Tag Archives: Generalized Anxiety Disorder

The Serotonin Misadventure

Recently, I had a misadventure with my serotonin levels. As I posted earlier, I have been on Neuris 1mg- An Antipsychotic & Lexapro 5mg- An SSRI for my Generalized Anxiety Disorder since I moved to Thailand.

Now, the Lexapro, in Thailand costs 15 times what it cost in India. Always one trying to cheap out, on my last doctor’s visit, I asked him if he could prescribe me a cheaper alternative. He prescribed me Fluoxetine 20mg instead and I happily went on my way chalking this up as a win.

After a few days, I started noticing signs of heart palpitations and sweats through the day. I had recently joined a gym so I chalked this up to the workouts. However, the palpitations became worse with time.

It was not until my family left for vacation leaving me alone with my dog at home that the symptoms hit hard.

I was in a state of constant anxiety. My heart felt it was going to burst out of my chest. To make matters worse, I took a Lexapro, too. It really pushed me over the edge and after suffering all day from a constant state of agitation I dumped my dog with the neighbours and went to the ER.

Serotonin Misadventure
Saw many such alerts throughout the day

They said I have Serotonin Syndrome, from an overdose of SSRIs. They shot me up with a sedative and sent me home with a few pills of Ativan. Ah! Bliss!

I slept for 11 hours and woke up the next day feeling much better. Things didn’t go back to normal immediately, but I could feel the improvements over the next few days; all I had to do was not take the SSRIs.

Lesson Learnt : Don’t mess with medication that work, just to cheap out.

PS: On SSRIs, I used to have vivid movie-like dreams. After stopping the SSRIs, the dreams stopped, too.

Anxiety Medication Withdrawal Fail

As discussed before, I have been on medication to treat my GAD for the past few years. I was lucky to have found a doctor who prescribed me medication instead of sending me to therapy. The medication had been working beautifully, but I always assumed that I won’t take them forever. When I moved to Bangkok, I decided to quit, as I won’t find a doctor here to continue the prescription. I put it off for many months fearing medication withdrawal. Running low on supplies, few weeks ago, I decided that that time was here.

I had been on the following medication to treat my GAD

Medication withdrawal

With high optimism and hope in my heart, I started the process of quitting, one medication at a time.

Levowave

Getting off Levowave was relatively easy. First I halved my dose for a week and then changed it to 3 days a week, then stopped completely. I had some confusion, irritability, anxiety, tremors for a couple of days but after that I was back to normal. No impact on sleep at all.

I assumed that the withdrawal for the other medications would be as easy. How wrong I was!

Buspin

I assumed this one would be the easiest to stop, but I was dead wrong. I halved the dose and in just 2 days, shit hit the fan.

  • Night 1/Day 2 – Uneventful
  • Night 2 – On night 2, suddenly I woke up at 01:00 AM with my heart beating fast, for no apparent reason. I was up for an hour, but was able to go back to (restless) sleep afterwards.
  • Day 2 – The entire day I was full of anxiety, irritable and confused. Lost my appetite. There was also a phase where I had to abuse random strangers on twitter for no reason.
  • Night 3 – Night 3 was horrible. I slept at 21:30 but woke up at 23:00. After that whatever I tried, I couldn’t go back to sleep. I either felt too hot (sweating) or too cold (shivering). After tossing and turning for hours and rousing the rest of my family, I think I finally managed to fall asleep at 04:00. Libido was also up 10x. Heart rate was above 90 bpm throughout.
  • Day 3 – Day 3 started slightly better than Day 2. I started running again, which brought back my appetite. But later in the day, my heart rate rose above 100bps doing nothing. A sense of doom & gloom pervaded my brain and I had only negative thoughts.

I Quit

Sometime in the afternoon of Day 3, I realised that I cannot go through with this and decided to go back on my remaining pills. I booked a doctor’s appointment to get a prescription to resume the medication.

Day 4 – I woke up refreshed after 10 hours of beautiful sleep. The world seemed brighter, and life seemed more beautiful.

After resuming my medication, I finally saw a doctor here. Fortunately, he was kind and patient and prescribed me medication to continue. Unfortunately, not all my medication is available in Thailand, so I have to switch medication.

After all this, I am extremely grateful for my medicines and medical science in general. I will never again take them for granted.

A Note on Mental Health

I have documented my struggles with mental health on this blog before. Considering the focus of the media on the mental health of famous people these days, I decided to write a longer rant about my own struggles.

During my college days I was a happy-go-lucky kind of guy. Although I did get depressed once in a while, I was never-ever worried about things. After college, while working a job I didn’t like, I also went through bouts of depression, but got over it quickly once I found a better job.

My second job was the best job, mentally, of my career. I had friends at work, I enjoyed what I was doing and I never even thought about work outside office. It was a shift-job where you could switch off completely after work.

It was in 2012 that I realized something was wrong. I suffered from IBS for almost 2 years. During this time I also turned lactose intolerant. I did read about the close connection between the gut and the brain, but I couldn’t figure out which affected which. After 2 years, I suddenly got better and didn’t think about it again.

Things started to go south again around 2016-17, when I wasn’t able to handle non-stresses from my work. I would lay awake at night thinking about trivial things from work, lost weight rapidly and couldn’t concentrate on non-work things. I tried things like meditation and mindfulness but nothing helped much. The mind just won’t stop racing and over-thinking.

This was the first time I decided to go see a shrink, at a hospital. I was hoping for a quick solution to all my troubles, but she prescribed me with very-expensive counselling sessions. The cost of the sessions made my issues worse, so I never went back. Thankfully, the shrink did give me a diagnosis, that of Generalized Anxiety Disorder. Eventually, this phase also passed and I forgot all about it.

I switched jobs again in 2020 and this time anxiety came back to attack me with a vengeance. It was clear that this time it was worse than before. It was so bad that I couldn’t sleep for more than 3 hours for a week straight. Sleeping aids didn’t help either.

Eventually, I decided to go to another shrink. This one was in a busy market popular with people I knew. I was ashamed to go see him. This doctor also confirmed the diagnosis of GAD and decided to prescribe me medications immediately. Within a few days, I was feeling much better. Although anxiety never went away completely, it is now quite under control, thankfully, to this day.

What I do

I use the following techniques to keep my anxiety under control

  1. Medication, which I am slowly weaning myself off of.
  2. Exercise – Even a short run helps a lot. Even walking is better than nothing.
  3. Listen to music I love everyday, without fail.
  4. Writing (Blogging)
  5. Whenever I have too many thoughts at night, I write them on a piece of paper before I go to bed. Next day I action all the items on that piece of paper and then tear it away. I found this strangely therapeutic.
  6. Stay as far away from Social Networks as possible.

I know many people have found relief with mindfulness, but for me it tended to make things worse. Maybe I was not using the tool correctly.

The Rich

On the news, I repeatedly hear stories about the struggle of famous people with mental health, especially sportspersons. Although I am happy that they are raising more awareness for mental health, the impact of mental illnesses on them is much different than it is on regular people like us.

For them, quitting means an outpouring of support and being called “brave”. For people like me, quitting would mean being called a failure, losing my house and not being able to feed my family. So no, I don’t think these sportspersons are brave for quitting. They quit because they are filthy rich & can afford to.

Not everyone can.