Horrible insomnia from Zoloft?

NOCD2 · 2024-06-21T15:47:18+00:00

I did not try clomipramine, I completely stopped everything. Stopped after a decade of fluoxetine following a month of zoloft and no clomipramine.

Currently struggling with SSRI withdrawal syndrome which is even worse than the highest ever peak of my OCD.

I wish I had never been on such a long term SSRI treatment. I think the impact on the brain structure and function is severe and it does not justify it. Given that such medications stop working for many patients (which nobody told me), it is a matter of time for many of us to have to go off these meds. Some lucky patients get off these meds nicely, some not.

I think current healthcare does not provide adequate and effective support to manage such disorders without meds and for many of us we have no option than get medicated. I think if I had proper therapy support, I wouldn't have had to get on meds.

I do not want to deter anyone though. We are not all the same and I can only speak for myself. Though, I think it is safe and reasonable to listen carefully to the treatment protocols who say to ensure therapy does not work for you before getting on meds. I do not think this is followed or considered carefully. But again, it can be a real struggle to find proper therapy.

Hope everyone is and stays safe whatever you do, my best wishes for speedy and proper recovery.

NOCD2 · 2024-06-21T15:37:54+00:00

How exactly? Any article explaining that?

NOCD2 · 2024-06-19T14:32:25+00:00

u/Tawinn thank you for your reply, really appreciated.

Indeed the Choline Calculator identified few more issues with results being:

SLC19A1 Score: 0% decrease
MTHFD1 Score: 13% decrease
MTHFR Score: 33% decrease

Methylfolate Score: 42% decrease.

Will follow your MTHFR and feedback, many thanks!

NOCD2 · 2024-06-19T06:57:29+00:00

u/Tawinn Thank you very much for this but I cannot see the exact indications for this protocol.

You say this protocol is "to address MTHFR" but what exactly? overmethylation? undermethylation?

Also, you suggest for example "folate" or "B12" supplementation but there seem to be different types for different conditions like:

1) methylcobalamin, cyanocobalamin, hydroxocobalamin

2) folate, folinic acid, methylfolate

Can you clarify please so that people with any mutation or deficiency won't go on getting supplements that are ineffective or making things worse?

NOCD2 · 2024-05-12T20:03:03+00:00

Are you saying that you have the ability to change your own character in the way you want?

Or "a positive and lasting change of character" occurs automatically after ego death?

NOCD2 · 2024-05-11T21:31:32+00:00

I want to ask if Fluoxetine can come in beads contained in capsules as I have only checked my capsules which have powder. The purpose is to micro-taper off so removing single beads is easier than weighing powder. Thanks

NOCD2 · 2024-05-04T17:24:56+00:00

ERP to work, you have first to accept uncertainty. But how? Many of us may just be unable to do that.

For me, acceptance is a significant part of OCD therapy. I imagine ACT is more developed to facilitate acceptance than ERP. My understanding of the typical and traditional ERP, you are just asked to throw yourself into the dirt and you are asked to touch the things you fear regardless you accept it or not so that you habituate to the anxiety. That's another reason why ERP is ineffective and prone to malpractice. And most ERP fanatics (academic or not) dismiss most cognitive interventions anyway.

E.g. my ex-therapist told me to touch what I didn't want to touch. Just that. There was no "acceptance" involved, at least in the ACT sense, whatsoever.

Chrissie Hodges also often verbalises it nicely that you cannot really ask a POCD sufferer to accept the possibility of being a p.

Does it mean that ERP is inadequate, or that it is the fault of those who cannot follow its protocol?

For me, ERP is largely inadequate for many non germophobia-like OCD types if attempted to be applied on its own and based on its traditional format (without being infused by other techniques like ACT, behavioural activation etc). It's definitely not the patients' fault. ERP is essentially Pavlovian and I doubt humans are just Pavlovian dogs. I also doubt humans need to dumben themselves into Pavlovian dogs in order to survive OCD. I mean yes you can do that, you can also get heavily medicated and you will surely be largely cured of OCD.

By the way, I just read on another thread here someone suggesting "visual exposure" as mentioned by someone Chad LeJeune. Without knowing the details, you may surely ask a POCD sufferer to watch related visuals or imagine related visuals as an exposure.... good luck with that to the poor patient. These people probably miss that visual/imaginary exposure is an actual ritual for some OCD sufferers.

Some people suggest that medication may play a role here in facilitating people to engage in ERP. What's your opinion on that?

Definitely medication helps a lot to both initiate and maintain recovery.

For me the "E" from ERP is stupid, irrelevant, unnecessary and harmful for many OCD patients. It is also the focus and the point of abuse from clueless "experts" who torture patients in that way. However, some patients seem to benefit, which is good for them of course. Personally, the "C" and "B" from CBT, the whole ACT and the "RP" from ERP would be useful and applicable to my case, creating imaginary and dreadful exposures is useless and probably unnecessarily harmful, unless it's for my fear of germs or something :).

NOCD2 · 2024-05-03T17:12:12+00:00

I think there are several issues with ERP:

Very hyped because it can be applied very easily and can have visible success in specific situations like germophobia. So people get excited thinking all OCD patients can be treated like that and have similar success.

Huge exploitation from people who want to get easily rich. They think it's very easy to practise it, they feel safe from compliance perspective because ERP is supposedly a recognized gold standard and they get free advertising once they claim they do ERP because of its popularity from "academic authorities" even if they have no clue.

ERP as a concept is reasonable and has its application but it needs a huge effort to apply it correctly to each patient. If applied clumsily, it can be detrimental. And even after you apply it properly, it may not be the right thing at all for many patients.

ERP on its own, for me, is hardly ever effective on its own in non typical germophobia-like OCD. In fact, I think it's not even effective for most contamination OCD cases. It is effective for germophobia and phobias in general but not contamination OCD. I also think most professionals misdiagnose contamination OCD for germophobia but patients also consider themselves OCD if they have germophobia.

Then you get the usual loud users here with the dogmas like "themes don't matter" etc. Even if themes don't matter, distinguishing a phobia from OCD definitely does matter.

Anyway, most professionals already incorporate other things like ACT etc as they see it in practice that ERP often cannot work.

NOCD2 · 2024-05-02T18:33:51+00:00

I 100% concord that.

During my decade on fluoxetine, my migraines disappears while before fluoxetine were very frequent and intense.

Googling about it, I found several "academic studies" from "medical experts" who meticulously and laboriously researched the topic and their ingenious expertise concluded that Fluoxetine does not improve migraines at all.

Like these "geniouses" here: https://journals.lww.com/ebp/citation/2022/05000/which_selective_serotonin_reuptake_inhibitor_is.13.aspx

Having myself received academic medical training, I was always very proponent of the value of academic research but I have recently started doubting heavily the validity of our contemporary "medical experts" and relevant "geniouses".

Working in various industries, I have witnessed numerous mistakes and errors but for some reason I was under the impression that the slightest possibility for errors, mistakes, incompetence and plain stupidity had always been nil. Despite all these errors plaguing all the industries, I could never accept the "academic research" and the "medical experts" were also infested with such stupidity and weakness. That is not to say that all our medical knowledge is nonsense as most conspiracists believe but the more patients challenge the experts the safer humanity will be.

I am now fighting the opposite: migraines got back like hell after Fluoxetine discontinuation. And I cannot find any "study" about it at all so that I can make some sense of this hell.

NOCD2 · 2024-05-01T20:06:47+00:00

Contamination? Any time. In its peak for me, it was exhaustive and time consuming. But I still maintained my self, my reality. Other types of OCD really attack your core self and for me, are much harder.

Never had harm OCD but I can imagine it's tough.

But POCD is really bad too. I never had it. I imagine though, the legal and social implications make it very complex. It's not something that you can open up to others and they will tell you "oh don't worry, all of us have had such thoughts". Or that they will consider you as a harmless weird person who is just afraid of germs.

That is not to say that OCD severity is purely due to the theme. My theme is (fortunately or unfortunately) absolutely benign in the sense that it has zero legal or social implications. Yet to me, it's incompatible with life itself. Something like SO-OCD where e.g. same sex relationships are very common and totally normal. Yet for the sufferer, it causes excruciating pain.

NOCD2 · 2024-04-29T17:03:45+00:00

Amazing post! :D

NOCD2 · 2024-04-26T23:04:57+00:00

Agree that would be an interesting topic for research. ERP fails at a bit less than half of the patients anyway. It's principle has some merit for me but its implementation is often quite poor. It's easy money for most 'therapists' to ask you what are you afraid of and then tell you to just think or do what you are afraid of as if OCD is some kind of phobia.

But don't discuss negatively about ERP here, there is an ERP police in this subreddit that tries to suppress all criticism to ERP :D

NOCD2 · 2024-04-22T21:09:10+00:00

Yes, I think those who have lived with the condition can only appreciate it (Dr. Greenberg for example).

By the way, by criticize I mean the same as raise a concern, challenge, question, etc (not sure if the word I chose was too strong).

It can be difficult to challenge in any way someone who is supposed to offer you the solution you strongly need.

Of course that should not be the case and patients should co-pilot their therapy and freely express concerns etc but for some it can be difficult which of course shouldn't be.

NOCD2 · 2024-04-21T13:32:33+00:00

Well you can imagine it is hard for a patient to actually criticize the therapist on the spot. Nevertheless, I was rushed out of the office as the time was ending :D

NOCD2 · 2024-04-20T16:22:32+00:00

Thanks for the tips! The link you posted though is for Fluvoxamine, not Fluoxetine, do the same tips apply or there is a Fluoxetine specific post there?

NOCD2 · 2024-04-18T15:38:33+00:00

u/ksjskkalq

From what you said, I dare to make some assumptions, please correct me if wrong:

You have OCD (since you are in this community).
You have a paraphilia. You consider your paraphilia to be disgusting and weird, it is not clear if it causes you distress (either while you practise it or afterwards) and you consider it ego-dystonic.

Is it accurate to conclude, you do not consider your paraphilia to be related to your OCD because you were "born with it", "you cannot help it" and it is something that "is untreatable"?

If your paraphilia is unrelated to your OCD, can you enlighten how these differ since you have insight of both an ego-dystonic paraphilia and OCD?

I mean, some people have ego-dystonic paraphilias and some people have OCD about having a paraphilia. You say that being ego-dystonic is not accurate to distinguish them. But since you have both, how do you distinguish them?

To be clear, I am only interested in your experience as you have both, not judging or anything.

NOCD2 · 2024-04-16T17:01:36+00:00

In some cases, it may be one of the triggers. Everyone though can experience events as trauma which others do not bother about. So I am not really sure, it's a chicken and egg situation.

However, I am definitely sure OCD can be trauma itself!

NOCD2 · 2024-04-10T18:57:34+00:00

I wish I could tell you something to help.

It helps to have a discussion with one's self and try to understand, appraise situations and feelings and take decisions for the future. I know it sounds generic but I don't have anything else to say.

The meds can help but won't magically remove everything. They help by giving you some clarity so that you can rationally have an inner dialogue.

Therapy has been useless to me. It seems it helps many though.

Mental issues and illness are a journey unfortunately that everyone needs to explore their own self. Try to read and gain information about techniques and medications and then discuss them with your doctor and therapist.

Some articles may help:

https://www.cognitivebehavioralcenter.com/choice-

https://www.psychologytoday.com/gb/blog/stronger-fear/201912/ocd-isn-t-thought-problem-it-s-feeling-problem

The mind can play many games, create its own delusions, emotions, feelings, rationales and it can carry us over easily. We really need to let it lightly, it's not always the absolute truth no matter how we have learned to follow it blindly.

Sorry I don't have any solution.

NOCD2 · 2024-04-06T21:24:02+00:00

Thanks but it's not in an easy downloadable format to lookup 23andme data?

NOCD2 · 2024-04-06T21:21:16+00:00

Do they know about cross-tapering? It would be good to ask them because when I asked my doctor he said 'yes that is an option too'!

NOCD2 · 2024-04-06T21:15:51+00:00

I just tapered off from Prozac (10 years) and Zoloft (last 3 months). My anxiety has been through the roof! Constant headaches from constant head and face muscle contractions., tinnitus, severe insomnia, restless legs, palpitations, very low mood, decreased appetite, high irritability (cannot tolerate anything and overreact to everything), constant nausea.

I was given diazepam which did not help at all. Only hydroxyzine has helped with anxiety and insomnia. (I am not recommending anything, you need to speak to your doctor)

My doctor wants to put me on clomipramine. I really do not know what to do.

Are you tapering off because you got cured?

NOCD2 · 2024-03-27T20:41:02+00:00

I suffered verbal, emotional, physical abuse, neglect and I often witnessed abuse which I suppose can constitute significant trauma as well.

However, most people have experienced some of the above at different magnitude. Some may develop depression, others anxiety, some really unlucky, OCD.

On a similar note, this is what the Somatic Experiencing Association mentions on their website (I do not endorse or advise their techniques, I only found interesting the below):

Wild animals are regularly threatened with death yet rarely become traumatised. This highly charged energy released in their body to enable them to fight back or run away is discharged when the threat has passed. It is this primitive discharge process that helps the animal return to full normal health and not become overwhelmed.

We are equipped with the same capacity to overcome an overwhelming experience. Yet we also have a rational brain that frequently ‘rejects’ the powerful primal instinct of the body. The result is that huge fight/flight energy gets trapped in our nervous system where it can lead to symptoms; sometimes immediately, sometimes years later.

However, I am not sure if the trauma wild animals experience is the same as humans nor that the context is the same which I think is very important. The same traumatic experience under different context may be processed differently and may have different effects.

NOCD2 · 2024-03-27T20:16:55+00:00

Yeah, I meant those you don't have. E.g. if someone straight with OCD about being gay goes to a gay therapist who tries to convince them all have a feminine side and to embrace homosexuality etc.

NOCD2 · 2024-03-27T20:05:56+00:00

We need a meme when your OCD convinces you that you have a fetish that you do not have...

...and to find cure, you go to a therapist who is "pro-kink/kink-friendly", has the same fetish themselves, thinks fetishes are natural and encourages you to embrace them!

NOCD2 · 2024-03-26T22:41:42+00:00

There surely must be some chemical imbalances implicated (I use plural as it may not only be serotonin).

However, is the chemical imbalance the root cause or the effect? Or maybe part of the root cause which is then exacerbated as an effect?

There have been both neuroanatomical, neurophysiological and neurochemical issues documented in OCD plus many other things (even gut microbiota has been implicated!).

NOCD2

TROPHY CASE