I’ve now been on 10mg of Trintellix for two full weeks. I still hope to finish tapering by early June, though that’ll partly depend on Ze Doctor: whereas I’m raring to go he’s much more restrained. And I need that restraint, because as much as I want to get this finished it’s far more important to do it slowly and properly. Yeah, it means the withdrawal symptoms are going to linger, but they’re nothing compared to what I experienced when I stopped taking antidepressants more-or-less cold turkey in 2014. As I wrote back then:
Day one was fine. Day two was okay. Day three was bad; day four was hellish. Day four was when the withdrawal symptoms really kicked in. Strangely enough I hadn’t really anticipated the possibility of negative side effects, yet they were myriad and surprisingly aggressive. I figured insomnia would be one of them, since one of my antidepressants was a sleeping aid, and it was. But what I didn’t reckon for was the nausea, dizziness, obsessive thoughts, or general sense of dread (not to mention some of the weirder side effects, like the inability to eat dairy or an itchy scalp). I think I was so focused on the end goal I never really stopped to consider the potential pitfalls. It took the better part of two weeks for the worst symptoms to abate.
I’ll take mild withdrawal symptoms over that any day.
(Not surprisingly the symptoms spiked during my recent work trip to Panama City, and in retrospect I probably should’ve waited till I was home before resuming the taper. My next trip, a ten-day jaunt to Dubai, Istanbul, and India, finishes on April 20; after that I’m home for good, one long weekend in Pittsburgh excepted.)
Those lingering side effects are abating. Meanwhile, the improved energy, motivation, and mental acuity remain, suggesting this taper’s establishing a new benchmark. I honestly feel as though I’ve begun uncovering the best version of me that’s ever existed (typical etc, but it’s true). It’s not just the taper that’s getting me there: it’s also the lifestyle changes, in particular a renewed commitment to proper diet. I can’t wait to see what the rest of 2018 brings. And I can’t wait to see how I’m feeling next week, when the new dosage should’ve fully kicked in.
I almost forgot I even had a bottle of Ativan. I say “had” because I just got rid of it. I hadn’t taken one since June anyway, but I wanted those pills out of my life. I used to use them semi-regularly, but the more I’ve learned about Ativan (and benzodiazepines in general) the more it frankly scares me, and since I’m currently tapering off antidepressants getting rid of that bottle seemed symbolically appropriate. I once wrote: “Don’t be afraid to take Ativan, Seroquel, or any other drug your psychiatrist or family doctor prescribes.” I stopped taking Seroquel in 2014; all being well I took my last Ativan nine months ago.
We’re a week into Phase Two of the Trintellix Taper and so far, so…not much of anything. I felt a bit sluggish to start, and while the obsessions that flared up the last time resurfaced they topped out at a 4/10. In other words: I’m experiencing mild, totally predictable withdrawal symptoms.
And that’s great, although I still don’t feel quite as good as a few weeks ago. If nothing else I’ve got a new benchmark: I felt so much better on 15mg than on 20. But it took three weeks on 15mg before I started feeling great, which suggests we’ll have a better idea of where things stand in mid-March.
So begins Phase Two of the Trintellix Taper, with me lowering my dosage from 15mg to 10. Zero is the ultimate goal, but the finish line’s been pushed back a bit: my doctor, who’ll henceforth be referred to as “Ze Doctor,” wants me to wait till I’m finished travelling to taper down again. I’ll be back from India April 20; our next appointment’s April 25. I’m expecting a brief downturn this weekend – I experienced moderate withdrawal symptoms last month – but I’m still feeling fantastic. Isn’t it incredible how a minute amount of chemicals can completely alter a human being?
Getting into the elevator following my appointment I was greeted by a guy in a Leafs hat. The interaction went as follows:
Him: “This elevator’s f*cked.”
Me: “Oh yeah?”
Him: “But that’s life, isn’t it? Up and down, up and down. And that’s why I do crystal meth.”
Him: “They’re trying to make me snap.”
Me: “…” (suddenly aware that we’re alone in a confined space)
(The elevator doors open. He and I walk out; I go in the opposite direction.)
I was supposed to go to an OCD group meeting tonight but bailed for a multitude of reason – chief among them the irresistible allure of sweats, a couch, and the Olympics. In another week I’ll have entered Stage Two of the Great Trintellix Taper of 2018. I’ve decided to give withdrawal another go, and so far the signs are encouraging: since I began tapering I’m feeling more alert, more motivated, and more energetic than I’ve felt in ages. I’m feeling more like myself.
I’m feeling more alive.
Again, I don’t want to seem like some sort of anti-antidepressant kook. That is absolutely not my intention. They’ve helped me get better; it’s entirely possible I’ll end up having to take them again at some point. But for now I’m better positioned to kick them than I was in 2014, when I more-or-less stopped taking antidepressants cold turkey before suffering the wrath of a discombobulated brain. I’ll have a better idea of where things stand in another couple weeks – but if there was ever a time for me to quit, it’s now.
Which brings me back to the group meeting I didn’t attend. Right now this particular support group just isn’t what I need. I need to keep doing the little things that got me better – like nights in front of the TV, for instance (hey, self-care’s important!). And I need to be a better mental health advocate. My engagement tends to wax and wane depending on how I’m feeling, but that’s something I plan on correcting. I don’t need to be in a roomful of strangers wallowing in their illness: I want to thrive in spite of mine, all the while using my experience to help those nearer the start of their OCD journey. My commitment to you is to keep telling my story in 2018 regardless of how I’m feeling. Because I anticipate feeling good – but I want to use my experience as rocket fuel to reshape the world.
This list began life in 2016. It’s evolution, baby: here’s the 2018 edition!
- Avoid becoming complacent in my recovery. This is the biggie. I may be in recovery from OCD, but I have to keep doing the things that got me better – in particular the sleeping, the healthier eating, the mindfulness, and the exercising. I’ve got a bad habit – a natural one, but still – of feeling great for a few weeks and then slacking off…which is how lapses start. Help keep me honest! And on the subject of OCD…
- Remain focussed on the process, not on the short-term results. An OCD specialist named Dr. Steve Phillipson wrote a wonderful (and long!) article about the importance of choice in the recovery process. It completely changed my perception towards my recovery. I think it’s a great read for non-OCDers, too.
- Withdraw from antidepressants – then see what happens. I’ve decided to give it another go. Last week I wrote: “I don’t know if [the goal is] complete withdrawal – but I’m allowing myself to entertan that possibility. I’m in a much better place than the last time I attempted it; this could be the time to give it another go.” Hopefully it is – and if it’s not, I’ll reverse course.
- Become a morning person. Three years ago I dabbled with waking up at 6am and loved it: I was waking up to start my day, not simply for the sake of going to work, and that subtle paradigm shift made a world of difference. Here are six other reasons to wake up early.
- Run. I was born to do it, and besides which I literally put it in my wedding vows – which means I’m a bad husband unless I get back to running in 2018.
- Bike 1,000km between now and the Ride to Conquer Cancer. It’ll be good for training; it’ll be better for shutting a certain someone’s mouth, at least temporarily (and insomuch as shutting that individual’s mouth is possible).
- Drum in front of an audience. I haven’t done it since 2007. The Smashing Pumpkins are back; can a Western Country reunion be far behind?
- Write. I miss writing, too, or at least I miss doing it for more than just the simple pleasure of writing. How am I supposed to produce the great Canadian novel if I don’t get cracking? The fact that a friend of mine recently published her first book was inspiring; the fact it’s one of the best books I’ve read in years means I’ll have to work even harder.
- Get involved in my community. I love Toronto for the most part, but there’s a lot I don’t love about it – in particular its current political leadership and in particular the gormless mayor who’s pushing to spend $5-billion of public money on a single-stop subway extension. It’s time to do more than sit idly by and tweet about it. And speaking of that…
- Cut back on screen time – and on social media. This is the other biggie. I don’t think technology’s the big evil; I do think we could all stand to use it less often, and I know I certainly can. Similarly, Facebook and Twitter are fine in moderation. I’ve cut back on both (or, well, I’ve cut back on Twitter at least), but I can still do more – like regular social-free evenings and weekends. To paraphrase Bruce Springsteen: I’m easily found if you want to see me.
Last week – eight months after a whirlwind sequence of events which had me first lowering, then increasing my daily antidepressant dosage – I started tapering again, from 20mg of Trintellix to 15. A few weeks ago I rated myself on the Yale-Brown Obsessive Compulsive Scale. I got a three, which is “indicative of little or no OCD symptoms.” That doesn’t mean I’m cured – OCD can’t be cured – but rather subclinical, which is almost as good. I decided to try solidifying my gains, and last Wednesday my psychiatrist approved the initial taper. We’re meeting again in three weeks to reevaluate.
Let me be clear: I’m not anti antidepressants. At all. They’ve helped me get better; I know in some cases they’ve literally saved people’s lives. I’d just prefer having less of them inside of me. (Of course, I’d prefer not having OCD in the first place, but since that ship’s already sailed you won’t hear me knock medication that literally improves brain function.) But having said that: I still don’t know the end goal of this latest experiment. I don’t know if it’s complete withdrawal – but I’m allowing myself to entertain that possibility. I’m in a much better place than the last time I tried it; in fact, this might be the perfect opportunity to give it another go. Or, it might not be! I accepted the possibility that I’ll be on antidepressants for the rest of my life a long time ago. Ultimately, it’s for my doctor and me to decide.
Anyway. So far the withdrawal symptoms have been mild: a slight uptick in OCD, some grogginess, but otherwise little of note. More updates to follow!