16 hours ago, Finni said:

So so troubling when I feel like I’m getting worse instead of better or at least just staying the same. Day 30 since late dose after other disruptions.

Deepest electricity and terror I’ve ever felt.

I’ve been taking lighter pills that just need a little tiny bit filed off to get to .1026 g and I’m doing that right before I take it. It just seems like I’m getting worse and worse.

I don’t know how to survive this type of deep deep activation that brings so much terror with it not because of anything I’m thinking just because the terror is a symptom.

My heart goes out to you @Finni , you have been so brave in your struggle.

It really is a nightmare, the suffering that has to be endured. You won'y stay like this, the body is trying its hardest to heal. If only we had a time frame.

Hold on tight and keep the trust and faith in your ability to endure. Not easy I know. And I totally understand terror that is not a result of your thoughts. This would have to be one of the worst symptoms.

Lots of love your way 🙏xx

7/1/26

Trying to make sense of this mess:

that’s one of the hardest parts of what you’ve been living through, and it’s understandable that you’re trying to make sense of it.

A few things can be true at the same time:

• Mirtazapine can still make you sleepy because its antihistamine effect is very strong, even if other parts of your nervous system feel intensely activated. Sedation and nervous system activation are not mutually exclusive.

• In someone with a very sensitive nervous system, the way the medication feels can fluctuate from day to day even when the dose is unchanged. That doesn’t necessarily mean the medication has suddenly become harmful or that it’s “making you worse.” It means your nervous system’s response may be unstable.

• Withdrawal, recovery from a disruption, the body’s own daily rhythms, sleep, stress, and the medication’s effects can all overlap. From the inside, it’s almost impossible to separate which sensation comes from which factor.

You’ve noticed a pattern where symptoms often seem to intensify after your evening dose. That’s a real observation. The challenge is that an observed timing doesn’t tell us the cause. For example:

• it could reflect the medication’s changing levels,

• it could reflect your nervous system reacting during a vulnerable period,

• it could reflect your body’s normal overnight physiology,

• or it could be a combination.

Because several plausible explanations fit the same pattern, it’s difficult to conclude that the medication itself is definitively causing the worsening.

One thing I do notice from your month of tracking is that the symptom profile changes from day to day. Some mornings the vestibular symptoms dominate, other days it’s deep pressure, other days terror or electricity. If the medication were producing exactly the same toxic effect every night, you’d expect a more consistent pattern. Instead, your symptoms fluctuate in both intensity and character, which is more consistent with an unstable, recovering nervous system than with one simple mechanism.

That doesn’t make what you’re experiencing any less real. It just means the body can produce very intense, changing symptoms without there being a single straightforward explanation.

I know it’s frightening because your mind naturally asks, “What if the medication is poisoning me?” Based on what you’ve shared over these months, there isn’t enough evidence to conclude that. There is evidence that your nervous system has been extremely reactive and that you’ve had prolonged waves after disruptions while remaining on essentially the same dose.

You don’t have to solve that mystery this morning. Right now, your job is simply to get through today’s surge. We can keep observing the patterns together without jumping to conclusions that the medication is definitely helping or definitely harming. Over time, the trends are usually more informative than any one difficult morning.

I wish I could talk to someone as destabilized as Ive become who eventually stabilized.

I’m feeling very desperate. My psychiatrist recommended slowly increasing mirt. I have no idea what to do. Not sure if it would stabilize me. Truly don’t know how to keep going like this.

9/10 and 10/10 level suffering hours and hours per day.

2 months now

Edited July 1Jul 1 by Finni

Hi @Finni , I’m sorry for your suffering, I truly am. Raising your dose sounds very risky, especially considering mirtazapine is more activating at higher doses. That’s a known fact. Please reconsider.❤️

I am so sorry you are in this terrible position. Making a decision like that is difficult at the best of times let alone in awful activation and withdrawal.

My tiny up dose by .6 mg 8 plus weeks ago ( or more as I didn't record it in my signature) really activated and destabilised me. I am still most likely trying to stabilise. I wasn't quite as activated as you are, however it has been pretty intense, relentless and scary. I only took one dose.

Wish I could help you more @Finni .

Time is your friend, however I know you are also so anguished and at your limits of tolerance. People would say to me you are stronger than you feel and can endure, I didn't always believe them , but it is true in some sense. So maybe you can keep going one day or hour at a time.

Are your blood tests all okay?

Sending you peace, strength and care xx

Edit : It has been 13 weeks since my updose destabilisation. I can cautiously say I am seeing some stabilisation signs. You may have to wait a bit longer than 60 days.

Edited July 2Jul 2 by Tracey

10 hours ago, Finni said:

I’m feeling very desperate. My psychiatrist recommended slowly increasing mirt. I have no idea what to do. Not sure if it would stabilize me. Truly don’t know how to keep going like this.

9/10 and 10/10 level suffering hours and hours per day.

2 months now

Hey Finni, I am so sorry. Personally I think this would be a bad move. Listen to Mark and Angie, I agree with their assessments, hold tight. xxxx

8 hours ago, Tracey said:

I am so sorry you are in this terrible position. Making a decision like that is difficult at the best of times let alone in awful activation and withdrawal.

My tiny up dose by .6 mg 8 plus weeks ago ( or more as I didn't record it in my signature) really activated and destabilised me. I am still most likely trying to stabilise. I wasn't quite as activated as you are, however it has been pretty intense, relentless and scary. I only took one dose.

Wish I could help you more @Finni .

Time is your friend, however I know you are also so anguished and at your limits of tolerance. People would say to me you are stronger than you feel and can endure, I didn't always believe them , but it is true in some sense. So maybe you can keep going one day or hour at a time.

Are your blood tests all okay?

Sending you peace, strength and care xx

Edit : It has been 13 weeks since my updose destabilisation. I can cautiously say I am seeing some stabilisation signs. You may have to wait a bit longer than 60 days.

Thank you 💓

It has only been 4 weeks since my late dose, which really seemed to be the “final straw”

All of my blood work is normal.

2 hours ago, Chippy said:

Hey Finni, I am so sorry. Personally I think this would be a bad move. Listen to Mark and Angie, I agree with their assessments, hold tight. xxxx

❤️

9 hours ago, Dnepr1234 said:

Hi @Finni , I’m sorry for your suffering, I truly am. Raising your dose sounds very risky, especially considering mirtazapine is more activating at higher doses. That’s a known fact. Please reconsider.❤️

❤️

7/2/26

Logged for 12:00 PM:

Category	Rating
1. Overall	10/10
2. Electricity	10/10 (you described it as “ungodly” and previously said it felt like 12/10)
3. Vestibular	10/10
4. Pressure/Pain	10/10
5. Terror	8/10 (climbing)

This is the most severe noon check-in you’ve reported to me. Even though the terror is “only” an 8 compared with the other ratings, the physical symptoms are at the ceiling.

Please make sure your PCP hears exactly this:

• Overall: 10/10

• Electricity: 10/10—described as “ungodly”

• Vestibular: 10/10

• Pressure/pain: 10/10

• The worst internal electricity and pressure you’ve ever experienced

• No new neurological symptoms—it’s the same pattern, just far more intense

I’m also encouraged by one small thing in the middle of all this: even with these unimaginable physical sensations, you’re still able to communicate clearly and keep tracking your symptoms. That tells me you’re staying engaged and giving your clinicians useful information despite how awful this is.

If this goes on much longer, I will have to taper. So so activated

I'm so sorry @Finni. I wish I could take your suffering away 💜❤️‍🩹

I'm sorry to hear you are doing that badly, regardless of whatever happens, this will pass, this is temporary, this thing eventually will be in the past, and the past doesn't exist outside our memories.

10 hours ago, Finni said:

Thank you 💓

It has only been 4 weeks since my late dose, which really seemed to be the “final straw”

All of my blood work is normal.

That is even better, I thought I read 8 weeks. Very early days @ 4 weeks. 🙏

On 6/30/2026 at 11:37 AM, Finni said:

So so troubling when I feel like I’m getting worse instead of better or at least just staying the same. Day 30 since late dose after other disruptions.

Deepest electricity and terror I’ve ever felt.

I’ve been taking lighter pills that just need a little tiny bit filed off to get to .1026 g and I’m doing that right before I take it. It just seems like I’m getting worse and worse.

I don’t know how to survive this type of deep deep activation that brings so much terror with it not because of anything I’m thinking just because the terror is a symptom.

Finni just saw your update, a drop can be challenging, but your doing wonderful, even if at the moment it taxing on your system, it's definitely part of the healing process. You have had a tremendous amount of pain through all this, just know were all here for you. Sending prayers for some needed relief hugsxxx Bernadette

2 hours ago, Tracey said:

That is even better, I thought I read 8 weeks. Very early days @ 4 weeks. 🙏

I’ve had all kinds of “disruptions”

I tried to reduce then went right back up about 8 weeks ago. Dose 5 hours late 4 weeks ago.

Finni, just a little clarification on my end. Did you do a drop 4 weeks ago and if so, at what dose are you currently at?

Do the deep electric sensations in my body point more to kindling or withdrawal? The electricity in my body has started spreading so deep and staying for hours and hours and I don’t know if it’s because mirtazapine is truly too activating, especially now, or if it’s just a withdrawal symptom.

It leads to akasthisia like feelings. So much agitation and upset.

I haven’t even made it to five weeks past my last disruption and I’m already fantasizing about dropping another portion of mirtazapine. I want it out of my body so bad.

In my experience when I dropped in dosage it was just a withdrawal symptom, and just your cns trying to regulate itself. I know it can be difficult but listen to your body , and slow is always better. The lower the dose the more changelings it can be. No need to rush, your doing great and please my friend be patient. The more stable your system gets the less your symptom suffer. You are. so strong and are doing amazing. Sending prayers for some relief 🤗🙏

18 hours ago, Bernadette said:

In my experience when I dropped in dosage it was just a withdrawal symptom, and just your cns trying to regulate itself. I know it can be difficult but listen to your body , and slow is always better. The lower the dose the more changelings it can be. No need to rush, your doing great and please my friend be patient. The more stable your system gets the less your symptom suffer. You are. so strong and are doing amazing. Sending prayers for some relief 🤗🙏

I tried to drop April 30 but went back up the next night. It’s not like I have a lot less mirtazapine in my system overall.

That’s why it’s so confusing

This morning is another really scary new level of suffering. I didn’t even think that was possible.

Sometimes in the middle of the night, I feel a lot of pressure in my whole body and like something is accelerating my whole body and that happened, but it is still happening three hours later.

It’s a strange full body pressure with deep electricity. My head is pounding. My eyes are burning. My legs hurt really bad. I feel electric and spongy to the core.

July 4,2026

ChatGPT summary

Over the last several days, you’ve described something like this:

• Instead of symptoms coming in shorter bursts, they seem to stay “locked on” for much longer.

• The dominant symptom changes from day to day—for example, one day the deep electricity is overwhelming, another day the vestibular symptoms dominate, and today the crushing pressure feels like it’s taken over.

• When that symptom is active, it feels like it’s turned up to an extreme level rather than fluctuating as much.

That’s a fair description of what you’ve been experiencing. It’s an observation about the pattern, not a conclusion about the cause.

What’s much harder—and something we can’t determine from symptoms alone—is why it’s happening. There isn’t a way to look at the pattern and know whether it’s due to ongoing medication adaptation, another nervous system process, or something else. That’s why it’s important not to jump from “this symptom is locked on today” to “this is how it will always be.”

I also remember that just yesterday you noticed something that seemed contradictory:

• Overall, the day was easier than the day before.

• Yet the late afternoon still brought a severe surge.

That tells us the overall burden and the way symptoms behave don’t always move together. A day can be somewhat better overall while still having one symptom that feels relentless for several hours.

Your observation is worth keeping in mind, though. If over the next week you continue to notice that the main symptom of the day stays “locked on” rather than waxing and waning, that’s a pattern you can describe to your clinicians. It’s more informative than simply saying, “I feel worse.”

On 7/1/2026 at 8:52 PM, Dnepr1234 said:

Hi @Finni , I’m sorry for your suffering, I truly am. Raising your dose sounds very risky, especially considering mirtazapine is more activating at higher doses. That’s a known fact. Please reconsider.❤️

My psychiatrist isn’t suggesting I go above 15 mg… Just move slowly from 14.79 mg back to 15 mg

Dr. Horowitz has suggested the same thing before.

4 hours ago, Finni said:

This morning is another really scary new level of suffering. I didn’t even think that was possible.

Sometimes in the middle of the night, I feel a lot of pressure in my whole body and like something is accelerating my whole body and that happened, but it is still happening three hours later.

It’s a strange full body pressure with deep electricity. My head is pounding. My eyes are burning. My legs hurt really bad. I feel electric and spongy to the core.

Finni, I see your having a difficult time with your last drop and your system is having a tough time regulating. I see you considered going up to 15mg, from your current dose, is that correct? In my experience with Citalopram when I dropped my system did a lot of what you described, yes your system is trying to adjust even at a small amount. It's kindof like your brain asking you, what the heck did you do, and I don't like it." I would caution or re-think doing an up dose and let your system regulate from the drop. Your stronger than you realize my friend, and things will settle down , your doing an amazing job. If your able to try to distract yourself as much as you can or able to, . Sending a extra prayer for some need relief. Hugs for now xxxxBernadette