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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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I was currently on .075 of xanax and it was OKMH106100

Resolved Question:

I was currently on .075 of xanax and it was upsetting my stomach. I went to the hospital and they switched me to Ativan. What happens to the xanax in my system? Does it just go away and if so how long does that take?

Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Dr. Mark :

Hi! I'll be glad to help you with this issue.

Dr. Mark :

Xanax has a very short half life. That by the way is why it is so effective to use as needed: it works very quickly. But it also leaves your system very quickly, in a matter of hours is its half life. Within a day and a half, it's out of your system except for trace amounts (that show in testing but aren't clinically significant).

Dr. Mark :

Does this help?

Customer:

Yes, but I had been taking Xanax for about a month now. I was trying to wean off it it and could not. I ended up in the hospital with severe withdrawls. It upsets my stomach. So they swithced me to Ativan. So I want to know what happens to the xanax I had built up in my system before the switch?

Dr. Mark :

Ativan and Xanax are in the same family of medications and have very similar half lifes; they both work quickly and leave quickly. That's why they're prescribing it for you.

Dr. Mark :

The problem with withdrawal you were having were not because of Xanax left in your system;

Dr. Mark :

Rather the problem was with your body trying to adjust to not having Xanax. So that's why they've gone to Ativan. Okay?>

Customer:

What I am trying to acheive here is to get off of these types of meds completely. So if the xanax willl be out of my system in a day and a half. When can I start to taper off the ativan?

Dr. Mark :

I was wondering about this. You are making an excellent point and I really don't understand why they would start you on Ativan!

Customer:

Because the xanax upsets my stomach.

Dr. Mark :

Most often, people are put on BuSpar for this purpose. It's a different class of medication so that you do NOT have to go through this again with Ativan.

Dr. Mark :

Okay. So if you're going to continue with Ativan, then it makes sense.

Customer:

The ativan does not upset my stomach like xanax

Customer:

I just want to be on the ativan long enough for the xanax to leave my system and then wean off the ativan

Dr. Mark :

Okay. That is fine. Let me give one additional piece of information for you to take along, okay?

Customer:

ok

Dr. Mark :

If when you begin to taper off the Ativan (make sure not to stop cold turkey),

Dr. Mark :

you feel side effects,

Dr. Mark :

then please talk with your doctor about temporarily taking a medication like BuSpar, which is easier to taper from without side effects, okay?

Customer:

Yes that happened with the xanax, it was awful

Dr. Mark :

Yes, that's not uncommon.

Customer:

Just want to make sure the xanax will be out of my system in a couple days, right?

Dr. Mark :

That is correct. It will.

Dr. Mark :

Okay, I wish you the very best!


 


My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer:

Yes thank you great service

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Dr. Mark do you recommend a taper schedule for the Ativan? I will probably end up at 2mg to get stable.

Expert:  Dr. Mark replied 1 year ago.
Yes. Please talk about this with your doctor. Ativan is a Benzodiazepine. And Benzodiazepines include Xanax as well. You had side effects with Xanax, so while each drug is different, history does help in choosing strategies.


Therefore, it is a much better strategy to wean off Ativan gradually.


There are some professionals who believe that all people should taper off Benzodiazepines even if there is no previous history to use. I, therefore, don't think it would be controversial with your doctor to taper off gradually when the time comes as it is a good way of stopping the medication.


Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 1 year ago.

Dr Mark I started my taper yesterday. I went from 2mg a day to 1.5mg today. And plan to taper down to 1mg in 3 days for 3days. Then to. 5mg for 3 days then done. Is that a slow enough taper?

Expert:  Dr. Mark replied 1 year ago.
It's a good starting plan. Like any starting plan, you have to be able to make adjustments as needed. This is true in every area of life, right? It's true with tapering off medications for sure.


So, if you are tolerating these decreases at this rate well, then you know to stick with the strategy. If side effects appear: if they are tolerable, then stay with your plan as it's a good strategy. Because the side effects will be temporary and will ease up after 10 days or so.


If the side effects are too difficult, then you'd discuss with your doctor slowing down the pace and perhaps slowing down the dosage decrease as well. That would be how you would adjust your strategy.


All the very best to you,


Dr. Mark
Customer: replied 1 year ago.

Thank you Dr Mark. Good advice.

Expert:  Dr. Mark replied 1 year ago.
Good for you and all the very best!


Dr. Mark
Customer: replied 1 year ago.

Dr Mark,


 


I am having a really hard time with just this first cut. stomach issues, can't sleep, can't eat. I was told by a family member that since between the xanax and the ativan I have only taken them for about a month that I should be able to tapper quicker.Is this true? And when you say "Because the side effects will be temporary and will ease up after 10 days or so." Do you mean after I'm off I will have side effects for about 10 days or so, or while on the tapper they will ease off as I go?

Expert:  Dr. Mark replied 1 year ago.
Your family member was not correct. These are fast working medications and each person's system adjusts to them differently and some people can feel the reduction even after less than a few weeks of administration.


You need to call your doctor and keep him/her in the loop here. There is no rule that applies to everyone on how long the side effect symptoms are present. For some, each step down can continue the side effects until after the weaning off is completed.


For others the side effects may continue for a period only during the initial tapering. There is no way for us to predict.


However, your doctor needs to be involved with this and in charge, so to speak, so that you feel confident about the procedure and the care. This is the best procedure to follow.


And do not get scared. That is another role your doctor needs to fill: to help you feel more secure about this process. So tell him/her that you need that help. Because I know how people when they feel side effects can get scared and worried about what's going on and whether it will go away.


It will go away. It is temporary. We don't know the time frame, but it is temporary. So work with your doctor on this.


I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Thank you again Dr. Mark

Expert:  Dr. Mark replied 1 year ago.
All the best to you!


Dr. Mark
Customer: replied 1 year ago.

Dr. Mark is it normal to be afraid to take the medicine that you know is causing you all these withdrawals? It does not make sense to me to keep taking something that is making me sick.

Expert:  Dr. Mark replied 1 year ago.
Well, yes, it's normal because of your logic.


But remember: you took the medication for a reason originally. These are very powerful medications that acted to help you during that time. Now you are ready to move on in life without them. That's a positive.


Unfortunately, the price of taking those medications is paid when you're done needing them! This is a common problem we have with psychotropic medications. When the patient needs them, the patient thinks of them as a blessing and is very happy they exist.


Then, the patient no longer needs them and the withdrawal side effects happen (many if not most of these meds have some side effects for a significant portion of the population) the patient thinks of them as the medications from hell (couldn't resist and I hope it made you smile).


So, my point to you is that you have to put it into context: It's like buying something you want on credit: at the time it's great, but then you have to pay the bill. So, this is the time that you're making that payment. But like all payments, there will be a final one:


There will be a day when all of a sudden you realize sometime during the day that it isn't as bad as it had been before. And that will be great. So please don't lose heart, okay?


All the best,


Dr. Mark
Customer: replied 1 year ago.

You are right I forgot why I took them. When I took them it was the only thing that gave me relief. I felt so bad the night I took them and it was the only thing that made me feel better. Now I realize I don't need them. It's just hard to take a pill during taper when I'm not feeling withdrawals, but when I have withdrawals I can't reach for a pill fast enough. You have a great way of putting it. And yes the "medication from hell" did make me smile. Thank you again, you are great! I wish you were my doctor.

Expert:  Dr. Mark replied 1 year ago.
All the best to you!


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Dr Mark I am on day 5 of my taper and I manged to go all the way down from 1.5 mg on 10-6-13 to today @ .0.75 cut into quarters of .025 about every 6 to 7 hours. The withdrawals are some times very difficult between doses. I've been cutting dose every 3 days. My question is if I stay at the .075 for maybe and extra two days will that make it harder to go to my next cut of 0.5? I don't want to make this any longer than I need to.

Expert:  Dr. Mark replied 1 year ago.
No, it typically would make it less difficult for your body as it adjusts now to the lower dose. Slowing it down to seven days is reasonable. It could make you more antsy, and that could increase your anxiety level, of course....



Because remember: your worry about it and your hypervigilance is also throwing various chemicals into the mix as well. That's part of life, though. I'd like to include here, so I'll paste it in, a technique I think might be very helpful to you. In therapy, when I'm working with people, they sometimes don't take seriously how really powerful this simple tool is. It takes some practice, but it will help your brain get out of the fight or flight anxiety state that our brains do. In response to that instinctive need, the rest of our brain uses up so many resources just to stay calm. So this tool is very useful. It's been researched a LOT.


So, go ahead and slow it down right now for two days and use that time to practice this technique. All the very best to you. I'll paste it in below, Dr. Mark



Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety states is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Thank you once again for your great advice! I will start doing the PMR, thank you for sending it to me.

Expert:  Dr. Mark replied 1 year ago.
Good for you! And all the best,


Dr. Mark
Customer: replied 1 year ago.

Dr. Mark since my last reply I only stayed on the .075 dose for two days only and felt well enough to go down to the .05. Today is my third day on .05 dose but the last two days have been very rough. This morning I had to take my .05 dose very early 5:00 a.m. since I could not tolerate the withdrawal symptoms. I am concerned that my next dose will be very early like about noon. Then I have the whole rest of the day without any medication and may not be able to make it to the end of day. I am dissapointed that I may need to go back to the .075 dose. Does this sometime happen? And is it because I jumped down from the .075 to the .05mg too quickly?

Expert:  Dr. Mark replied 1 year ago.
No, it's not because you jumped down too quickly. It's because you're having side effects, period. But they are temporary. If it's too hard the next couple of days, you might need to go back up. You'd need to get your doctor's okay, though. Make sure he/she is on board with that. And then you might need to cut the pills even more gradually.


Yes, I know that sounds weird, but it's been done before, believe me. But again, talk with your doctor to make sure he/she knows the situation. Because if a doctor feels left out of the loop, they will not be as eager to help when there's a need that arises. Okay?


So, see how it goes, try to delay taking the second dose, contact your doctor, and discuss if you might step up just a smidgen, cutting the pill in smaller increments.


All the best,


Dr. Mark
Customer: replied 1 year ago.

I made a call into my doctor and am waiting for his return call. I don't have enough pills to go slower so I am also requesting anther prescription. I have some .05 mg tabs but they are so tiny to cut. If I am able to cut them in half with my pill cutter is that ok, when they are not scored and so small? I've been cutting the 1mg into quarters and that is what I have been tapering off with. And also when you said "side effects" do you mean withdrawal symptoms is what am having?

Expert:  Dr. Mark replied 1 year ago.
Yes and yes:


Yes, withdrawal symptoms is what it sounds like you're going through. Verify this with your doctor, but it sounds very much like withdrawal symptoms.


And yes, you can cut with your pill cutter. I know you are anxious and worried and so I'm not quite sure this is a good thing to tell you, but there have been people who, with some withdrawal symptoms from medications that come in capsule form, have had to count out grains of the medication after opening the capsule in order to slow down the tapering.


So you can cut your pills as well. But the idea is to keep remembering that this is a temporary suffering for the sake of a lifelong gain and boost. The boost from being off the benzodiazepines will be lifelong; the difficulty is temporary. So talk about that with your doctor as well, to let him/her know you are committed to this and that you're getting there, because you are!


All the best,

Dr. Mark
Customer: replied 1 year ago.

I'm glad you told me about people having to count out grains. Puts it in to perspective for me. Since you said I can cut the .05 mg tabs that's even better because those cut in quarters will give me .0125 amounts that perhaps I can use to go up for a few days, like tonight. I couldn't handle the withdrawals so I had to take my other half of the .025 for the day at noon. :-( So I have already reached my .05 mg for the day. I'm hopeful I won't need anymore tonight, but it's only 2:30 p.m. here. Lots of day and sleep time to go. Not that I get much sleep. My doctor has not called me back yet and I'm sorry for continuing to ask you questions but you respond quicker than he does. So do you think it would be ok to try just the .0125 tonight if needed? Instead of going back up to the full .075?

Expert:  Dr. Mark replied 1 year ago.
Yes, that would be preferable. And do the PMR I showed you above: I call it scrunching...you scrunch your muscles, then relax them.



So, yes, taking less is better than taking more: you can see if you are tolerating it. And if you are, then you may need to step down more gradually as we've been saying.


When you do talk with your doctor, tell him that you're taking it very slowly because the withdrawal symptoms are tough. And that you've learned Progressive Muscle Relaxation and you're using that to help as well.


And so, slow down the tapering steps, meaning graduate in smaller increments, and scrunch away!!


Also, is it time for you to learn mindfulness meditation?


All the best,


Dr. Mark
Customer: replied 1 year ago.

Yes I've been doing the muscle relaxation. I'm not too good at it yet Frown And yes I would love to learn the mindfulness meditation. Dr. Mark, I've really grown to trust you. I do better when I have a guide to go by. So if you were my doctor and I told you I was at the .05mg @ .025 twice a day morning/nigt and I can't even make my night dose and have to take it early along with having a tough time, what would your taper schedule for me look like?

Expert:  Dr. Mark replied 1 year ago.
I might break it up into 4 times a day instead of 2 rather than stepping up. What do you think? Ask your doctor what he thinks.


Alternatively, I would consider not going back up totally to what you were before, but only half way like we said above.


Mindfulness meditation is something you should add to your life; it is something that all of us today should: we ALL live with so much anxiety and tension and stress. And now you've got this new thing of trying to get off the Ativan.


There are many sources on the internet to learn mindfulness meditation from. So you can start just browsing. Or here's some information that might help.

The psychologist who brought mindfulness meditation into psychology more than any other person is Jon Kabat-Zinn. His first book is the one I want you to look at: Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Pain, Stress, and Illness. Here's the Amazon page for it and you can look at some of his others there as well:

http://www.amazon.com/Full-Catastrophe-Living-Wisdom-Illness/dp/0385303122/ref=sr_1_1?ie=UTF8&qid=1292376629&sr=8-1


I want you to look at this video of him. If you stay with the video and listen carefully, I think you will hear much that will feel relevant for you:

http://www.youtube.com/watch?v=3nwwKbM_vJc

His most popular book is Wherever You Go, There You Are. It's a true classic; I think they just did an anniversary edition of it. So, enjoy getting to know Kabat-Zinn and learning to not fight against your racing thoughts but, instead, feeling more in harmony with your mind and being able to slow down your thoughts naturally.

Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 1 year ago.

I just did my pmr and will definitely look at the above links. Thank you for suggesting them. My doctor has not called me back yet, but it's still early here. But I will ask him about the 4 times a day. So you are suggesting cutting the .05 into .0125 cuts and taking it like every 4 hours a day for the next maybe 3 days?

Expert:  Dr. Mark replied 1 year ago.
Right. Remember that Ativan is very fast acting; thus it leaves your system quickly also. So I would recommend you see if the smaller doses more often relieve the withdrawal symptoms more, or at least make them less of a pain in....your whole body (hope that made you smile).


All the best,


Dr. Mark
Customer: replied 1 year ago.

haha yes it didLaughing The most uncomfortable withdrawal is my upset stomach. Nausea, diarrhea, and tight stomach muscles. I sometimes get stomach palpitations that are painful. I have no appetite either. Any suggestions to relieve those symptoms?

Expert:  Dr. Mark replied 1 year ago.
I think you need to get your doctor to help with that. There are several medications that are used for nausea in these situations. So it will be a matter of what is appropriate for you medically. That's what your doctor will need to assess. So, know that this is a common withdrawal symptom and that anti-nausea medication can help. And keep smiling!


All the best,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Thank you Dr. Mark, you are the best!Smile

Expert:  Dr. Mark replied 1 year ago.
So are you,


Dr. Mark
Customer: replied 1 year ago.

Laughing

Expert:  Dr. Mark replied 1 year ago.
Thank you. The system doesn't like it if I don't respond, so let this one go without you responding or I'll be late for afternoon therapy sessions....


All the best,


Dr. Mark
Customer: replied 1 year ago.

Well Dr Mark I failed. I couldn't handle the withdrawal symptoms and had to go back up to .05 mg twice a day. :-( I called my doctor and he told me that the only schedule he has to discontinue is cutting the 1 mg into quarters and 3 quarters for three days, then 2 quarters for three days, then 1 quarter for 3 days. Is there a better taper schedule you can recommend to me?

Expert:  Dr. Mark replied 1 year ago.
That's a standard tapering schedule. I'm concerned, though, that you aren't establishing a close enough collaboration with him; or he with you. You speak of his involvement always as if you are uncomfortable about confiding in him and treating him as your go to person.


I am concerned for you about this. Because maybe you should tell him that you want to feel more comfortable talking with him about the difficulties you're having since he's your doctor. And see if he will soften up.


Okay, enough of my editorializing: I'm concerned for you, and that's why I said this.


Back to the schedule: first of all "failed" is a final grade. I don't think that's an appropriate emotion. It's self defeating. I'm not giving you a final grade yet (hope that made you smile).


Second, everything in life is information. We learn from everything. What did you learn from this? Does it mean you need to spend more time relaxing? Does it mean you need to spend time watching motivational speakers? Speaking of which:


Here's a simple YouTube search I put together on "motivational speakers":


http://www.youtube.com/results?search_query=motivational+speakers&aq=f



Some like Tony Robbins are the classic big guys. Some are newer. There are now wonderful women speakers as well. There are now great women speakers as well. Watch them all. Get inspired. Buy a book or two. Here are some possibilities, but they are only suggestions as there are so many good ones.


Does it mean you need to do other things to help yourself through this?



Third, this schedule is okay, but it's a bit fast for you. And you can always cut the pills even smaller if you wish. But it does help by giving a starting point: 1 mg, then .75, etc. per day.


But slowing down the pace from 3 days to 7 days might be a better rate for you. Or you could split the difference and do it for 5 days. But I think 7 days may be good.


Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 1 year ago.

Dr. Mark


 


First of all thank you for all the links you send. I watched the mindful relaxation video with Dr Zinn at Google. I really enjoyed it. Have not had a chance to look at the book but will.


To address the issue with my doctor. He is a great family doctor and has know me for over 20 years. I just don't feel that these types of medicines are his specialty. He has yet to return my call from yesterday. I know he is off Fridays so I may not hear from him until Monday. Today I decided to contact a psychiatrist which was given to me as a referral. The bad news is I don't have an appointment unit 10- 26. In the mean time I really have no real guidance other than what you give me. So I am reaching out to you again. I hope you don't mind.


 


I'm not sure how to take my medicine. It still upsets my stomach, my doctor did call in nausea medication, zantac, and others to help with the stomach issues. I have terrible diarrhea.


 


As I told you before I went back up to .05 x2 a day of the ativan. I take .05 in the morning and try to make it to the evening for the other .05 but sometimes the stretch is too long and have to take it sooner. Which means I don't really sleep long when I take it earlier. Since I just went back up two days ago, to the .05 x 2 is it going to take a few days to stabilize? Just to remind you I had gone all the way down to .05 once a day before going back up. And should I be cutting the .05 2x a day in quarters and taking it like every 2 hrs, 3hrs 4hrs,. etc through out the day? There is where I am confused. I already know to stay on that dose for at least five days to seven days, I learned that from before and your recommendation. Not to go so fast.


 


Thank you for helping me, I will look into the motivation links today.

Expert:  Dr. Mark replied 1 year ago.
First things first: you just got the anti-nausea medication. Good. So, what's the first things first?


Only in movies do things happen within 1.35 seconds. The rest of us have to be patient and accept our suffering knowing it will take time. We put it in perspective: you're having really unpleasant difficult withdrawal symptoms. You're suffering. But, you know it will go away in a matter of weeks. If you were at the pharmacist picking up the anti nausea meds and there was someone in a wheelchair suffering, you'd take your suffering any day. So, take a few deep breaths and anticipate the motivational videos:


Thank you Lord that this is the challenge you've given me. It's tough. I'm suffering. I'm not taking it like a movie star. I'm me, Lord. But I'm doing the best I can, Lord, and thank you for not making it worse. And thank you, XXXXX XXXXX making the appointment still be in October with the shrink. Dr. Mark says that in most areas of the US today, appts. for new patients is usually 8-10 weeks out at the earliest. So, thank you Lord for that!


You know, now that I reread that, I like that soliloquy (hope that made you smile as well.)


You can try 2 Benadryl at night to help with steady sleep. It usually doesn't irritate the nausea issue for people. But right now do whatever you can to keep your family physician on your side until you get to the psychiatrist and have him/her guide you though with a "customized" withdrawal schedule.


I'm SO glad you have this appointment!


All the best,


Dr. Mark
Customer: replied 1 year ago.

Dr Mark, Smile


You are right, I have to be more positive. Yes things could be worse. I just feel like it's never gonna end. Two months now, and it's been tough. I pray every night and I have a book "Jesus Calling" given to me by the doctor that put me on this med. It helps and I believe. I would never leave my Doc and it's not his fault, he was trying to help me.


Today I mustered enough energy to go to the pharmacy for diarrhea medication . The pharmacist told me a better schedule is to cut the 1 mg in to 4 quarters and take it every 4 to 6 hours and then taper down by a quarter in 5 days. And then another quarter in 5 days and so on a quarter at a time every 5 days. What do you think about that?


 

Expert:  Dr. Mark replied 1 year ago.
That sounds very much like what I was saying as well somewhere up above. (Our thread has gotten so long, I've lost track....that was for a smile...)



Yes, that is a good pharmacist to keep on our team. You're building a team for yourself. Good for you. In fact, I was going to go on to talk about cutting the pills more, but I distracted myself with the soliloquy. So, you see you receive blessings in many ways: you were brave and went to get the meds and lo and behold, someone with good advice!


All the best to you,


Dr. Mark
Customer: replied 1 year ago.

I don't blame you that is a great soliloquy! I had to re-read it tooSmile Yes that was a blessing to have the pharmacist there at the moment I was there. They are usually busy. In fact I was suppose to take my quarter at 2 but I was watching Tony Robbins and lost track of time. So now I'm off to take my next quarter. Thank you for your inspiring words and suggestions. They really help.Glad you are on my team!

Expert:  Dr. Mark replied 1 year ago.
Hooray for Tony Robbins!


Be well,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Dr Mark,


 


So today rather than take the .05 all at once I took just a quarter at 2:30 p.m. along with the .05 I had earlier at 8:00 am. Just like the pharmacist recommended. Just about 30 mins ago I had the worst sadness, depression like feelings. Is that because I made the cut to the quarter and haven't taken the last quarter yet?

Expert:  Dr. Mark replied 1 year ago.
Hi,


I am so sorry, I don't know why the system did not alert me you had made a posting. I only found this while doing a manual review of answered questions. You might need to start a new thread perhaps. Just write "For Dr. Mark" on it and everyone will know to direct it to me.


How are you doing now?


Dr. Mark
Customer: replied 1 year ago.

For Dr. Mark,


 


I'm having a tough time today. Stomach is upset and I feel down. I'm still taking the 1 mg in quarters 4 x a day. No appetite or energy. Are this common withdrawal symptoms? And I thought if I stick to the current dose for at least a week the withdrawals will stabilize. Today is day 5 at that dose. Will it get better if I stay maybe the 7 days you suggested?

Expert:  Dr. Mark replied 1 year ago.
Yes. Mood changes especially toward depressed mood are common withdrawal symptoms. If they persist, you'll be discussing this with the psychiatrist and the two of you will decide about whether you want to be put on an antidepressant temporarily. I may have discussed that somewhere above.


It's a mixed blessing: it can help with the Ativan withdrawal, but then you'll have to deal with its own side effects. HOWEVER, if you go on Prozac or a similar med (they're often what's used), the withdrawal is usually much less problematic after only a month or two.


But still, have we talked about Omega 3? Make sure you're taking a good quality supplement: 1,600-3,000 mg daily. Vitamin D is probably a good idea for you at this time if your nausea is better. Exercise is important even if you don't feel like it, okay?


No coffee, or not more than 1-2 cups a day. No fast food restaurants. Lean fats (skinless chicken, fish, etc.) And, lots of smiling!

Motivational videos. Tea with friends. Saying nice things to old people on the streets. Volunteering.


In other words: commitment, commitment, commitment. The reward will be so sweet a couple of months from now!!!!


Dr. Mark
Customer: replied 1 year ago.

Yes If I continue feeling sad I will tell the psychiatrist. I'm so afraid of anti-depressant medication. I am very sensitive to medication. Which in your opinion is the most mild and less side effects? I do take my vitamins everyday. I take omega, but I think I am only taking 1200 I will increase it. I also take vitamin D. How much Vitamin D do you recommend? I try to exercise and I don't do any caffeine. The weekends are easy to stay busy. My husband is off and keeps me busy. the weekdays are hard because I don't work and I'm in the house alone all day. I do need to find something to do. Do you think the sleepy time teas are good idea?

Customer: replied 1 year ago.

For Dr. Mark


 


 


Yes If I continue feeling sad I will tell the psychiatrist. I'm so afraid of anti-depressant medication. I am very sensitive to medication. Which in your opinion is the most mild and less side effects? I do take my vitamins everyday. I take omega, but I think I am only taking 1200 I will increase it. I also take vitamin D. How much Vitamin D do you recommend? I try to exercise and I don't do any caffeine. The weekends are easy to stay busy. My husband is off and keeps me busy. the weekdays are hard because I don't work and I'm in the house alone all day. I do need to find something to do. Do you think the sleepy time teas are good idea?

Expert:  Dr. Mark replied 1 year ago.
Yes, Sleepy Time is okay. Traditional Medicinals is another well known brand like Celestial Seasonings that makes good teas. I think they're a little less "added flavors" oriented than Celestial Seasonings teas. Any of the big, well attended health food stores will have natural sleep aids, and evening calming herbs, etc. that will be fine. The only one you have to be careful with is St. John's Wort as it is a real medication. If you try it, make sure to tell your doctor because you don't want to be on antidepressants with it as it is a potent antidepressant itself.


In fact, I just realized SJW is a worthwhile option for you to try given you're sensitive to psychotropic medications; you can inform your doctor you're trying St. John's Wort as you're not on meds right now, just tapering off the Ativan. Use the recommended dosages on the bottles at the health food store. It really helps a lot of people.


Vit. D is a difficult one: most Americans are deficient. Next time you have blood work, as for a Vit. D reading and use that. It's the best way. Until then, just use the dosage recommended by the manufacturer you're using.


Keep on being you!


All the best,

Dr. Mark
Customer: replied 1 year ago.

For Dr Mark


 


I'm going to try the wellness tea from sleepy time. I think I will hold off on SJW until I see the Dr. Are Zoloft and Prozac the same? Do you prefer one over the other?

Expert:  Dr. Mark replied 1 year ago.
Prozac is usually used more often in this situation as a temporary medication during the withdrawal period from a benzodiazepine.


This is because it is much more long acting and so after a couple of months use, when you discontinue it, you can taper off from it more easily. Zoloft is more quick acting. But, a lot will be determined by your psychiatrist's personal experiences with the medications. There are so many now...


All the best,

Dr. Mark
Customer: replied 1 year ago.

For Dr. Mark


 


Is it possible to taper off Ativan without adding anything else? And since I'm going longer on the 1 mg (7days) will the withdrawals stabilize eventually you think?

Expert:  Dr. Mark replied 1 year ago.
Yes and yes!


Remember: you've made it this far without any additions. You can keep on trying to brave through this and you WILL get there. You will get there. In case you still don't believe me:


You WILL get there.


So you don't have to add on an antidepressant. Keep on breathing, mindful meditation, PMR, exercise, positive thinking, and getting through it. And you will get there. Like a cold, with the over the counter cold medication it will take a week. Without the over the counter medications it will take seven days...(hope that made you smile.)


All the best,


Dr. Mark
Customer: replied 1 year ago.

For Dr. Mark


 


Yes it did make me smile Laughing You really do motivate me. I am currently sipping tea and going to go for a walk. The positive thinking has become a little difficult since I tried and failed the last time.

Expert:  Dr. Mark replied 1 year ago.
There was a song called "It Don't Come Easy". I think it's true...


But on your walk keep remembering Dr. Mark's mantra: nothing in life that's worthwhile comes easy. Our victories are victories because we worked hard to get them!


All the best to you; you're doing it!!!

Dr. Mark
Customer: replied 1 year ago.

For Dr. Mark


 


You are right Dr Mark, you made tears come to my eyes because I know it's true. And I believe in the end I will be a better person for it. I will recite your mantra as I walk. Thank you for always being there.


 


You are the best!

Expert:  Dr. Mark replied 1 year ago.
Have a great walk,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

For Dr. Mark


 


I just returned from my walk and thought of a question. So when you taper down from benzos I have read that your gaba works to re-establish. I still don't really get that. Can you explain that to me?

Expert:  Dr. Mark replied 1 year ago.
You know, Google is an amazing thing! I wanted to see if there were articles online that would give an understandable explanation. And toward the top of my search was this wonderful article by someone who knows what he's talking about. That's great. Here's the link:


http://www.lexington-on-line.com/naf_xanax.htm


I'm not sure what lexington on line.com is, but the page says The National Anxiety Foundation and when I scanned through the article, it was very impressive.


So, there you are...ask and ye shall receive?...


All the best,


Dr. Mark
Customer: replied 1 year ago.
Dr Mark,
You are a great researcher!
This was a great explanation, especially this part
(And equally wisely she had her go 2 weeks on that dose to let her brain GABA increase and liver enzymes decrease before cutting the dose further). So maybe I need to stay at the 2 week dose. What do you think Dr Mark, two weeks?
Expert:  Dr. Mark replied 1 year ago.
It's always a risk/benefit ratio in my book:


If you freeze at 2 week dose, you've extended the pain that much longer. I'm not sure I want you having this drag on more. I'd rather you get it over with. It take so much effort anyways, why drag it out? What do you think?


Dr. Mark
Customer: replied 1 year ago.

For Dr Mark


 


I think you are right how about 7 days instead?

Expert:  Dr. Mark replied 1 year ago.
You're wonderful!


You make me want to say: I'll counter with....5 days...


(Hope that made you smile).


Keep on pushing yourself. Don't look in advance for when you may need to pull back. Rather, you'll pull back if and when you can't keep moving forward. Agreed? It'll be there, but we won't plan for it.


By then, you'll have the psychiatrist on the team as well.


All the best,


Dr. Mark
Customer: replied 1 year ago.

For Dr Mark,


 


Haha counter with 5...


 


Everything you write I am right there with you, but for once I'm confused with what you mean. What do you mean by this? " Rather, you'll pull back if and when you can't keep moving forward"

Expert:  Dr. Mark replied 1 year ago.
Right now you're on a schedule that the pharmacist recommended. It's a good one. I am merely saying:


Don't plan in advance to freeze that schedule at a certain point, like the 7 days dose. If we need to slow down the schedule, so be it. If we need to freeze it for a period of time, so be it. But neither is our "plan". Our plan is to keep you moving toward that moment when you are doing something and you realize, you know, I haven't felt those feelings nearly as bad today. Wow, that's great. And it goes on like that, slowly.



Good things happen slowly most of the time...


All the best,

Dr. Mark
Customer: replied 1 year ago.

For Dr Mark,


 


Gotcha!Cool Have a plan but be flexible. I can't wait for the moment when I haven't felt those feelings nearly as bad. You are a great person to have on my team. Thank you again!

Expert:  Dr. Mark replied 1 year ago.
Onwards and upwards!


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 12 months ago.

For Dr. Mark


 


Hello Dr. Mark,


 


Well here it is day six on 1 mg of ativan in quarters 4x a day. Yesterday was a pretty good day. I was able to space the quarters to 6 hours in between. Almost didn't feel like I needed the last quarter, but I took it anyway. Today I woke up feeling not so good. Very nauseated, didn't really sleep and feeling discouraged and depressed. Why do I feel bad today after a pretty decent day yesterday? Could it be that I spaced the quarters so far apart?

Expert:  Dr. Mark replied 12 months ago.
Hooray!


You've had a good day in between the tough ones. That's fantastic.


This is what we've been looking for: your system is beginning to adjust. Or, if you want more dramatic terms: the demon is beginning to let go.


You have to look at this like starting a car up when it's run out of fuel: at first it sputters a bit before the engine runs smoothly, right? That's how it works. Your system needs time to readjust. That's what this process has been all about: getting your system readjusted. And it's doing it!!!


See how I'm looking at it? You're worried about microtuning this as if you're a software program. I'm looking for signs that you, the lily plant in the center of your garden, is beginning to respond to the new weather, soil, and watering conditions. So I'm rather pleased for you. Can you join me in that?


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


I see what your saying. I almost felt like myself yesterday. So It makes sense that my system had a little more of my fuel yesterday. So do you recommend I continue to try to space the quarters as close to 6 hours as I can? Also based on today, I don't think it's good day to eliminate a quarter, right?

Expert:  Dr. Mark replied 12 months ago.
Right. We don't move to the left nor to the right. We stay on track, agreed?


Remember: it's not a moment here, a moment there, that we're using to judge our course. It's keeping our eye on the goal. So, stay on track with your plan. This encouraging news does not mean we get off track, agreed?


All the best,


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


Ok I will do my best to weather the storm today. Hopefully it won't be too rough. I am a little anxious about seeing the psychiatrist. I really don't want additional medicines to get off this one.

Expert:  Dr. Mark replied 12 months ago.
First, remember: you've weathered storms just as bad as today before. And look where they got you?


Right: to yesterday!


So remember that.


Second: psychiatrists are only as pushy as you let them be. If he/she is a real medication oriented doc, then you balance him/her out, okay? I always remind patients that they, the patient, is the employer; we the docs are the employees. We have to go with your flow.


All the best,


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


Yes you are right, I've been through some rough ones. Gotta keep my eye on the goal! Thank you for being so positive. You are the best!Smile

Expert:  Dr. Mark replied 12 months ago.
Well, you are the bestest!


All the....best,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 12 months ago.

For Dr. Mark,


 


Dr Mark, today is pretty rough. So yesterday as I told you I spaced the quarters about 6 hours. I am only into my 2nd quarter taken about 2 hours ago and I'm having a really tough time. Would it be ok to take a quarter now or try to at least make it another two hours?

Expert:  Dr. Mark replied 12 months ago.
Hi. I was in session all afternoon in my office. How are you doing?


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


It's ok I understand you have your practice as well. I am doing Ok. I waited and didn't take the 3rd quarter until 5 hrs later. I had a stressful situation though and I didn't know how I was going to handle it. My Son had moved out to go to college, he lost his job and didn't do well in school. My husband and I had been paying his rent. Financially it was hard on us, cause I lost my job. Today he decided to come back home. He brought back all his stuff and he looked so depressed. I think he is suffering from depression from all of this. I kept telling myself this was not good for me because I want to help him and I am in the middle of tapering. I felt so bad for him, but I don't feel that well enough to help him. He left to my daughter's house and just brought in all his belongings and will be back home in a few days. I am so afraid this is going to hurt my process of my taper. Help

Expert:  Dr. Mark replied 12 months ago.
So far it seems to have strengthened you: you didn't take the 3rd quarter till 5 hours later. Isn't that true?


Sometimes, being needed to help another human being is a source of strength for ourselves, is this perhaps what happened for you?


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


I think you are right especially when it comes to my kids. I try to be strong for them. That is why I want to get off this med. I think I am stronger without it. Taking it makes me feel weak. I was super anxious when he came home but I pretended to be ok for his sake. I hope this situation does not set me back. I want to continue to taper. What do you think?

Expert:  Dr. Mark replied 12 months ago.
I want to tell you a story:


I had a client once via Skype. They were uncomfortable going to someone locally as they lived in a small town and so they worked with me via Skype. This person grew up in the small town and, despite a tremendous lack of self worth and self confidence, had a lot of that small town wisdom, if you know what I mean. This person told me a wonderful thing that he/she realized, or remembered, toward the end of our therapy sessions. The person said:


"You know, you're right. My mother always told me there's no point worrying because we always wind up worrying about the wrong thing."


This was a good memory and a wonderful statement. I shall always remember it. My urging to you?


Be that mother who teaches her son that there's no point worrying because we always wind up worrying about the wrong thing.


You have that love inside of you and you're finding out you have that strength as well. Don't be scared of your own strength. Keep remembering you made it for 5 more hours than you thought you could!


All the best,


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


Great story and great advice. I will go to bed with this in mind...


 


" Don't be scared of your own strength. Keep remembering you made it for 5 more hours than you thought you could!"


I love the way you inspire and write!


 


You are the best!

Expert:  Dr. Mark replied 12 months ago.
And who's the bestest?


Right, YOU!


All the best,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 12 months ago.

For Dr. Mark,


 


Hello Dr Mark. Well kind of a rough morning, feeling nauseated and no appetite. Trying to stay busy though. I wanted to tell you that I have an appointment with a therapist tomorrow. She was recommended to me at the hospital. I am a bit nervous about it. What issues do you think I should discuss with her?

Expert:  Dr. Mark replied 12 months ago.
Let yourself discuss as many things as you can at first. Of course you'll give a description of what's going on, but let yourself see what it's like being with her and establish a working therapeutic relationship with her. That means not being totally problem/solution oriented right away but seeing what it's like being with her and sharing with her. So let it flow from the anxiety on to whatever comes naturally, okay?


You're really going on a journey!


All the best,
Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


I value your opinion. Do you think this is a good journey to add a therapist? I am so comfortable with you already, but my family wants me to see both a therapist and the psychiatrist.


 


Also I am feeling discouraged today. I am still on the 4 quarters a day and still don't feel well enough to cut. Today I feel depressed and I feel like I'm not real, it's weird I can't explain. Today is a week since I went back up to the 1mg. I have been dealing with feeling bad all but one of those days since last Wednesday. I feel like I will never be able to go down in dose. In fact some days I feel like just giving up and taking the higher dose to feel better. What do you think?


 


 

Expert:  Dr. Mark replied 12 months ago.
First on the therapist: You're not signing a lifetime contract. What's the downside? It can only help. And if the therapist is a bad fit and it would be not helpful, then you can withdraw from the therapy.


Second paragraph: never is a very long time! Are you sure you want to tie yourself down to this feeling forever? and ever? and ever?


Instead, how about if you download and watch (maybe with your husband and son) a wonderful old animated movie, An American Tail and wait expectantly for that wonderful song where Feivel the mouse sings about Never Say Never....


That's my prescription for today...


I'll be going into sessions soon,


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


Ok I understand about your sessions, maybe you can answer me later.


 


I watched the video song, I like it. Maybe this weekend we can see the whole movie when everyone is here. I have a hard time watching tv. The only time I feel a bit better are towards the evening when I know I can go to bed and stop thinking.


 


Are the feelings I'm having withdrawals from the med taper?

Expert:  Dr. Mark replied 12 months ago.
Yes, they will. They will.


Just like your son will one day move out of the house, because he will (Hope that made you smile).


Remember Monday? We're looking for another of those days. Keep an eye out for them. The more you think about them, the better chance that you won't be fighting and resisting so hard that you make it harder on yourself, okay?


Listen to the song again, then go out and find some optimism and positive thinking vibes out in the park or the mall, okay?


Talk to you soon,


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


Didn't quit understand the answer. "yes they will." What did you mean?


 

Expert:  Dr. Mark replied 12 months ago.
Hi there. You had asked, "Are the feelings I'm having withdrawals from the med taper?"


To which I replied, "yes they will."


Does that help?

All the best,


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


Yes the feelings will feel like that when you taper?

Expert:  Dr. Mark replied 12 months ago.
The feelings you're having from the meds WILL taper off. That's how I understood it.


They will indeed taper off. You will feel like you felt Monday.


Ah, Monday. You're too young, but there was a group The Mamas and Papas; they had a song Monday, Monday...


Smile through the day,


Dr. Mark
Customer: replied 12 months ago.

For Dr. Mark,


 


Yes I do remember the song, I'm not that young. I have my appointment with the talk therapist today. Feeling a bit anxious.

Expert:  Dr. Mark replied 12 months ago.
That's okay. The therapist is trained to put you at ease, that's his/her job, right?


You just have to be you!


I'll be leaving soon for sessions most of the day, but remember: you're moving forward.


All the best,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 11 months ago.

For Dr. Mark,


 


Hello Dr. Mark,


 


Well I went to my psychiatrist appointment and he deemed me not ready to come off the Ativan. I am now taking 1mg in the am and 1mg at night. I'm not 100% on board with that but he made sense that I have a lot going on right now with my son and I haven't really taken a stable dosing of the Ativan to where I can become stable. He also added 10mg of Celexa, which I am ok with that because I know a lot of people have been helped with antidepressants and I was kinda leaning to wanting to try one. I was very nervous taking it last night, since I fear these types of meds and any side effects that I can feel, but I felt ok.


 


If Celexa works for me, will it be easier to get off the Ativan? I know that is my goal to not continue with benzo's.

Expert:  Dr. Mark replied 11 months ago.
I wish I could give you a definitive answer to your question. If our brains functioned like machines, the way, let's say, our pancreas does, it would be much easier to give you an answer about whether Celexa will affect the withdrawal symptoms of Ativan and in what way and how much.


Because with the pancreas, we take a blood test to measure the sugar levels in the blood. We now have blood tests that are routine that not only measure your sugar level right now but tell the doctor the level over 3 months!


Based on that blood test your doctor decides if you're okay, pre-diabetic, or diabetic. He/she then decides on the type of treatment. And it's the same treatment for everyone who has that result on their blood test, everyone. Like a car, right?


But our brains are a whole different animal (couldn't resist). Without getting into the concept of "mind", let alone "soul", it is so complex and with so many intertwining systems and factors, that it's miraculous. And then there is the fact that each person is somehow different. That in itself is not quite clear to the scientists, how and why...


So, given that, I think you need to discuss it with the psychiatrist. Because if your goal is to go off the Ativan, there is indeed a good chance that you'll be having symptoms with the Celexa as well. And if you're going to try to control them with substitute medications during the tapering off period, then it might mean either increasing Celexa dosage at that time or supplementing the Celexa. But when that time comes, you'll be more prepared because you already have gone through most of the worst part this time. So it won't be so new. Plus you'll have the Celexa that will certainly help and the psychiatrist with you to increase that dosage, etc.


All the best to you!


Dr. Mark
Customer: replied 11 months ago.

For Dr. Mark,


 


I don't mind staying on the Celexa if it works. I think I need something for a while. I also think going to talk therapy will help me to get off all meds eventually.


I just feel like a failure to have tried 3 times to stop the ativan and could not do it. Actually I feel like a failure that I can't be the strong person I have always been and have to look to medication to help me be me.

Expert:  Dr. Mark replied 11 months ago.
Yes, I thought this was behind your writing me (hope that made you smile, too).


This would indeed be a good focus for talk therapy, because if there's anything that will egg on those symptoms, it will be the fear of failure brought on by a conviction that you ARE a failure. Trying to fight both physical symptoms and lack of self worth is a double whammy!


To get you started in this:


Reread what you just wrote to me; then reread it as if you're reading something your son wrote; the think about how you would want to reply to him. Then use that reply with yourself. Then think how would he probably reply to that reply? And how are you replying?


In other words, start to work on this self worth issue, okay?


Be the bestest,


Dr. Mark
Customer: replied 11 months ago.

For Dr. Mark


 


Very clever (yes that made me smile) Yea I know I would not want him to say anything negative. And I of course would try to say something positive. Like...You will be that strong person again, you've been here before and have come out stronger. I admire your strength to deal with this so you are not weak you are strong.


 


Thing about me, is that I am a very positive, strong willed person. I think that is why I have anxiety issues, because I am a perfectionist. I'm not a depressed person though. I always have thoughts of being positive and that things will work out somehow.

Expert:  Dr. Mark replied 11 months ago.
I like that end paragraph. Why not print it out as your mantra?


I am a very positive, strong willed person. I think that is why I have anxiety issues, because I am a perfectionist. I'm not a depressed person though. I always have thoughts of being positive and that things will work out somehow.


Apply it here. Keep reminding yourself and memorize it, okay? (Hey, it's not me trying to make you believe this, YOU"RE the one who wrote it!).................


All the very best,


Dr. Mark
Customer: replied 11 months ago.

For Dr. Mark,


 


You are the best! I will print it and refer to it daily. who better to believe than myself, right?!


 


Thank you so much for being a part of my team. I hope you have a nice Sunday. We shall see where the road takes me. It should take me where I and God insist is the right path for me. Smile I have to set the example for my son for him to get better too.

Expert:  Dr. Mark replied 11 months ago.
Good for you. You know, if you look at the life of Moses, it's remarkable: the journey was the important lesson, not the goal. The journey and how we grow on our path.


All the very best to you,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 11 months ago.

For Dr. Mark,


 


Sorry had to come back to what you just wrote. Another good mantra...


the journey was the important lesson, not the goal. The journey and how we grow on our path. I will add it to my mantra, thank you!


 


Look at my word sheet made up already...


 


 


 


 


I am a very positive, strong willed person. I think that is why I have anxiety issues, because I am a perfectionist. I'm not a depressed person though. I always have thoughts of being positive and that things will work out somehow.



The journey is what is the important lesson, not the goal. The journey and how we grow on our path.


 


 

Expert:  Dr. Mark replied 11 months ago.
Fantastic!


One day, you may be giving workshops....that would be fun...


All the best,


Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5130
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you

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