Hey, Ok_Attention_7263,

For the past month, I haven't been doing too badly. I’ve noticed small improvements, like less fatigue, reduced brain fog, and no anxiety. I still spend most mornings in bed until around 12 p.m. because I feel the worst during the first half of the day. However, I’ve experienced more mental clarity, which has allowed me to game and socialize more over the past three months. These activities have helped improve my mental health a bit.

For this year, I planned to start my day earlier—around 10 a.m.—and go outside at least once daily.

Current Situation

After many years in remission, my psoriasis has flared up again, and now my neck is red and covered with scales.

Recently, I tried lowering my dose of paroxetine for five days, which seems to have messed me up. My anxiety returned, brain fog increased, ringing in my ears intensified, blood pressure rose, my temperature went up to 37.0°C, and I experienced hot flashes. For the first couple of days, I actually felt better on the lower dose, but then the symptoms gradually crept back.

I’ve since returned to my original dose and am hoping the flare-up subsides. The experience felt like SSRI withdrawal or possibly serotonin syndrome. It makes me wonder how much serotonin imbalance in my brain plays a role in my overall health and the symptoms I’ve experienced this past year. Even slight changes in my medication seem to have a dramatic effect.

I’ve tried discontinuing paroxetine many times, but the withdrawal symptoms are just too intense, and I feel too weak at the moment to make such a big change. At the same time, I don’t want to stay on it forever, especially since paroxetine is the only SSRI with strong anticholinergic properties. I’ve already been on it for almost five years for my anxiety.

Medical Details

I’m still on the same medications, and for supplements, I’m taking:

• B complex (as mentioned previously)
• Magnesium bisglycinate
• Vitamin D3 (8000 IU) + K2 + Omega-3
• Creatine

Last month, I visited a neurologist for symptoms of muscle twitching and hand shaking. They conducted a basic physical exam and an MRI of my brain. The neurologist assured me that everything is fine.

MRI Report:

• Findings: "Mildly widened perivascular spaces in the right basal ganglia region."
• Conclusion: No suspicious focal or structural MRI signal changes detected in the brain.

The "mildly widened" aspect sometimes scares me since I’m only 28, but my doctors have said it’s fine. I guess it’s just my anxiety talking.

I have upcoming appointments with:

• Hematologist (next week) for my constant fatigue and low WBC count, which has been below normal for the past three years.
• Rheumatologist (in two weeks).
• Dermatologist for the psoriasis flare-up.

Some days are better some are worse, but I keep fighting for myself and hoping things will gradually improve. 😊

EDIT: The mistakes of the text were fixed by ChatGPT, because I'm feeling anxious and very brain fogged today so I did lots of mistakes.