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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 put on Zoloft a year ago for postpartum

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I was put on Zoloft a year ago for postpartum depression/anxiety. It was very helpful with the anxiety almost right away. However, throughout the last year, I have had periodic "weird spells" lasting anywhere from a few hours to a few days where I was very energetic, agitated, impatient and felt like I was going crazy. Like I would just only think about running my body into the ground all day long and I would spin around the house and just get as dizzy as possible or I would go running in my street clothes at night to try to get that annoying feeling out of me. The more mild version would result in me craving alcohol (I'm not a big drinker) or junk food or sex, but the more severe version made me feel really out of control like I was going to do something stupid. I even called the psychiatrist and said "I can see why these SSRIs have suicide warnings because they make you feel like killing yourself." While on the Zoloft I have also had some pretty bad depressed spells lasting for a few days to two weeks where I just hated myself (not unlike me) and had gory suicidal thoughts (unlike me). Anyway, my psychiatrist doesn't think it's the Zoloft because it comes and goes and isn't a constant feeling, but I am convinced it is the medicine. Anyway, I just tapered of the Zoloft because I am sick of that feeling and I don't feel anxious but I have been really energetic and super moody/angry. Anyway, I spend a lot of time trying to figure out why I am the way I am, and I was just wondering if you thought it was the Zoloft causing these issues.  Additional info : I am a stay at home mom with 4 kids.  I have a history of ADHD and anxiety. I eat very healthfully and exercise every day.  I try very hard to maintain a regular sleep schedule although I often have trouble sleeping.  I have a lot of friends and family support and go to a therapist twice a month.  In other words, I am taking really good care of myself so in theory I shouldn't have any problems like this!
Submitted: 6 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 6 years ago.

Hi! I believe I can be of help with this issue.

First, let me say I can imagine how overwhelming and distressing this situation must be for you. That your psychiatrist doesn't think it's the Zoloft is an important opinion to keep in mind. That you have an internal sense that the medication IS causing this anxiety reaction is also an important opinion to keep in mind.

And this is actually the key to my answer to you that you need to consider and think about. Zoloft has been known to cause overstimulation. I've known psychiatrists to most often replace it when this happens with Kolonopin because tapering off Zoloft needs to be done gradually. And one of the problems with the medications today is that doctors don't tell people that once you're on them for more than a brief period, weaning off is not a pleasant process.

You have big advantages over most people I deal with trying to wean off: you've established good and healthy life routines. This is going to be a BIG part of you life now as you try this tapering off process to find out if indeed it is the Zoloft. Stick to the exercise no matter what. Don't follow your anxiety reactions no matter what. You've been doing well so far, so this naturalistic self-experiment you're doing seems worth the effort you're putting in. Support system is a big thing. So, please print out my answer and take it and your husband to Starbucks or some similar quiet neutral place and discuss it. You're doing an experiment right now to identify the cause of some severe threatening symptoms. You're doing it wisely: you've informed your doctor, you're tapering gradually, you're maintaining healthy routines, you're not making any life changes, you're shoring up your support systems. Your husband needs to be on board and aware of what's happening and be monitoring for you the situation. He should have a release to talk to the psychiatrist and the therapist to discuss any changes or concerns he might have or questions.

So while I'm not usually very positive with naturalistic self-experiments, that's because they're usually done spur of the moment with no support systems. Here, I'm quite optimistic for you. I don't know whether the doc is right or your intuition. I tend to think your intuition is right because I've been informed by people of difficult reactions like these. But please remember that you will need time to let these symptoms ease and use all of this in your therapy as well. You may have to go to once a week for a while also if you think it will help.

Okay, I'm going to give you here a self help technique you may not know of that you can use to help you bring the level of anxiety down. You can use it over and over. It is not curative in any way, it is an anxiety reduction technique to give you a little time to use some of what you should be learning to do in therapy. I wish you the very best!

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 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?


  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.


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