443 - Psychotherapy and tapering off protocol

grab a cuppa...1,204 words coming ! 

I didn't blog my psychotherapy sessions from July and October, due to several reasons that I won't go into right now (might never do it). I will, however, summarize those sessions' content, and blend with to the newest one, from 14th of January 2021, because they share topics. 

If you recall entry 430 about my April 2020 online therapy session, you'll know that we had discussed coping tools during covid19's lockdown here in France. Despite many activities, as time passed and additional curfews and/or lockdowns were mandated, I struggled with them and my chronic depression flared up, especially during the summer - a season I used to go out quite often, hiking in the woods. 

We also couldn't see friends, nor family, in person, not for the fun of it nor for the practical aspects of running errands/shopping together. That started to weigh on me, both physically (due to having to do it all and carry extra) and figuratively, or rather, psychologically. 

Therefore, In October's therapy session, I asked if we could raise my antidepressants. My therapist doubled my dosage - telling me that if it was hard on my stomach, to alternate my previous half pill one day and take a full on the next day. In fact, it was so difficult, that I had to take the full dosage only every 3-4 days. 

After initial benefits from this increase, I started to experience additional side effects to the ones I had with the half pill : gas buildup and chest pains, extreme drowsiness : I often fell asleep for hours at a time.

My already declining vision became more frequently blurry, as well as further reduction in my concentration both caused me difficulties in reading and taking away one of my coping strategies. 

In December, I rang him to discuss these issues ; he told me to go back to half pill, taking it every other day for a week, and then to fully stop until January's session. 

The goal was to ascertain if my experiences were indeed side effects, or independent of my antidepressants : if they'd stopped, it'd be higher probability that they were indeed linked, but if they hadn't, I'd have had to see my GP, to investigate other possible causes. 

As most of those reduced significantly after stopping my treatment, I can be almost sure that they were indeed awful side effects to the full pill - since I had fewer and less intense ones with the half pill, taken from February to October (2020). 

During the week of weaning, I started to experience sudden, intense, and repetitive 'brain zaps'- sharp, electrical pain, shooting straight inside my head. They gave me bad migraines, and increased in the weeks leading to my latest session - the one from the 14th of January. 

My spouse found that they were common after stopping antidepressants, and that they tend to disappear after a week or two... but, when I discussed the changes and these zaps with my therapist, he said that after these 3 long weeks, they shouldn't have persisted. Since it had taken me 2-3 months to get used to this medication in the first place, he said that perhaps my body is just super slow with these things, and he set a super gentle 'weaning protocol' as follows :  he told me to resume it, at half pill, 

daily for 15 days, 

daily and omit 1 day/each week, for one month, 

daily and omit 2 (not consecutive) days/ per week, in the second month,

daily and omit 3 (again, not consecutive week days), in the third, 

and so forth, as this entire process would take 7 months, using our sessions (every 3 or so months) to update and perhaps adjust if necessary. 

He told me that if my brain zaps didn't stop within 15 days, they'd most likely be unrelated to my medication, to measure my blood pressure when they occurred, note the values and see my GP for further investigation. 

So, I resumed my antidepressants on the 15th and can already see a drastic improvement : the first day, I had fewer and fewer zaps, reducing also in intensity, and on the second day, they turned to a background hum, with no more shooting zaps at all! 

Today's the third day and third half-pill. As I hoped this morning, my brain feels less fuzzy, though not fully freed from a background hum. 

Before resuming my treatment, I was rather concerned that after the buildup of this SSRI in my body/brain chemistry, that my struggles with depression would reignite once again. My therapist reassured me that even after the end of this long-term gentle weaning protocol, there is no guarantee that my depression would flare up again, because I have learned tools that I didn't use to have, and also because my body may adjust by then and not need my medication anymore. I found that to be reassuring and hopeful. 

He reminded me that in his initial suggestion a few years ago, and again when he finally prescribed it upon my request last February, that his goal was never to cause me any dependency on any medication, but to only use it as an additional tool - a clarification I had already felt, since he hadn't insisted after my first refusal, and I told him that I already knew and appreciated that.

Other topics were covered in July, October and again January. Some pertain to personal difficulties that I haven't shared on this blog yet, and remain unsure if and how I want or could do so. In the meantime, I had very mild progress towards the end of 2020 and wish to pursue them - but I'm sorry that at least for now, I shall stay vague. 

After my therapist asked about my current situation with my various phobias, I answered that for the most part, I'm "ok" but didn't have a lot of possible triggers during these long lockdowns, but that I do feel the need to accept my CBtherapist' offer from last year, stop procrastinating and putting it off, and just ring her for a phone session, both for update and that boost in order to continue working on my tasks once again, as my CBT has been on hold since last March and first lockdown. This is due to my wish not to take risks in going to see my CBtherapist, who works in the psych department of the same hospital where they treat covid patients.

We discussed the end of 2020 ; I explained the mixed feelings about not seeing my family for xmas, the vid call to them instead of the usual visit, and the vid chat, meal and games with other friends over the holidays. I also mentioned that I felt pride in my current flat painting and renovation work I've been doing, having learnt to do some of it out of necessity, and lastly, the various art projects that I've been doing either alone, or with my spouse, and plans ahead... So, indeed, expect additional art entries in the coming weeks! 

Next psychotherapy on 12th of April, with quite a bit of to work on, read, practice and create. 

Thank you for reading this super long entry! Until next one.