Paxil Free

February 28th, 2001.

I began taking Paxil, paroxetine hydrochloride, for depression and post-traumatic stress shortly after a traumatic event in November of 1999. By July 2000, ten months later, my doctor and I agreed that I was doing well enough to stop taking the medication. So I followed his medical advice and discontinued the Paxil. Within 24 hours, I experienced such severe paroxetine withdrawal that I eventually became suicidal — and it scared the hell of me. The neurological trauma of paroxetine withdrawal was more physically and mentally debilitating than any kind of depression I had ever experienced.

Most of the records I kept during my withdrawal experience were in the form of messages I posted to Paxil withdrawal support groups such as paxilprogress.org. Saved on this blog are the most informative of those messages. The postings appear in the order in which they were written, along with all the relevant responses I may have received.

It is a record of my withdrawal experience, not because I’m vain and I like listening to myself talk, but because it’s the only record I kept, and having reviewed all of it recently, I can see that it presents the reality of the experience more accurately than anything else I’d have the energy to put together right now. Along with a support group such as paxilprogress.org, I can’t think of anything more valuable for someone living through paroxetine withdrawal than to read exactly how someone else survived it.

While it’s true that there isn’t a whole lot of fun to be had for someone living through the effects of Paxil withdrawal, the important thing to remember is that you can survive it. That may not sound like much right now, but I have done it and so have many others who had it worse than me. If there’s one thing to learn from the record and testimony on this site, perhaps it’s how to smooth out some of the bumps in the road ahead so that when the worst of it comes at you, it doesn’t knock you so far down that you can never get up again. It can be overcome. As unbearable as it may seem at times, it will eventually go away, and you’ll be all right.

Okay, maybe not all right, but I’m pretty sure you’ll feel at least a thousand times better.

March 19th, 2001. (Basic Facts – continued)

This is the scariest one of them all, and I probably should have put it #1 on my list ahead of the electric shock sensations, but it’s the most difficult one to talk about and I still don’t know what to say about it — except that it was real, very real. I’ve heard many people going through withdrawal talk about this. The reason it’s scary is because it’s not just a feeling; it’s an overwhelming urge, an almost primal drive, a suicidal compulsion that kicks in when the experiences of the withdrawal become too much. There is no way to describe how real this aspect of the withdrawal experience can be. It’s not the kind of thing that is casually discussed because of the fear that everyone is going to think you’re crazy and beyond help, and nobody going through this wants to feel that alienated; the experience is lonely enough without adding that to the list.

The reality of Paxil withdrawal, though, is that it can wear a person down, testing one’s ability to stay civilized on the outside while inwardly the experience is pushing them to the edge of their sanity, of their ability to cope. This I think is the greatest challenge of the withdrawal experience. All of these issues are addressed in the further postings on this blog, but the most I can say for now is to remember that it’s not you — it’s the Paxil withdrawal. It may feel like a living hell that, if you survive it, will have damaged you so badly that’ll never be the person you were before. But it’s not as bad as it feels. I know it because I’ve lived through it. I had the seizures so bad I was convinced that permanent neurological damage was being done to me, and I didn’t want to live to see what the hell was left of me when it was all over with. So on more than one occasion I felt a compulsion to want to get it over with now (and sometimes it wasn’t just an urge but seemed to be a perfectly logical course of action; that’s what’s scary about it).

But just remember it’s the Paxil withdrawal, not you, and that it will pass. I saw a quote from Winston Churchill the other day which I would love to have heard during the worst moments of my withdrawal: “If you find yourself going through hell, keep going.”

(See also Thoughts of Suicide.)

P.S. (Sept. 2006): I realize this could be read as one hell of a depressing blog. No doubt about it. But if you’re already going through withdrawal, reading a blog like this isn’t going to make it any worse. I’m only on the second day of re-posting all this stuff, and I’m already receiving emails from people saying they appreciate it. I don’t like revisiting all these bad memories; I want to get this stuff re-posted as fast as I can — because it’s a bit of a downer, to be honest. But it does seem to bring comfort and reassurance to people who are going through withdrawal or have had recent experience with it. So that’s it — that’s the reason I’m doing this. Beyond that specific demographic, though, I would say, “Move on. Nothing to see here, folks.” Really.

April 7th, 2001.

I was prescribed Paxil (20mg/daily) for depression and post-traumatic stress in November of 1999. At the same time I began to see a therapist who helped me deal with the symptoms of the post-traumatic stress (which included flashbacks; no fun there, let me tell ya). More than Paxil, more than anything or anyone else, the benefits of this communicative therapy (a.k.a. talking) were immeasurable.

However, the Paxil did provide a certain calm which allowed me to deal more effectively with the emotional trauma of the experience I had gone through. (For my own privacy, I’ve chosen to withhold the exact details of that experience.) It seems to me that Paxil regulates one’s emotions so that they are more manageable. How exactly it does this nobody really knows, but there are a few theories out there which I think have some validity to them.
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Friday, July 21st, 2000.

In my previous posts I mentioned that I’ve been back on Paxil for about a week or so after the hell of going cold turkey, and that, although I’m feeling better than I was during the withdrawal, I was feeling depressed occasionally in a I-don’t-want-to-live sort of way. I’ve been doing my best to walk it off, so to speak, but last night I made an effort to go to bed early and not stay up late as is my tendency.

It made a difference. I slept all night and woke up feeling more myself. I’m not feeling depressed; I can usually tell the second I wake up whether I’m feeling depressed or not and whether I’m going to feel depressed or not. And right now I feel good.

I read that during deep sleep, serotonin production increases. So I didn’t have to take a pill; I just had to get some good, natural, unmedicated sleep. It did the trick. I’m not going to begin weaning myself of the Paxil just yet, but I wanted to mention that a good night’s sleep can make a big difference (for those of you who stay up late and wonder why you’re feeling depressed). I’m going to do more research on this.

Wednesday, September 20th, 2000.

Colin said:

I can’t believe I’m going to do this. After almost a month, I caved in and called my doctor. I get a Paxil refill this afternoon. I’m scared to go back on it but I’m also scared to be off of it. Can anyone help me?

You may have mentioned before how you went off the Paxil, but I lose track of who says what around here, so forgive me if you’ve outlined how you went about it. If I were to take a guess, though, I’d say you got off the Paxil cold turkey — and if not cold turkey then way too fast. That’s my best guess.

I went cold turkey a few months ago, lasted 6 days and on the 7th day had go back on the Paxil. I felt suicidal a few weeks later. Losing control like that — and not having control like that — just doesn’t jive well with me. I’m much better now, but it was definitely one experience I could have done without.
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Thursday, September 21st, 2000.

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.
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Sunday, October 15th, 2000. A journal entry:

I haven’t had a cigarette for months now. Occasionally I still feel like sucking one back, and the urge is extremely strong. Living without alcohol seems to be no problem. But boy would I love to have a smoke right now.

I still can’t say for certain whether I’ll still be alive by Xmas. Simple reason. I don’t want my life anymore. I’m not exactly thrilled about it. My life, that is.

Postscript – April 14th, 2001: In July 2000 when I first got hit with the Paxil withdrawal, I decided to quit: (1) Smoking cigarettes, (2) Drinking coffee/caffeine, (3) Drinking alcohol, and (4) Smoking dope (which I never did much of anyway). At the same time I tried to quit Paxil. Talk about fun. My withdrawal experience may have been a bit more harsh because I tried to quit so many things at the same time. Not drinking or smoking dope was the easiest thing, mainly because I no longer hung around with recreational drunks and potheads. It was a simple decision: That’s not for me. A lifestyle choice. No problem there. Cutting back on the coffee and then gradually switching to decafe was a bit harder, but I did it and sticking to it shouldn’t be a problem. But cutting back on the cigarettes was the hardest. I didn’t smoke any cigarettes until December 2000 when I bought a pack and smoked it all in about two days, and after that the urge was gone. But then I began to have bad headaches in February 2001 which made my getting back on track with life again almost impossible. As I write this postscript, I’m taking special medication just to keep the headaches away. But about ten minutes ago I bummed a smoke from a friend who was visiting, and man oh man did that ever feel good (although I know it’s going to make me feel nauseous in about 20 minutes). I’m not recommending that anyone start smoking up again if they’ve managed to quit, but by letting myself have that cigarette, it was like I was agreeing not to be so hard on myself. And that, psychologically, feels like a great relief. Not that I’m going to begin smoking again, but I think this was the first time since my withdrawal began that I was easy on myself. I think that’s an important thing to remember, especially for people who are usually driven by a strong will and determination. One’s will can be one’s worst enemy at times.

Monday, October 16th, 2000. A journal entry:

I’ve been feeling suicidal. It’s an interesting feeling to say clearly, “I don’t want to live.” It seems to be a very reasonable decision. Weird.

Tuesday, October 17th, 2000.

Angela wrote (on 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.

Wednesday, October 18th, 2000 (continued).

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.
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Monday, October 30th, 2000. A journal entry:

I’m feeling better today. I was going to say much better, but that’s probably pushing it. I got up at 7:30 this morning to help a friend move some things into a new office. I haven’t been sleeping lately, so I was expecting to be tired, grumpy and out of sorts when I got up, and I was. Never too hungry that early in the morning, I had a slice of toast with honey, my usual handful of vitamin supplements, a bottle of water and off I went — hit the road in the pickup truck (someone else driving).

I immediately got dizzy and off balance lifting things and walking up and down the stairs. I wasn’t long popping my first Xanax (electrical sensations were beginning to stir behind my eyes). It took a couple hours to do the work, then I had soup and a bun from doughnut shop. By the time I got home about an hour or so later, I felt good. Not nearly as lousy as I’ve been feeling for the past few weeks, on-and-off suicidal and all that.

This wanting to live stuff is tricky business.

Friday, November 3rd, 2000 (3rd day off Paxil). A journal entry:

The withdrawal is getting worse. Feeling emotional and a little suicidal today. Unable to make full use of my cognitive abilities — that’s the reason, I guess. To have that taken away from me makes me feel useless. Meaningless. How long can someone live like this?

Right now I don’t know if I’ll be alive by Xmas.

Preface (Sept. 2006): For awhile after my initial withdrawal experience, I thought I might actually have a chance of getting on with my life if I pushed hard enough. I was wrong, though I didn’t know it at the time. Psychologically, I was in fragile condition. Then one day an incident occured that pushed me over the edge. I’ve decided to remove all the details of it because I don’t want the person involved in the incident to think they drove me to near-suicide. If the following post doesn’t make a lot of sense, that’s why; it’s heavily edited. I was also in a very messed-up state of mind at the time, and it shows.

Sunday, November 5th, 2000 (5th day off Paxil). A journal entry:

…the effects of the cold turkey Paxil withdrawal were totally unexpected and disturbing. Debilitating and nearly constant electrical surges in my brain; they wiped me out. Unable to take any more of it (I gave it a week, a week where every day it got progressively worse), I started taking the pills again. The symptoms went away, but, in a sense, something else went away. And I haven’t been myself since.

A couple weeks after my cold turkey withdrawal, I was driving alone down a long stretch of highway and I pulled over to the side. I reached down into a bag on the floor of the passenger side, looked over my shoulder to make sure I wasn’t about to be ploughed into the ditch by an 18-wheeler, pulled out my notebook and scribbled down a thought that had just occured to me.

The car was still running. I don’t know how long it took me write down the words, probably no more than five minutes. I looked at what I’d written to make sure my handwriting was at least semi-legible. It was. I then got the car going down the shoulder of the highway as fast as I could without crashing, turned onto the highway and away I went…
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Sunday, November 12th, 2000 (12th day off Paxil). A journal entry:

This past year of my life hasn’t been measured in months or days. Not even the beating of my heart, as Kazantzakis might contend. Misery and numbness is more like it.

I don’t think it’s right that a human being should be allowed to live through as much as I have. I should be dead.

The whole lobby was empty. It smelled like fifty million dead cigars. It really did. I wasn’t sleepy or anything, but I was feeling sort of lousy. Depressed and all. I almost wished I was dead.

That’s one way to measure my life from this past year, in dead cigars and cigarettes. That’s exactly the description I’d give my life: fifty million dead cigarettes. Excuse me if I’m feeling a little lousy.

Friday, December 1st, 2000 (continued). Responding to a post on paxilprogress.org:

I’ve always been able to deal with the emotional symptoms (e.g., the suicidal feelings) easier than the other symptoms (e.g., the electrical surges). The electrical sensations just about drive me insane. More than any of the other symptoms, they’ve made it impossible to be me and to do what I love to do.

I have felt on-and-off suicidal since my first cold turkey experience in early July. I still haven’t completely shaken the feeling, but I can tell you that it subsides to the point where it’s just a faint echo of what you’re feeling now. You’ll remember it, and in a sense it’ll still be there, but you won’t feel any urge to go through with it.

The only way to get through now it is don’t kill yourself (simple, right?). Your body and your brain are going through one serious motherload of a neurochemical adaptation. You have to give yourself a chance to get through it and to go through it. As you know, there are some sudden benefits to getting off the Paxil — I’d say focus on those right now and enjoy them as much as you can. And the next thing you know, you’ll be feeling crappy, but you won’t be feeling suicidal. And that’s progress. And gradually everything gets better. That’s the only thing I can say with some confidence.

It’s been a long dragged out experience, but a little tiny bit at a time, I’ve gotten better. So don’t kill yourself and you will too. And don’t forget to take plenty of B Complex.
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Friday, December 15th, 2000 (45th day off Paxil).

Dave wrote:

My emotions are all over the place. I keep bursting into tears very suddenly and out of the blue. Also, in the evenings/nights the last few days I have had really frightening feelings that I’m going to suddenly do something really awful and will just lose control. I feel like something inside me that usually inhibits these actions has come undone and is in danger of activating. It’s really scary.

Has anyone else felt this? It’s not a feeling of wanting it all to end — it’s a feeling that it just suddenly will with some rash action. This is very hard to write — probably to read to. Please reply if you’ve felt the same. I just want to hear there are others going through the same thing — please don’t write and tell how SSRIs are thought to induce suicide — I can’t handle that.

My response:

I know the feeling. You don’t have to describe it to me, and I don’t feel like elaborating on it. I know it too well to want to think about it too much. Since my first attempt at cold turkey withdrawal, I have experienced what you’re describing more than once (the last time I experienced it was about five days ago). I’ve experienced it at various times during my withdrawal and in many variations, but it’s all basically the same thing. It’s extremely difficult and scary to describe, but it’s like a knowledge that I could die now; a human being can only take so much, then something’s gotta give. But that doesn’t even come close to it.

Anyhow, I have lived through it, and continue to do so, because I’m able to avoid things that could set me off.

How I’ve managed to live through these moments, I don’t know. Recently, I even wrote a suicide note. Then I spent an hour or so polishing it up. And so I wrote a note instead of jumping off a bridge. By the time I finished polishing up the note, I’d managed to live through it, and although I wasn’t feeling too hot, I was no longer in danger. It’s the scariest thing I’ve ever had to face. And maybe I survived it by not facing it, by doing something else. Or maybe by actually facing it through writing and saying, “You won’t get me, you motherf**ker!” I don’t really know, and I’m not sure I can talk about it because it’s still very fresh in my mind.

But I’ve survived it and done most of it alone. There are times when I don’t want to talk to anyone, and don’t. I know when I have to be careful. That’s probably what got me through it, a knowledge that, “I have to be careful now.” And I run from everything — probably not the best thing to do (social isolation is usually not a good thing), but when even the slightest thing can set me off, can push my buttons in the wrong way, I make sure not to bump into anything or anyone who could push me more over the line.

Don’t push yourself. Know that now may be a time to be careful. Very careful.

None of this is probably any comfort to you, but what I can I tell you? I’ve been feeling extremely worn down lately and I don’t have as much to give as I used to. But I’m still alive.

Fall head-first into the agony of it. Live through it. Whatever it takes. Maybe that’s what I did. Maybe you can do it too. The main thing is don’t kill yourself. It isn’t you, remember; it’s the damn Paxil withdrawal.

Tuesday, December 19th, 2000 (49th day off Paxil).

Scott said:

“I was driving into work through the most beautiful countryside this morning and remembering something someone said about how the colours are so much more vibrant when you are off the Paxil, and I was thinking about the fact that nothing has really touched me since I went on the Paxil, and that I don’t feel like I’ve really experienced things deeply — colours or smells or joy or excitement.”

This is something I can relate to. It’s something I’ve noticed even more since I began weaning myself off the Paxil, which completely messed with my normal capacity to appreciate the world around me. Over the years I’ve developed an appreciation and a connection to simple things, uncomplicated things. Things which are diminished by words: sunshine, gut-driven laughter, a compassionate touch, a genuine smile, a cool breeze that can lift you out of the weight of your days, poetry. All that good stuff.

I can remember the last time I had a moment like this. It was somewhere between the hell of my cold turkey withdrawal and the beginning of my weaning off the Paxil. I was on shaky ground, but I remember taking a walk behind our house in the woods with my father’s dog. I was walking past a crab apple tree in our backyard just at the edge of the woods when I heard a thump. It didn’t make me jump ten feet in the air like it would later on in the withdrawal.

I turned slowly and looked around, trying to figure out what had made the sound. I was standing there looking at this crab apple tree, a crab apple tree that was weighed down with these huge red and yellow apples. Then I knew it: One of those big apples had fallen out of the tree and thumped against the ground. That was the sound. And just as I was thinking that, another apple fell free, and I smiled.

It was one of those moments that wouldn’t have happened had I been three footsteps further down the path when the first apple fell. The whole thing probably took less than a minute to be over and done with, but I can still remember the joy of being able to appreciate that moment, the calm and the quiet of it all. Reading this you may not have any idea what I’m talking about it. But it was a moment of deep of appreciation, of being glad to be alive.

That sort of appreciation requires a certain kind of willingness, a certain kind of calm that allows a moment like that to happen in the first place. And since I’ve been living in Paxil Hell, I haven’t lived a single second like that. Believe me, I have wanted to die.

But there is a happy ending to this (I think). But I’ll tell you about that in a day or two. I’m not ready yet.

May 16th, 2001.

Thinking the worst was over, I began looking for work on February 16th, 2001, about three months after I got off Paxil. I began to take what I thought were the first steps towards living my life again. I still had a hypersensitivity to light and sound, but it didn’t seem to kick in until much later on in the day, usually somewhere between 7 and 8pm, which was manageable to me and which seemed to indicate the withdrawal effects were gradually working themselves out of my system.

Psychologically, the transition was more difficult than I thought it would be. Just being around people again in a normal social environment took some getting used to. I found myself feeling apprehensive, hesitant and less spontaneous than I was used to being. But after seven months of social isolation, I suppose this was understandable. Socially, I was feeling a little rusty, but I was confident that I’d be all right as soon as I could find a job, get into a routine and develop a normal structure of social relationships again, all that good stuff. I’d been in starting-from-scratch situations before and, although I had my down days, I knew I could get through it if I kept pushing myself.

The social adjustment wasn’t easy. Things were made even more difficult when I began having bad headaches after the first week. I now understand what people mean when they refer to a “pounding headache.” It was as if I could feel my heart pounding — but inside my head; it was a pulsating pain. I took every kind of headache pill to fight off the headaches, but nothing worked. As the headaches continued, the hypersensitivity began to set in earlier during the day until I was eventually hypersensitive all the time, twenty-four hours a day.

It was a sinking realization the day I said to myself, “It’s still not over.” The withdrawal seizures were over and done with, but my life still wasn’t mine. I was determined not to let this experience take away any more of my life, and so I tried to jump back on the horse the first chance I had. But that determination may have gotten the better of me.

I can’t say for certain, but I probably shouldn’t have pushed so hard so soon after my withdrawal. My body, physiologically, neurologically, was still in recovery and in need of healing. I don’t know what the hell I should have done (sitting around on my ass out in the country by myself was driving me crazy), but I probably should have given myself another month to take it easy, to give myself more time to heal instead of throwing myself into a situation that was more stressful than I anticipated. It’s as if I was trying to will my life back, but my body wouldn’t let me. Mind over matter, my ass.

The headaches and the hypersensitivity got so bad that I could barely function. Trying to put on a pleasant face during an interview or any kind of social interaction was — well, it wasn’t working. I couldn’t fake it. I was so physically miserable that my spirit couldn’t fight it anymore. And after a month or so of trying to walk it off, I had to give in to the damn withdrawal again. At this point I may have wanted to blow my brains out. I wasn’t exactly taking track and was having a hard time really giving a damn about anything anymore.

That was about two months ago as I write this. I’m taking a small dose of Xanax to help with the headaches, and although I can still feel a pounding in my head, it’s not killing me like it was before, and my hypersensitivity is gone. (But I don’t know how long I want to keep taking these pills.)

In the opening to her novel, Ordinary People, Judith Guest writes that to have a reason to get up in the morning, it is necessary to possess a guiding principle, a belief of some kind; even a bumper sticker will do. But I don’t know what the hell keeps me going anymore. I don’t know what my next move is. I’m still waiting around for the withdrawal to work itself out of my system, I guess.

I’m not so sure how high my confidence is flying right now, or even if it’s confidence that I’m lacking. Which leads me to a question of faith (not religion). This is a big one.

I’ll leave my final thoughts on that, though, for when we get to the end of this blog. Until then, what follows is a sample of how my post-withdrawal experience played itself out between February and July 2001. (July 2001 would be a year since my initial withdrawal experience.)

May 29th and July 26th, 2001.

I want to talk about the common thread which I think is apparent in the experiences of everyone who has been through paroxetine withdrawal; and, in big bold letters, that common thread is THE FEELING OF BEING CUT OFF FROM THE WORLD. Often it’s not just a feeling; it’s a reality. There are plenty of other crappy things I could single out, things others may consider more important issues, but for me, this is the big one because I’m still working on it; it’s the one which I think causes the most damage and requires the most healing.

Oliver Sacks addresses this in his book, Awakenings (1990 edition), when he describes how a disease can consume a person’s life, consume all of their energy and attention for such a long period of time that (from page 240): “they feel, on the one hand, cut-off or withdrawn from the world, on the other hand immersed, or engrossed, in their illness,” a feeling which I’m sure anyone living with paroxetine withdrawal can relate to. Then he goes on to speak about the ‘awakening,’ or the recovery, in which one ceases to feel the presence of the dis-ease, but is instead naturally drawn towards and engaged by the presence of everything in the living world around them.

It’s been just over a year since my initial withdrawal experience and I wish I could say that I no longer feel the presence of this disease, but I can’t. (Paroxetine withdrawal, and post-withdrawal, is a dis-ease. I’d love to meet someone going through withdrawal who’s sitting back at ease with all of it.) It is less present than it used to be for me, but, along with other symptoms which I am too sick and tired of to describe in detail, I have chronic pain (as in all the time) which disrupts the relaxed flow of my thoughts and feelings and kind of takes the fun out of things; it gets to me at times. It is this cognitive disruption, one which seems physiological in origin, that interferes with my fully feeling the presence of the world around me like I used to, of my fully being able to be myself. I’ve been trying to “walk it off” all this time, but I can’t.

Throughout my Paxil Experience I’ve had people full of good intentions pass on to me the age-old advice, “Don’t dwell on what’s happening to you. Just go outside and enjoy the sunshine and the simple things. You’ll feel a whole lot better.” That’s a simple solution that works, and I know it works because I’ve lived by it for many years — but it works for people who have their health, not for someone who feels like they’ve been hit in the head with an aluminum bat from the withdrawal seizures and the constant headaches and body aches. Let’s crack one of these good-intentioned people across the head with a two-by-four and then tell them not to focus on the pain (impossible); tell them to go out for a leisurely walk while their head is pulsing with pain and enjoy the sunshine which will surely make them feel so much better. Maybe then they’ll realize how misplaced and absurd some of that age-old wisdom can be, especially when it comes from people who don’t have the experience to back it up.
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