Last week I read the text of an National Public Radio (NPR) article that suddenly opened my eyes to something that had been puzzling me for a long time. It was not just an “Aha!” moment. It was a “Holy Cow! Now it makes sense!” moment.
About a year ago I was advised by a doctor to stop taking Bupropion, an anti-depressant. He told me to stop taking it daily but to take it only every other day for a month and then to gradually reduce the dosage over a few months until stopping completely. He also said that anti-depressants are not recommended for seniors over extended periods of time as they increase the risk of falls and fractures.
I was quite happy to come off this medication and had, in fact, asked previous doctors to reduce the dosage and to take me off it. One doctor asked me if I felt “normal” while I was on it and, when I said I did, she recommended that I keep on taking it. So, when the most recent doctor told me to quit, I was pleased to do so.
An anti-depressant (Prozac) was first recommended to me over forty years ago when I had post-partum depression that never went away. No-one ever told me that it would be a permanent thing. My assumption was that I was going to be on this temporarily, but I had to trust the medical advice I was given. The brand name has changed over time, and the dosage has been reduced, but I have been taking a daily pill all that time.
Since reducing the dosage and eventually ceasing to take the pills, I have noticed some changes in my well-being. Significantly, the insomnia I had occasionally experienced has become worse. I have often woken in the night but in recent months I sleep every night for only about four hours, then I read and do word puzzles for about three hours or more, then I go back to sleep for two or three more hours. This has been an ongoing problem and I have tried every remedy, but these days I simply cannot sleep through the night.
A more troubling change in my daily life has been an increase in social anxiety. I spend a long time thinking about going to social events, worrying about what to wear, how to get there and so on, until I eventually talk myself out of going. In the last two weeks I have talked myself out of going to a Canada Day party for residents of my building and a barbeque lunch organized by a social group that I belong to. I had even paid $40 for the ticket to that last one!
Until last week, I thought that the insomnia and the social anxiety were problems I had created for myself by lifestyle choices I had made, and I was trying to deal with them appropriately. Then I read this article from NPR by Emily Corwin, and suddenly it all made sense. Coming off anti-depressants was causing these problems.
Corwin writes: “What most prescribers and patients don’t understand is that “you can have symptoms that persist for long periods after you stop them,” said British psychiatrist Mark Horowitz, who specializes in antidepressant withdrawal. According to one analysis of patient narratives, people who experienced long-term withdrawal suffered for an average of eight years.”
Since reading the article, when I find myself resisting socializing, I say to myself “This is not you. This anxiety is because you came off Bupropion,” and that makes it easier for me to get out and about. I hope that as time goes by these symptoms will become less debilitating or even go away completely. Regardless, it seems to me someone should have told me this might happen.
Snowbird of Paradise 
I’m thrilled for you and we barely know each other 🙂
Thank you, June! (Although, by now you probably know me quite well!)
Hi Anne: Congratulations for taking yourself off antidepressants after all this time! At age 83 I quite often wake in the night. I often get up and do something or read or watch television or whatever. I don’t worry about it too much. I don’t think I sleep 8 hours at a go anymore. But I always have a sleep in the afternoon which I really enjoy.
Thank you for this, Barb. What is it with this insomnia in old age?? I don’t remember it being a problem when I was younger.
Anne: I think we just roll with it. There are worse things that could happen. Barb
I know you are right, Barb, but it is still annoying.
Sheesh! I wish doctors (or pharmacists) talked about the “back end” of a medication. I read a bit about this medication (I used to take small doses in the Winter for Seasonal Affective Disorder) so started and stopped every winter. I read the withdrawal may be more marked with long term use. I certainly hope you don’t have side effects for eight years!
Great skill, though, to do what I call “self talk” to get yourself to activities!
I agree, Lorna! With hindsight, I should have been asking those questions all along, but I was too trusting.
I get that. I am too trusting as well.
I sometimes think that we give too much power (credit?) to doctors. After all they are also mere humans who just have a different education than what I have. However, with that white coat (not so much anymore), I tend to forget all that and mildly agree to what is suggested to me. It has literally taken me a lifetime (81 years and still going) to remember that I can question what a doctor may say and not just accept it as gospel or even dare to ask questions which delve deeper. Along with that I have discovered that some doctors overlook or simply miss obvious information that we, as patients, need. I’ve found that most of my doctors accept my gentle refusal to accept their pearls of wisdom. Those who have not are no longer doctors of mine. I’ve heard it said that doctors are expected to have a pill for every ailment. My question has become “why is this drug necessary for me to ingest?” I do share social anxiety with you, my friend, mine being based on lacking physical abilities. I’d much rather remain at home where I know I am safe from possible falls and also hidden from questioning stares. However, as I have aged, I now appreciate that in a lot of the social settings I seem to have gained status. I have not sought this, it has just come to me. I am now the matriarch of our family and somehow that means something. And so it goes…also a PS: I sleep in similar broken pieces as you describe.
I was raised to always be respectful of and obedient to people in authority, and doctors were high on that list. Now I realize that subservience was often misplaced but the trust never went away. I need to work on that.
I’m glad you have gained social status over the years, Mary Beth! You certainly deserve it.
And you are another insomniac! I am in excellent company. 🙂
Yes Anne, we insomniacs must stick together! Yesterday I had what was for me a busy day. I randomly recall thinking that I may sleep better Monday night. As it turned out, I maintained my usual routine and slept for about 3 hours and then was awake for almost 4 more hours, finally sleeping for about 2 hours before it was time to get up. Seems useless to fight against it. But I do need to do something when I am awakened. Attempting to go back to sleep seems to release old memories, not necessarily accurate, that tend to really keep me awake. So, I read. Wednesday will be another day of added activity, so I’ll find out if sleep is any better Wednesday night. Oh the anticipation! LOL
I know what you mean about those, often inaccurate, old memories. Gah! I hope Wednesday night finds you out like a light.