What Helped and What Hindered My Recovery from PSSD and Protracted Withdrawal from Antidepressants?

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After many attempts, I finally managed to come off antidepressants. But then I had to struggle with six years of horrible withdrawal. Recovering from protracted withdrawal was a huge challenge, and I had to approach it wisely, doing everything I could to survive the process and help my body and mind heal. In this article, I will outline what helped and what hindered my healing process. All the information is based on my own experience of over six years with protracted withdrawal from antidepressants and post-SSRI sexual dysfunction (PSSD), which occurred after taking sertraline. I eventually recovered after a lot of hard work on my part.

Pop art style. Two workers carry a bandaged brain on a stretcher.

Time

At the beginning of my journey after stopping the medication, I often gave myself ultimatums: either I would feel better by a certain date, or there would be no point in continuing to exist as an empty shell. Unfortunately, there were times when it seemed like the suffering would never end, but in the end, that turned out to be far from the truth. Despite feeling stagnant, as time passed, my life became more bearable, and the withdrawal symptoms lessened year by year.

One thing that was helpful to remember was that recovery often has a non-linear pattern and follows a “waves and windows” pattern. After moments of temporary improvement, sudden setbacks can occur. The comforting fact is that over time, the windows of improvement become more frequent and the waves of setbacks fewer, until I was fully stabilized.

In my case, it looked a bit different; for several years, I felt like there was no improvement at all. It was only later that I started to notice that things were moving in the right direction.

If I had to go through it all again, I would definitely track my recovery progress.

Grief

When I realized what I was facing and that it was uncertain if or when I would recover, I fell into despair. Looking back, I gradually went through the stages of grief: shock, numbness, longing for my former self, bitterness, anger, sorrow, and confusion, and finally, acceptance of my situation.

I had to come to terms with the temporary deterioration of my cognitive, emotional, and sexual functions, even though at the time, I wasnā€™t sure if they would ever improve, especially since I saw no progress for many months.

I sought support through therapy and support groups so I wouldn’t go through it alone. Unfortunately, my close family struggled to understand what I was going through, so I looked for people who were going through the same thing.

Sadly, places like Reddit or Facebook support groups are often poorly moderated, making it easy to spiral into despair and hopelessness. For a long time, I was a regular participant in these communities. While they provided temporary relief through understanding, I often sank deeper into hopelessness. Worse, I became one of those dragging others down with me, something Iā€™m not proud of. Eventually, I started seeking out people who had recovered rather than drowning in desperation with those who, like me, saw no hope of recovery.

Sleep

For a long time, I neglected the crucial activity of sleep, focusing instead on desperately searching for help. After coming off the medications, my sleep was severely disrupted, and my sleep hygiene was poor. Ultimately, I decided to prioritize it. I started going to bed at regular times (preferably before 10 PM to maximize melatonin production during sleep), eliminated blue light exposure before bed, ensured the right room temperature, and avoided eating several hours before sleep.

It was tempting to resort to sleep aids like melatonin, but in the long run, that only deepened my circadian rhythm dysregulation. Once I finally managed to regulate my sleep cycle and improve such a simple activity as sleep, it became much easier to implement other changes in my life.

Gut, Ketosis, and Autophagy

Due to the use of psychiatric drugs, my neurotransmitter factoryā€”my gutā€”was deregulated, and my microbiome was depleted. I decided to adopt a diet that would help rebuild my gut flora. I eliminated processed foods and switched to an anti-inflammatory (keto/carnivore) diet, which improved my mood, sleep, and cognitive function.

Additionally, I took psychobiotics, supplementing with bacterial strains like Bifidobacterium infantis, Bifidobacterium longum, Lactobacillus acidophilus, Lactobacillus helveticus, Lactobacillus reuteri, and Lactobacillus rhamnosus, which also benefited my gut health.

I also decided to support my body’s natural self-regulation and cleansing processā€”autophagyā€”by entering ketosis. To switch my body’s energy source to fat, I couldn’t exceed 50 grams of carbs per day. The adaptation process and initial “keto flu” lasted about two weeks. It was extremely challenging, especially when the keto flu symptoms overlapped with protracted withdrawal symptoms. Once they subsided, though, the results were remarkable. For me, ketosis was a turning point that accelerated my recovery process.

Neurogenesis and BDNF

Another idea I explored was neurogenesis. As a neuroscientist, I decided to use the knowledge I gained during my studies and see if theory would translate into practice. To stimulate brain-derived neurotrophic factor (BDNF)ā€”a protein secreted by neurons, part of the nerve growth factor familyā€”I knew I had to stay physically active.

During physical activity, whether strength training or aerobics, a lot of neurotransmitters are released. Regular, long-term physical effort at moderate to high intensity leads to an increase in BDNF levels, which promotes neurogenesis, stimulates the branching of nerve cells, and stabilizes neural connections.

Despite being in a state of complete lack of motivation and anhedonia, feeling like my life was hanging by a thread, I forced myself to be activeā€”including walks as well as four gym workouts a week. For many months, I felt no reward, as if my reward system was turned off. After workouts, I only felt exhaustion and disappointment. Nonetheles, I kept exercising, gradually increasing my workout volume. The reward came with a significant delay. Over time, I began to feel my brain rewarding me for the effort. The first time I felt endorphins and post-workout euphoria was a breakthrough! Regular physical activity proved to be a lifesaver, giving my body the right stimulus to start the healing process.

In the photo on the left, I am about a month after quitting 100 mg of sertraline (early 2018). The photo on the right was taken in August 2024, right after completing a multi-kilometer race with over 30 obstacles, the ‘Runmageddon’.
Substances and Reinstatement

After quitting meds, I often considered taking various substances to experience even temporary relief from suffering. Despite the severe state I was in, I quickly realized that using substances during recovery significantly disrupted and slowed the process. My nervous system was slowly returning to homeostasis and regenerating, so I ultimately chose to remain completely abstinent.

In moments of crisis, I sometimes thought about going back on meds or trying a different group of drugs, hoping this time it would be different or wouldnā€™t affect me as negatively. A year and a half after stopping sertraline, I was dealing with intense suicidal thoughts. Seeing no improvement and feeling a growing sense of hopelessness, I made the mistake of visiting a psychiatrist again, who suggested trazodone as a “safe drug.”

Even though I took only one pill, the consequnces were catastrophic. It led to even greater destabilization of my nervous system during its recovery, and my condition worsened significantly. This was a valuable lesson for me, ensuring I would never go down that path again, hoping another pill would fix things.

Supplements

Supplements are another risky tool for self-help, which should be a last resort, and which I donā€™t recommend trying first. Unfortunately, I fell into the trap of thinking, “There must be a pill that can fix me, since another pill broke me.”

The search for a quick fix and relief from suffering was understandable, but in this case, it didnā€™t necessarily work and often had the opposite effect. Early on in my recovery, I tried many seemingly safe substances, which turned out to also affect the serotonin system (e.g., St. John’s wort or ashwagandha), unfortunately leading to negative consequences and disrupting the healing process.

Although I eventually found supplements that helped with recovery (such as magnesium orotate), from my perspective today, especially in the early stages of coming off meds, further interference with an already deregulated nervous system seems quite risky. The response to supplements is highly individual, making it a gamble, and each trial carried the risk of a “crash,” adding unnecessary stress. If I could choose again, I would steer clear of them.

Relaxation Techniques, Mindfulness, and Cold Exposure

During recovery, especially early on, I often experienced confusion, irritability, and anxiety. Calming the nervous system was very helpful, particularly in difficult moments. In moments of crisis, I used Wim Hofā€™s breathing techniques and Jacobson’s relaxation.

Another excellent method was cold exposure. It gave me a temporary but significant dopamine release, effectively improving my mood when I was thinking about the worst.

“It’s Not How Far You Fall, It’s the Way You Land”

This quote, which is the title of an album by the American band Soulsavers, perfectly captures the essence of the problem of protracted withdrawal in my view. It is undoubtedly a trauma for both the mind and body, but ultimately, itā€™s up to us whether we let ourselves fall or manage to overcome this difficult time, take care of ourselves, and recover.

The passage of time since the last dose of medication is our ally, but simply lying around and waiting for improvement may not be enough to survive the tough moments. Taking action by introducing routines that positively impact the mind and body during the recovery process can be the spark that initiates a cascade of positive changes, easing and even accelerating recovery. At least, that was the case for me.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussionā€”broadly speakingā€”of psychiatry and its treatments. The opinions expressed are the writers’ own.

4 COMMENTS

  1. Thank you so much, Tomasz, I’m so grateful for you sharing your story about healing from psychiatric harm. As a US psychopharmacology researcher, who stands adamantly against big Pharma’s, psychiatry’s, and psychology’s systemic abuse of American children, I’m very grateful for your truth telling.

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  2. This is FANTASTIC. Thank you. So very relatable. Iā€™m down to 3.56 hard earned milligrams of Citalopram. I am micro tapering. My withdrawals are smaller and shorter lived that way but they are still there and at this rate I have 3 years to go, roughly. (I decrease 2/100 mg every 5 or 6 days) My hope is to avoid the protracted withdrawal by, well, protracted tapering. I exercise, eat ā€œcleanā€ for the most part, and have found great help in probiotics, especially the yeast eating strain of Saccharomyces Boulardi. I have just been reading and listening to the talk about the keto diet or at least a much lower-carb diet. Your testimony above has given me strength for go do it. I canā€™t tell you how grateful I am. Thank you. And congratulations.

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