Sertraline and anger

Many thanks I just keep having anger episodes nice to no they subside

Yup, they call them "neuro emotions" when coming off - neuro anger, neuro anxiety, neuro depression, neuro apathy etc.  There may be a real trigger, but the extent of the emotion is usually disproportionate!

Thanks what do you mean by a trigger ? And sorry I'm no good with big words what does disproportionate! mean ?

Disproportionate means out of proportion, so for instance, if someone cuts you off on the highway, most folks would get irritated, but a disproportionate response would be to fly into a rage.  Triggers are the event that causes us to have an emotional response, such as the event of the idiot cutting us off on the highway :-)   So, when you have anger episodes, they are't just happening, right?  Something sets you off, but perhaps you are feeling more irritable and prone to anger than might be normal for your personality.

Thanks for replying

Some times I can see what sets the anger off but some times I can't it puzzles me but I think it's my thoughts that do it most of the time my personality as totally changed my girlfriend said to me why are you so angry I say because of what ever but some times I can't say what it is it's frustrating do u think it could be be douse I'm coming of sertraline?

Absolutely, it is because you are coming off, probably too quickly.  Don't mistake this to mean that you need to stay on the drugs.  These drugs are powerful and change our brains physically, so when you come off too quickly, you are left with an imbalance that your brain is scrambling to adapt to, but that adaptation takes time, sometimes many months.  The more steeply you taper, the more severe and distressing the symptoms.  It is much better to do a very slow taper, allowing your brain to make small, gradual adjustments so that you aren't as aware of the withdrawal symptoms or find them more tolerable.

You should never make a med cut when you are feeling anything other than good!  It is important to allow your system to stabilize betwen cuts.  The ideal is to make a cut, and wait four weeks for everything to settle.  It is also important to keep a journal with dates of when you made the cuts, by how much and dates for when symptoms crop up.  For instance, I know through my journaling that five days after a cut in mirtazapine, I will start to feel anxiety for up to five days, so I would wait for at least a week after they go away before making another cut.

The next problem is that the meds don't come in dosages that fascilitate small enough tapers.  People are taking half a pill, which is a 50% cut, and then a week later they take half of a half, and that's another 50% cut from the previous amount, and the brain REALLY notices those big jumps, especially since not enough time was allowed for the brain to adapt to the previous cut!

If you need help with tapering, please reply and I will see what I can do to help..

I created a post with information on how to get off safely here:  

https://patient.info/forums/discuss/sertraline-488781?page=0#1834227

Don, it might help if you tell me how you are coming off.  What was your highest dose, for how long, when did you start to come off, how did you do it, and how much are you on now?

If this is really distressing you, you could updose a small amount and see if you can get stable, but this might take up to a week to help.  Sometimes just understanding what is causing the anger helps everyone put up with it until you stabilize again (with that symptom going away).  You might hold at this current dose for one or two months to get stable, and then do a much slower taper from there.

Hi betsy

My highest dose was 100mg that sent my anxiety mad went to 50mg for about 5-6 weeks then 25mg for 4 weeks now then 12.5mg for 3 weeks then 12.5 every other day only for 4 days I just went back to 12.5mg the I've realised its the negative thoughts that are making me angry

Thanks for you advice it's very helpful

I'm glad you reinstated, and it does help to be aware of the negative thoughts because guess what?  You don't have to have them!  Now, the WD makes us prone, but you actually do have a choice to have the thoughts you have, and ruminating over bad stuff just increases our suffering, as you have seen.  So, while waiting for stability from the updose, simply try to notice when you enter into that type of thinking, and say to yourself, no, not going to go there!  Take three deep breathes, really slowly, expanding your belly on the inhale.  Focus on the sensation in your body of breathing.  This is mindfulness, focusing on the present moment, being aware of the "now."  So much of our suffering comes from run-away thoughts about the past and future, or even about what has been done to us right now.  We do have a choice about the thoughts we have; we dont' have to let them "use" us, run away with us.  It just takes awareness of it happening.  And you don't have to be perfect; it is normal for the thoughts to get the better of us even as we try to be more aware, but there's no award for doing it perfectly - just notice and nudge yourself back to being present.  Most of the time we can say, "at this moment I am ok."

Now, ask your doctor about getting sert in the liquid form.  It comes as 50 mg per 5 ml, so 10 mg/ml.  After you are stable on the 12.5 mg daily, start taking 11 mg, which is 1.1 ml.  Be sure you get a syringe from the chemist that can measure at least 0.1 ml.  Take that amount for at least 3 weeks and assess how you are feeling.  Keep a journal of how you feel each day and when you are making dosage changes.  You may still feel WD symptoms, but at a level that is tolerable.  Note what day that starts and ends.  Then, you will know whether you need 3 or 4 weeks between doses.

Your next cut would be 10% off the previous dose, so about 1 ml.  I know this seems painstakingly slow, but when we get down to the lowest doses of these drugs, that is when larger cuts are really noticeable to the brain.  You could try doing a 20% cut and see how it feels.

It is truly better to do it this way, because unfortunately, when coming off these drugs, getting off faster doesn't mean you will get through WD faster!  In fact, fast tapers and cold turkey lead to protraced withdrawal that can last many months and even years, with profoundly difficult symptoms.  If I didn't already post it here, read my post about getting off, which includes links to a support forum and more information:

https://patient.info/forums/discuss/withdrawing-from-antidepressants-and-benzos-safely-485891?page=0&order=Oldest#1809368

I hope this helps.  Sorry to run off at the keyboard LOL!

I want to add that the half life of sert is about 26 hours, so every other day dosing is not recommended as a method for getting off.  It just causes your system to yo-yo and makes it more difficult for your nervous system to adapt.

Thanks do u think these negative thoughts are because I'm withdrawing? My minds been going at 100mph today 😕

Yes, racing, negative thoughts can be part of withdrawal.  Do you remember how you were before meds?  I know there was a reason for going on them, but do you remember being like this before?  Because it all feels so real, withdrawal tricks us and has us doubting and forgetting who we were before.  Another good reason to keep a journal, so you can look back periodically and see the changes.

When I was in protraced withdrawal, there was a period where my thoughts were racing and my memory was really badly affected, in part because I was so caught up in the inner dialogue, I couldn't remember what I was doing!  I'd head down to the barn to get something, and by the time I got there I couldn' remember what I was going there for!  Concentration was also badly affected.

It is difficult when you are in that state of mind to use the advice I gave you about interrupting the thoughts, ect, but you can be aware of it and remind yourself that this is withdrawal, not part of your "illness."  Be kind to yourself and take it easy on yourself when you are having a hard time with it.  Don't judge yourself and don't fight it; fighting it and fretting over it just makes it worse.  Also, protect yourself from stress during this time.  

I forgot to add that two supplements that can be helpful are 2 mg of fish oil a day, and magnesium supplements. Magnesium glycinate is excellent for absorption and not causing digestive upset.  Magnesium taurate and magnesium threonate are both excellent but might be harder to find.  Stay away from the citrate, oxide and sulfate versions as they act as laxatives.  Magnesium helps calm the nervous system, so can be helpful for anxiety and insomnia.  I take the glycinate version both AM and PM.  Taking a good probiotic is also good.  There is new research that shows that our gut organisms actually influence our mental health!  Start off very slowly with that one if you decide to add one, as once in awhile people have a strange reaction to changing their gut flora for the same reason!

Thanks for reply

I'm really struggling at the moment with intrusive thoughts and low mood I thinking of just stoping sert and see how things go I'm only on 12.5 mg I'm just puzzled because it Xmas soon

How long have you been back to 12.5 mg daily?  Have you tried the fish oil and magnesium supplements?  I think you are suffering withdrawal from dropping too fast, and jumping off now will not be pretty!!!  I strongly encourge you to join the Surviving Antidepressants forum that I mentioned in the link I gave you, and put an intro there so that you can be better advised.  The folks there really know what they are doing, and there are people there who have dealt with sert and can help you.  Making another big change now is not adviseable with the holiday, a stressful time as it is.  I don't like that you are having intrussive thoughts and want the experienced folks at SA to advise you.  There is no cost and you can be totally anonymous.

I only had 2 days that I without 12.5 mg 1 day on 1 day off 1 day on 1 day off then went back to every day

Thanks for your help

My pleasure, and I hope you have an enjoyable Christmas!

Thanks hope you enjoy Xmas!