Exercise and w/d Symptoms

[LarryJ]

This topic is something that intrigues me. We started discussing it in a different thread, but I thought it was a topic that needed its own thread (and I didnt want to derail the original thread).

For many folks, vigorous exercise done during, and sometimes much after the taper, results in the reappearance of w/d type symptoms. For some, these symptoms can be very strong and last days and even weeks. And, many times these symptoms may not appear for several days after the vigorous exercise has been completed.

What are the various theories out there for why this is so?

[carolyn]

My theory is that physical exertion mimics a lot of the physical symptoms of anxiety: racing heart, sweating, shaky limbs, lightheadedness, fatigue, etc etc.

Sometimes that can trigger the brain into continuing those symptoms as anxiety even well after the physical exertion is over.

That's my experience, at least.

[jenny76]

I don't have any clue as to the cause of this but I cannot exert myself for long at all or I am in trouble. I use to go to the gym and do cardio at least 3-4 times a week, not anymore. Exercise makes me feel really sick. I wish I knew why.....

-Jenny

[LarryJ]

Originally Posted by jenny76

I don't have any clue as to the cause of this but I cannot exert myself for long at all or I am in trouble. I use to go to the gym and do cardio at least 3-4 times a week, not anymore. Exercise makes me feel really sick. I wish I knew why.....

-Jenny

Jenny-

What do you feel after exerting yourself?

[nicemom]

I believe that adrenal issues play a role also. Jenny, have you read the adrenal thread that Johnny started?

[nicemom]

Originally Posted by LarryJ

And, many times these symptoms may not appear for several days after the vigorous exercise has been completed.

I also wanted to add something about this. I am not as familiar with tapering and there could be something different that that I don't understand. But...there are times I read that people have symptoms appear several days after doing or changing something and they associate it with that. I completely understand wanting to have a reason or cause for symptoms appearing but in my experience symptoms can come and go and have no reason behind it at all. There are many times I wonder if people stop doing some things that might actually be good for them because they 'think' it caused symptoms when in fact the symptoms were going to happen anyhow. I know that over and over I tried to rationalize my symptoms until I finally realized that w/d has a mind of its own and comes and goes at its will. Just my 2 cents.

[jenny76]

Originally Posted by LarryJ

Jenny-

What do you feel after exerting yourself?

Larry,

I feel lightheaded, dizzy, nauseous, headache.....you name it. I get really short of breath, have to sit down and really feel like I am going to get sick. Legs shaky...

-Jenny

[rangerNY]

There are entire courses of exposure therapy that use exercise to mimic the symptoms of panic and anxiety. Its no mystery why a strenuous workout might cause problems for someone in the midst of withdrawal. For that matter, people long out of actual withdrawal that still have anxiety issues can have the same reaction to exercise.

Elevating your heart rate, sweating and breathing hard (especially when overbreathing is already a problem for many battling withdrawal symptoms) is basically putting your body into a basic anxiety state. Your brain then reacts by filling in the blanks with the lightheadedness, de-realization, rubber legs and all the other fun anxiety symptoms.

Assuming no real physiological problems that would make exercise dangerous, the only way past this is to not be afraid of how you feel after a workout. Not exercising is avoidance behavior. That simply reinforces the fear of those physical sensations and ultimately makes things worse.

That being said, there's no need to approach each workout like you're training for the Olympics. Get moving, starting with gentle exercise. Ramp things up as you learn to accept the sensations and the fear starts to go away.

[carolyn]

Originally Posted by nicemom

But...there are times I read that people have symptoms appear several days after doing or changing something and they associate it with that. I completely understand wanting to have a reason or cause for symptoms appearing but in my experience symptoms can come and go and have no reason behind it at all.

This was a key part of Cognitive Behavior Therapy for me. My therapist worked long and hard (and sometimes unsuccessfully! ) to show me how the brain will search for a reason for its panic and anxiety when, really, there was no reason at all.

I've never had any trouble with exercise, but I find it very difficult to take medication (even over the counter cold meds) because my brain associates the drowsiness with panic and anxiety. I suffer through colds and the flu instead of just taking the stupid cough syrup.

It's the same way people develop agoraphobia. At some point it becomes easier to stay in the "safe place" (home, bed, whatever) than to go out and risk panicking or feeling the scary symptoms.

Anyhoo, long story short: don't let withdrawal get you down! Get out there and kick its @ss!

[rangerNY]

Originally Posted by jenny76

Larry,

I feel lightheaded, dizzy, nauseous, headache.....you name it. I get really short of breath, have to sit down and really feel like I am going to get sick. Legs shaky...

-Jenny

Hey Jenny,

Its OK to feel that way. Give yourself a break and don't beat yourself up over it. Its totally understandable that working out would trigger an anxiety episode. Your brain has "learned" that there is a link between working out and anxiety. You just need to "un-learn" that.

Maybe just do some slow, gentle walking. Go only as fast as you can sustain without going "off the deep end". Something like Tai Chi or yoga might also work well. Slow, gentle movements that don't necessarily drive your hear rate into the stratosphere. After doing things like that for a time, you'll start to feel a sense of accomplishment, you will see the benefits of moving your body, and you'll probably find that the workouts are getting more intense over time as the link between exercise and anxiety gets broken down.

Sounds easy to say, hard to do. I know. I spent many months with the treadmill on zero incline at only 2 or 2.5 mph because it was all I could manage before having a panic attack. Back then, a 25 minute mile was an accomplishment. It does get better.

[LarryJ]

Originally Posted by nicemom

I also wanted to add something about this. I am not as familiar with tapering and there could be something different that that I don't understand. But...there are times I read that people have symptoms appear several days after doing or changing something and they associate it with that. I completely understand wanting to have a reason or cause for symptoms appearing but in my experience symptoms can come and go and have no reason behind it at all. There are many times I wonder if people stop doing some things that might actually be good for them because they 'think' it caused symptoms when in fact the symptoms were going to happen anyhow. I know that over and over I tried to rationalize my symptoms until I finally realized that w/d has a mind of its own and comes and goes at its will. Just my 2 cents.

Heres my situation----

5 times I have exercised hard playing tennis (3 while tapering and 2 since the taper was completed).

Every single time, a few days later, I have gotten hit with symptoms which mimic w/d. And, they last for quite some time.

I am not afraid of exercise nor the feelings associated with it in the least! In fact, a miss playing tennis terribly!

So, in my case, I am certain that I have not attached a psychological stigma to the activity of strenuous exercise. There is something physical going on.

Light exercise does not ellicit this same w/d response at all. It must be heavy strenuous exercise.

So, you see why I have started this topic.......it seems as though there is definitely a physical connection somehow.

[Paxilalmostkilledme]

Originally Posted by nicemom

I believe that adrenal issues play a role also. Jenny, have you read the adrenal thread that Johnny started?

I completely agree that it is an adrenal issue. I have virtually stopped any serious exercise until I feel 100% better. when I was 6 months off I started a serious work out for a few months and really think it postponed my recovery.

My goal is to take things as easy as possible, and that includes my mind and spirit.

[nicemom]

I'm not doubting you Larry, especially if the same reaction happened several times. I am always reminded that w/d is unpredictable and also that every single one of us is different and our bodies react differently during this unusual time. THAT is one of the few things I know for sure. We definately need to listen to our bodies. Oh don't even go there with things that I miss!!! I'll start crying! I have always been extremely physically active and had tons of energy. In time I think we will all get back to the things we love and miss. Healing just takes time.

[rangerNY]

I don't mean to rain on anyone's parade, but "adrenal fatigue" (aka "adrenal burnout") is an alternative medicine construct with no basis in actual scientific research. The assertion that prolonged periods of increased adrenal output leads to "burnout" sure sounds like common sense, but that doesn't make it true. Its easy to imagine that your adrenal glands somehow need a rest. We can all relate to the concept of "burnout", however there is no quantitative evidence to support the claim that our adrenal glands get tired like we do. There is lots of scientific and medical data that support adrenal insufficiency due to underlying disease state, but not due to "overwork".

That doesn't mean that there aren't physiological factors at play here, but the actual role of the adrenal glands in this situation is hardly well defined.

[nickels]

I have the same issues with exercise and withdrawl as Jenny, Larry and Paxilalmostkilledme all mentioned. I can understand that the way the body reacts to exercise and exertion are very similar to anxiety/panic attacks...however how can you explain that this didn't happen while on paxil or during poop out? I exercised very well thru both. I think it does have to do with adrenal issues as well....I don't think its completely "in your head".

I've had anxiety LONG before I took paxil. Exercise was never an issue for me...it always helped me out if anything, so I only have positive experiences with it.

[rangerNY]

Originally Posted by nickels

...however how can you explain that this didn't happen while on paxil or during poop out? I exercised very well thru both. I think it does have to do with adrenal issues as well....I don't think its completely "in your head".

I didn't say it was "all in your head".

Especially in Larry's case, it sure sounds like some kind of physiological process is at play, however that's obviously not the same as finishing a workout and immediately starting a panic attack. Apples and oranges, if you will.

There is no doubt that any process that alters brain chemistry is going to have an actual physical impact on your body. That's no mystery. Our brain chemistry changes and we experience unwanted symptoms of withdrawal after working out, or watching an action movie, or reading the newspaper, or listening to loud music, or engaging in any activity that never caused a problem before.

My problem lies when we get stuck in the physical and ignore or downplay our psychological and emotional reactions to those symptoms. While its not ALL in our heads, I do assert that our minds can prolong the agony in many cases when the underlying physical processes that originally caused our symptoms may have resolved themselves.

[LarryJ]

Originally Posted by rangerNY

I don't mean to rain on anyone's parade, but "adrenal fatigue" (aka "adrenal burnout") is an alternative medicine construct

I will agree with you here....I mentioned adrenal fatigue to my doctor (when I was there just for a normal checkup) and he said there is no such thing.

Of course, that doesnt mean its not real, only that mainstream medicine doesnt not believe it, or perhaps understand it yet. We know all too well how sometimes a lack of understanding leads to it "not existing" in the established field of medicine.

Of course, this same doctor (who is a good man) also said that within a week, all the paroxetine would be out of one's body and that should be that. We all know with certainty this is not the case.....yet we (nor maintream medicine) are not really sure why. We can only theorize.

Personally, I dont know if adrenal fatigue exists or not, but it seems logical that it could.

[LarryJ]

Originally Posted by rangerNY

Especially in Larry's case, it sure sounds like some kind of physiological process is at play, however that's obviously not the same as finishing a workout and immediately starting a panic attack.

Right...that is not what I have experineced at all. It is not a situtation where I immediately get w/d type symptoms after finishing the strenuous exercise. Although I find myself abnormally tired after playing tennis, it takes a day or so before the w/d symptoms hit.

One theory, that honestly seems to make the most sense to me on a physical basis, but that will likely be disagreed with by many, is that there are residual drug toxins/metabolites tucked away in fat cells and these come out en masse after hard exercise. When they do, the body is overloaded with them and thus the symptoms.

I know for sure that if I detox too hard using undentaured whey protein, but do not exercise, I have also gotten the same w/d type symptoms. But, in the cae, the immediate reduction of the whey ingested ceases the reaction.

And, I also have found that when I have these symptoms, if I drink huge amounts of water, the symptoms are many times somewhat relieved.

This is all anecdotal evidence on my part, and surely nothing scientific, but I have found that certain actions lead to certain outcomes.......but the exact reasons why I can only speculate on.

[LarryJ]

Originally Posted by nickels

however how can you explain that this didn't happen while on paxil or during poop out? I exercised very well thru both.

Nickels...the same was true for me. Although I didnt take it long enough to hit any sort of poop out, I had no problems exercising while taking Pexeva...it was only during the taper and thereafter that the difficulties arose.

[LarryJ]

Originally Posted by nicemom

I'm not doubting you Larry, especially if the same reaction happened several times. I am always reminded that w/d is unpredictable and also that every single one of us is different and our bodies react differently during this unusual time. THAT is one of the few things I know for sure. We definately need to listen to our bodies. Oh don't even go there with things that I miss!!! I'll start crying! I have always been extremely physically active and had tons of energy. In time I think we will all get back to the things we love and miss. Healing just takes time.

Nicemom-

Since this happened 5 times likc clockwork, I know its not in my head. Not that my brain is not active enough to be able to create such constructs! Its just that this pattern has developed which does not seem to be pure coincidence.

But...could it be coincidence? Im sure there is a chance it could be, but those odds, especially when others seem to notice the same patetrn, seem to be small.

There is no doubt that well all get back to being able to do the things (such a exercise) that we love doing. It will just take some more time. When I have spoken to LMS about this, theyve told me that its very common (defined by many of their customers have reported) that for 3-6 months after finishing the taper this generally can happen. In that timeframe, its probably best to just stick with gentle, non-competitive exercise.

I believe Ive learned my lesson on this and for the time being morning walks will have to suffice!

[BJo]

Larry, reading your thread makes me want to go for a run! Just to see what happens!

Really- I've been an avid runner for 6 years now, but I have nearly quit running since June. I blame it on the heat, but it's really just that I got out of the habit, and haven't kicked myself back into it yet. I think the last time I ran was 2 weeks ago, and only 2 miles!! YIKES! For someone who has run a marathon, that 2 miles should be a walk in the park. But it wasn't. And THAT was de-motivating for me.

Anyway, didn't mean to sidetrack. I find your thoughts very interesting. That must be frustrating for you, to feel like you can't get out there and enjoy the sport you love, because of this stupid drug and the way it has altered your body. That would make me angry. Like I said, it makes me want to go put on my running shoes and knock out a 6-miler, just to slap Paxil in the face.

What are the symptoms the rigorous exercise brings to the surface?

[LarryJ]

BJo-

Of course, I would like to be able to go play tennis as vigorously as Id like without a "penalty"., but thats just not the way it is right now. So, Im not terribly "mad" about it, as Im not sure if that would help any. So, for now I just accept it and trust in time it will pass.

Of course, by then, Ill have to start very easily again as Ill be so far out of shape!

As far as the symptoms that vigorous exertion brings to the surface----

Its pretty much the gammut of w/d symptoms! For instance, Ill get periods of high anxiety for no reason, mood swings, some periods of very low mood and serious lethargy, negative thinking, nausea, adrenalin "rushes", etc etc. It pretty much bumps me back into what feels like w/d. At times, this really gets me down, but other times, I am more accepting and willing to just let more time pass. Obviously, the more time spent in the latter, the better!

[BJo]

Originally Posted by LarryJ

So, for now I just accept it and trust in time it will pass.

You are more level-headed than I am. I envy you for that.

Originally Posted by LarryJ

As far as the symptoms that vigorous exertion brings to the surface---- Its pretty much the gammut of w/d symptoms! For instance, Ill get periods of high anxiety for no reason, mood swings, some periods of very low mood and serious lethargy, negative thinking, nausea, adrenalin "rushes", etc etc. It pretty much bumps me back into what feels like w/d. At times, this really gets me down, but other times, I am more accepting and willing to just let more time pass. Obviously, the more time spent in the latter, the better!

I would love to know the medical reason behind this. I agree with you - it's more than likely not coincidental. I wish I had an answer, as well as a solution, so you could get back out there.

[nicemom]

It becomes so frustrating not having answers as to why all these things happen to us. No tests seem to show anything. It boggles my mind as to how that can be. How are we supposed to prove anything.

I understand the doubts about adrenal issues. I'm not 100% convinced myself. To be honest, I probably use it as an explaination for my symptoms because it helps me to give it an identity. Otherwise my mind keeps trying to figure it out. To me things need to make sense.

I have had times in recovery that heavy exercise is tolerated better than others. Right now I cannot tolerate it. It weakens me and like you it seems to aggrevate my symptoms. I work out at Curves but not as hard as I used to and I do walk daily and do yard work, housecleaning, etc.. Even with doing those things I just feel very weak some days. Some days I don't.

Let your body guide you Larry. You will know when it is time to try it again. Maybe the healing and balance that the body is trying to find just takes all of our energy.

We have all learned very important lesson in patience!

[LarryJ]

Originally Posted by nicemom

Maybe the healing and balance that the body is trying to find just takes all of our energy.

Thats a very good way to look at it nicemom......thank you!

In w/d, I suspect there really is only so much "energy" to go around, and one has to carefully allocate what its used for. Obviously, getting back to feeling "100%" is the highest priority and "niceties" (like playing tennis) will have to wait.