Book Excerpts

The following excerpts have been taken from our highly recommended essential read ‘Recovery & Renewal’ by Bliss Johns:

 

Author’s Note

This book has been written expressly as my personal account of my experience with withdrawal, both as a survivor and through my work supporting thousands of people worldwide. Omissions, if any, are genuinely a result of any residual cognitive impairment present at the time of writing and for no other reason.

 While I believe that informed choice is important, I am not against the use of medication and I do sincerely feel that all my doctors were well-intentioned. Under no circumstances has anything here been written with the intention to be malicious, slanderous or vindictive.

 The contents are more factual and anecdotal than scientific. This is, however, a responsibly written comprehensive guide which will prove invaluable to anyone discontinuing sleeping pills, other tranquillisers and antidepressants, their families and the professionals who provide care.

My sincere wish is that the guidance and reassurance offered here will give courage and hope to many.

 

Preface

Coming off sleeping pills, other benzodiazepine tranquillisers and antidepressants is often challenging and can result in losses, isolation and feelings of being misunderstood and unsupported. The concept of a ‘feel-good’ book that would give an emotional boost during     withdrawal came as a result of numerous requests from visitors to our old recovery support website which was started during my own withdrawal.

As I shared more of my experience, I was asked to describe what the symptoms were like for me and how I coped. I soon started receiving emails seeking permission to print the logs. Relatives and carers also began requesting written information to pass on to those too unwell and cognitively impaired to use a computer.

I have included practical information about withdrawal based on my experience, my counselling training, chemical dependency  studies, and knowledge acquired through my past helpline support work. The main focus, however, is on being emotionally safe and coping well.

Due to brain fog and other withdrawal issues, cognitive function is often impaired and this can cause incoherence as well as poor  reading comprehension, concentration and memory. Because of this, I have assumed an informal tone throughout and have devised a simple format. Any clichés and repetitions such as ‘This, too, shall pass’ and ‘Withdrawal is temporary’ are intentional. I hope these modifications will have the desired effect of making this easy to read.

Introduction

When I wrote the original Benzo-Wise book I had no idea that just as many people discontinuing antidepressants as those coming off benzodiazepines would end up reading it and would contact Recovery Road about our services. More than fifty percent of the people we communicate with are coming off either an antidepressant only, or an antidepressant taken with a sleeping pill or other benzodiazepine. The symptoms are very similar and so are the challenges and repercussions.

During the almost three years that the Benzo-Wise book was in print I received many emails from people coming off antidepressants saying it has been a ‘lifeline’ and the recommended coping tools have proven to be very effective. Some asked why had I not included specific information on antidepressants and why were there no success stories from people who took antidepressants only. I now offer this updated version in response - to acknowledge our anti-depressant readers and to validate their experiences.

I will never be able to fully articulate how privileged and grateful I feel to be able to use my experience in a positive way. When I wrote the first edition of the book I was unaware of the magnitude of the withdrawal problem. It was written for my then online withdrawal friends with the primary intention of giving hope to those experiencing the most distressing symptoms. For it to be considered of value not just to individuals coming off these drugs but to their relatives, doctors, counsellors and other caregivers is an unexpected bonus. I am pleased and relieved that it is indeed fulfilling its purpose and has even surpassed expectations.

What I am about to share next is extremely important and needs to be assimilated well, especially if you are reading in preparation for your taper. I had an intense withdrawal; you may not. There are people who have successfully quit antidepressants, sleeping pills and other benzo tranquillisers with very few or no problems; it is possible that you could too. These success stories are not found on the Internet because those individuals had no reason to communicate online.

Instead, on the Internet we have the people who are having the worst experiences and may also have had very little or no information and support. So you must always keep this in mind as you read any withdrawal stories, including mine. If you don’t and you anticipate the worst, you will worry and become anxious about something that may never happen. It makes more sense to preserve this emotional energy to keep you anchored while you withdraw.

On the other hand, if you are tapering or are completely off your medication and are already experiencing intense symptoms, you will agree that a problematic withdrawal can be, at the very least, upsetting. Discontinuance after long-term use can result in the most bizarre physical and psychological symptoms: from muscle pain, burning, twitches, gastrointestinal problems to distorted perception, anxiety attacks and sleep difficulty. This can happen to someone with no history of psychological problems, as in my case where I was  prescribed the drug for a facial tic.

Finding as many positives as possible while the recovery process takes place can make a big difference to your withdrawal experience. Try to focus on accounts where people have successfully tapered, rather than the more disturbing stories. If you have the support of family or friends, share pertinent information with them so they can have a better understanding of what withdrawal entails.

Using a technique that works well for you will be to your advantage. It can be as simple as a breathing or mindfulness exercise, or repeating a positive statement. Do it as often as you feel is   necessary. Stock up on a few books that make you feel encouraged, movies that are lighthearted and music that uplifts you. Try to use as many resources as possible to make your days lighter without becoming too preoccupied or obsessive; moderation is key. By the time this is over you will find that you have become an expert self-nurturer.

Although the word ‘healing’ is used frequently, withdrawal is not in itself an illness; it is a syndrome or cluster of symptoms that occur at the same time and can make one feel unwell. Unless there are   pre-existing or concurrent medical conditions, this will be the only reason for your symptoms. When the recovery process is complete, the symptoms will subside.

Provided you are well-informed, when you experience a symptom, no matter how bizarre, you will know that it is withdrawal and not an isolated medical problem. If in any doubt, seeking medical advice to confirm this will provide peace of mind. The most important thing to keep in mind is that as unpleasant and unsettling as it can be for many, withdrawal does not last indefinitely. Recovery is the natural outcome.

If you have discussed coming off your medication with your doctor but feel daunted or overwhelmed by negative accounts of the withdrawal experience, please do not let this deter you. More than likely the reason you want to quit is because the side effects are making you unwell and you feel worse than you were prior to taking it. It will be worth it. Remember, your experience could end up being less extreme and only mildly unpleasant. If you prepare yourself mentally and get your doctor to supervise your taper, your withdrawal should be manageable.

Never stop taking an antidepressant, sleeping pill or other benzodiazepine abruptly or what is referred to as ‘cold turkey’ as this can cause serious medical problems including seizures. Instead, taper slowly and stick to your schedule. Don’t be tempted to skip a phase of reduction if the symptoms seem manageable. Be patient; it is better to have what may seem like a long taper than rush the process and end up in protracted withdrawal.

If symptoms appear while you are tapering off the drug, try not to resist them. Accept them as evidence that you are on the way to being drug free. This is the beginning of your recovery. When it is over you will be able to celebrate having a clear, lucid mind and a quality of life that is much better than you could ever have imagined. The most satisfying feeling will be the sense of accomplishment, invincibility almost, and the relief you will experience when you begin to have glimpses of recovery. While you wait, be as gentle with yourself as you possibly can.

Chapter 1

A Faded Memory: My Success Story

L

ife was good. Not only was my life good, it was charmed. I was introduced to the concept of our thoughts influencing what we attract into our lives in my early twenties, and had become an expert at what I consider to be the manifestation of unlikely opportunities and many pleasant experiences.

This was confirmed during the summer of 1997. After being    commitment phobic for what friends and family felt was a ridiculously long time, I gave in to their subliminal pleas and the incessant ticking of my biological clock. At age thirty-four, I started affirming to meet my ‘kind, loving, attractive husband’. I was finally ready. It was no surprise that a few weeks later I met Dylan. The following year, on Valentine’s Day 1998, he asked me to marry him. I accepted. Of course, you could say it was coincidental but it is more exciting to think he appeared in answer to my affirmations.

There was just one problem, however. It seems insignificant now but was a source of bother at the time. For most of my life, from around four years of age, I had had a twitchy ‘quirk’ where my right eye would tic involuntarily. It was not always noticeable and despite the mild twitching I enjoyed a normal, active, happy childhood. As I grew older, I became more distracted by the tics and explored every possible complementary treatment in an attempt to relieve them, but to no avail. By the time I’d met Dylan I had consulted chiropractors, physiotherapists, osteopaths, herbalists and different types of massage therapists. These approaches contributed to my wellness but did not have the desired effect.

As Dylan and I planned our wedding, I knew I had to find at least a temporary cure. The tics were mild and infrequent at the time but there was a ninety percent probability that my face would do its little ‘dance’ in the middle of the exchange of vows. If that happened I knew I would become flustered and embarrassed. I was adamant about not letting the tics ruin the day and this is why I went to see my doctor early one wet morning in the spring of 1998.

He first prescribed an anti-epileptic drug which was much too   potent for my mild condition. Within days I returned to let him know it was making me too drowsy to focus. He then prescribed clonazepam, a drug I had no clue was used as a tranquilliser or that there was a high risk of dependency associated with its use. It was a low dose and helped the tics initially, reducing them to a few daily. I was elated. I had found the miracle cure and our wedding day was going to be perfect.

My euphoria was short-lived, however, as the tics soon returned but this time more frequently and intensely. Once I realised the medication was no longer effective, I stopped taking it. A few days later, I had the most frightening involuntary movements. I quickly took a dose and the fitting stopped. I thought I had developed a form of epilepsy or other movement disorder when I had in fact quickly reached tolerance (when more of the drug is needed to be effective) and by quitting ‘cold turkey’ instead had what was my first with-drawal reaction.

When the dosage was increased, I once again rapidly became   tolerant and the tics returned with renewed intensity. For fear of having more seizure-type movements, I continued taking the drug. The wedding dilemma seemed imminent and one week prior to the big event, I shared my concerns with my new doctor. He prescribed a small amount of diazepam to be taken adjunctively with the clonazepam. By the time the nuptial day arrived, I was tic-free but also heavily sedated. Despite my being in a near-catatonic state, Dylan and I enjoyed a charming, country manor ceremony and an unforgettable reception with family and friends.

I did not take diazepam again until my taper. Sadly, my dependency on clonazepam had become well-entrenched within one year of my first prescription. I just did not know it at the time. I ended up taking the medication through repeat prescriptions for more than seven years. For most of that time I was in tolerance, gradually having more and more obscure complaints and minor ailments, or what I now appreciate were withdrawal symptoms.

During the earlier years on the medication life was relatively normal. I worked diligently within the voluntary sector in the areas of domestic violence crisis support and counselling. I also completed three years of clinical psychotherapy and counselling training. But gradually everything became a blur: the fog descended on my brain, I became easily fatigued, emotionally anaesthetised, spaced out and absent-minded. Despite eating healthily and exercising, my weight gradually ballooned out of control. This baffled me but I still did not identify the drug as being contributory in any way.

I also had regular, dramatic visits to the local hospital emergency room. On one occasion, due to a lapse in concentration, I peered at a tube of super strong adhesive to see if it was empty and squirted it directly into my eye causing my eyelids to stick shut. My neighbour must have questioned my sanity when I banged on his door jumping up and down, shrieking like a psychotic cheerleader.

“Rhys, Help! Are you there? Crazy glue’s in my eye. I’ve glued my eye shut,” I cried. He looked at me in horror as I tried to tug the lids apart. When we arrived at the hospital I was immediately seen in a special ‘ocular super glue injury’ cubicle. It was reassuring to discover that this was a common mistake. I had more accidents that led to emergency visits that year including one involving beetroot, and all too embarrassing to share.

When my memory began to be affected and the brain fog became too severe, for ethical reasons and in the interest of my clients, I gave up counselling and went to do a less demanding job. I made unsound judgements with dire consequences but still did not, at that time, make the link. Although I had a feeling of foreboding and was generally unwell, I had no idea that this was in any way related to the drug.

In an effort to regain control of my life, I started desperately searching the Internet for answers. I eventually stumbled upon my deliverance in the form of the Ashton Manual, also entitled Benzo-  diazepines: How They Work and How to Withdraw. This lifeline is written by C. Heather Ashton, Professor of Clinical Psycho-pharmacology at the University of Newcastle upon Tyne, England and it contains the most invaluable information on benzodiazepines. (Please note that there should be flexibility in withdrawing from these drugs and rates should be dependent on withdrawal responses.) I recall the tears gently rolling down my cheeks as I finally identified the reason for my challenges.

The following morning I practically sprinted to my doctor’s office,   eagerly showing him my printed copy of the Ashton Manual. “Look Doctor,” I beamed. “I’ve found out what’s wrong with me!” He quickly flicked through the tapering schedule pages and prescribed the diazepam required for me to wean off. I left feeling optimistic.

Contents

Full contents of the book:

Preface

Introduction

1        A Faded Memory: My Success Story

2       How They Work

About Antidepressants

About Sleeping Pills and other Benzodiazepines

Down-regulation

Tolerance

Half-Life

Paradoxical Reaction

Dependency or Addiction?

       The Basics

‘Cold Turkey’

Tapering

Recovery Timeline

4        Symptoms

Withdrawal or Underlying Issue?

Acceptance

5        Managing Psychological Symptoms

Brain Fog

Depersonalisation

Derealisation

Depressive Thoughts or Low Moods

Paranoid Ideation

Obsessive, Unwanted Thoughts

‘Rational’ Mind

6        Acute Withdrawal

Journal Logs

7        Post-Acute and Protracted Withdrawal

Journal Logs

Progress Reports

8        Coping Tools

9        Stimulants, Supplements and Diet

10    Supporting Someone in Withdrawal

Tips

11    Suicidal Ideation

What to Do if Someone is Suicidal

12    Counsellors

What Every Counsellor Should Know

13    Doctors

What Patients Wish Their Doctors Knew

14    Employment and Debt

15    Recovery

Journal Logs

The Aftermath

16    Closure

Letting Go

17    Your New Chapter

18    Success Stories

Resources Guide

List of Common Antidepressants

List of Common Benzodiazepines

Symptoms A to Z

Bibliography

Index