TW for suicide and SA
I’ve had GAD and panic disorder since early 2019. I was started on Escitalopram, it was a rough onboarding to start, but things did settle and I worked my way up to 20mg in 2023. I did have the occasional breakthrough panic attacks, and noticed increased panic around my ovulation window and the week leading up to and including the first few days of my period. Usually propranolol sorted this out and it was something I could live with for the most part.
Last year through my job I came across the mum of the teen (15/16 at the time I think) who SA me (I was 9/10). I didn’t disclose, so I don’t think she knows and it’s something I’ve always pushed deep down and locked away. He was doing things with his sister too who was a bit older than me but I can’t remember by how much..a couple of years maybe. But when I saw his mum, all these memories and wrong disgust feelings came back. I couldn’t immediately leave because I was there to see a patient, but when I was able to get back to my car I broke down and had a panic attack. I escalated to my line manager so I didn’t have to go in to that place and was clear why. She was great, however SLT said long term it wasn’t viable (it would have been but there you go), and my only option was to change teams to avoid that place. I agreed to this but also wasn’t able to move for a few months. Thankfully I was kept out of that place.
I started getting depression symptoms so being on the max of Escitalopram I decided I needed to change meds. Went to my GP, agreed to taper and switch to fluoxetine. At first it was fine and then 4.5 weeks in it really wasn’t. I’d had an interview and got a new job. Then the next day it started with a panic attack that propranolol wouldn’t control and carried on from there. This was the beginning of November. We thought it was possible a combo of side effects and due to it having been my dad’s birthday, who I lost to suicide in 2017. I persevered and we went up to 40mg. With propranolol and diazepam I stuck it out, so desperate for it to work. I was signed off during this time and the panic was intense most of the time, as well as hyperawareness of my breathing. I got to mid January and asked the GP if I could go back to Escitalopram. While it wasn’t perfect it was much better that what I was going through. Due to me starting a new job in the next fortnight he started me on 15mg mirtazapine and said if it didn’t settle then I could look to switch back with the mirtazapine as cover.
10.5 weeks on 40mg fluoxetine I felt a bit of a positive change. I started the new job on the Friday and I felt antsy but I managed it. On the Sunday I went to meet a friend and I felt really unsteady, like I could fall over, and I felt panicky too. It was the start of the week before my period. I tried my best to manage but on the Monday I had to leave work early (new manager very understanding which I am so grateful for). Tuesday wasn’t too bad but Wednesday and Thursday were no good. The next few days continued to be bad. On the Saturday I reduced the fluoxetine to 20mg ready to do the cross taper back to Escitalopram. Monday morning came around again and I drove to work but when I got there I couldn’t walk across the car park. I felt like I was going to fall over still..just really unsteady. Even though I knew it was panic I had to go home again. Got an appointment with the pharmacist (it’s what the GP surgery arranged) and I discussed with her about cross tapering. She was really reluctant, as she wanted me to continue on 20mg fluoxetine then stop for 4 days, then commence on 5mg Escitalopram but initially agreed for me to do the fluoxetine and Escitalopram for a week, then drop the fluoxetine, do another week of 5mg Escitalopram and then up to 10mg. I had some 5mg in already from when I tapered down so I took one after the phone call. She then rang back after 20 mins and said she hadn’t realised I was on mirtazapine too so I needed to do the washout period. She was worried about serotonin syndrome. I didn’t want to stress her out so acknowledged that.
After a lot of thinking and reading I decided I really couldn’t do with the fluoxetine any longer and the wash out period would have co-incided with my ovulation window. I concluded the best thing to do would be to stop the fluoxetine and carry on with the Escitalopram at 5mg as planned. My period also started on Monday, which has helped a little. So I’m now on day 5 of Escitalopram and still having panicky feelings, breathing hyper awareness and feeling unsteady - all of which I’ve been having since November. I have a GP review on Tuesday next week. I know that Escitalopram kicks in much quicker than fluoxetine and the fluoxetine is kind of like a self taper, so I’m hoping by the time it comes to go to 10mg Escitalopram that things will have settled.
My problem is the sensations I’m having, which I’ve been having for months now. Diazepam helps but I don’t want to rely on that. I am mentally and physically exhausted, even though I’m not doing much. I’ve had to take this week as emergency annual leave as I desperately do not want to go off sick again, especially with this being a new job. But I’m so tired. I feel like I’m never going to get better and the hyperawareness/panic/unsteadiness is never going to go away. I know Escitalopram has worked for me in the past and I am kicking myself for ever changing. I am desperate for it to get back to how it was before I switched. I grieve all of the lost time and ruined plans..there have been many. I’m scared that I won’t be able to get through this onboarding with Escitalopram and/or it won’t work like it used to. I’m scared of losing myself. I don’t know why posting really, but any advice or anything would be appreciated. I know it’s long, I’m sorry I didn’t mean for it to be so long. If you got all the way through then thank you for reading.