727 replies to this topic

[fishinghat]

Normally if I am stuck on that kind of situation I just don't go. That is a tough call and hard to make but is a one week trip worth a 2 month setback? Only you can decide that. Adding the stress of the travel, change in diet, a lot more people around and more noise would just set me back too far. If you have to go I would suggest ab extra dose of hydroxyzine/clonidine/benzo or what ever you use for anxiety. That should keep you calm during the trip. Also, just remembered, a dose of diphenhydramine (Benadryl) may help you get through the flight as well.

[invalidusername]

Hat does make a very good point. The setbacks at this stage can take longer to recover from than those who are in a more stable place. Personally speaking, I would probably be OK with the flight with some benzos, but the 5 days away from my creature comforts and my routine would take a bit of getting over.

 

One of those situations where you wish you had a crystal ball...

[frog]

I've never taken a dramamine or a Xanax or the other two drugs you mentioned so I guess I don't know how they would affect me or if it's enough to make it through the flights/travel? I'm trying to see a psychiatrist sometime in the next few weeks so which one would you recommend I ask for? 
My husband's family's house is actually very quiet and peaceful so chaos isn't necessarily a concern. And I do seem to benefit from having a little bit of distraction in the form of a couple other people around. There's also no pressure to do much of anything while I'm there if I don't want to. I think truly my biggest anxiety is about the process of getting there and back. Like I said, these are normal anxieties for me and of course during this process they are going to be extra amplified. 

Can you clarify what you mean by a setback? Like if I end up having excessive stress from the trip it would mess up the recovery? 

[frog]

Oh also I just picked up some Suntheanine from the store (Jarrow brand. is this ok?) I wanted to try since it seems like others have had success with managing their anxiety better with it. How do you recommend to start taking it? I think one dose is 100mg. Should I start at half? Once a day? Mornings or evenings? Is it ok to take if I'm also taking ashwagandha? 

[invalidusername]

Difficult to say which pills to opt for - but a good p-doc should be able to make a good call on that asking the right questions, but it is however, subject to trial and error. As a rough guide, a benzo (Xanax or Valium) is like an emergency pill. Quick onset and in most cases brings the situation under control. Dramamine and Benadryl will relax you as well, but is more of a drowsy state. Almost gets you to a mental relaxation through a physical means if that makes sense. A benzo will usually allow you to keep more awake. So I would opt for a benzo in the airport that would allow you to get through the various check-ins and boarding, and a dramamine or two for the flight itself so you get comfortable in the seated environment.

 

The hydroxyzine/clonidine route is used more for maintenance, but act in a similar way. You might find that continued use give more confidence and thus reduces the anxiety. I have never used these myself, but Hat found relief here where others didn't. Again, trial and error.

 

Hope that helps.

[invalidusername]

Regarding Suntheanine - one should be the same as another as it is a specific means of producing the theanine. It is best to take it 2-3 times a day, so to err on the side of caution (not that there is much in the way of side effects), start with 100mg twice daily. Maximum recommended is 200mg three times a day. 

 

Perfectly fine to take with Ashwagandha - but don't change doses at the same time otherwise you won't be able to tell which is causing which symptoms.

[frog]

That's very helpful. How long do Xanax effects last? Would it poop out during the flight? I'm really unaccustomed to taking multiple medications and/or supplements so the less I can get by with the better especially not knowing how they affect me. 

 

I'll give the suntheanine a shot. I poured out half the capsule for my first one just to be safe. 

[fishinghat]

"Can you clarify what you mean by a setback? Like if I end up having excessive stress from the trip it would mess up the recovery?"

Oh yea. Symptoms worsen and longer to recover. If you have never taken any of these then this is no time to experiment. In the long run you will be better off as well.

I agree with IUN on the Suntheanine. The clonidine would be a better option to me for the anxiety as it is not addictive and has no withdrawal like the benzos although one usage on the airplane there and one on the airplane back would be safe. The clonidine is very frequently used as an emergency dose (o,1 mg) for PTSD. It has worked fine for me in that application but as IUN said....Works for some and not others.

[fishinghat]

Benzos about an hour to kick in and lasts 1 to 4 hours depending on the dose and the individual. Clonidine about 1.5 hours to kick in and lasts about 6 hours.

[frog]

Thanks guys. Since I don't have a doc at the moment I can't get anything prescription so I'm trying to manage the day to day with a supplement or two. If I'm not able to see a doc before the trip I will probably stay home. I'll only be 7 weeks along then and that doesn't seem like enough time to manage a big trip without extra help when I'm barely making it to the grocery store (though I did today! for the first time in a month. Just for a few minutes and I don't think I could manage alone yet - my husband led the charge this time while I felt scattered and kind of overwhelmed - but I went and I didn't die and I made it home ok). I'm trying to push myself wherever I can to get back to doing normal things and slowly desensitize my currently overactive stress systems. I hope it's working. I would hate to undo all of my hard work and a 2 month set back is just not acceptable. We have a really big trip to Japan planned for April and I need to do everything I can to be back to normal by then. 

[fishinghat]

when I had my nervous breakdown in 2002 my therapist told me to go into immediate isolation. No phone calls and no visitors. Do things ONLY as you want to. Make a list of things that cause your anxiety to increase and those that didn't. With time I learned what I could do and couldn't. It was a slow process but it helped greatly along with cognitive behavioral skills (stress coping skills). To this day I still use the isolation technique when things are stressful and it really helps.

[Lovey]

Frog, I was reducing at a 3 bead per week pace throughout spring and summer with no problems. I hit a wall when I dropped below 40 beads per day. I was down to maybe 37, maybe lower, and started having freak outs. Extreme anxiety, panic, death obsessed, etc. Scary shit. Out of body feelings....so I added back beads and stabilized within about 3 days. If there is something more specific you're after lmk.

[frog]

FH - that's incredibly scary. For me I'm trying to just slowly push myself to do all the things I was already doing before all this garbage kicked in. Maybe I'm rushing it? I guess I don't know. We went to the grocery store this morning and then went out to see a movie in the afternoon. I survived both though there were definitely some iffy moments here and there. I definitely felt kind of wired when we got home and suddenly all the crazy stimulus had been removed. It's taken me like an hour to mellow out and my brain to stop feeling buzzy. Does this happen to anyone else? In a small way the movie experience felt like a mini preparation for what it might be like to travel on the plane! I waited in a line for snacks for like 20 minutes and then had to sit in my seat for 2.5 hours. One challenge I had was toward the end of standing in line I definitely started feeling kind of lightheaded and was starting to get a bit anxious. This has been a bit of a recurring theme with the lightheadedness. Is this withdrawal or dehydration from withdrawal? I've read Cymbalta can mess with your salt and sugar levels in your blood. I'd feel less anxious about waiting in a line or having to stand for a while if I can address the lightheadedness better. 

 

Hrk - sorry! for some reason I thought you had stopped taking it for a good while and then reinstated at 10mg or something like that. I must be thinking of someone else. I'm still trying to stabilize with the 7 beads after quitting cold turkey nearly two months ago and then getting hit with the bad symptoms 4 weeks ago. At what point do you consider yourself 'stable'? My nausea is clearing up (thank god) and overall anxiety level is improving though I still get acute intense moments of anxiety with some frequency during the day. I have no plans to go any lower with my dose until well past Christmas regardless of whether I get on a plane or not, but I'm trying to figure out if stable means feeling great/normal or if it's just some kind of point of equilibrium where things are manageable and not getting worse I guess? 

[fishinghat]

"Maybe I'm rushing it? I guess I don't know."

You are probably rushing it. Your body needs time to heal.

"It's taken me like an hour to mellow out and my brain to stop feeling buzzy."

That is fantastic. I remember that I would go to a drs office and take 2 days to begin to calm down. That is not bad at all.

"Is this withdrawal or dehydration from withdrawal?"

It could be and probably is both.

I know you are probably not going to believe this frog but you really aren't doing too bad. It will pass.

[invalidusername]

Absolutely - this is some great progress. I would be wary of the the big trip knowing this progress is at stake. But if you choose not to go, you absolutely must not see it as a failure. You have run a marathon and you don't just go off and run another one. No - you need a rest. And during this rest, you focus on the achievement at hand. In terms of the anxiety, you are doing everything right. You are meeting exposures head on, and braving the tough parts. But the trick here is to not get complacent as it will result in a setback. It is a fine juggling act - just as it is with my stress, but sometimes life hands you these things and you don't get a choice. For example, I was doing well for 3 weeks straight, then I had the brakes fail on my car and then headaches and eye issues which required me to have immediate medical intervention. I held it together through this period, but this weekend when all is now said and done, I have hit a wall. My stress wall. This is my trying and testing time. It is not the fact that it has occurred - it will happen to anyone in my position, it is how I deal with the symptoms it has caused.  

[frog]

Thank you both. FH I think I'm starting to see that I'm doing ok. The past couple of days have been much better overall but I feel like it's hard to relax because I'm waiting for the other shoe to drop in a sense. I know it's going to get worse again soon. 

 

IUN what do you mean by getting complacent? Like getting too used to things feeling better? 

[invalidusername]

"I know it's going to get worse again soon."

 

Well this at least means you are not getting complacent! Yes, meaning that you think you are home free after a few good days - but by the same means, you shouldn't fixate on when the next rough patch may come about. Withdrawal is trying to be as close to a glass half full approach rather than a glass half empty. Withdrawal is up and down all over the place, but it slowly gets there...

[frog]

Funny enough I think I may have hit the patch. I had some gastro distress again today which of course jump started the anxious feelings. We still went outside for a quick walk down the street to pick up some breakfast, but it was taking a long time for the food to be made and I started getting extremely hot, and restless, and anxious about my stomach suddenly betraying me. Luckily the cafe had a bathroom. I felt a tiny bit less anxious after that. My stomach definitely contributes to a large amount of my episodes of anxiety. We made it home, I've calmed down a bit after crying to my husband about all of it including Christmas. 

Is anyone aware of Ashwagandha causing gastro problems? I did a quick google and apparently it's a potential side effect. Should I stop taking it and see if my stomach improves? I've been trying to take just 1 at a time (300 mg) but last night I took two to help me sleep and then 1 again this morning. I also just started taking Suntheanine as of yesterday. 

By the way I think splitting the dose in 2 might have helped with the nausea. I still have almost no appetite but at least I don't feel like throwing up after every bite of food. 

[invalidusername]

Frog... as said before... don't be changing the doses while experimenting with other supplements! You will not know which is causing which effects. While you introduce the Suntheanine, you need to keep the Ash at a steady dose. GI upsets can be a side effect in higher doses, as can anxiety and depression as it happens. But the correct dose for this - and timing thereof - needs to be established before throwing Suntheanine into the mix...

[fishinghat]

IUN said it well. One thing at a time and see where you land before trying the next one.

[frog]

Fair enough. What should I do? Cut the Ash or the Suntheanine? I feel like I only had a somewhat established routine with the Ash. I was taking it twice a day. One pill in the morning and one in the evening. Last night I took it closed to bed time and took 2 to hopefully get better sleep. I think it helped because I slept longer but I had more gastro issues so far today than I did yesterday too so maybe two is too much but what a trade off! A reliable stomach for better sleep? Yipes. 

[fishinghat]

It isn't just a matter of too much ash causing the stomach issues. In addition serotonin (which Cymbalta controls) is most common in the stomach and intestines. They are very sensitive during withdrawal.
Drop the Suntheanine and stay with a set dose of one ash in the morning and two at bedtime (sleep is important) for 2 to 4 days and see where you level out at. If the stomach issues persist then drop to just one at bedtime (and one in the morning) for a few days and see if the stomach issues continue. After that you can decide what to stick with concerning the ash and consider moving on to the Suntheanine. Just my thoughts on the issue.

[frog]

I think that's a great idea. I did a little Googling about my specific gastro problem and... wouldn't you know it, but it says it can be a common symptom of anxiety. Too much anxiety = sped up digestive process = not properly transforming fats and other nutrients from the food as they should be. 

I was hoping this part would have been better by now but the nausea has lessened so hopefully this is the next one to go. I guess in the meantime more imodium? 

[fishinghat]

Nausea seems to fade before the rest of the stomach issues so just hold on.

[frog]

It will be a glorious day when it goes. Once the nausea/stomach issues go away do they go away for good or do they come back around like the other symptoms? 

Also when I do eventually begin my taper down from the remaining beads, do you think a lot of this stuff will get bad again or do you think since my brain has pretty much adjusted to the worst of it by then, the remainder will go smoothly as long as I take it real slow? 

[fishinghat]

The stomach issues sort of fade in and out until they fade away. The stomach issues tend to be replaced by the emotional instability. These symptoms will come back some as you start weaning and others will appear but even stronger. (Usually) The longer you stabilize the less severe the next step down usually is. If I had to do mine over I would plan on a three year wean. 6 Months to get down to 10 mg and 2 1/2 years to wean the rest of the way.

Now this is just my opinion based on the suffering I had and seen in others, if I was you I would drop around 1 bead a month once I started again. Definitely takes a lot of patience.

[frog]

... Ouch. Can you elaborate on this emotional instability? Truthfully I thought what I was already dealing with was the worst of it, with the crazy anxiety. I didn't think there were still NEW symptoms to come? What's come already has really been tough as it is. 

 

Also re: the weaning, the anxiety and stomach issues and emotional stuff will come back each time I drop a bead? AND there will be other new things as well? That's a hard pill to swallow I have to say. 

[fishinghat]

Let me clarify. Typically where you are at in the process each time you drop a bead your existing symptoms will of course worsen with the possible exception of the stomach/GI issues. They may flair up some but not a lot. They are the first to go. Your anxiety will probably get a little worse right after the drop, you may have some bouts of depression (this varies a lot), as you drop you will find massive crying spells for n o apparent reason. As you hold at this level the symptoms will slowly improve until you drop the next bead BUT if you hold at a certain level for a long time until you feel much better (not just able to push forward and drop another bead) then these surges in symptoms are much less when you do drop the dose.

I have a hard time to explain to people that when we say stay at a certain level until stable and then drop some more I am not saying that you are tolerable or not getting worse. I am speaking of feeling good for at least 3 or 4 days in a row. Then you can consider dropping more beads without such a terrible spike in symptoms. Sometimes that requires a wait of a month or two before dropping another bead. The longer you wait the more your body heals and the more prepared it is to handle the next drop.

I will give you an example. I was put on a massive dose of lorazepam (a benzo) to help with mu withdrawal (long story). It did not help so I had to wean off. Most people and drs would say to take a year to wean off. That would be a year of hell and a few moths after the wean before recovering. I am doing a 6 year wean (almost done) and gone so slowly that my symptoms are barely noticeable and I have been able to lead a normal level and feel well. The problem is that most people would find this unacceptable and would not have the patience to deal with this. On the other hand I find suffering unacceptable and will gladly take my time. lol

[frog]

Thanks for clarifying FH. I don't plan to rush anything with the actual taper part. And I plan to continue on the 7 beads at minimum until after Christmas if not longer. Even though a bead a month means I would still be on Cymbalta during our big trip in April, I'm just going to have to be ok with that. 

 

I understand better what you're saying about being stable. I've been seeing improvement over the last week but I have more to go before I can even consider dropping. 

 

I guess I thought you meant that at the level I'm at, at the 7 beads, without touching anything, I still have more new symptoms on the horizon. So if that's not what you meant then that's a relief. Because I really feel like I am stabilizing slowly now. The anxiety is pretty reliably concentrated in the morning, and then it's still ratcheting up pretty intensely when I start to get anxious about something specific. But it's more predictable and it does seem to let go fairly quickly (an hour or so) once the catalyst of the anxiety is removed. A big improvement compared to a few weeks ago when I was anxious all day long no matter what I was doing. 

 

I think if I'm able to be feeling good before the drop, it'll make it easier to deal with any smaller relapses in symptoms because I will have already had good days to lean on and I can attribute the change to the drop in dose rather than just random symptoms out of nowhere which is more discouraging and disorienting. 

[fishinghat]

"I guess I thought you meant that at the level I'm at, at the 7 beads, without touching anything, I still have more new symptoms on the horizon."

Unluckily that is what I meant but the plan is to minimize them.