Emotional Numbness | Why I Stopped Sertraline

I made the decision recently, to stop taking my Sertraline antidepressant. In hindsight, I could have approached this in a much less aggressive manner, but I stand by my decision to stop. Sertraline was causing me to have emotional numbness. I was unable to cry, which I was finding incredibly frustrating.

My inability to cry had been happening for a while and tapering off my antidepressant had been on the agenda. However, before I could visit my GP to discuss this, my Mum was rushed to the hospital and passed away the same day. Now, I needed to cry more than ever, yet the Sertraline held back the floodgates. Enough was enough. I needed to stop my medication as quickly as possible.

Recovery From Emotional Numbness

Being able to cry, is something that I value very highly. I am someone who has historically had difficulty crying. I spent my entire life being emotionally numb. When I began my recovery from alcoholism in 2010, it was as if someone had turned on a tap and I couldn’t stop it. I cried when I was sad, and I cried when I was happy. I cried it seemed, whenever there was a heightened emotion, whether that be a good or a bad one. It was such a relief, at last, to be able to shed a tear, albeit a little embarrassing that it happened so often!

Losing My Ability To Cry Again

When I started testosterone therapy as part of my gender transition in 2013, initially the difficulty with crying resurfaced. I did not return to feeling emotionally numb, but I stopped being able to cry as easily. However, things did eventually level off, I cried less, but I had access to a good sob when I needed it. I felt I had regained an essential part of myself. My whole journey of recovery has been about restoring access to my emotions and learning to manage them. Therefore, to recently find myself once again in a place where I was emotionally numb was devastating for me

Emotional Numbness and Sertraline

I am aware that not being able to cry, is not an uncommon reaction to grief. However, I knew that my inability to cry was primarily due to Sertraline as this was not a new discovery. I had realized I could no longer cry a few months earlier. My boyfriend is very emotional, he often cries at films (something I love about him!). On watching a movie together, a film I would typically have shed a tear at, there was my boyfriend sobbing, and I felt like a piece of dry driftwood. Then I began to notice this happening more and more frequently. Searching online, I realized I was not alone in this reaction. It seems that emotional numbness is a common side effect of sertraline.

Prescribed Sertraline after a Misdiagnosis

Finding out that sertraline was likely to blame for my emotional numbness, made me very upset (but not enough to cry!). I was upset and frustrated because there had been no need for me to start taking Sertraline in the first place. I had only been placed on Sertraline because of a misdiagnosis.

In October 2018, I had attended a GP surgery as a new patient. The symptoms I presented with, were put down to being due to my existing mental health challenges. At this time, I was prescribed and started taking Sertraline. My symptoms only got worse. I repeatedly explained that I knew myself well, and these were not my usual symptoms. Unfortunately, an understaffed GP surgery and the inability to see the same GP meant that I was not properly listened to. Each time I visited, the GP increased the dose.

Diagnosis of Hypothyroidism

Finally, in May 2019, it became clear that my problem was, in fact, an underactive thyroid that had been making my mental health issues far worse. I needed Levothyroxine, not Sertraline. I changed to a new GP surgery, with a much more helpful doctor. She advised waiting until my thyroid levels settled back to normal, before withdrawing from the Sertraline. Unfortunately, my Mum died before this could happen.

Stopping Sertraline

I realize that to a lot of people, deciding to stop my medication at such an emotionally painful time, may sound counterintuitive. I admit that choosing this option wasn’t ideal. However, it was the best of three equally bad options. The first option was to stay on Sertraline and then look at coming off it after the most intense part of the grieving was over. Option number two was to taper the medication off really slowly over a long period.  The third option was to rip off the plaster so to speak and taper off the Sertraline as quickly as possible. Now, in hindsight, I realize there was a fourth option, but I will get to that later.

Emotional Numbness and Recovery

Out of these three options, each would cause my mental health to worsen. If I stayed on the sertraline, in full or slowly tapered off, the emotional numbness would remain.  Being numb to the pain would mean that I wouldn’t start to feel or deal with the grief until much further down the line.

I know my mental health very well and I know what works for me. One of my primary diagnosis is Anxious-Avoidant Personality Disorder. I spent the entirety of my life trying to avoid any emotions. However, I know now that avoiding things only serves to make them worse. I have been in recovery from addiction since 2010, and in my recovery, I have learned the benefit and growth that comes from sitting with pain and trusting that it passes. I knew that delaying the grief would cause me more damage than abruptly stopping the sertraline would.

Sertraline and Discontinuation Syndrome

I did taper my Sertraline dose slightly, but it wasn’t tapered enough to avoid the withdrawal symptoms. By the end of the first week, I was dizzy and felt incredibly foggy-headed. I also experienced frequent brain zaps, which are like a strange whooshing sensation, where your head pulses.

Brain zaps are a common symptom of discontinuation syndrome. Especially when you withdraw from antidepressants too quickly, as I did. I felt awful.

Regaining My Ability to Cry

Despite experiencing dreadful withdrawal symptoms, I was spurred on by feeling the emotional numbness start to lift. I began to cry again. Not a great deal of tears but some. I felt relief, to be able to start accessing my emotions again. Now, surely, I could begin to properly grieve for mum.

Complicated Grief

Unfortunately, I had underestimated the power of grief to make any existing mental health challenges ten times as bad. I honestly thought, that once off the Sertraline, I would be dealing with ‘simple grief’. However, as the weeks went on, I began to experience a rather disturbing re-emergence of old personality disorder behaviors. I began to feel and act in very impulsive ways, which were likely to lead to danger. I had to admit that what I was feeling, wasn’t just grief.

Finding a New Antidepressant

I knew I had to get help and that this was likely to mean going back onto an antidepressant. I was ready to accept this, as long as it was not Sertraline. Antidepressants, in of themselves are not bad and I am not someone who is against medication. I believe that antidepressants can be helpful in the right situation. However, it is important to get the right medication, that works in the best way for you.

I visited my GP and discussed my concerns in wanting to avoid anything that might cause emotional numbness. Together, we decided to trial Mirtazapine. Although Mirtazapine has a side effect of drowsiness, we thought that as I was having so much trouble with getting to sleep and staying asleep that they may help me with that too.

Things I Could Have Done Differently

In hindsight, as I mentioned earlier, there was a fourth option that I could have considered. I could have come straight off Sertraline and straight onto something else. Where I may still have got the Sertraline discontinuation syndrome symptoms, I might have avoided the intense reaction and resurgence of the personality disorder traits. Who knows, perhaps they would have surfaced anyway.

Learning From My Mistakes

It is tough, when you have complex mental health issues, as I do, to always know what to do for the best. We have to follow our body, our instincts and our past experiences. Then, if decisions are wrong, we can remake them, and that’s OK.

My advice though would be to learn from my mistake. Talk to your GP before deciding to come off any medication. Not because your decision may be wrong, but because your GP might be able to point out another way to deal with things. Like with my situation, for example, had I visited my GP initially, she may have suggested the cross over between coming off and going on new meds.

The Emotional Numbness Begins To Lift

My ability to cry has not yet returned to normal and I still have the sensation of my tears being stuck. I begin to cry and then its as if an invisible tap is turned off. I can feel that there is still some emotional numbness there, but at least it is shifting. At least it is a start in the right direction. I will update soon, on my experiences of Mirtazapine.

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