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Thread: Back on sertraline - but will it help? Swallowing issues etc.

  1. #11
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    Hi

    This is just a courtesy reply to let you know that your post was moved from its original place to a sub-forum that is more relevant to your issue.

    This is nothing personal - it just enables us to keep posts about the same problems in the relevant forums so other members with any experience with the issues can find them more easily.

    Please also read this post:

    http://www.nomorepanic.co.uk/showthread.php?t=213239
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  2. #12
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    Jul 2015
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    This is true, however - I do think I am *nearly* there and feel like the stress of booking a neurology appointment, waiting for the appointment, undergoing the various tests and then having to wait on the results would probably be counterproductive at this stage when Iíve already been basically having a breakdown for 4/5 weeks now, especially when Iíve started to improve the last few days thanks to my medication. I go to therapy and I try my very very best to educate myself on HA and OCD but this one has a particularly strong hold this time.

    At the end of the day itís up to me to rationalise: I have had this 3 years at least, and itís only started to worry me since I stopped taking my medication (before I restarted). Iím sure if it was MND it would have progressed by now, or it would be happening with everything I try to swallow (not just trigger foods or during times of high anxiety)

    It actually happened tonight again when I was eating dinner, my mum started talking about another HA topic I have worried about in the past while I was in the middle of chewing (not realising it would trigger me), and of course: I felt like I was choking and the inevitable tick Iíve developed of putting my hand up to my mouth and jolting forward ensued lol

    It wasnít pleasant but basically reinforced the idea of it being anxiety related. Itís just very annoying since it has taken my enjoyment of food and meal times away from me and created a very vicious cycle of fear: panic about eating = choking = panic about eating. Anyone that knows me knows I love my food so itís all quite foreign and alien to me to now be terrified of eating and choking!

  3. #13
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    So I had a catch up with my GP today, they wanted me to call back after a week of being back on Sertraline to see how it was going. I said I had improved slightly though still fearing food, not having any enjoyment from eating, and still having trouble initiating swallowing at times.

    I asked him if he had any concerns about the swallowing thing and he reassured me that after having it 3 years it would have progressed/would happen with every bite if it were something serious (like a muscle disorder). So, I think I'm ready to move on from this now and put it down to anxiety/dry mouth.

    If anyone that's been through this (or any similar food phobias) has any ideas on how I can reignite my love for food again it would be most welcome - finding it really difficult to get excited about my favourite things to eat after all of this!

  4. #14
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    Quote Originally Posted by stk149 View Post
    they wanted me to call back after a week of being back on Sertraline to see how it was going. I said I had improved slightly though still fearing food, not having any enjoyment from eating, and still having trouble initiating swallowing at times.
    ADs don't begin to work this quickly. It usually takes 4-12 weeks for them to kick-in and it tends to become a little longer each time they are stopped and restarted. You may also need to take a higher dose than the last time to achieve the same response.

    any ideas on how I can reignite my love for food again it would be most welcome - finding it really difficult to get excited about my favourite things to eat after all of this!
    If it is anxiety then it will likely happen naturally as the med takes effect.
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  5. #15
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    Quote Originally Posted by panic_down_under View Post
    ADs don't begin to work this quickly. It usually takes 4-12 weeks for them to kick-in and it tends to become a little longer each time they are stopped and restarted. You may also need to take a higher dose than the last time to achieve the same response.



    If it is anxiety then it will likely happen naturally as the med takes effect.
    well, I am miles different to what I was last week but still not great. It does say on the NHS website it takes a week for them to build up in your system and further weeks to adjust. Can you link me to a source on needing a higher dose is reinstating after a previous treatment please? Thank you!

  6. #16
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    Quote Originally Posted by stk149 View Post
    It does say on the NHS website it takes a week for them to build up in your system and further weeks to adjust.
    Yes, it takes about a week for sertraline blood plasma levels to stabilise, but SSRIs and other ADs do not have a direct effect on anxiety (or depression) in the way say diazepam has, or aspirin on headaches. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly, and they take around 7 weeks to bud, grow and mature although improvements in mood can start a few weeks earlier. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act...

    BTW - the cognitive/behavioural/mindfulness therapies also work by stimulating hippocampal neurogenesis.

    Can you link me to a source on needing a higher dose is reinstating after a previous treatment please? Thank you!
    This is what I've observed during my years in support groups like this one, plus there is growing evidence antidepressants, especially the SSRIs, may become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control, or not working at all. They may also produce more severe, and/or different, initial side-effects. Two studies, Amsterdam JD, 2016 and Amsterdam JD, 2009, found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC, 2018; Amsterdam JD, 2009; Leykin Y, 2007; Paholpak S, 2002).
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  7. #17
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    Jul 2015
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    Just as a note to anyone that finds this thread if they're trawling NMP for people with similar issues/symptoms: This IS anxiety (or at the very worst, some silent reflux/dry mouth issues which can also be caused by anxiety). I am a different person to what I was even this time last week, and as people rarely jump back on these threads with info on how they got better/improved, I'm just going to leave a few notes on what I've done differently this past week and some tips which I think have helped me tremendously:

    1. Go on/go back on medication if you feel it's necessary (do some research on long term antidepressant withdrawal, I found a lot of info on the Surviving Antidepressants forum and "relapses" tend to be common around the 2-4 month mark after stopping). Remember that in the first fortnight you might get worse before you get better.
    2. Read the Self Help For Your Nerves book by Claire Weekes if you haven't already (this has really helped me get over my morning dread/butterflies in the stomach issues I'd been having, and has given me a new outlook on my anxiety). I can't believe I've only found this book now, I feel like if I'd read this when I started suffering from anxiety 11 years ago my life would be much different. My main takeaway from it has been to acknowledge my anxiety symptoms and let them be present without stressing over when they'll go away. If you purposely try to make them more intense, you'll find that you can't.
    3. Stop googling your symptoms, and if you're trawling NMP for similar sufferers, please just read 1 or 2 accounts to reassure yourself that others have suffered the same due to anxiety: if you read too many of them you are bound to come across suggestions of illnesses they think they have, and then you'll start thinking you have that illness too
    4. Do not stop eating: avoidance of food will only prolong your anxiety. Even if it takes you an hour to finish dinner, do not stop eating and get someone to hold you accountable if possible - my mum has been a fantastic support throughout all of this and I couldn't be more thankful.
    5. When you are eating: Focus on dropping your shoulders while you swallow - this has really helped me when I feel like I'm getting to the point where I might "choke" again. I don't mean to avoid thinking about swallowing either, as thought suppression can prolong this also. But releasing tension from my shoulders (which is where I carry most of my tension!) seems to really help me swallow more easily.
    6. Remember that in cases of serious illnesses, a symptom like this will not come and go but will be constant with every swallow
    7. Do not judge yourself or be hard on yourself for what you're currently experiencing: Be open to allowing as much time as possible to make a full recovery. Thinking about swallowing is not dangerous and if you can accept that, it will eventually cause you less distress (and hopefully it will go away altogether!)
    8. Do not shut yourself away no matter how tempting: spend time with family and call them for long chats even if you don't feel like it, you will feel much better and more grounded afterwards. Talk to the people that you find comforting.
    9. Remember that when your body is in fight or flight mode, you're rest and digest system can prevent you from swallowing. Adrenaline also makes your mouth dry up, making it feel difficult to swallow!
    10. Do soothing activities like yoga, deep breathing exercises, colouring, pampering, reading, walking, practicing gratitude, cuddling with a pet, sound healing, reiki, praying WHATEVER usually makes you feel better
    11. Get checked for deficiencies (I once worked with a girl that said she couldn't swallow steak due to B12 pernicious anemia!! So I currently am waiting on results for B12/Iron/Vit D/Thyroid tests - just in case )

    This all started with me just over a month ago now, and peaked around a fortnight ago. I honestly thought I was losing my mind and that I would never be the same again, I was convinced my whole body was about to fail me and that I had something seriously wrong with me, I had a lot of twitching too which is mostly gone now (I know that worries a lot of people on here too!). I am back on my medication almost 2 weeks now and already am starting to feel like my old self again, especially over the last 2-3 days. Last week, I couldn't look at pictures of food without feeling like my stomach was dropping and my heart racing, now I find myself lying in bed at night craving curry chips

    I am still tentative about eating some things and where I eat, don't get me wrong, but I am nowhere near as bad as I was. I also still think about each swallow most of the time (though earlier I was 2-3 bites in to a banana before I realised I hadn't really thought about swallowing it!!), but you must not judge yourself for thinking too much about what is supposed to be an automatic process. Once you realise and accept that these thoughts and your anxiety symptoms are not dangerous, you will start to get better.

    If your battling this particular anxiety symptom right now - I am so sorry, it is the worst I've ever had to endure, but you will get through it. Good luck to you <3

  8. #18
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    Good info

  9. #19
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    Re: Back on sertraline - but will it help? Swallowing issues etc.

    I'm really pleased that you are feeling better and thank you for taking the time to try to help others with such an insightful post. It's really kind of you and much appreciated.

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