Transcription
Some people have told me that they've gone nights without rest. They felt wide and tired at the same time. Stress hormones can flood your body, and they can leave you feeling in a constant state of alarm. And for some, the nervous system can become so sensitive that lights feel too bright and sound unbearably loud. And for the unfortunate few that are sensitive to withdrawal, it can feel like your mind and your body are on fire.
Let's start with what anti-depressants actually do. Now, most people hear from their doctors that these medications restore balance to the brain. They boost serotonin. However, this is a myth. These drugs do not correct any type of chemical imbalance. In fact, how they work is through a drug effect which typically is causing some form of numbing, sleep promotion, or maybe an energizing effect. It is essentially papering over uh symptoms that you have underneath that.
And in the short term, you have to give the devil its due. This does work and it will quiet down anxiety. It will make sleep improve, and some people feel even more energized. But the problem with this is that the brain is not a static machine, and it does not like being thrown out of balance. And it will notice that the chemicals have been adjusted. For instance, that the serotonin has been artificially elevated by the SSRI, and so it starts to push back against this. And it will begin to slow its own production of serotonin. It will desensitize the receptors in the brain, and it will begin to rewire those networks that regulate your stress, your sleep, your motivation, and even your sexual functioning. And because of this, over time, the effects of the drug wear off, and essentially being on the drug has become the new baseline for your brain because you have fully adapted to it.
Now let's talk about what happens when you go into sudden withdrawal. Well, remember what I said a moment ago that this drug has become kind of integrated into the brain. Well, if you withdraw that drug suddenly, and suddenly for me can mean in a couple of months, it is if you are pulling out structural and foundational beams from a building, and if you yank them out when the brain hasn't had a chance to readapted to them, the building will metaphorically collapse. And people sometime describe this experience as being worse than heroin withdrawal. That's what Bobby Kennedy famously said. And the reality is is that coming off anti-depressants for some people can feel worse than coming off heroin. In terms of the symptoms that they feel, and also the duration that the withdrawals go on for. And that's what we're going to unpack in the rest of this video.
And so why are these symptoms so unbearable for some? Well, when you make rapid changes, it destabilizes brain circuits, and the serotonin signaling is thrown into chaos. And because of this, your mood regulation and your sleep regulation completely break down. Many people will report symptoms like dizziness, nausea, and strange brain zaps that feel like jolts of electricity when they move their head or their eyes. And for some, this can escalate into relentless insomnia, overwhelming panic, waves of despair, uncontrollable crying, flu-like exhaustion, and crushing fatigue. Some people have told me that they've gone nights without rest. They felt wide and tired at the same time. Stress hormones can flood your body, and they can leave you feeling in a constant state of alarm. And for some, the nervous system can become so sensitive that lights feel too bright and sound unbearably loud. And for the unfortunate few that are sensitive to withdrawal, it can feel like your mind and your body are on fire.
But thankfully, most people don't go through this. And many people, even if they come off the medications quickly, for some reason, their brains are just very elastic, and they'll have bad withdrawal symptoms, but they'll recover quite quickly. But there are two groups of people who are very unlucky. And those are the ones you need to be aware of. One is unlucky, and the other one is terribly unlucky. Let's start with the unlucky group first.
So the first group are those who are simply sensitive to withdrawal and they don't recover from it as quickly as others. These patients are usually told that the withdrawal is mild and self-limiting, meaning that it goes away in a couple of weeks. And so when they do a fast taper with their doctor, and they start having severe withdrawal symptoms, their doctor will tell them that their depression is coming back, and that because of this, they need to get back on the medication. Well, that's not the case for all patients. For some of them, they've simply come off the medication too quickly, and they're still in a state of withdrawal. And when you interpret these withdrawal symptoms as being caused by the previous condition coming back, many of these patients can end up getting stuck on a medication for the rest of their life that they don't really want to be on.
Okay. Well, if that sounds bad enough, for some patients, unfortunately, it gets worse, and they can actually develop a condition called protracted withdrawal. So, what is protracted withdrawal? Well, the best way to explain this is kind of with a story of how this happens. So, you get some patients, they get pulled off their anti-depressants in a very quick way, sometimes in about two months or so, and they go into severe withdrawal, just like I described previously. And for them, they try and white knuckle through it. They say, you know, this is really bad, but I want to use my willpower. I'm going to just wait until it goes away and things will get better. For some people, it does, but for this group of patients, it doesn't. And usually about two months or maybe three months into the process, they are still feeling terrible. In fact, some of them are even feeling worse. And at this point, they say, "Well, I don't want to feel like this anymore. I want to go back on the drug and have this go away. I'll find another way to come off, or I'll just stay on the drug." But unfortunately, the symptoms don't go away. Because for some patients, when they go into states of severe withdrawal, it can actually be harmful to the brain in an injurious sort of way. I liken it to having a concussion of sorts. And so even if you bring the drug back, the brain is still very sensitized and hurt. And this condition is called protracted withdrawal.
Now, this is what Bobby Kennedy was talking about when he said that it could be harder than heroin heroin withdrawal for some patients because this can last up to a year or two. Yes, that's right. And when you look at documentation from the Royal College of Psychiatrists in the UK, they acknowledge this. But you can also find stories about this on survivingantidepressants.org where there's hundreds of thousands of patients who are using that forum right now to try and support each other as they go through withdrawal.
So what do you do if you want to come off this medication and you want to avoid all of this? Well, there are a few things to keep in mind. I would recommend for anyone who's been on the medication for longer than a year is that you start your taper with a five to ten percent reduction. Just see how you respond to it. Wait two to four weeks, and if you're doing okay, do another reduction. If you're tolerating that five percent rate, you can increase it to seven point five the next month. If you're tolerating the seven point five uh reduction, you can increase it to ten percent. Generally, people do best when they keep the rate of reduction below fifteen. And it's not uncommon that as you get to the lower end of your taper, that you actually have to go slower. This is because at the lower range, there's not a lot of drug left into your in your system, and so when you remove an amount of it, it rapidly decouples it from the receptors. The converse might be easier to explain this. Imagine when you're on the full dose of the drug, there's so much drug floating around between the neurons that you could remove quite a lot of it, and there's still a lot of residual to hit those receptors. And that's not happening when you get to those lower dose ranges.
But Yseph, you might be thinking, what do I do with these tablets? They're so hard to break up when you get to the lower dose range. Well, what I'd recommend that you do is talk to your doctor about having your drug turned into a liquid. When you have your drug turned into a liquid, you can then draw it up into a syringe. For instance, if you had five of Lexa Pro, you could turn that into one milliliter and then you could draw it up in a one milliliter syringe. The backs of brand of syringes that I recommend have one hundred spaces on the side of them. That gives you one hundred little points of high precision to slowly lower that medication down.
Now, the final rule of safe tapering is to simply move at a rate that your body can handle. Don't follow a fixed schedule. Don't listen to, hey, you know, you just have to do this much every week or so. Your brain will tell you what rate to move at. And so, take your time, listen to your brain. If you go into withdrawal, go up to the previous dose that you handled and do a smaller reduction.
Now, the final thing I will mention is that for some patients, this can take time. I routinely work with patients who have been on these medications for a decade or so, and for them, they're coming off in one to two years. And so, don't stress about this. Take your time, and that's the safest way to come off these medications.
And so, that's it for today. If you found this video helpful, please consider liking and subscribing to the channel. It helps more people out there on YouTube find this kind of information. Thanks.