How To Handle SSRI Withdrawal
By: William Drake
Updated November 06, 2020
Medically Reviewed By: Amanda Andrews
Prescription medications are not always the right choice, but they can be extremely helpful for someone dealing with depression, anxiety, or other mental health conditions. Selective serotonin reuptake inhibitors (SSRIs) are the medications most commonly prescribed for these conditions. In fact, the American Psychological Association reports that one out of eight Americans took an antidepressant in the last month. As with any medication, people who stop taking them can experience withdrawal. While that may sound scary, it's also very common, and there are ways to manage it.
Basic SSRI Info
SSRIs function by increasing the rate of communication between neurotransmitters in the brain. One of these neurotransmitters is serotonin, which is known as the "feel good" chemical. For people with depression, neurotransmitters may not move between cells as they should. SSRIs ensure there is an appropriate amount of serotonin communicated between brain cells so the areas of the brain that regulate mood can function optimally.
SSRIs help many people deal with depression, bipolar disorder, and anxiety. If you struggle with these mental health issues, t's possible that your psychiatrist or physician may recommend taking an antidepressant medication. You will likely start on a low dose, but side effects are still possible.
SSRI Side Effects
It is extremely important to be aware of any changes in your mind or body that can arise when beginning, continuing, or ending treatment. SSRIs are supposed to help you feel better, not worse. Unfortunately, due to the way medications can react in different people's bodies, this is not always the case. Common side effects of SSRIs include:
- Change in appetite
- Weight gain or loss
- Joint or muscle pain
- Increased suicidal thoughts
All of these side effects should be reported to your doctor, but the most important one to be aware of is the last on the list—increased suicidal thoughts. It seems counterintuitive that medication for depression could cause someone to have thoughts of suicide, but unfortunately it does happen when some people take SSRIs. If you experience any suicidal thoughts, whether on SSRIs or not, it is extremely important to talk to someone. You can talk to a friend or a loved one, a therapist or a psychiatrist, or someone at the National Suicide Prevention Hotline.
It's also important to know that many of these side effects (and others) can appear when you stop taking SSRIs, so you should be vigilant for signs of withdrawal.
Discontinuing SSRI Treatment
You may choose to discontinue taking SSRIs due to negative side effects, or you may feel the medication is not helping your depression. If you would like to continue using SSRIs, but you feel your current prescription is not effective, you might want to try switching to a different SSRI.
Some of the most common SSRIs are Citalopram, Fluoxetine, Paroxetine, and Sertraline, all of which are also produced under brand names. These SSRIs may have different impacts on your brain, so if one doesn't work for you, another might be a great fit. There is no reason to settle for a medication that is not effectively serving you. If that is the case, be sure to speak up, and let your provider know, so you can adjust your treatment.
That said, you may experience negative side effects with all SSRIs, and these effects may not outweigh the benefits. This is okay; everyone is different. Treatment for a condition like depression or bipolar disorder is about finding the plan that works best for you individually. If you are not experiencing benefits from SSRIs, let your provider know.
In almost all cases, your provider will instruct you to start taking a lower dose of the medication before completing discontinuing its use. This process of weaning off SSRIs can help reduce some of the withdrawal symptoms. Because SSRIs alter mood by influencing neurotransmitters and neurons, removing the SSRI from your brain can affect your mood while your body adjusts to its absence. For this reason, many people experience unpleasant SSRI withdrawals.
SSRI Withdrawal Symptoms
The decision to stop taking your SSRI medication should not be taken lightly. Always discuss your choice with a physician first, so you can plan on tapering off the medication. If you abruptly stop taking your medication, or in some cases even when you do slowly wean yourself off it, you may experience intense withdrawals.
There is no clear-cut reason why some people experience SSRI withdrawal, and some do not. It's likely due to the changes that SSRIs cause in the brain. When certain people stop taking them, the brain needs more time to adjust to the changes.
Though not everyone experiences SSRI withdrawal, the phenomenon is fairly common. SSRI withdrawal, also referred to as Antidepressant Discontinuation Syndrome, affects approximately 20 percent of people who stop taking SSRIs. You can experience the syndrome even if you have only been taking the medication for six weeks.
Some of the symptoms of SSRI withdrawal are physical. Many people report flu-like symptoms, such as nausea, vomiting, fatigue, and lack of appetite. Some people also experience sensory issues, such as imbalance or a "tingly," shock-like feeling in parts of their body. Other symptoms include muscle spasms, headaches, and insomnia. You'll notice that most of these symptoms are similar to the negative side effects associated with taking SSRIs.
Other symptoms of SSRI withdrawal syndrome are mental, and arguably more problematic. When discontinuing SSRI treatment, many people feel especially anxious and possibly more depressed. Some people report feeling especially irritable and prone to major mood swings; they might have a "short fuse" with others. These moods are normal, and should be temporary.
Coping With SSRI Withdrawal
It can be difficult to handle the side effects of discontinuing SSRIs. If you're working with a psychiatrist or physician to wean yourself off the medication, they may prescribe an anti-nausea or sleeping medication to help you cope with the symptoms. However, many people are not eager to add another medication to the mix when dealing with the side effects of withdrawal.
Thankfully, there are ways you can cope with the symptoms of SSRI withdrawal without resorting to more prescription medications. (Note that if you do choose to go that route and feel it is best for your health, that is okay, too.)
When you stop taking medications for your depression, bipolar disorder, anxiety, or other mood disorder, it's important to continue seeing your therapist. Often, the period of withdrawal can make a lot of negative mood conditions resurface. It can be helpful to continue working with a counselor, whether in-person or online, to process any emotional withdrawal symptoms you may experience.
It is also a good idea to begin an exercise routine or to maintain your current routine. It can be difficult to feel motivated when dealing with symptoms such as fatigue or depression, but exercise is a great, natural way to boost your mood. Studies have shown that exercise can help people deal with symptoms of depression, and this outlet is especially important when going through an SSRI withdrawal. Exercise, and the endorphin rush that comes with it, can help you feel better.
In addition to exercise, mindfulness can help you deal with emotional symptoms of SSRI withdrawal. Techniques such as meditation and deep breathing can help you reduce levels of irritability by reminding you to slow down and step back from a situation before you react. Yoga can be a great tool for coping with mood disorders, too, as studies have shown, and in general it tends to make practitioners feel calmer in their daily lives.
Journaling can also be a great tool when dealing with SSRI withdrawal or any mood disorder. If you have never kept a journal before, it may feel strange at first, but once you get into the groove of writing your thoughts out on paper, you will feel the benefits. Journaling allows you to let out your thoughts and feelings without physically acting on them, and it can provide relief from anything you have kept bottled up. It can also provide clarity on how to handle certain situations or help you see things from a different perspective.
Online Therapy Is an Option
For many people SSRI withdrawal is a very difficult thing to overcome. To reduce the burden, talk to your doctor and make a plan to reduce your dosage gradually instead of stopping cold-turkey. Even if you take the necessary precautions, you may still experience withdrawal symptoms. Remember that it is normal and that the symptoms will pass with time. Be sure to try out the techniques above to ease your symptoms, and do not hesitate to talk to a therapist or counselor.
Research has proven that internet-based therapy can help people cope with stress, anger, and other emotions potentially stemming from SSRI withdrawal. A study of the effectiveness of internet-based cognitive-behavioral therapy (CBT) in managing certain mood disorders found that online treatment can significantly improve symptoms of anxiety and depression. The study states specifically that online therapy reduces the barriers commonly encountered when seeking counseling. The study also mentions that improvements in symptoms were maintained after 9 months, which indicates that internet-administered CBT can have long-term benefits when working through certain mental health issues. With online CBT, therapists can create an easily accessible program that includes exercises, counseling, lessons, and other resources for working through difficult-to-process emotions.
As outlined above, online therapy platforms can be a convenient, effective way of connecting you with a qualified counselor, so you can seek help during withdrawal. With BetterHelp, you have the option of messaging, chatting live, speaking over the phone, or video conferencing with your licensed therapist—no more sitting in a waiting room, or worrying about long commutes. Also, you can reach out to your licensed therapist any time of day, without an appointment or the need to speak with a receptionist. Just send a message, and they will respond as soon as possible. Qualified professionals know how to guide you through the process of managing SSRI withdrawal, and other difficult mental health issues. Below are a couple of reviews from clients who found support with our counselors.
"BetterHelp is the best thing I've found in a long time. My counselor always has time for me to fit me in. And this fits my schedule. A lot of my crises happen at night and I'll sit and email Suzanne and she wakes up early and I usually get a response early in the morning. There have been times when I've had meltdowns and I will mark urgent and Suzanne gets back to me very quickly and she has a great effect to ground me. I've been through a tough couple of years and Suzanne is really helping."
"David supported me in becoming aware of my strengths and being the best version of myself. He helped me in a period of my life in which I was literally stuck and my negative beliefs were holding me back from being myself and shine."
As you now know, millions of Americans have taken SSRIs, and many have experienced withdrawal when they were ready to stop taking this medication. It may not be easy, but it's normal. If you need support during this challenging time, don't hesitate to reach out today.
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