Treating Depression and Anxiety (and What Doctors Didn’t Tell Me)

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Link to “9 Physical Symptoms You Didn’t Realize Were Caused By Depression”

This is my story of coming off of two prescription anti-depressants, Wellbutrin and Cymbalta. I will be updating this post periodically as I taper off and end each of them.

Disclaimer: this post is not meant to be medical advice. Please consult a physician you trust before altering medications in any way.

Since my earliest childhood memories, I have been in pain. “Everything hurts,” is a phrase I have uttered too many times for over two decades. Migraines, back aches, numbness, joint pain. Then came the depression and anxiety. My journey to finding relief has been a long one. It has included many different medical professionals and several different medications.

Some medical professionals, especially when I was still very young, concluded my symptoms must be psychosomatic. One or two dismissed my symptoms altogether. Others, after conducting various tests with inconclusive results, decided it was easier to treat the symptoms rather than find the root cause. Until two months ago, I did not know that I have scoliosis, two bulging discs in my C-spine and carpel tunnel (so it is possible that my lifelong struggle with pain has ultimately made my battle with depression and anxiety more difficult). Neither did I know that my current medications were both highly addictive and toxic.

Starting the Prescriptions

In 2010 I was overcoming the last persistent clouds of depression from over a year of severe, suicidal depression (my abusive boyfriend had threatened me in an effort to keep me from seeking medical help for the depression so it took me a long time before I sought help). I was also experiencing extreme numbness and chronic pain; the kind of pain which dramatically impacted my ability to function. I was in graduate school. I needed my body and my mind to work! So when my doctor said, “We don’t know what’s wrong but there’s a drug I would like you to try”, and it worked, I was only too happy to continue taking it. Thus began my seven years on Cymbalta.

Approximately two years later I was experiencing increased anxiety. Another doctor said it was most likely a side effect of the first prescription so he put me on Wellbutrin to combat the anxiety. When my prescriptions ran out a year after that and I was forced to quit cold-turkey while searching for a new primary care physician, I ended up in the ER because the withdrawal symptoms were so extreme that I wanted to kill myself.

My doctor after that, when I told him that my anxiety had reached an all-time high, doubled my dose of Wellbutrin. I trusted these medical professionals and believed they were doing what was best for my well-being.

I also failed initially to research the prescriptions myself because I was – frankly – barely 20 years old and just so relieved to feel better!

Fast forward to learning that my wacky spine accounts for most of my pain and that it’s possible the prescriptions have begun doing more harm than good. I spoke to my [amazing] new doctor at my first appointment two months ago and we decided it was best for me to come off of these two prescriptions.

I have found that some doctors have a habit of not giving their patients the information they ought to have before taking the prescriptions. Drug companies are also less than honest when it comes to those who consume their products. For example, I just learned that Wellbutrin has a similar chemical makeup to cocaine (it has been called “the poor man’s cocaine” because, when abused, it has a similar affect). Both medications have caused severe addiction issues for thousands of users (although I do not believe they are considered addictive by the FDA) and are considered two of the most difficult prescription drugs to come off of.

My doctor told me about one woman who went to rehab for drug abuse – and later tried to taper off of her Wellbutrin – said the withdrawal was just as difficult from the prescription as it had been the illegal substances she had once used. I have read testimonials from other Wellbutrin and Cymbalta users, as well, who have had similar experiences when trying to stop.

That’s a pretty significant detail that at least three different doctors failed to tell me.

In the past year I have also gained what, for me, is a significant amount of weight. Exercise and dietary changes have done nothing to move the scale. When I asked a doctor in 2010 “could Cymbalta make me gain weight?” the answer was, “No”. I received the same answer when I asked about Wellbutrin. I have a history of anorexia and laxative abuse: I needed to know!

I have since learned that both medications can contribute to weight increase but, for Cymbalta specifically, the weight gain may not occur until you have been on the drug for several years. It’s called pill pudge: “antidepressants block acetyl choline, histamine and/or serotonin receptors—and when some or all of these are blocked, weight gain can follow”. Now that I know that, and am coming off the pills, my doctor and I are hoping that my weight will drop and balance out to what is my healthy norm.

It also took seven years and four primary doctors before someone said, “Do not under any circumstances get pregnant while on these medications”. Now I had done some research on anti-depressants and pregnancy/breastfeeding so I assumed that I would need to wean off my medications prior to conceiving a child. But no one had told me about the specific dangers of taking these medications while pregnant until two months ago: studies have not found that the risk of birth defects increases however the possibility of miscarriage may increase, heart and brain development can be affected, delivery complications may become more likely, and breast milk can be adversely affected.

Any prescription will have its side effects and risks so it is important to not only talk to your doctor at length about those but also do research on your own! Check out on-line forums and groups ( like Depression Hurts – Cymbalta Hurts Worse) to get an idea of other peoples’ experiences. I do not recommend making an informed medical decision based on a chat room BUT it can be helpful.

Coming Off the Prescriptions: My Experience with Withdrawal

I am currently at the end of week six for tapering off Wellbutrin. I am following a carefully mapped out plan from my doctor (I do not recommend trying to come off of a medication without the supervision of a doctor). Once the Wellbutrin is out of my system, I will start tapering off of the Cymbalta. I am hoping to be prescription drug free by Christmas at which point I can begin to figure out a new normal for my body – and possibly start thinking about pregnancy.

Wellbutrin withdrawal sucks. Suuuuuucks. My doctor told me, “You should be very afraid. Most people want to quit, especially by week four. But you have been through worse and you’ve survived so I believe you can do it”. I needed that brutal honesty mingled with just enough encouragement.

Seven weeks ago I was taking 300 mg once a day. The first week I alternated between 300 mg and 150 mg each day. Gradually, I increased the number of days I had a half dose until by the end of July I was taking 150 mg every day. Now I’m slowly alternating between 75 mg and 0 mg.

Everyone’s experience with withdrawal is different but here are the withdrawal symptoms I have experienced thus far:

  1. Sleeplessness
  2. Body aches
  3. Headaches
  4. Dizziness
  5. Fatigue
  6. Agitation
  7. Tremors
  8. Nausea
  9. Changes in vision
  10. Confusion
  11. Difficulty concentrating
  12. Difficulty processing information
  13. Problems with balance
  14. Nightmares
  15. Over-sensitivity to heat, feeling feverish
  16. Sensitivity to light and noise (not to the extent of a migraine)
  17. Loss of appetite
  18. Panic attacks (these happened when I forgot to take my meds two days in a row but were also partly the result of triggers and flashbacks to prior abuse)

As someone who has had a headache every day since before she can remember, I will say that the headaches I have experienced during withdrawal have been unique; I can tell they are the result of coming off Wellbutrin because for the first time in my life, coffee alleviates some of the pain.

Other people report experiencing withdrawal symptoms which include: seizures, vomiting, aggression, cramps, loss of sex drive, suicidal thoughts, and an increase in the symptoms the medicine was initially prescribed to treat.

I have never been hungover but that’s the best analogy I can think to use: I look and feel hungover. I wear my sunglasses inside. I drink far more coffee than I used to. Sometimes I try to talk and my speech is slurred because my brain is not working fast enough. In the words of a close friend (and I fully agree), I’ve been “a hot mess”.

Mindy-Lahiri-Hot-Mess.gif

Let me tell you: week four for me was positively hellish. I absolutely wanted to quit.

Week four is a blur of pain, exhaustion, and confusion. I could barely function and actually had my husband drive me around because I did not feel it was safe to drive. I vaguely remember saying things like, “Why does the sun have to be so bright?” and “No wonder drug addicts don’t want to go to rehab!” and “I don’t feel human” and “Why did anyone ever let me take this drug?!” and “Shhhhhhh…” [to inanimate objects] throughout the week. Since I could not sleep at night and I felt so miserable, I ended up taking two sick days from work (I HATE taking time off) and spent all of the daylight hours asleep which only messed up my sleep cycle more.

But, I made it. Week four ended and that Saturday I felt like a new person.

On the plus side, I have noticed a decrease in my anxiety! I’ve also learned that, while it is used to treat anxiety, Wellbutrin may also “exacerbate anxiety”.

At my last week recheck, my doctor said, “If you can survive week four of coming off Wellbutrin, you can survive anything”.

Several friends have asked me, “If you knew withdrawal would be this bad, would you have started the drugs in the first place?” That’s a hard question to answer considering how very depressed I once was and how severe my chronic pain had become. My answer: I would have asked my doctor for an alternative treatment plan.

Another question I’ve been asked is, “Do you think the withdrawal is worth it?” My answer there is “Yes. 100% worth it.” I am eager to get my body detoxed and cleared from prescriptions. They helped me once but now they’ve overstayed their welcome and I am ready to start another chapter of this journey through chronic pain and abuse recovery.

Withdrawal Support

My husband, family, friends, and coworkers have been amazing during this time of my life. I do not recommend coming off of any prescription that is known to cause withdrawal without a strong support team. I do not fear the process of coming off Cymbalta, beginning next month, the way I did when I started tapering off Wellbutrin because I have experienced so much love and encouragement.

My friends are planning a “Rehab Party” to celebrate being prescription drug free. My program manager has said so many times, “Take whatever time you need” and that definitely sets my mind at ease. My coworkers have relieved me of responsibilities before those responsibilities even came to my attention. Plus they’ve had a full pot of coffee ready and waiting every morning (although, most advocates survive by caffeine anyway).

My husband goes above and beyond every day to help me, whether it’s cutting my pills in half before I’m even awake or doing chores around the house, he’s made me feel invincible. My mother-in-law, who was already an essential oil guru, did a ton of research and created what I call a “survival kit” of oils and oil blends for me to ingest, wear and diffuse to combat my withdrawal symptoms. I have her and lavender oil to thank for being able to finally sleep again. My mother, even though she’s six hours away, checks in on me regularly and cheers me on.

As with all areas of abuse recovery and mental health treatments, find support. You do not have to do this alone.

Be sure to practice self-care, too! One friend suggested that, for mental self-care as I taper off my medicines, I plan a special treat for myself at various stages like going out for ice cream or buying that book I’ve been wanting to read. That has helped me stay focused on the end goal.

Hopefully this post has been informative and encouraging. I know I am not the only one who has faced the difficult decision of how to treat depression, anxiety and/or chronic pain. If you have a similar story, I would love to hear it. Updates will be forthcoming!

For more information, visit the following resources:

Recovery.org: Wellbutrin Withdrawal

Addiction Hope: Wellbutrin

How Long Does Wellbutrin Withdrawl Last?

International Coalition for Drug Awareness: SSRI Antidepressants 

Recovery Connection: Cymbalta

Cymbalta Warning: Discontinuing May Result in Severe Withdrawal Symptoms

A Timeline of Cymbalta Lawsuits

Update No. 1: Week 11

I am no longer taking Wellbutrin and I plan to begin SLOWLY weaning off of my daily 60mg of Cymbalta (according to the schedule created with my doctor) by the end of this month.

tenor

I took my last dose of Wellbutrin eleven days ago. I felt great for the first few days! Then the weekend hit and I plummeted. I have since learned that it takes approximately 4 days for it to leave the body entirely and then, as the body detoxes, the withdrawal spikes again. It’s been a difficult week, similar to Week 4. I’ve had a hard time functioning: the vertigo-type dizziness has been almost non-stop, sleeping has been difficult, the headaches are relentless. I quote Leslie Knope a lot.

No one can say exactly how long withdrawal will last once the drug has left your system because everyone is different. I’m trying to mentally prepare myself for several weeks of slow progress. In the meantime, I will celebrate the 11 weeks I have conquered and will be back here once Cymbalta and I have begun to part ways. I have been warned that Cymbalta will be harder than Wellbutrin and that is daunting.

Update No. 2: Week 14

I did not anticipate another update so soon. I still have six days before I begin cutting back on my Cymbalta dosage. I’m nervous, to put it mildly. But I also broke through the proverbial wall of Wellbutrin withdrawal and, for the most part, have felt really good for the past two weeks. It’s a nice little break before I plunge back into withdrawal.

However, I have noticed some changes now that the Wellbutrin is completely out of my system. Primarily hormonal changes. I’ve had terrible periods since I was barely 12 years old and I’ve never outgrown acne (and I have tried every cure in the book, from home remedies to accutane) – it just morphed into adult hormonal acne instead of teenage acne. Over the past couple of years, without explanation, my periods have grown shorter, lighter, and generally far more tolerable (as tolerable as it is to bleed from a major organ for 4-8 days every month) and my face has cleared up. As I gradually came off of Wellbutrin, however, I noticed that my periods were getting worse and my (hormonal) acne was getting worse. That is, I was reverting back to my old “normal”.

Now that I’m off Wellbutrin completely I’m back to the long and heavy, painful periods and the monthly acne flareups. I can’t say I missed either one but now that I’ve put two and two together, the changes make sense.

So, if you menstruate or have acne: if you notice changes while taking or coming off of Wellbutrin, that could be why (my birth control is non-hormonal but hormonal birth control can have similar affects so be aware of that). If you have concerns it’s best to talk to a medical professional.

The other side effect I continue to notice now that the Wellbutrin is gone is that my skin – namely my chest, shoulders, upper arms, and back – is incredibly ITCHY. It’s not dry. There’s no rash (yet). It’s just a constant itching as my body. Being on Wellbutrin can make people itch when they are taking it (although that could also be an allergic reaction). I do not remember that happening when I started taking the medicine but it’s sure happening now! It could also be psychosomatic itching as a result of the withdrawal (individuals experiencing withdrawal from cocaine may have extreme itching and Wellbutrin, as mentioned above, has a similar chemical makeup to cocaine). In other words, my brain may be detecting an itch but my skin is not actually itching. Whether my brain is tricking me or not, I might need to duct tape oven mitts to my hands like Phoebe Buffay to avoid scratching.

Update No. 3: Week 15

I had a good run between the end of my Wellbutrin withdrawal and the start of my Cymbalta. What was that…two weeks of feeling human? It was a beautiful thing.

Today is Thursday and three days ago [Monday] I began the process of tapering off my Cymbalta. Hear me now: it’s been just over three days. Just four smaller-than-usual doses of Cymbalta. I’m following doctor’s orders and weaning off rather than stopping cold turkey. And I feel unspeakably terrible.

Wellbutrin Week 4 terrible.

Monday I had a type of headache I recognized from the Wellbutrin withdrawal but it was not unbearable. I did not need much more than a cup of coffee to keep myself going. Tuesday was worse: raging headache, no appetite, fatigue and agitation. Wednesday I wondered if I really have what it takes to really come off this drug. I could not handle light or noise. I did not want food. I was exhausted and irritable and eventually wondered if what I could see was real or if I was hallucinating (thankfully that happened late at night in bed, not while driving).

But I was determined to push through.

Speaking of his own experience with Cymbalta – side effects of taking the drug as well as what it was like coming off – James Evans writes:

“…it felt as if it [Cymbalta] was handed to me without warning, without indication of what it would take to quit. One in ten Americans are on antidepressants, and medication can be a viable, beneficial, and sometimes life-saving option for those suffering from clinical depression; it’s important, though, that patients are armed with a full understanding of potential side-effects, both while they’re on a drug and if they should choose to come off it” (from The Withdrawal I Experienced After Quitting Cymbalta was Worse than My Depression)

Today is Thursday, as I said, and I stayed home from work. Today, withdrawal feels like the flu. My newest withdrawal nightmare began today in the form of sudden, gut-wrenching diarrhea. So fun.

I know that getting a drug this debilitating and toxic out of my body for good is a battle worth fighting. I will keep telling myself that. I have said to many hurting people in the past, “You are worth fighting for.” Now I have to say that to myself. Daily. Hourly. I am worth fighting for.

My husband encouraged me to call my doctor and talk about slowing the tapering down more. I did because I’m about to go on-call at work for four days and I cannot be sick in bed for that. My doctor suggested I go back up to my original dose and then at my appointment next week we will talk about the next step. I went from 60mg of Cymbalta daily to 30mg and now we know that’s too fast.

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