@Richie

Thanks for sharing. It’s surprising how similar our withdrawal timelines are. Sorry I haven’t read your post yet. Right now, my underlying OCD combined with PWD has pushed me almost back to the severe state I was in seven years ago, when I started sertraline. What are your primary symptoms? From your signature, I see you’re still on mirtazapine, right?

Sleep remains a huge struggle for me. Some nights I wake up in the middle of the night and stay awake until morning. Lately my OCD even flares up before bed. I know the perceived dangers aren’t real, but PWD is making my muscles tense up, making it hard to fall asleep.

I think within the first year of withdrawal, most of us deal mainly with depressive symptoms. After the first year, we all have to face rebounds of our underlying conditions. I don’t know how to handle this yet, so I’m sticking to my low‑exertion routine for both physical and mental energy. I’m hoping once PWD fully subsides, my OCD will settle back to my original baseline.

Just to add a bit more: my 7‑day average HRV baseline sits between 28‑50. When my sleep has been poor recently, it drops below 35.

My OCD is making me worried about reassessing whether I need to go back on an SSRI. Still, I know I shouldn’t consider this until all PWD symptoms have fully faded. Also, restarting an SSRI could make future withdrawal even harder.

Right now, meditation and daytime naps work best for my OCD. More often than not, though, I can only do a single downgraded compulsive wash to ease my anxiety and headaches.

Just a brief illness update. My OCD has been pushed to its worst peak in 20 years by PWD over these two weeks. Especially this past week, I’ve spent nearly 3–5 hours showering every single day. I’m more experienced than I was all those years ago. I’ve been using waiting, downgraded washing, and even distraction to prevent the CSTC circuit from strengthening. There were times none of these methods worked, and I ended up screaming in the bathroom. Interestingly, screaming seemed to act as an emotional release, and my OCD would ease briefly afterward.

Thankfully, my OCD loosened up today. However, depression returned after more than a month. Fortunately, it’s not severe.

I suspect my primary OCD is just extremely intense, compounded by the amplifying effect of PWD. This makes my windows extremely short — only a few days, sometimes barely perceptible. The wave periods alternate between two dominant states: OCD and depression.

My fitness tracker’s vitality score jumped from staying below 10 for seven straight days post-withdrawal to over 70. I believe this came from spending all day in shower rituals. To some degree, it may indicate improved neural tolerance.

Sometimes this forum feels like our base. Every time I log off, it’s like heading out on an expedition. I don’t know what I will face, how long this journey will last, or even if I’ll be able to return to base next time.

May we all achieve final victory!

Thanks for the update @TonyLee. Sorry to hear that things are still so tough, but I do think it's a good sign that symptoms are still changing and evolving. All signs that the CNS is still seeking equilibrium. I hope that you get a longer, brighter window soon. I have no doubt that you'll achieve final victory in time.

@TonyLee Sorry things are still tough, you sound like you are doing well in diffucult circumstances and exercising coping skills, as Sarah said symptom fluctuations is a great sign imo.

I hope things ease in the coming days and weeks, and of course base camp is always here waiting for you. 😉

@SarahMc @Chippy Thank you both for your replies; it means a lot and warms my heart. Starting this week, my OCD has eased a great deal, and I’m no longer stuck in the showering ritual. In its place, depression has flared back up. Still, so far this depressive episode is nowhere near as intense as what I endured during months 6–12 of withdrawal. At the very least, I don’t break down crying anymore. I believe this represents adaptive changes as my nervous system heals.

I’ve noticed something rather unusual, and I don’t seem to see anyone else on the forum with the same pattern. Every evening between 8 and 9 PM, I get a temporary full reset: all symptoms vanish, including anhedonia, headaches, tinnitus, fatigue and poor appetite. But after sleep, once I wake up around 3 or 4 a.m., every symptom comes back again. I suspect these frequent windows of relief might cost my nervous system a lot of energy. Regardless, all I can do is accept it and protect conditions for recovery as much as I can. Those three-plus hours of relief each evening show me my nervous system can return to a normal state. I hope to see the next stage of symptom reduction ahead.

4 hours ago, TonyLee said:

Starting this week, my OCD has eased a great deal, and I’m no longer stuck in the showering ritual. In its place, depression has flared back up. Still, so far this depressive episode is nowhere near as intense as what I endured during months 6–12 of withdrawal. At the very least, I don’t break down crying anymore. I believe this represents adaptive changes as my nervous system heals.

It's good that your symptoms are still evolving, and I'm glad to hear the depression isn't as bad as it was previously.

4 hours ago, TonyLee said:

I’ve noticed something rather unusual, and I don’t seem to see anyone else on the forum with the same pattern. Every evening between 8 and 9 PM, I get a temporary full reset: all symptoms vanish, including anhedonia, headaches, tinnitus, fatigue and poor appetite. But after sleep, once I wake up around 3 or 4 a.m., every symptom comes back again.

It is actually relatively common to get some relief in the evenings. As you say, definitely proof that your nervous system is capable of healing. Hang onto those windows, more healing is coming 😊

On 9/22/2026 at 1:33 PM, SarahMc said:

Thanks for the update @TonyLee. Sorry to hear that things are still so tough, but I do think it's a good sign that symptoms are still changing and evolving. All signs that the CNS is still seeking equilibrium. I hope that you get a longer, brighter window soon. I have no doubt that you'll achieve final victory in time.

This is very true.

Relief in the evenings is also fairly common, for some reason. It's a good sign that you do sometimes get relief.

Hopefully those periods will become better or longer soon.

@TonyLee Thank you for the update, it is great you are seeing some progress. Having windows of zero symptoms is very encouraging. Unfortunately it is common for this to be followed by further waves. In time I hope and expect this to ease for you.

@SarahMc @Chippy @Luke Thank you all for your concern. I’m taking advantage of this brief window of relief to update you on my recent symptoms.

I had an external ear canal infection last week. The pain kept me barely able to sleep for nearly five days, and I believe this is one of the reasons my depressive symptoms have worsened over the past couple of days. Thankfully, after six consecutive days of taking ibuprofen and using topical levofloxacin ear drops, I no longer feel ear pain. The feeling of fullness and pressure may take around another week to resolve. I chose levofloxacin ear drops without corticosteroids, as I was concerned they might negatively impact PWD.

My depressive feelings have indeed been heavy these past few days, yet it does not seem to reach the extreme distress I experienced during the worst year. Still, the hopelessness brought on by depression still brings suicidal thoughts. Every evening after 8 p.m., I still have that window where both OCD and depression fully subside.

I’ve recently noticed something: around six months after stopping medication, I developed onycholysis (separation of nail from nail bed) on one big toe, similar to nail atrophy. It started to heal on its own at roughly ten months post‑withdrawal, and the newly‑grown nail is now completely normal. Other symptoms, such as easy buildup of keratin on the belly button and the folds of my ear; when picked or torn, these areas leak serous fluid, have gradually come under control. New skin is slowly returning to normal. After reviewing some literature, I suspect SSRIs not only block serotonin transporters in the brain but also those circulating throughout the body, impairing immune function and skin‑barrier regeneration.

All the same, my experience confirms that my nervous system has truly been undergoing self‑repair over these 15 months. I still suffer from persistent fatigue, and my deep‑sleep duration rarely exceeds one hour each night. During the days of ear pain, my deep sleep dropped to merely a dozen minutes for entire nights. Apathy and anhedonia have seen very little improvement. Last month, when OCD was dominant, I thought the depressive phase had passed, yet depression has returned. I do not know when I will return to baseline, but whenever I feel hopeless, looking back to the previous month shows me some degree of improvement.

May we all recover soon. Thank you for your companionship. Thanks to all of you, we are not alone.

Hi @TonyLee. I finished my taper on Aug 1 2025. Seems like our timelines are quite similar. I’m getting windows and the waves are still quite bad and hard to navigate. Still have depressive periods with apathy and numbness. I’ve had good windows also. Just wanted to come on and say that our timeline is similar and hope we both heal sooner rather than later. 👍🏼

@TonyLee, from what I have observed from many, many cases, if things are moving the right way over time, then that's a good reason to suspect that more time = more improving, even if it is nonlinear and there are setbacks or flare ups of symptoms.

I hope down the line you're able to again look back and see an improvement.

@TonyLee it's great to hear you can see that you've improved overall, even if you're back in a wave of depressive symptoms. You're essentially following the standard healing trend, as horrible as it can be. I feel confident that as time goes on you'll continue to heal and those waves will come less frequently, and eventually disappear altogether 💜

@Wildgoose It turns out we stopped medication on the exact same day. According to my records, my last sertraline dose was 25 mg on July 31, 2025.

I tried CBT this month, yet it proved totally ineffective against my current depressive state, nothing like how ERP brought noticeable relief for my OCD last month. Even to this day I can still benefit from that neural extinction training gained through ERP. A lot of anxiety triggered by long‑standing intrusive thoughts now fades away much more easily.

I’m still struggling. This is day 12 of my depressive wave. Hopelessness persists, though fatigue has eased somewhat. Importantly, that sense of despair still cannot reach the crippling level that brought me to uncontrollable crying during the first 12 months; it’s more of an inner, quiet hopelessness.

@Luke @SarahMc When I am at my lowest, I often look back on how I felt last month and earlier, trying to find reasons to keep going. Still, when hopelessness washes over me, fear lingers that I might get stuck in some permanent state. No‑one can guarantee the pace or extent of neural recovery.

I am now 15 months post‑full discontinuation, and I intend to hold off on restarting SSRIs. It has been 22 months since I first began tapering. Only those who have lived through it understand the daily effort and suffering, and I am not ready to give up easily.

After passing the 12‑month mark, I have lost any clear time reference. I know many people enter another phase of recovery between 18‑24 months, yet recovery slows down, timelines stretch wider, and individual differences become enormous. Uncertainty keeps growing, which disturbs me greatly, especially during depression‑dominated phases that amplify feelings of despair.

In any case, thank you all for being here. Hope we all get better soon.

This month has been largely dominated by depression. After two weeks, the depressive despair seemed to ease, yet only slightly. Headaches have set in over the past couple of days. My energy levels remain very hard to restore. OCD flared‑up suddenly yesterday, though fortunately I was able to stop the episode using ERP.

I am now 15 months post‑withdrawal. My willpower feels completely drained. I struggle to envision the recovery timeline many others report of 18‑24 months. Physical strength has not returned; simple outings are beyond me and I tire very easily, with fatigue triggering headaches in turn. Waves of depressive hopelessness come almost every day. The best I can do is try to distract myself, avoid deep rumination and spare my neural reserves — yet in practice this is extremely hard to achieve. Memories from the past and regrets over lost time constantly hang over me, viewed through a sad emotional filter.

To be honest, each day remains a struggle. I do not need long working hours; I have cut work down to just one hour per day and mostly given up housework. I simply have no extra energy, and pushing myself further only brings fatigue and headaches. This medication withdrawal has changed me as a person.

What keeps me going is that every month or every two to three months, my symptoms lessen to some degree. Progress, however, is agonizingly slow. Part of me wants to restart SSRIs at a low dose like many others, yet I am genuinely afraid that my existing PAWS symptoms could worsen or even become permanent.

These thoughts leave me feeling hopeless and trapped between two bad options. At times I regret my decision to come off the medication. Perhaps I should not keep re‑examining my illness, yet what else can I do in this low point of physical and emotional functioning?

My physical stamina has never been this poor in my life. It may not be bodily exhaustion but central‑nervous‑system fatigue, even though the subjective sensation is identical. My body is like an engine that refuses to start; whenever it runs, it overheats.

I have read posts in the recovery section describing people whose healing suddenly accelerated one day. I wonder whether that will ever happen for me. Right now I am stuck in a depressive trough and dare not taper my nutritional supplements. I previously lowered my inositol dosage to 3 g daily. I am taking phosphatidylserine and magnesium threonate at their minimum effective doses, and I worry that discontinuing them might deepen my depression. Back when OCD was predominant last month, there were days when I thought I could stop all supplements entirely.

Fully recovered case reports are rare on the forum. While I understand many people leave without posting success stories once better, I still find it difficult to believe I will definitely return to the stable neurological baseline I had before taking antidepressants.

Sorry things are still so tough for you @TonyLee. You're doing well by getting through the days -- sometimes that's all we can do.

Please remember that this forum is still very new -- less than a year old -- which is why you're not seeing many folks on here who have recovered. You'll find many more success stories on Surviving Antidepressants and on the Youtube channels of coaches like Angie Peacock. I'm confident that as this forum ages we'll add to our collection of success stories, and one day yours will be among them 💜

Thank you for your encouragement and advice. Reading your replies always feels warm, and it reminds me of Sarah from the UK.

Actually, this community has been a good place. I’ve met many friends here, including some who stopped their medication around the same time as me. My energy remains extremely limited, and these 15 months seem to have slowly worn away my willpower bit by bit. Still, I’ve noticed I’m visiting the forum more often. Perhaps that’s a sign my reward system has partially recovered.

Looking back, starting SSRIs was like opening Pandora’s box, striking a pact with a devil. The day I tapered off the medication, I was destined to endure this punishment.

To be honest, I cannot tell whether it is willpower or sheer refusal to give up. All I know is that if I do not keep going, I will either head toward the precipice or turn back and compromise with the devil. This perseverance is not charging forward bravely; it is merely enduring blows passively. I truly hope one day I can fully recover. Right now, though, my central nervous system fatigue has hit its worst point. I am utterly exhausted, and I cannot see any way back to my old energetic, strong self.

Hi @TonyLee

Really sorry to hear about your struggles mate. I also suffer with OCD and have had a terrible time with medication, I took sertraline and couldn’t tolerate more than 2 doses!

I have been making good progress in my recovery and my OCD hasn’t been causing me as much anguish apart from more recently when I was made redundant at my job and it has caused quite a bad flare up. I’m learning to live with uncertainty and focusing on nervous system healing and repair.

I’m still tapering Mirtazapine and this has set me back a bit but I’m confident to succeed one day (I hope).

Sending healing to you from the UK brother.