I've been oddly silent for over a week recently, and I know a lot of people are wondering what happened to me. Clients even told me they were worried about me, because I never cancel appointments, but I canceled just about all of them last week.
Well, the truth is that I spent the last week withdrawing from drugs. The legal kind.
A few years ago (and I honestly can't remember how many - 4, 5, 6?) I began taking a small dose of Lexapro to help with severe PMS. I took just 5 mg, half a pill, 10 days before my period. The first month, I didn't notice a difference. Erin did, however. She sat me down and told me "Honey, I want you to take this pill every day."
In just a few months, I was taking it every day. It helped tremendously with the feeling of underlying anxiety that I had dealt with for as long as I could remember and didn't realize was a problem for most of my life. For the first time I was realizing that this low-level anxiety was doing a lot of damage. It was hard to be happy when I was always nervously anticipating what would go wrong next.
All these decisions were made, of course, under the guidance of a psychiatrist, and I've talked a little about this experience in my book. And over the years I've noticed that most of my clients are on both an SSRI (such as Lexapro, Paxil, Prozac, Zoloft) and a psychostimulant (such as Concerta, Ritalin, Adderall), just like me. Depression and anxiety are the two most common coexisting conditions for people with AD/HD, and many of us find ourselves needing a little quality of life boost.
So fast forward to 2008. I've made a lot of changes in my life. I've made physical changes that help keep my brain balanced, like eating more nutritiously and getting better sleep. And I exercise moderately, although I probably got more exercise when I lived in the city. I've also made practical changes in my life by learning and applying the skills I need to manage anxiety.
I saw my psychiatrist a few weeks ago and told her that I thought it was time to go off the Lexapro. "I can't explain it," I told her. "But I just have this weird, intuition-like feeling that it's time to go off the Lexapro." She had a wise response, I thought, which was to go off the medication and then, if I felt anxious again and I needed to go back on it, at least I'd know why. I wouldn't feel like I was popping pills for no reason.
So we set up a schedule for me to begin weening off the Lexapro. Seven and a half mgs for 2 weeks, then 5 mgs for two weeks, then 2.5 mgs for 2 weeks, then done. It would take a while, but it would hopefully be easier than going "cold turkey." And my doctor warned me that the withdrawal would be bad. "So bad," she said, "that you'll feel way worse than you did before you went on the medication. Don't confuse the withdrawal with anxiety or depression symptoms."
I had no idea just how bad the withdrawal would be.
I had some mood swings and fatigue each time I went down a notch on the meds. Going down from 7.5 mgs to 5 mgs was a little harder, and I decided that I wanted this process to be done already, and that I would go from 5mg to 0. (And, please be sure to note, this is something I discussed with my doctor.)
I planned it perfectly, or so I thought. I stopped taking the meds on a Wednesday night, with no appointments that Thursday or Friday, and I figured that I would pretty much experience most of the withdrawal symptoms over the weekend. I might need to sleep a little late on Monday and Tuesday, which would be no problem because my client appointments started later in the day. I thought it would be fine. I was wrong.
For a few days after dropping the Lexapro completely, I just had mood swings. I oscillated between being giddy, weepy, and angry. I was tired. But it wasn't that bad. On Sunday, we took our usual hike in the mountains, and I felt like walking in the sunshine and brisk air for a couple of hours was exactly what I needed. By Monday, I was in a completely different place.
For four days, Monday through Thursday, I was in the throws of SSRI withdrawal. It was awful. Here are just a few of the symptoms I experienced:
- Extreme mood swings, which included raging anger. I looked for things to throw on more than one occasion. And I'd be lying if I said that I didn't actually throw them.
- Awful sadness. I cried at everything. I cried when I saw 10 seconds of upcoming scenes for the Chef Jeff Project. A troubled kid was hugging Chef Jeff, and I lost it.
- Extreme fatigue, and extreme insomnia. I was so tired, and often couldn't sleep.
- I felt flu-y. Stuffy head, sore throat, headaches, muscle pain. I would start off strong, and go downhill quickly in the day. You wouldn't think that withdrawal from a psychiatric medication would cause flu-like symptoms, but it's actually really common.
- General fogginess. I was on slow speed. It took me a lot longer to process what I was hearing, and to put my own thoughts into words. On one or two occasions, I told Erin the same thing twice, as in repeated the sentence right away without even realizing it.
- Really intense, anxiety-filled dreams. Tons of them, including the one about some guy trying to have sex with my mother at a county fair. (Yes, you read that right.) When I told my mom about it, she quickly responded, "That's not a dream, it's a nightmare!"
- Cravings. I mostly wanted salty meat and a lot of Asian food. I had a craving for a dish that I used to get at a Vietnamese restaurant in the city...that I haven't had in over 3 years! Also, orange juice. I don't really drink juice, so that was a bit weird, too.
- Skin sensitivity. One night the sheets would feel super comfy, and the next night those same sheets made me itch beyond belief.
Probably the most notable symptom, especially to those around me, was the anger I felt. It was so bad. Everything pissed me off...and I mean pissed me off. I knew the anger was coming when my poor little babies (my dogs) would start shaking. It was like they felt it coming on before I did. And just to be clear, I did not hit or abuse them at all. If you have dogs, then you know that they are very sensitive to the moods of the people around them.
I used to watch Celebrity Rehab and think the people on there who got pissed off so often were just fucked up. Now I understand that the drug withdrawal makes them fucked up. So fucked up that minor trespasses become major, anger-filled events. I can now relate, because even though I didn't withdraw from heavy drugs, I was that fucked up.
It strikes me as I write this post that I can't quite put into words just how badly those 4 days were last week. It was more than not just feeling like myself. It was painful, both physically and emotionally. And even though I knew that the feelings would pass, I couldn't help wondering if it was worth it. The Lexapro really helped me for years, and I'm thankful for that. But I might have thought twice if I knew that this withdrawal period would be a part of the process.
I've been feeling better for a few days now, and I actually feel pretty good today. Well, that might be an overstatement. I feel good compared to how I had been feeling. But I'm confident that I won't have to cancel any coaching appointments this week. Catching up on email is another story...
I wrote this post for a few reasons:
- I wanted to explain to everyone why I "flaked" for over a week. I especially wanted to explain to my clients who aren't used to this kind of behavior from me.
- I wanted to document my experience, and process it for myself.
- I wanted to offer an open account of my experience to those who might benefit from it. Even though I knew that I would experience a withdrawal period, I wasn't quite prepared for the severity. I spent a good deal of time online this week trying to make sure I wasn't crazy.
I'm leaving the comments open on this post (for now, anyway) but my assistant and I are going to be really diligent about deleting inappropriate comments. If you want to tell me that drugs are evil, don't bother. If you want me to look into Scientology or you represent an "alternative" product, don't bother. In fact, if you want to tell me what I should or shouldn't do, don't bother. Even if you're trying to be helpful. Fortunately, I have a good doctor, a supportive partner, and two loving dogs who haven't had the shakes for 5 days. I have everything I need.
If, on the other hand, you want to offer a kind word or share your own experience, then please do.
And if you've stumbled upon this post and are looking for more information on the subject, then here are a few resources that might be helpful:
Thanks to everyone who patiently awaited my arrival back to society. I'll be reporting more on this subject and my experience in the coming weeks.
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