This is how a rough patch becomes a pharmaceutical spiral

A story like countless others, which could have been avoided with up-front warnings and more awareness

February 2021: Optimism turns to terror

When I arrived on my parents’ doorstep on Christmas Eve, I thought I would need a few weeks of TLC.

I would be teaching online for the winter, so I wouldn’t need to go back home to Winnipeg for anything for a long time. I wouldn’t be teaching in person again until September.

Maybe I could turn this into a fun new experience: establish myself in Ottawa and use the location as a perch to heal and see new things. Oh, the optimism!

I would stay in town, make some new friends, and visit old ones. I couldn’t just linger in my parents’ home after all — I hadn’t done that for 20 years! — and I wasn’t getting any younger.

When lockdowns weren’t the order of the day, I was able to get out and spend time with people. There were windows of joy.

I’d been enjoying the company of a woman we’ll call Melissa, who had invited me to spend time with her at her place when the government told us it was okay to do so. There weren’t many other places to go otherwise. I also went to go visit a wise, welcoming friend from my PhD program, who lived about an hour from Ottawa. It was during that visit that I started to have my first few panic attacks, but I shrugged those off as the result of COVID isolation.

The symptomatic spiral

Not long after, I started to become anxious about everything: new places; the intentions of other people. Not because I actually feared harm, but because, as I would later discover, withdrawal from serotonergics can cause something called “neuro-emotions,” which are chemical feelings that don’t really belong to you. They're overstated nervous system reactions to your environment — including other people. Something that might otherwise feel like excitement becomes hyperarousal, as tiny things become overwhelming. I felt reactive and a bit out of control.

Something was terribly, terribly wrong, and it was becoming embarrassing. On the forum survivingantidepressants.org, one survivor posted the following list of symptoms:

“Dark depression, anxiety, paranoia, obsessive compulsive, panic attacks, intrusive/obsessive thoughts that tortured me, hopelessness, irrational thinking, suicidal thoughts, brain zaps, intense organic fear, severe inner-body tension that felt like my whole insides were clamped up, sexual dysfunction, severe tension, tremors and pain in the back of my legs and calves, terrible shoulder and upper arm pain, mania, extreme bloating and stomach pain, nausea, dizziness, vertigo, feeling like my brain was on fire, feeling like a part of my brain was missing, feeling like a bomb had gone off in my head, floating head feeling, super-hot face, body temperature regulation problems – being super-hot or cold, constipation, dehydration, lack of appetite and weight loss, feeling dead, anhedonia, akathisia, mood swings, insomnia, terrible brain fog and inability to think clearly, sensitive vision and hearing, inching and burning skin, cold like symptoms, head congestion, phantom smells, constant tinnitus, severe fatigue and exhaustion, health anxiety, I could not read, listen to music, or meditate, heart palpitations, random traveling aching and stabbing pain throughout my body, headaches, and so many other symptoms that I can’t remember.  The torture, pain, misery, suffering and utter despair was never ending…”

These, my friends, are chemical neuro-emotions. That list sums it up pretty well.

I realise, in hindsight, that there was no way I could get comfortable anywhere I was; that I had trouble relating to everybody. I felt locked away behind some chemical veil. Imprisoned in my psyche.

New problems with people and expectations

Melissa generously invited me to stay with her in Ottawa, but by mid-March I could hardly sleep and found myself in crying spells throughout the night. I’d wake up at 5 AM begging for mercy. I was never a crier, so this was alien, to say the least.

I felt like I had to isolate from other people, but not because of COVID. Because I just didn’t know myself anymore.

“You shouldn’t have to deal with this alone,” Melissa said. Conceptually true, I thought, “but it’s irresponsible to subject someone to this,” I responded.

I felt ashamed. Sadly, that’s been true ever since, even though I’ve tried to balance my shame with a deep desire for acceptance, love, and connection.

To complicate things, this was the depths of the pandemic, and I still thought the worst of these circumstances would be temporary. I had a really hard time opting for social isolation at a time like this.

We settled on a middle-ground option: I’d stay with my parents for awhile longer and we'd hang out during the day. Maybe I’d get better. She and I ended up spending a lot of time together, and I’ll always be grateful for how much relief that provided during such a dark moment.

But things would get worse yet, and, as I feared, much harder to negotiate interpersonally. At my parents’ house, I could express my pain and discomfort with a bit more ease. I was bedridden most of the time.

I spent hours a day writhing and groaning in agony in bed, with my poor parents bewildered by my lapse into despair.

We still all assumed it would pass. Nothing in my life prepared me for this or seemed to suggest it would be a permanent descent into hell.

Weeks went by. Months.

“Maybe I needed to change my environment again,” I wondered?

I was running out of patience.

Moving around would become another theme. My nervous system had become stuck in fight-flight or freeze mode. So I would run to a new place, and then stay there, paralyzed. As I know now, this is also “normal” for someone in the depths of protracted withdrawal. But I was negotiating all of this in complete darkness.

When teaching ended for the season, I would head back to Manitoba, where I took a job building furniture. If Ottawa wasn’t working, being in a more familiar environment and doing something with my hands might be good for my brain. Right? Who knew at this stage.

Hospitalizations and pharmaceutical roulette

When I got to Winnipeg, I went straight to the hospital. My vision wasn’t improving and my tinnitus was so bad that I couldn’t hear anything over the internal noise. I realized that I could not make sense of images. I couldn’t see fine patterns in real life — like gravel or leaves. They looked incomprehensible, blurry, like static, and it was disturbing.

I sat in a hospital for hours, waited to see a neurologist, and was put on an anti-epileptic medication that the doc thought might help reverse some of the symptoms. Nobody investigated withdrawal.

All the new drug did was sedate me to such a point that I couldn’t even show up at the job I had arranged for myself. And when I did show up, my boss asked if I was okay. I did not look well.

I had never been this unreliable before. I couldn’t follow through with commitments, and I kept seeking “safety” in the presence of any willing person.

I felt like I was dying. I wanted hugs, I wanted to be told I was okay. I felt infantile.

I was staying at an AirBnB and it might as well have been a prison cell.

It was at that moment that a Winnipeg friend offered to host me for a few days while I “got back on my feet,” or so we hoped. That wasn’t likely going to happen in this moment. But I took it anyway.

Melissa, who I kept trying to release from this mess, was tenacious. She offered to come and help me. I said no, that we “shouldn’t keep seeing one another under the circumstances,” but then she came anyway. I didn't have a choice. I was thankful, but also so terribly, overwhelmingly embarrassed.

She told me I need to come back to Ottawa to explore further treatment and hospitalizations. This wasn’t romantic, it was survival.

I had spiralled so far that I couldn’t even care for myself and was relying on the kindness of a relative stranger.

Ketamine in Saskatoon

I was desperate. I could hardly move my body, see, or hear properly. Friends sent me articles about ketamine infusions, which seemed to work miracles for some people.

Ketamine is a dissociative anaesthetic used for the treatment of pain and depression. For the brain, it works on the glutamate system, which excites neurons in the prefrontal cortex (the same part of the brain that rTMS works on).

I felt I had nothing to lose. Remember — most doctors and internet resources indicated that withdrawal would take weeks, not months, so it was only a glimmer in my imagination that this would somehow all be related to that moment of revelation months ago.

When I got to the Saskatoon clinic, I sat down in a chair, and I told the doctor that I was so anxious and disoriented I could hardly breathe.

“This is extremely safe,” he reassured me. “This drug is administered to babies and the elderly. You’ll be fine.” He offered me an Ativan, which I declined, and then he popped the IV into me. The doctor and attendant left the room.

What happened next will endure as one of the most bizarre sensations I’ve ever experienced. I felt like I was being electrocuted.

I called for the doctors to come back.

“Sorry, I have this terrible feeling. Is this normal?”

I started talking so quickly that I felt like I was under total control of this narcotic. I would spew out any tiny bit of information that entered my brain. Like rainman on steroids, for you oldies who get the reference.

One doctor shoved an ativan into my mouth. The other took my hand and — in the middle of my incomprehensible ramble — said “this is what healing feels like, James.”

Is this what they tell people who are lobotomized?

Then I heard her whisper to the doctor: “have you seen this before?” How reassuring.

But then, a brief miracle. After the treatment, I felt 100% normal for a whole hour. Incredible relief. I went back to my hotel and went straight to sleep, hopeful. I slept like it was 2018. Incredible.

And then when I woke up, panic again. Unbearable, paralyzing panic.

Shaking, hyperventilating, the works.

Once again, I felt like I had to run and find another human to sit with. Any kind soul. I called a friend in Winnipeg and booked it back to the city.

The next day, the ketamine seemed to have knocked me further back into my psyche — my perceptual window closed further and I could do nothing but hide under blankets. I had no initiative. I was utterly frozen.

Recently I’ve been reading that, after devastating withdrawal episodes, sometimes the body reacts to anything you put inside it, whether it’s omega 3, B12, or ketamine.

I’d stay with my friend in Winnipeg until I felt well enough to drive back to Ottawa again.

I couldn’t work, I couldn’t socialize. I couldn’t walk. This experiment was a failure.

One more tour of the hospital system in Ontario

When I got back to Ottawa, I was stuck in freeze mode. I split my time between Melissa’s and my parents’, but my routine was always the same: cry for hours, pray to God for healing and peace, get out of bed, try to eat, go back to bed, cry, try to walk, run back in a terrible panic, and pray again that eventually sleep would come and that something would change tomorrow. If anyone left the house, I would freak right out. This was sheer, incomprehensible madness, especially for someone who used to love solitude in the woods.

I repeated this routine until the end of the summer. I’d soon have to go back to Winnipeg to teach in person for the fall.

I made arrangements to be seen at a clinic in Toronto, and Melissa and my Dad alternated taking me to appointments there. I felt like I needed the best care I could get. I made the mistake of telling the social worker that I was at the end of my rope and couldn’t live like this much longer. Could you blame me?

Well, they could: the clinic called the police. In what was the lowest moment of my life (until that point), I was escorted to a Toronto hospital for assessment. I was told that I had PTSD. Again, nothing about withdrawal and no supports were set up. Undoubtedly, PTSD was an ingredient, because the traumas were piling up. And my confidence in the medical system was declining.

We headed back to Ottawa, utterly demoralized. But the low would get lower.