It’s been creeping up on me, this lethargy, this heaviness, the fogginess in my head. First it was the day after I did much of anything, then it was part of every day, and now… now all I do is lie around in bed. Maybe I read the New York Times online… but maybe I can’t finish the article. My concentration is terrible. Maybe I sort a few of my digital photos… but maybe I can’t focus on it, and soon I find I’ve been staring into space for the past five minutes.
I have thought that it could be good to force myself to do something. So on Thursday, I scheduled my day more fully than usual. It didn’t help. Even with a lot of caffeine, my eyelids were made of lead and couldn’t resist the pull of gravity. I was dull company to the friend I met for tea. I was an absent-minded (but lucky) driver.
I know it doesn’t make sense to other people when I say, “I can’t get out of bed.” Of courses you can, they think. Your legs work. All you have to do is move.
And they are right, of course. I get up to walk to the bathroom, to feed my dogs, to grab something from the refrigerator, occasionally. But I lack all motivation to do anything. I’m just floating in an in-between space, waiting for things to change. I don’t know how to make them change myself, or if I do know how, I can’t really remember or I can’t summon up the will to do them.
I did put on semi-clean clothes this afternoon to go and see Tabitha, my psych nurse. She thinks, and I agree, that this is a reaction to the big drop in Effexor I made in late December. It’s a bit like my old depression, though not exactly the same. I don’t hate myself (though I’m not happy about not accomplishing anything). I am not despairing (though I am discouraged). I am not harming myself (I thought about it but it wasn’t hard to resist the impulse).
So what to do about this? For now, we are bumping up my dose of Cymbalta. I’m agreeing to this, even though I don’t really believe in anti-depressants anymore, not as a long-term solution at least. I guess I am agreeing because 1) I don’t know what else to do and 2) I am hoping for some short-term relief that could allow me to implement the things I think help more: yoga, exercise, structure, meditation, companionship, healthy eating. Right now I don’t have the energy to do any of these. If pharmaceuticals can give me that, I’d be grateful.
CREDIT: Photo by Jessica Castro on Unsplash
I have found that success helps. Actually, not the success itself, but a
Doesn’t sound like you’ve got much of an option at the moment. The de-motivation was something I really noticed during withdrawal, and it seemed to be out of proportion to the overall severity of other symptoms of depression. No easy answers though. Activity scheduling and those sort of strategies work to a certain extent, in that you get more done, but that’s not quite the same as *wanting* to do any of it.
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Really? I haven’t heard anyone else talk about this as a withdrawal symptom, so to be honest, I have wondered sometimes if maybe it was from something else. But the way you describe it, with de-motivation out of proportion to the overall severity of other symptoms of depression, that seems exactly right. So do you think boosting the Cymbalta is a wise strategy? Will I just have to repeat this again later with the Cymbalta? If I didn’t add meds and just waited, would this go away? (Of course, I get it that you can’t really answer those questions and even if you knew, no one knows how long it might take). Thanks for sharing your experience, and for normalizing mine.
I didn’t connect the demotivation with the withdrawal at first. I had a fairly consistent pattern of symptoms with each dose reduction of the citalopram – agitation, anxiety, diarrhoea, visual lag (but never any brain zaps), depressed mood and suicidal ideation – which would settle after a few days to a week and I’d be relatively okay until the next dose reduction.
I think I was down to about half my dose when the demotivation became a problem. I was just watching tv all the time and not getting anything done, and I thought I just needed a bit of a push. That was what prompted me to see Abby, the CBT therapist. My initial thought was that I needed a life coach, but I was worried that pretty much anyone could call themselves that so I decided to see a psychologist instead.
It went well at first, I liked how structured CBT was but as I continued decreasing the drug dose I became more overtly depressed and suicidal, and also began to have the problems with mood instability (to the point where I nearly punched out a transport security officer one day). As I worked longer with Abby I also began to have what I now recognise as transference problems. Ended up being a big mess. Quit with both Abby and Dr L simultaneously (I’d been still seeing him ocasionally for the medication management). Came to my senses several weeks later and went back to Dr L but was highly suicidal for several weeks, and it took quite a few months for the depressive episode to resolve. To be honest I don’t think things have ever gone back fully to normal but I suspect that is partly because when you have symptoms for a long time you start to make behavioural adaptations which then need a lot of work to shift.
My impression is that increasing the dose will improve things in the short term, but the problems will just come back when you reduce the dose again. A slower taper seems to make the physical withdrawal symptoms less severe but not necessarily the mental symptoms.
Sorry, that probably doesn’t help a lot with deciding what to do in the longer term. For myself, I think that if I’d known how bad things would get I may very well have decided to just stay on antidepressants indefinitely. I don’t want to risk trying them again because there is NO way I’ll put myself through withdrawal again.
…perception of success. When I’m struggling, I set very tiny goals for myself and I recognise this is about a motivation strategy. I am doing it to help myself, but it requires compassion for my difficulties and knowing no one is motivated by yelling and complaining.
You know, I do this sometimes, too. I set a timer and tell myself, okay, I will just work for 20 minutes. Or I will just put in this one load of laundry, and then if I need to go back to bed, I will. Just very, very small and limited goals. And you are so right: it needs to go together with some compassion for myself. I keep reminding myself that when I feel better, I do things. If I could, I would. If I’m not, that means I’m really not okay, and that’s not a reason to punish myself. So thank you very much for reinforcing that message. It can be hard to hang onto sometimes.
oh boy, I can relate, low energy here too. I am continuing to do what I normally do, but its so tough. I really feel the lethargy a lot these days. xx
It’s hard, isn’t it, when you struggle to do even the most basic things.