in these cases, it is recommended to control PT at the beginning of treatment with sertraline and after its cancellation).

Pharmacokinetic interaction

Sertraline binds to blood plasma proteins. Therefore, it is necessary to take into account the possibility of its interaction with other drugs that bind to proteins (for example, diazepam and tolbutamide).

Cimetidine. Concomitant use significantly reduces sertraline clearance.

Drugs metabolized by cytochrome P450 isoenzyme 2D6. Long-term treatment with sertraline at a dose of 50 mg / day increases the plasma concentration of simultaneously used drugs, in the metabolism of which this enzyme is involved (tricyclic antidepressants, antiarrhythmic drugs of the class propafenone, flecainide).

Medicines metabolized by other enzyme systems of cytochrome P450. Experiments to study the interaction in vitro have shown that the beta-hydroxylation of endogenous cortisol carried out by the CYP3A3 / 4 isoenzyme, as well as the metabolism of carbamazepine and terfenadine, do not change with long-term administration of sertraline at a dose of 200 mg / day.Plasma concentration of tolbutamide (but with simultaneous administration reduces the clearance of tolbutamide, blood glucose control is necessary with simultaneous use), phenytoin and warfarin with long-term administration of sertraline in the same dose also does not change. Thus, it can be concluded that sertraline does not inhibit the CYP2C9 isoenzyme.

Sertraline does not affect the serum diazepam concentration, which indicates the absence of inhibition of the CYP2C19 isoenzyme. According to in vitro studies, sertraline practically does not affect or minimally inhibits the CYP1A2 isoenzyme.

Lithium. The pharmacokinetics of lithium does not change with the concomitant administration of sertraline. However, tremors are more common when they are used together. As well as the appointment of other SSRIs, the combined use of sertraline with drugs that affect serotonergic transmission (for example, with lithium) requires increased caution.

Drugs affecting serotonergic transmission. When replacing one inhibitor of neuronal serotonin uptake with another, there is no need for a washout period.However, care must be taken when changing the course of treatment. Avoid co-administration of tryptophan or fenfluramine with sertraline.

Induction of liver microsomal enzymes. Sertraline causes minimal induction of liver enzymes. Simultaneous administration of sertraline at a dose of 200 mg and antipyrine leads to a small (5%), but significant decrease in T _1/2 antipyrine.

Atenolol. When administered together, sertraline does not alter its beta-adrenergic blocking action.

Glibenclamide and digoxin. With the introduction of sertraline in a daily dose of 200 mg, drug interactions with these drugs have not been identified.

Phenytoin. Long-term use of sertraline at a dose of 200 mg / day does not have a clinically significant effect and does not suppress phenytoin metabolism. Despite this, it is recommended to carefully monitor the level of phenytoin in the blood plasma from the moment of administration of sertraline with appropriate adjustment of doses of phenytoin.

Sumatriptan. There have been extremely rare cases of weakness, increased tendon reflexes, confusion, anxiety and agitation in patients who were simultaneously taking sertraline and sumatriptan.It is recommended to monitor patients who have an appropriate clinical reason for the simultaneous administration of sertraline and sumatriptan.

Zoloft 50mg tab.p / vol. No. 14 (Pfizer italia s.r.l.)

From the digestive system: dyspeptic disorders (flatulence, nausea, vomiting, diarrhea, constipation), abdominal pain, pancreatitis, dry mouth.

From the CCC: heart palpitations, tachycardia, arterial hypertension.

From the musculoskeletal system: arthralgia, muscle cramps.

From the side of the central nervous system and peripheral nervous system: extrapyramidal disorders (dyskinesia, akathisia, teeth grinding, gait disturbance), involuntary muscle contractions, paresthesias, fainting, drowsiness, headache, migraine, dizziness, tremor, insomnia, anxiety, agitation hypomania, mania, hallucinations, euphoria, nightmares, psychosis, decreased libido, suicide, coma.

Respiratory system: bronchospasm, yawning.

From the urinary system: enuresis, incontinence or urinary retention.

Reproductive system and breast disorders: sexual dysfunction (delayed ejaculation, decreased potency), galactorrhea, gynecomastia, menstrual irregularities, priapism.

From the side of the organs of vision: visual impairment, mydriasis.

From the endocrine system: hyperprolactinemia, hypothyroidism, syndrome of inappropriate secretion of ADH.

From the hepatobiliary system: hepatitis, jaundice, liver failure.

Allergic reactions: urticaria, itching, anaphylactoid reaction.

Others: weakness, skin redness or flushing of the face, ringing in the ears, alopecia, angioedema, facial edema, periorbital edema, photosensitivity reaction, purpura, increased sweating, decreased appetite (rarely – increased), up to anorexia, decrease or increase in body weight, bleeding (including nasal, gastrointestinal or hematuria), peripheral edema, rarely Stevens-Johnson syndrome and epidermal necrolysis.

Laboratory test data: rarely, with prolonged use, there is an asymptomatic increase in serum transaminase activity. Cancellation of the drug in this case leads to the normalization of enzyme activity.

Development of leukopenia and thrombocytopenia is possible, as well as an increase in serum cholesterol levels.

Rare cases of withdrawal have been reported with discontinuation of sertraline treatment. Paresthesias, hypesthesias, symptoms of depression, hallucinations, aggressive reactions, agitation, anxiety, or psychosis symptoms that cannot be distinguished from the symptoms of the underlying disease may appear.

What was your experience when you first started taking antidepressants?

Despite a couple of previous therapists, I never had a diagnosis of MDD (major depressive disorder) until about twenty years ago. In their defense, I was completely self-medicated until then.

I was prescribed Prozac and Lithium. I don’t remember the dose, but it’s pretty funny that I say, “I don’t remember.”

After gradually increasing to the recommended dosage level, the effect was generally subtle sedation, muted euphoria, and a great ability to keep me out of the big trouble upsetting me.For example, my truck fell apart while driving in Northern California. Literally while I was driving.

I got towed to a garage in the nearest town. To paraphrase Colonel Teague in the last episode of Battlestar Galactica, I was told, “She has a broken back, she will never jump again.”

My answer was kind of, “Hmm. Well, how about this?

It bordered on “Lah Di Dah”.

I should have been unhappy. I should have been angry with the universe. Instead, I bought a HUGE bag overseas at a nearby store, unloaded the truck, got a bus ticket, and casually headed back to North Hollywood.

The drone pretty much sums up the feeling. I spent the next seven months at SoCal without wheels. I had a job out of town. I made the greyhound rich.

And all this thankless, fruitless and pointless work was just “Oh, good.”

Sometime before or after my stay at NoHoSoCal, New England, I played at a club just north of Boston.

The gig lasted several nights in a row, and I used to hide my guitar in the club owners’ office so that I could roam and roam and roam free until the next night.

The owner of the club had a fun idea. He went out one of those afternoon evenings, found a cheap unwanted guitar the same size as me, dyed it the same color (black), cut the neck in half and put it in my bag.

That evening he and the rest of the guys were in their office, pretending it was a coincidence to be there at the same time, and awaiting my arrival.

I grabbed a suitcase from behind a filing cabinet and unzipped, ignoring their holding of breath.I pulled out the guitar and immediately saw that it broke in half, held together with only six strings that were fastened at both ends.

In hindsight, it was Harry Chapin’s moment. The other person might be angry. The other person may have been a really stupid maddened loss of mind.

I just said, “Oh dear.”

My immediate thought was, “I think I’ll give an oral speech tonight.”

Of course, the guys were terribly disappointed that I did not react the way someone who was not bewitched by pharmaceuticals would react.

Again, looking back (and in hindsight – 20/20, right), I had to suffocate, grab my chest and feign a heart attack. I would have a day off, and over time, I would be a fairly wealthy person.

At this stage in my life, I wonder how I would react to the death of a loved one. I am glad that I was not passed in this department.

Okay, time for a confusing proposal.

Remember at the top when I said, “Is it funny when I say ‘I don’t remember’?”

All my stories about psychobiochemistry seem to have an overture, and then we come to what I wanted to say.

Perhaps even more significant than this evoked accusation was what Prozac did to my memory. The lithium component soon left the cocktail when I suspected it was causing my eyelid to twitch, and my doctor excused me for that.

Yes. Memory. The problem was too much memory.

It all started when I met people and asked them if I had met them before, because they looked very familiar. I would not (for myself) accept the answer “no”.I didn’t mock them, but I wondered how I knew them.

At that time there was a new woman in one of my permanent clubs, about my age. I could not shake the feeling of her familiarity. Not like the previous person somewhere in my past landscape. Not like passing overnight. No, I was 110% sure that I was in an extremely tense and intimate situation with her. The only way I could describe was as if I was wiping her face with a cool, damp cloth while she was giving birth.

This is something you can’t go back and ask her about. By that time, I already knew about this “chemical déjà vu”.

Years later, my attending physician thinks that presque vu is the closest he can think of, describes it. But Presque Vu is what they call the tip of the tongue phenomenon, the feeling that you know what you want to say but can’t think of words.

No. It was different.

Funny, when I learned self-restraint and control during these episodes, the je ne sais quoi atmosphere would fill the air and my fake acquaintances would begin to feel like they already knew me.Maybe it was the sparkle in my eyes that I tried so hard to hide. At least that part was fun.

Oh, there was so much room to mess with people’s heads, but I secretly knew what they had been through. Plus, messing with them at such a disadvantage would be such bad karma.

It didn’t stop there. This manifested itself when I was about to fall asleep. I would suddenly “remember” a song or a conversation piece that I wrote a long time ago and say to myself, “Wow, I haven’t done this for a long time.I have to do it again very soon.

After thinking about it a little more, I suddenly realized that I didn’t remember anything. Nothing at all. I had the feeling that I was remembering something, but nothing was attached to it.

And this continues to this day.

At least I’m not going crazy trying to figure out how I know a complete stranger.

But it’s like my brain is releasing a chemical that’s usually released when you remember something.

And at least it is limited to the twilight zone of sleep.

Example: I will drift, think about what to do tomorrow, right? It would occur to me that the old oil painting I bought from this shed is still in the trunk of my car. Well, at least in the garage for the night.

Nice, harmless thought like Velveeta and Wonder Bread, right?

Except:

There is no oil painting that I have never been in the barn. There is no garage that has no car.

Well, that’s kind of interesting. It seems.

I haven’t been in Prozac for a long time, but as I said, this curiosity still exists.Since then, I’ve taken half a dozen antidepressants. It is not that I am still, otherwise I will still be on them, except for Wellbutrin.

I’ve been pretty happy with Wellbutrin for several years now. Am I in LaLa Land? No. Am I a wretched lump on a log? No.

I still get depressed, but I talk about it with my therapist. Then I feel better. Lord, she needs to be lifted.

Confessions of a novice addict: katrindreamer – LiveJournal

4 weeks without Zoloft, who thought that this would be another battle, and as it has become absolutely clear now, the recovery process will take time.

During this time, I turned over a lot of sources available in two languages.

If I could go back three years, knowing what I know now, I would never take these pills.

Because the reality is that after I got better and I decided to stop taking the pills, I felt much worse than it was before I started taking the drug.

I am writing this partly for my therapy, but also, perhaps, for someone it will serve as useful information.

At the same time, I was told that it was better for me to take Zoloft, since it does not cause addiction, unlike Klonopin.

Klonopin, I must say, perfectly removed attacks, but children like to take it to improve their mood. Therefore, here you are, zoloft does not cause addiction, take a course for 6 months and that’s it.

Now it is difficult to remember the details, because I was very bad, I thought even worse due to lack of sleep, and I really wanted to finish my first year, transfer to the second, and not jump under the train.Alone in a foreign country, a lot of things have accumulated. Well now lament, done and done, maybe this post will help you not to make my mistake.

Zoloft did not turn out to be a magic candy, it actually became easier for me in less than six months. And these 6 months, intensive therapy, rest, panic attacks every night before bed, and sleeping pills for sleep. I went to India to see my Ayurvedic doctor specifically with this problem, there was little time, so I could not go through the full panchakarma.But the qualitative transition took place in India.

Now I would go there for a month, all my neurons would be smeared with Guy oil. I brought with me supplies for another six months of this magic oil, now I regret not logging my changes. The clenched neck warmer was also my constant companion.

But nevertheless, I must say, I felt better, after a year I completely recovered. What helped me? It is hard to say.

By the way, let’s just stipulate that I took Zoloft just for panic disorder, and not for depression, the pills did not prevent me from consciously going through rather deep crises and depression during these three years.

Then I decided to stop taking pills and everything returned to normal, or rather no, I felt much worse than it was before.

I just fell ill with the flu, and the next morning I woke up with a wild feeling of a tight head and a loss of concentration, to such an extent that I could not remember my phone number, everything was floating in front of my eyes. I then went to the same hospital where these pills were prescribed to me and at the reception I frankly ran into the doctor, asking her how they sleep at night, knowing what they prescribed to patients.I now understand why she then defended herself in an aggressive form against my attacks, assuring me that many of her patients safely left this drug, and I just need to continue taking it for another six months, since I, apparently, did not finish the treatment.

I had no time to argue, as there was no time to lie in a disabled state in New York either. I returned to the previous dose and after 10 days everything became normal again, I remembered my phone number, I could learn texts, the energy returned and I felt myself again.

But, of course, I wanted to deal with this issue, and what actually happened to me, and how in the end I would get off these pills.

And then I went to the Internet and read on the forums reviews of unfortunate patients who, trying to quit, returned to their broken trough and, due to the unbearable symptoms of Alzheimer’s and Down’s, at the same time, started taking pills again, calling themselves drug addicts. The fact that I experience all the same symptoms as drug addicts with withdrawal is now also colorfully told by Patrick Melrose.

Do the prescribing doctors know about this?
I don’t even know which is worse, a doctor who signs you a life sentence and does not tell you the truth, or a doctor who is simply not competent and does not really know what he is condemning a person to. Of course, I was not quite myself, but I clearly remember being told that this drug is not addictive.

Well, believe me, it is very challenging. Since there is very little information, especially in Russian, no one can explain what actually happens in the biochemistry of the brain and the entire nervous system under the influence of these drugs (reuptake inhibitors).

But, by the way, there is plenty of information in English. Including because there are much more victims than in Russia. A very good overview, by the way, on Wikipedia.

https://ru.wikipedia.org/wiki/Selective_inhibitors of_serotonin_reverse_uptake

Without going into molecular metabolism and organic chemistry, very briefly, addiction occurs even in healthy people with a fairly short use.

Yesterday I dug up the most beautiful site, though in English, where survivors and those living on refusal of pills keep their diaries.The information is very well distributed on important topics. https://www.survivingantidepressants.org

And yes, as with all injuries, I prefer to call myself a survivor instead of a victim. The site details the withdrawal syndrome and how to cope with it.

Doctors talk about withdrawal syndrome, which lasts only 2 weeks with a competent withdrawal from the drug. But in reality, withdrawal symptoms can last for years, and no one knows exactly how you will have, because there is no exact research, and each nervous system responds differently.

There is light at the end of the tunnel, it can be experienced, but it will not happen quickly.

Because the nervous system will have to re-learn to live and function without the help of external intrusion. It is interesting, however, that the word medicine and drug in English is denoted by one word -Drug, (drugstore – pharmacy)

So, this site contains recommendations and reviews of living people who want to live drug free.

Zoloft is prescribed so easily here, as if it were ascorbic acid, it is not necessary to be a psychiatrist, an ordinary therapist or even a gynecologist can prescribe zoloft in case of life troubles, postnatal depression, or apathy.

As I said, from my previous experience, this time I started to gradually reduce the dosage in order to reduce the withdrawal symptoms.

Why I decided to get off the pills on the eve of my departure to New York, in which I got panic disorder, I do not know, but it seemed to me completely inhumane to start taking the drug in Moscow in winter in deep depression. New York, in spite of everything, invigorates me very much and makes me happy, possibly contributes to the production of serotonin.

Reducing the dose by half, I survived more or less safely, and after a month and a half I decided that it was time to say goodbye to them.

The first 4 days were normal, now I know that this is called “honeymoon”, this is when the refusal syndrome gives you the opportunity to breathe a little. But this time, I also knew to provide a good battlefield and stock up on ammunition.

Minimum stress, positive emotions and recharge at all levels.

About feeding in detail, because I promised.

Yes, indeed, lifestyle, and in particular nutrition for the brain, is a big support in this battle. Enjoy. But these recommendations are not only for those struggling with panic attacks and looming Alzheimer’s, but also for those who want to maintain mental flexibility and mental stress.

https://katrindreamer.livejournal.com/57697.html

Actually, I was cheating a little, saying that by reducing the dose in half everything went smoothly, insomnia overtook me, and as a result, exhaustion and a slight loss of concentration.

But when I arrived in New York, the jet leg effect happened, I managed to deceive my psyche a little. Later, while watching the series by Patrick Melrose, I learned that experienced drug addicts know how to use the jet.

I don’t know what was going on there, but sleep returned and the next three weeks were absolutely stable. So I decided that I could go down further.

After 5 days I woke up with a characteristic feeling of tightness in my head, the picture blurred before my eyes, but I kept focus with all my might.Every morning I repeat my phone number, this is an indicator for me. Vitamins clearly prevent the body from going into the flu. Turned into the wrong street once.

Sleep is very superficial, in the morning I wake up with red circles under my eyes. It feels like she hadn’t slept at all. That is, the dream is, as it were, but it is very superficial.

And then I was shocked by the attack, I had even forgotten what it was and how scary it was. It’s scary mainly because you completely lose control. The feeling that you are endlessly flying in space in a state of gravity.But I must say, I pulled myself out of it very quickly. I stood on my shoulders, then threw my legs into the plow, sat down, loudly and distinctly said my name, what date is today, where I am and that I am in charge here. It let go quickly, then there is such a post-stress and fear that it might happen again in the wrong place and I cannot save myself.

In general, of course, now after 4 weeks without pills, I can say that this trip I can compare with rehabilitation after a very difficult abdominal operation, when tissues are regenerated and you have to learn to move again.It’s good when there are close people nearby, it’s better if it’s a mother, but I don’t have a mother, so I am my own mother, children help me a lot. Another practical tip from Patrick is to switch focus from yourself and how unhappy you are to others, to help others. Ordinary bodily contact, the mere presence of a living being nearby helps a lot, just a heartbeat. Probably also the understanding that I should be strong next to them, because they are smaller.

There were no more attacks, but my neck cracked again.

I have a feeling that the story of my panic disorder, then wrapped in a horn 3 years ago, now unfolds and releases the same symptoms through the body from memory, but now I deal with them myself.

It was very hard for the first two weeks, when it seemed that my brain was simply degraded, I will never be able to learn a paragraph of text again.

I still managed to go on dates in this state .-))

One thing was very funny, because I was very tense and collected all my inner strength so that the picture would not blur and the words would reach my brain, this can be compared to the sensations when you are very drunk, but desperately trying to concentrate.

In general, to begin with, let’s also outline the advantages of this situation, yes, you will not believe it, but they are.

While my brain was tensely busy building new neural connections6 it had no time to control me, to put some kind of barriers, partitions and restrictions on me, so spontaneity appeared.

I also noted that I do not bother myself with a certain correctness, but I say exactly what I think. No compromises with yourself, because there is no energy at all for nothing.Everyone is going to fuck off very fast. I have severe resuscitation, so either in my opinion, or not at all.

And here’s Kevin, from the Bumble app.

Cute from photos, even several years younger than me, we met almost a year ago, two days before my flight to St. this surprised me a lot.

We didn’t talk often, but when we finally agreed to meet, I had the feeling that he was somehow close to me and I knew him.

And so, evening, Manhattan, a beautiful French bar, it’s good that I came first, because I would be completely at a loss if it were the other way around.

At some point, a man approaches me, introduces himself as Kevin, but has nothing to do with those photos that were in the profile. Cognitive dissonance happens to me, I strain very hard so that his face does not split in two, and at the same time I wonder if I’m completely crazy, because this man is 10 years older than that guy from Bumble and outwardly does not look like him at all.

And since there was no strength to think over the expressions, I could not hide my surprise. From the outside it probably looked very funny, he entered like a narcissistic peacock, and for a long time I looked at his face thoughtfully silent.

But from exclamation you are so old, I still kept it-))

But Kevin as a whole turned out to be nothing, treated him to champagne, supported the conversation, but did not admit that he had not posted the photos of his own and it was impossible to grab him by the tail, because when we exchanged phone numbers, we removed the “sympathy” and the link to the profile …I decided not to meet with him again, because Kevin openly invited him to play the game “race-persecution”, and my 10 years of therapy were not in vain, and I recognize sophisticated narcissists quite quickly nowadays and I can say, no more thanks.

That evening I drank two glasses of champagne and it seemed to me that I felt better the next day, although now I think that drinking is not worth it at all. Even more so during the rehabilitation period.

Even more so, survivingantidepressants.org says alcohol can reverse the process.

With a pinched neck, I came to a Chinese doctor for acupuncture, needles help well in stimulating nerve endings. But you need to walk regularly for support.

Then, at the end of 3 weeks, 2 strange things happened to me, proving that sometimesbreakdown is a breakthrough

I went to the beach and, having entered the ocean, I suddenly caught myself thinking that I was no longer afraid of the waves. Those who know me that I have a panic fear of the ocean, with all my love for it, I do not swim well and always splash near the shore, I will go to meet the waves only when I feel the sand under my feet and I am sure that I can touch the bottom.

And now a wave comes at me, but it no longer causes terror, I learned to dive under it. The wave is passing.

It is interesting that a panic attack is perceived just the same as a wave that covers, twists you in its foam, carries you into the unknown.

So the attack goes like a wave, you probably need to dive into it, and therefore also climb onto the board. That will be a joke if I am still surfing on this wave.

The next day I went to yoga and got into an asana that was very disturbing for me.Perhaps this is something when fear reaches such an extent that you already cease to be afraid of life, or desperately want to live.

Will Smith in this video claims that God has hidden all the beautiful things in life behind a screen of fear.

As you can see, I really want to make lemonade from lemons. And I want to believe that I can handle it. After all, Patrick managed to get off heroin.

Sometimes I feel that everything is already very good, sometimes it seems that someone is taking my spine and separating it from my body.

And if my brain is really making new neural connections right now, it might be time to rewrite the entire script.

PS Those who wish to help the survivors or are simply grateful for the article here:

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