Alice wrote:

I was wondering, is it possible that going off 30mg of Paxil cold turkey may have affected me neurologically?

My response:

Yes, it may have affected you neurologically, and I often wonder the same thing, whether my cold turkey experience caused permanent neurological damage. And, despite my optimism at times, I don’t really know the answer to that question.

I have been off Paxil since November, but I am still feeling the effects of the withdrawal. Maybe the cold turkey withdrawal did cause permanent damage of some kind. I’m not sure. I can only wait and see how things go. My body and my mind have gradually been readjusting to being Paxil-free, but, for me, the adjustment is still going on, so I’m not able to say how permanent any of the damage is yet.

I can’t judge my level of anxiety or my mental state too well right now either because there’s nothing about my present situation which is socially normal. In February I tried to get back into the real world and find a job, etc., but I got hit with extremely bad headaches for a month before I finally had to come back to where I am now, out in the middle of nowhere, sitting around doing nothing, feeling useless.

My problem hasn’t been anxiety, per se. What I’ve been experiencing is extreme muscle tension, especially in my head and neck, but not exclusive to my head and neck. If you know how to crack your knuckles — my whole body makes that sound. I’ve tried to describe this before, but I’m afraid of sounding like some guy who wears a tinfoil hat to keep the alien signals from penetrating his brain through the fillings in his teeth. When I describe this stuff, it seems as crazy to me as it does to anyone else. But imagine the sound of your knuckles cracking. I get that around my head. My head feels like it’s filled with wet cement. It’s not like the electrical shock sensations, but it’s not much better either.

And that’s what I’ve been dealing with since February. Although I will never take Paxil or anything like it again, I had to give in and take a heavy-duty muscle relaxant to help with my present condition. I don’t have headaches or hypersensitivity to light and sound anymore, but neither do I feel like a normal human being. It kind of gets to you after a while (my first withdrawal experience was last July).

For the past week I’ve been trying out some breathing and muscle-stretching exercises, even some meditation sort of stuff, and it seems to help although I’m not too good yet at sticking to it. I hate resorting to this sort of thing. It goes against the whole grain of my personality. Waking up every morning and meditating before I start my day? Give me a break. No offense to anyone who meditates, but it’s just never been my kind of thing.

But this is what it’s come down to for me. If I want to get on with my life, and get on with a good life, I have to change the way I live. No more bacon and eggs every morning for breakfast. Now it’s yogurt and a piece of fruit. That kind of crap. I feel like a schmuck. But that’s just my tough luck. I have to learn to eat healthier, live healthier (no booze, no cigarettes, no “recreational” drugs, no caffeine) — all that jazz. Next thing you know I’ll be wearing tie-dye shirts and playing “hacky-sack.”

So I have extreme muscle tension instead of “social anxiety.” Or maybe I have both. But whatever it is, it’s probably my body’s way of saying, “You can’t keep living the way you have.” And I know it’s the truth.

And I have never felt more lost than I do now. I don’t know what the hell I’m doing, what the hell I can do, or what the hell I’m going to do next. It’s like someone who’s been writing on a typewriter their whole life and then given no choice but to learn how to use the latest version of WordPerfect or MS-Word. Go under “File” and select “Save As” and all that crap. I just want to write! You know what I’m saying?

But to bang home again what I’m saying here, whether it’s post withdrawal anxiety or muscle tension — or migraine headaches, digestive problems, chronic fatigue, fibromyalgia, eczema, sleep disturbances, asthma, muscle spasms or any of the other stress-related ailments — I think the message is loud and clear: “You can’t keep living the way you have.”

The solution is not as simple as taking a little pill. It’s a new lifestyle. I have to pay closer attention to my needs. I have to take better care of myself now, and that requires a willingness, a commitment really, to change. And when you’re 31 years old and used to living a certain lifestyle that has worked well for you for many years, it’s like trying to learn a new language. That’s the closest thing to a theory I got going right now.

First response:

Thank you so much for writing down your experience. I’ve been completely off Paxil for a year, having withdrawn slowly. I started to feel the effects over a year ago and I’m still going through withdrawal. I was on 40mg for a year, so I don’t know how long it’s going to take, but I think we all have that familiar refrain running through our heads of: “I just want my life back.”

I was also thrilled to read your earlier description of how time seems to expand and contract as this stuff goes on in our bodies — that’s something I was talking about with my doctor and with my family… and it’s not really understood. It’s got to do with disassociation. And thank you also for making the connection with epilepsy — I’ve always thought it was me creating metaphors trying to understand a body going through war, but it may be more literal than I thought…

I am lucky to have a supportive family, but I still hold them to such high standards. We need to let go of expectations and just accept the love they are capable of. And my doctor, well, he initially thought the withdrawal was a depressive relapse, and now that a psycho-pharmacologist acknowledged — in what felt like a really blasé manner — that what I was going through was withdrawal and not relapse, my doctor is now telling me to stop focussing on it and start focussing on living. He worries that by writing and reading the postings on the Paxil withdrawal message boards that I am wallowing. I know better.

Thanks again for your site and your story!

Second response:

Thank you for telling your story.

I am a professional writer, but have been in the lion’s mouth too deeply to write as you have. To read your story pierced me with its awful familiarity, and gave me courage. Most of all, reading your words helped me not feel so insanely alone. You have made a friend in me, and although you may not know it, I am sending you the good thoughts of one who is struggling for some kind of faith in this Paxil purgatory.

Basically, we are more or less “contemporaries” in our Paxil experience. I am just short of one month off the poison. I started taking Paxil in February 1999, and it bruised me from the start. I went through my first withdrawal in August/September 1999, but since my shrink had said nothing about problems I might encounter, I thought it was a nervous breakdown. I then tried to taper last summer which was aborted and then another doctor ramped me up to 45mg.

This January 1st I began a slow tape. I’m now using Trazodone, Valium, and Xanax to manage the “fresh hell” which greets me each day.

Your story touched me to the core. I admire your strength in even being able to write your story. Also, I think you’re a damn good writer.

I have a brave knight of a husband, and several stalwart friends, not to mention a fine psychiatric nurse, all of whom have helped hold me up. But I have no one in my life who has experienced this GlaxoSmithKline hell; finding your site has been a real comfort. Your understanding that suffering can have meaning, and that one can not only survive, but live to tell the tale brings me to a better place. I could quote from your writing here, but I think you get the picture. Thank you.

My response:

I appreciate everything both of you had to say. I think it’s fair to say that I can relate to everything you shared in your messages about your withdrawal experience, and it’s always good to hear from other people who know what I’m talking about. I’ve been Paxil free since mid-November, and even though I’m am gradually getting better, I can still physically feel it in my head and my body that I’ve been through a major neurological and physiological trauma.

Trying to describe some of the post-withdrawal effects to people who haven’t experienced it — well, I just don’t do that anymore, because I don’t need people looking at me like I’m nuts. And I’m not sure if I blame them; it is so difficult to find the language to describe what this stuff is like that even our trusted medical professionals think we’re nuts when we give it a try.

Anyhow, we’re not nuts, and I’m glad you were able to relate to what I wrote on this blog. That’s the reason it’s here.

This is something I wrote in an email today. I don’t have the energy to explain the context of the conversation, but basically it’s about the paradox of beginning to feel healthier, having survived my withdrawal, but instead of feeling better, I feel an apprehension, not necessarily a resurgence of depression, but a kind of insecurity.

I wrote:

“At this point in my life, recovering from my Paxil Experience and about to return to life as I used to know it, I feel an apprehension, a feeling that the foundation I used to stand on, my personal history (which has been sort of blank since last July when my withdrawal began), that my history (the experience that makes us) isn’t there as firmly as it used to be. And it’s almost as if the healthier I become, the more insecure I feel.”

First response:

I can understand wanting to get back to “normal” in a hurry, but sometimes it just doesn’t work like that. Slow for someone else may not be slow enough for you. The one thing I have learned is that I now take as much time as I need to get over some things. Like at this point in my life I am still kind of getting over the shock of how the person I was seeing before my withdrawal experience ended our relationship. It has been about a year and a half and I am just now slowly beginning to trust people again. That is how much time I needed for it and maybe even a little more.

Do you know just this past year I have met men that actually admit to crying? I know it feels bad but it is really a good release. I do think from reading your posts and what you’ve just said that you need to say “stop” and try to start with the little things, like how the sky looks. I still have this “awe” for things, it’s so hard to explain.

In a previous message I mentioned feeling suicidal at times. I know that’s the kind of thing that scares people off, but most people who go through this kind of thing eventually get around to feeling something like it. The problem with actually admitting it out loud is that people think you’re crazy — and nobody listens to crazy people, right? (Right.)

But the fact that I can say it out loud demonstrates, I hope, that I’m probably more healthy than the people who don’t say it out loud. And the last thing I’m going to do is smile and pretend everything is a.o.k. when it isn’t. I see people every day like that who are living in Disneyland and it’s a way of life for them. (And between you and me and that wall over there, these are the people who are nuts. Seriously.)

Despite all the depressing things I’ve experienced because of the Paxil, I am not depressed. Believe me, I know depression, and this isn’t it. This stuff is a headache, and there’s no joy to be found in any of it, but my personality is still relatively intact, and I’m not depressed.

When I’m genuinely depressed (which I don’t think I have been for a long time), I don’t want to do anything (that’s one of the things about it). What I’m experiencing from the withdrawal may be similar in that I’m not exactly animated — in the run of my day I do pretty much nothing. I try to read and I try to write as much as I can, but otherwise, I’m a walking turnip; I’m useless. (I’m also lucky to be in a position where my responsibilities are minimal. Yes, I admit it, I’ve had to move in with my parents who are nowhere close to rich but who have a big house and who feed me well and pay all the bills. I know how lucky I am to have them at this time.) But I think most of what I’m experiencing now is the withdrawal, not depression.

Unlike depression, I have the desire now to move, to do things, to live. The desire is there — underneath all the Paxil withdrawal crap, I can feel it there. But when you’re so wired up waiting for the next electrical brain zap to kick in and wipe you out (and other such wonderful conditions of the Paxil Experience), it’s hard to have enough energy to care about that desire, to give it the attention it deserves, to nurture it and to go with it. It takes energy to care, and to live and to make something substantial of that desire. And for me — stuck in the middle of Paxil withdrawal — that energy isn’t there.

I think my spirit is still intact, but everyone needs some kind of fuel to keep them going, and no matter how good-natured I’m able to be, the fact is this: I’m all out of gas. The Paxil withdrawal is using up all of my fuel. Psychic fuel, spiritual fuel, whatever you want to call it — my tank is empty, and I have Paxil to thank for it. I may be bumping around like zombie half the time running on empty, but that doesn’t mean I’m depressed.

My desire to be alive is well intact. But it’s like a car without any gas. As long as the Paxil withdrawal is burning up the fuel, I can’t expect to get any further than the end of the driveway. That’s not depression, though; it’s an empty tank. (I know, I’m repeating myself again.)

And to belabour this point even further, sometimes when I’m scrounging around for some fuel to burn — and being in the middle of Paxil withdrawal is like walking through a desert — it’s easy to feel like, “Man, I’m a goner. No water to drink to quench my thirst, and no fuel to burn so I can start up my car and get the hell out of this place. I might as well just close my eyes and die. There’s nothing here to save me. I’m already dead.” Those may seem like the words of someone who is depressed and suicidal, but that’s not necessarily so. Crawling through a desert like this, who the hell wouldn’t feel like that every now and then? That’s not crazy — that’s normal. It’s human.

And that’s the important thing to recognize. Without it, I would be depressed and I probably would be suicidal. But I know that ALL OF THIS is from the Paxil withdrawal, not necessarily from some underlying depression. (I’m just speaking for myself, remember.) That’s the knowledge that gets me through all of this crap. There’s withdrawal syndrome and there’s depression.

I’m glad I know which is which.

And just to be on the safe side, I am seeing a doctor once a week to make sure that if I do become depressed and genuinely suicidal (which, under the circumstances, would be understandable, even though I think I have a pretty good handle on it), I’ve got someone looking out for me. But so far so good.

Sorry if this turned into a rant.

First response:

Rant away! I could read your posts all day — you’re hilarious! You sound very healthy and funny. More healthy than a lot of “healthy” folk I know.

Second response:

I understand exactly what you’re saying about the suicidal thoughts not being connected to a depressive state. I went through a few weeks of that also. The scenario would go something like this: Early morning brain zaps, a little vertigo, uh-oh, no milk for coffee. Think I’ll kill myself instead of going to the store. Uh-oh, it’s snowing outside. I don’t feel like leaving the house. Think I’ll kill myself. “You’re making what for dinner? I don’t want pasta. Think I’ll kill myself.” It all seemed perfectly logical to me at the time. My husband had to hide the knives for about a week because I’d be standing at the sink doing dishes and the next thing you know I’d have a 12″ chef’s knife at my jugular and very calmly announce, “I think I’ll kill myself.” It was as though there was this little voice in my head whispering, “Okay, NOW!” It was very frightening, but I knew it was the Paxil, and it did pass — like everything else in life. I spent a lot of time in bed with the covers over my head during that period of withdrawal. I figured the worst that could happen to me is that I’d smother from the down comforter! I laugh about it now, but it wasn’t even remotely funny at the time.

Postscript – February 7th, 2001: Despite the knowledge that almost everything I was feeling was being distorted by the Paxil withdrawal — that it was the Paxil withdrawal and not me — I had moments where that thought wasn’t much of a comfort and, to quote André Gide, “Despite every resolution of optimism, melancholy occasionally wins out…” Just after my first withdrawal experience in July, there was an incident where if there hadn’t been anyone in the house at the time, I may very well have taken my life. (I know how you’re probably reacting to reading this. Note: I’m having the same reaction.) This aspect of my withdrawal experience has, I think, left the greatest impression on me. Having lived through it and survived it, it still scares the hell out of me. Despite my optimism, I probably was suicidal at times. In December 2000, near the end of the weaning process, I was feeling so beaten down by the experience that, despite everything I’d been able to deal with, I felt like I couldn’t take it anymore. A human being can only take so much. Nothing has ever pushed me so close to the edge, and it still scares me to think about it, the recognition that I have a breaking point — the ultimate breaking point where there is simply no will to live. I have survived this experience, but sometimes I have no idea how I did it.

Doug said to a previous message:

This is an excellent response. I agree. However, I must state that I took Paxil for almost 3 years and it seemingly worked wonders for me… for a while.

The people I know personally (not through email or through paxilprogress.org) who took Paxil for extreme anxiety and panic attacks — every single one of them ended up taking on that “sedated” look I mentioned before. And there’s no way that can be good. All of them say they couldn’t live without Paxil, regardless of the weight gain and the sexual dysfunction it causes them. But neither have any of them done anything else except take Paxil to take care of themselves. They’re still living off coffee and cigarettes like they’ve always done. So, in a way, they got what they deserved. Nothing gets better in the absence of a willingness to change. Taking a little pink pill only delays the inevitable.

The calm that Paxil may provide can offer one the opportunity to work on the anxiety, but the anxiety will come back if one doesn’t actually work on it. This is something I see happening with many people, as well as having lived through it myself. It doesn’t take much to figure this one out.

I agree with you that Paxil can and often does make a difference at first. I have no doubt about it that Paxil did help me at one point; it helped me get through an extreme crisis situation, extreme stress, extreme anxiety, all during a time when my coping skills were not so good. For the duration I was on Paxil, I did everything I could to get my act together — and now, except for the anxiety related to the withdrawal, I do have it together (I hope). When I think of how I was, say two years ago, I am amazed at how far I’ve come, how effectively I deal with anxiety and stressful situations when they come up. I’m not 100% all the time, but who the hell is? (Nobody.)

I haven’t a single doubt that the makers of Paxil deliberately perpetuated a fraud by not fully informing the FDA, doctors and the public of the withdrawal effects of Paxil — to this day they clearly misinform doctors (the ones prescribing the medication) by telling them that Paxil is not an addictive drug, that there is no risk of physical and psychological dependency. Bullshit. And everyone who’s experienced Paxil withdrawal knows it. Like you said, “[It] has been an absolute nightmare getting off it (and there were side effects).”

You said:

I spent a good portion of my life avoiding most social situations, and am finding myself back there again. Only now there is the withdrawal and all of its symptoms on top of that. And I did a lot of work to get over all that when I was on Paxil. So, I’m very disappointed in the overall usefulness of the drug.

The same thing has happened to me. I find that I do experience some anxiety in social situations, or in anticipation of social situations. Not all the time, but when I do, there’s no doubt about it, it’s there. But I don’t relate this entirely to any previous condition. I think it’s due in large part to my Paxil withdrawal.

At the moment I am weaning myself off the Paxil and am down to 10mg (alternating between 5mg and 10mg). At least half of this past month I’ve been a walking zombie. Talk about being out of it; my brain has felt like mash potatoes. The last few days have been surprisingly smooth, but I’m only down to 10mg right now — that’s halfway there. My body is going through an extreme physiological adaptation now. Everything is out of whack. Experiencing some of the old anxiety doesn’t surprise me.

It’s my feeling that when I finally get the Paxil out of my system, and I’m exercising, taking my vitamin supplements and doing all kinds of other good things to keep myself healthy, the anxiety that I occasionally experience now from the Paxil withdrawal won’t be as common; it certainly won’t be debilitating. And the same may be the case for you.

Also, having taken Paxil for three years, even after you’ve taken the last pill, I’m inclined to think that it could take several more months before your body and your brain have flushed all the Paxil out of your system and have readjusted to living without it. Three years is a long time to be on Paxil (any more than 6 months is a long time if you ask me). I think the longer a person is on Paxil, the longer it will take to get over it.

Paxil can play a positive role in dealing with certain types of anxiety, but, again, it should always be a last resort. I can’t see what the good is if trying to get off the drug is worse than the problem you took the Paxil for in the first place. What a scam, ah?

Postscript – February 6th, 2001: In this post, I said, “I think the longer a person is on Paxil, the longer it will take to get over it.” This isn’t necessarily true. Everyone is different.

P.S. (Sept. 2006): Wikipedia has an entry for social anxiety. It may not be a simply a marketing slogan. However, treating social anxiety with Paxil or other SSRIs should be a last resort. Paxil is the easy fix; it requires absolutely no work or will power. So it’s very attractive. But from my experience, the risks aren’t worth it. It’s been almost 6 years since I stopped taking Paxil, and I can still feel the effects of the withdrawal. Here’s a quote from the Wikipedia article:

Research has shown cognitive behavior therapy, whether individually or in a group, to be effective in treating social phobics. The cognitve and behvioral components seek to change thinking patterns and physical reactions to anxious situations. This may be done through a technique called role playing. Prescribed medications consists of a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Such treatment has a high response rate and low risk of dependency [sure it does] but has been criticized for its adverse side-effects and possible increase in suicide risk.

Attention given to social anxiety disorder has significantly increased since 1999 with the approval of drugs for its treatment. Marketing campaigns by pharmaceutical companies may be largely responsible for driving this.

Paxil should be an absolute last resort. Communicative therapy (a.k.a. talking) should be tried first. Then there are dietary changes that can make a difference to all kinds of anxiety. You can take vitamin supplements like B-complex to begin with. If you drink caffeine, stop now. Alcohol and cigarettes don’t help with anxiety either (but if you smoke, don’t try quitting while you’re trying to quit something else; trying to quit two things at once will wreck anyone). Making sure to get daily moderate exercise can make a difference. Try a herbal remedy. Listen to good music. Breathe fresh air. Get out in the sunshine.

Speaking from experience, these are basic things that can make a huge difference.

But it’s easier to pop a little pink pill than it is to actually make any real effort to take care of oneself (hence, we have close to two billion dollars in sales of Paxil last year).

It’s easier to take a pill than it is to actually face the fears underlying the social anxiety.

No offense to anyone suffering from panic disorder, but “social anxiety” sound like another made-up term by drug companies. I’ve been shy my whole life. I know what it’s like to be anxious around people and or large crowds. But that doesn’t mean there’s something wrong with me. I consider it a natural reaction to the madness of crowds.

Working to ease my shyness took some time, and although today I am aware that I do have this tendency to become anxious in social situation, it doesn’t bring everything I want to do with my life to a halt. I value all of my relationships and I am glad to be around the people I choose to be friends with, but I also know when I could use some time alone. I may have a certain shyness to my personality (although most people who know me socially would probably find that hard to believe), but there is nothing wrong with being this way as long as it doesn’t control my life. “Social anxiety” is a marketing slogan, a stigma that deliberately shames people into thinking they need these medications. It helps sell Paxil and other SSRIs.

If you experience “social anxiety,” it doesn’t mean you’re sick. All it means is that you’re sensitive. Big whoop. There is nothing wrong with being a sensitive person. Screw it — I’ll go as far to say it’s a good thing. My sensitivity has caused some anxiety at times, but it’s also given me a sensitivity to the feelings of other people in my friendships and close relationships which has enriched my life in ways that Paxil never has. I’m more of a one-on-one person; I’m not a group person. So what?

If Paxil is the last resort for you — I am in no way recommending Paxil — but if you decide to take the Paxil, remember that the more you take and the longer you take it, the harder it will be to get off it. If your doctor tells you something different, then your doctor can join the thousands of other doctors who are completely uninformed and misinformed as to the withdrawal effects of Paxil, and you’ll want to go see another doctor immediately. Paxil withdrawal is hell. For a substantial number of people who take it, Paxil is not an easy drug to get off of. That’s the first thing you should know.

The second thing is, if you do take the Paxil, don’t just rely on the Paxil. If it provides you with some kind of calm, take advantage of that calm and work on your anxiety. (I know plenty of people who take Paxil and then sit on their butts the whole time, never taking any action to actually deal with the anxiety or depression they had in the first place. All they do is take Paxil, and within months they begin to take on the look of a person who is medically sedated.) If you decide to take the Paxil, it would be beneficial to put yourself in situations where you can develop the coping skills (sometimes known as social skills) to ease the anxiety so that you can be relaxed and be yourself where before you used to feel anxious. If you don’t do this, and eventually you want to get off the Paxil (and seeing how hair loss and sexual dysfunction are common side effects of Paxil, you may not want to live with it forever) — when you try to get off the Paxil, all of the anxiety will come back, and on top of the effects of Paxil withdrawal, it’ll probably come back with a vengeance.

So if you do take the Paxil, do it right. And be informed.

Hope that helps.

Response:

I would like to tell a story which I think some may find more informative than your message.

While this drug may or may not help people, it does fall under a new classification of “life enhancing” drugs that has only really been around for the last 30 or so years. The aggressive marketing of this drug towards the general public is at best circumspect and possibly heinous in its design and implementation. In reading some of the legal documentation of the lawsuits currently in the courts, I noticed that Glaxo SmithKline refuses to accept the term “withdrawa” and instead uses only the term “relapse” in their dealings with plaintiffs. I know what I went through (and what most EVERYONE on this board is either going through or has been through) was a “withdrawa” from a drug.

Now the ethical question: Does the fact that a drug company knowingly refuses to use a proper term in order to protect themselves legally outweigh the use of a term of demeaning tone and inference, especially when it is used to describe the said product whose usage, after stopping, made me feel like “crap” (there are worse terms) for several months afterwards and most importantly: which use of language is more justified?

You see, it isn’t the situation that is the problem, but the language (and the fear of the language) that hides the problem.

P.S. (Sept. 2006): I seemed to have no problem giving advice in this post. I’ll be making some cuts if I find too much of that going on in future posts. I question how qualifed I am to give certain advice. Some people do have serious social disorders that require medication; otherwise, they couldn’t function. I wouldn’t want to be dismissive of that. My life is still affected by my so-called social anxiety. It does hold me back at times, and I’m not happy about it. But I’ve managed to live with it. It’s a part of who I am.

Angela wrote [on a forum similar to paxil progress.org/forums]:

It has been three weeks since I have been off of Paxil. I’m terrified.

Every now and then I feel some withdrawal symptoms, nausea, severe headaches and total lack of focus and concentration. But what scares me most is the way my mind is working.

I have been so angry lately, I lash out at my friends, I already lost one, and almost lost my best friend because of the horrible things I was saying. I just spoke to my boyfriend, and hung up feeling terrible, because I keep having mood swings. One second I want to hurt someone, I want to punch, kick scream, anything — the next, I am sorry for feeling this way, and sorry for acting the way I do. Is this a result of a chemical imbalance created by the Paxil? Wow. I wonder if the chemistry of my brain is going to remain in this “schizophrenic” trance.

While I am no longer feeling depressed, I feel trapped. Like I’m in a jail, and I want to break through the walls that surround me. I want to kill myself because I am afraid of what I might do, who I might hurt, that I am a truly horrible person and that I do not deserve to live. I don’t know what to do, or think, or say.

Susan wrote:

My advice is not to be alone too much, and not to let your thoughts dwell on dying. You are not a terrible person — keep reminding yourself what you are going through, that it’s the Paxil withdrawal, not you.

I haven’t quit yet — I just lowered my dose from 10mg to 5mg every other day. About a month ago, I lowered my dose to 10mg and I noticed the ANGER more than anything. I don’t think I have any more anger inside me than the average person, and possibly less, but I felt furious for about a week or two. And I noticed that the worst seemed to be that time before my period. (The Paxil may have been buffering my emotions during that time.)

My boyfriend was over one evening, not feeling well himself, and said something that I normally could have handled, and I slammed the door behind him when he left. We tried to talk a few days later, but it didn’t go well — then we didn’t talk for nearly two weeks, but are now back on track.

My point is, I’m sure the change in my neurochemistry had a lot to do with it. I was so upset one evening, I got into the word processor on my computer and wrote down, “I am angry…” and then a list of all I was angry about. I came up with 23 things, and intended to come back to it. And a lot of the things were not concrete things that had been done or said, but my perceptions about what others thought about me, and the INJUSTICE of it all! I really felt vulnerable. (I am a little nervous about this upcoming week of my cycle.)

Please be kind to yourself, even if you are having a hard time feeling kindly towards others right now. If you had a daughter and she were experiencing what you are experiencing, how would you want her to think about herself? Try to be a kind parent to yourself. Take care.

My response:

Experiencing irritability problems? Kind of feeling like killing someone else or killing yourself? At this moment in time, I think I can relate…

The number one thing to do right now is not kill yourself. I’ve been weaning myself off Paxil for 41 days now (I’m almost down to 5mg), and that’s 41 days of my life not being mine. I’ve been smiling patiently the whole time, but I am so sick of it that I am ready blow, I am ready to lash out, and I have days where it seems that the most reasonable thing to do would be to kill myself. The clarity of this thought when it’s there is — how do I describe it? Talk about a mind trip. The only thing that keeps me going is the knowledge that everything I’m experiencing is being caused by the Paxil withdrawal, and that eventually the withdrawal itself will withdraw. I don’t know when, but for now I know that what I’m feeling isn’t my fault, and that I’m not crazy.

At the same time, while I know that I’ll be enduring this for some time to come (and I hate it that my life isn’t mine while this is happening, that I can’t even begin to live my life the way want to while this junk is making me into a zombie) — at the same time I know what I have to look forward to (it’s going to get worse before it gets better). On top of the frustration I naturally feel from having my life made unproductive, uncreative and useless by this wonderful little pill, I’m beginning to experience the irritability that comes from withdrawal — and it’s the kind of irritability where I don’t even want to look at some people, I don’t want them to look at me, I don’t want to listen to them open their mouth and say something stupid that I don’t have the energy for. I have become one big ball of sunshine. I have moments where I feel I could grab some people by the head and break their neck, or just punch them in the face and knock them unconscious so I won’t have to deal with them.

Kinda scary, isn’t it? Everybody thinks I’m handling this situation with ease. They don’t know the half of it. If it’s disturbing to read what I’m saying here, it’s a hell of a lot more disturbing being the one living it, believe me.

Right now I would like to live in a log cabin in the woods and be left alone. Not so that I can go off by myself and blow my brains out, but because I know that the more people I have to deal with everyday (especially stupid people, as well meaning as they may be), the more likely I am to punch somebody in the face or tell them to f*** off…

Well aware that this is where I am right now, I do everything I can to avoid people. This isn’t anti-social; at the moment it’s just a matter of survival. I would like to lock myself away until the worst of this is over with. Goddam Paxil.

But the point is, you’re not alone with the mood swings, with the extreme surges of anger, etc. — and after everything you’ve been through because of our little friend, Paxil, who the hell wouldn’t be? I’m ready to commit violence on some people because they have no idea how debilitating this experience has been — they have no idea what a challenge it has been for me to maintain my civility throughout all this.

I haven’t lost any friends yet, mainly because I’m staying clear of everyone as much as possible. I think most of us going through this have experienced some kind of personal loss due to the Paxil withdrawal. That’s doesn’t include the loss of the quality of our lives while we’re being put through this shit, the loss of our living. Regardless of the physiological effects of Paxil withdrawal (which are extremely unpleasant and often debilitating), the psychological effects aren’t exactly a walk in the park either. Let’s not forget this.

My own personal prediction of how my withdrawal will go is that all the feelings I would have normally experienced while I was taking the Paxil but were numbed out by the Paxil — every single one of them is going to come back with a vengeance. It doesn’t mean a relapse into a depression or anxiety; it means that all the feelings that the Paxil didn’t allow me to feel are going to be felt now. So regardless of the physical symptoms of withdrawal, of living without Paxil, the psychological experience itself will be a motherload. When I get off the Paxil, I don’t expect to bounce back to my good old self right away. It’s going to take time. That’s just a theory, my own speculations based on my previous experience of cold turkey withdrawal.

This Paxil withdrawal experience has affected everything in my life since it first happened in early July. I’ve been living a useless life ever since. That’s how it feels anyway. And now that I’m almost down to 5mg, I’ve got the mood swings, the sudden burst of anger, irritability on a level which is off the scale, insomnia, occasional suicidal feelings, dizziness, gastric disturbances (to put it kindly) — the works. The only thing that keeps me going right now is that I know it isn’t going to last. I don’t know how long it will last, but I know it will pass as long as I do everything in the meantime to keep myself healthy (vitamin supplements, exercise, staying away from annoying stupid people, etc.).

The other thing I’ve had to do recently is to tell the people who know that I’m going through withdrawal that I have reached the stage where I am extremely irritable and that they shouldn’t take my unfriendliness personally, and that the best thing they can do is to not push themselves on me. It other words, I’ve politely told them to get out of my face. While I’m going through the irritability stage, something as simple as that has made a difference.

First response:

Reading your message is like reliving my own nightmare. You have so very eloquently expressed feelings what I and many others have had as we journeyed through our withdrawals. I still have a lot of anger over the experience, but in our society you’ve got to be careful who you express those feelings to! You’ve done so much for us on this board in letting us know that our experiences weren’t out of the ordinary or unique — unless you’ve taken Paxil.

THANK YOU for sharing. It really means a lot to me to know that others have felt similar emotions.

Second response:

Thanks for being so candid and sharing your story. I’m gonna risk getting my neck broken here, but the rush of emotions that you will feel again when you complete withdrawal may not be as bad as you’re expecting. I’ve been reading posts here since July 2nd, and I’ve never read any that make it sound hard to deal with. On the contrary, most have said that it felt great to be able to cry again, etc. Tapering can be rough and the days after your final dose may be rough, but at that point, you know that the end is in sight. Your anger should subside. Hang in there, you’re probably in the worst of it right now. When you’re out of this, I hope you can spread the word about what Paxil did to you and prevent others from suffering. I sure have sympathy for you. Let us know how you’re doing.

Third response:

Thank you for your post. I felt myself choking up reading it and reliving the experiences you have described.

I, too, have been down that road. I have never been prone to angry outbursts, so it was really hard for me. I have felt so much shame for acting the way I have toward family (strangely I didn’t feel anger toward others). Many times they would just look at me “stunned” at what they were hearing come from little ole docile me! My rage was mostly ranting and raving. Thank God I didn’t feel suicidal or want to physically hurt anyone. My words were bad enough and I am sure they caused pain to others.

I have been off Paxil for 6 weeks after taking it for 6 years and can tell you that it will get better. My anger lasted for 2 weeks past my last pill and then went away. Some days it wasn’t too bad and others… well… let’s just say I wasn’t too much fun to be around.

I started taking St. Johns Wort about 3 weeks after my last Paxil and just quit taking it a week ago. I have been going through the anger period again just in the last week. I really think and hope it is from discontinuing St. Johns Wort. I am hopeful that I will get past this last bump too.

Carol said:

I am just so upset because I was put on this for depression and the depression is worse getting off this stuff. I just want my life back.

I want my life back too. I’m in the middle of weaning, and although it’s going relatively smooth, I can still feel the Paxil in me. I don’t think I’m going to feel like myself again until it’s completely out of my system.

As far as feeling depressed again, I got really depressed after my cold turkey withdrawal — and this is after having gone back on the Paxil. I just couldn’t handle not having control over my life again. This is a general feeling I’ve been dealing with since my bout with post-traumatic stress last year. Since then I’ve gone through a series of experiences where I couldn’t do anything about what was happening to me, and then just when things started to look settled again, I followed my doctor’s orders in July and went off the Paxil cold turkey, and wham-o, down I go again. I’m weaning myself slowly off the Paxil now; I’m more or less standing on my own again, but my legs still feel pretty wobbly.

So I know the feeling of wanting my life back. But remember that the depression you may experience after the withdrawal is most likely related to the withdrawal (you may even feel somewhat suicidal as I did — but it’s the withdrawal; it’s not you). I say this from experience, having lived through it, but “withdrawal syndrome” is starting to show up in the medical literature too.

I went through exactly what you’re going through now, and eventually I had to go back on the Paxil because I felt that damage was being done to my brain every time I experienced an electrical surge behind my eyes. Every little zap I experienced was like a miniature psychological trauma. And if you ask me, those traumas add up.

You may not want to flush your prescription down the toilet just yet. Some people who have gone cold turkey will tell you everything will eventually pass. But from what I’ve read, the more severe symptoms such as electrical surges are more likely to “occasionally” occur with people who have gone cold turkey than with those who have slowly weaned themselves off Paxil.

I obviously can’t hide the fact that I think weaning slowly is the best way to go, but you may want to more carefully consider which is the best method for you.

P.S. (Sept. 2006): I’d also like to remind anyone reading this that I haven’t done any research about Paxil or Paxil withdrawal since I originally uploaded Paxil Free 5 or 6 years ago. I suspect most of my information is still relevant today, but you might want to confirm what I’m saying here at paxilprogress.org before taking action in regard to weaning yourself off Paxil.

There is no way I will be silent about what’s happened to me. But right now I’m back on the Paxil only because the brain zaps were killing me. Today is my 7th day back on Paxil (previous to that I was experiencing withdrawal syndrome), and only in the past day or two have I been feeling like myself again.

My plan is to wean myself off the Paxil eventually. If you’ve only been off four days cold turkey, it’s going to worse before it gets better. Some people bear it out; I couldn’t, and you may want to go back on it too — knowing that you can wean yourself off it. And weaning is definitely less traumatic than cold turkey.

This is still my 5th day back on the Paxil after trying to cold turkey. I’m taking 20mg, my regular dose, but if you can believe it, I’m considering increasing it.

Before I went off the Paxil cold turkey as my doctor ordered, I was feeling fine. Happy, functional, smiling joe. Now my 5th day back on Paxil after my terrible cold turkey withdrawal experience, all of my withdrawal symptoms have long gone, and the headaches and the sleepiness I experienced when I first got back on the Paxil have also disappeared.

All I’m left with now is feeling depressed. My body feels fine, but emotionally I’m feeling depressed and easily saddened.

I plan to wean myself off the Paxil, but I need to feel not depressed before I do that. Right now — or at least today — I don’t have the guts to do anything. And I’m not used to feeling like this. It’s not overwhelming yet, but it is interfering with my ability to do what I want to do; that irrational, underlying fear is there. I’m fine when I do talk to people, but I’m not feeling as brave and easy-going as I was before.

I don’t want to increase my dosage. I’m trying to eat well, trying to get outside, trying to be positive, but I don’t feel like any of it. I’m hoping this will pass. I’m hoping I don’t have to increase the Paxil.

I’ll be making a doctor’s appointment today, but does anyone whose been through this having any suggestions? (I hate this shit!)

P.S. (Sept. 2006): That’s the vicious cycle of Paxil. You take it because you feel depressed or you’re axious in social situations. But once you stop taking it, whatever depression or social anxiety you experienced before doesn’t just come back — it comes back with a vengence. Some call this relapse, but how do you relapse into a condition that is worse than what you started with? This is one of the many ways paroxetine messes with your nervous system. Paroxetine may not be considered officially an addictive drug, but I’ve heard from heroin addicts who had an easier time going clean. (See also the Wikipedia entry for SSRI discontinuation syndrome and paxilprogress.org’s Published Withdrawal Studies.)

There’s not much that can be done about this, and I’m not sure if anything should be done. A heightened emotional sensitivity is a sign that you’re beginning to have real feelings again, the kind of feelings that Paxil and other SSRIs have a tendency to numb out. What this means for someone withdrawing from paroxetine is that you’re going to feel like crying a lot. Unresolved feelings of any kind that happen to pop into your head will have you bawling and crying and feeling them deeper than you’ve ever felt them before. My advice is to go with it. Don’t hold it back. This may be difficult, especially for men, but falling into the depths of these feelings and coming out the other end is probably the healthiest thing you could do. More the better if you have someone you can turn to and not have to hide these feelings from while they’re happening.

And it doesn’t mean you’re depressed or having some kind of relapse. It’s just the way it goes. It all balances out in the end.

P.S. (June 9, 2010): I was emotionally messed up while I was on Paxil, during my withdrawal, and even more messed up for a couple years afterwards. I had unrealistic ideas of what it meant to be in an intimate relationship (to have a girlfriend), and let me tell you, I was looking for love in all the wrong places. I got tangled up with one particular individual I should have never said hello to, and I spent years of my life obsessing over her. You want to talk about regret? I know all about it. I was nuts. Then add to the mix the crazy emotional sensitivity that kicks in after Paxil withdrawal — and stays around for a long time — I’m surprised I didn’t jump off a bridge in despair over that silly girl. God, I was dumb. Painfully, miserably dumb. My advice: If you find your self-esteem totally wrapped up in the whims of another person who probably doesn’t think much of you unless you’re saying something nice about them, end it now. Politely say goodbye and learn how to run like Forrest Gump; that is, focus on something else. Obsess about something else if you have to, just as long as it’s a thing, not a person. Trust me on this, and do it now.