New to forum, my story

[Y2Kyle94]

I've recently just found this forum for the first time. Kind of refreshing to see a new place talking about some of this stuff. Happy to be here, and I would like to discuss further topics relating to PSSD. I don't think all of my problems extend from this condition, but I do think and extensive amount are related to this. I think a bigger problem for me has just been serotonin in general. I will leave this as a "TLDR" header. Down below I'll leave a more detailed intro that has lead me to where I'm at today. It will be long though, so you might not want to read it.


My story is a bit of a wild ride. I'm 29 now (be 30 in February), but started experiencing problems as early as 17. When you start to notice certain things are wrong with you, especially at an early age, it can be next to impossible to know what's really happening to you. During my late teens I started to experience some depression, not completely abnormal I don't guess. However I dealt with it in very unhealthy ways. Namely drug abuse. I used opiates quite frequently, mainly morphine pills. But I'd use whatever I could get barring the exception of heroin. As bad as things got for me with drugs, I actually never devolved to the point of sticking needles in my arm. So I guess I lucked out in that regard. This was also back in like 2012-2013, and the fentanyl crisis wasn't actually as bad. I mean it existed, and I knew some personal friends who'd even use it. But as far as trusting pills to be what they actually were, and not fake, it was a pretty safe bet. I also smoked a lot of weed, thinking that would be the least of my problems. Actually turns out I think the weed messed up my serotonergic system far worse than the opiates did.

I won't draw this out into a big thing, suffice to say the drugs didn't help my situation any. My best friend landed up in jail, I almost did. I ended up getting arrested for a unrelated domestic incident, sent to a "psych ward." I say that tongue and cheek, more of a place for troubled teens. But they would take your shoe laces because they thought you'd hang yourself with them. They might do that everywhere idk. Anyways I lucked out because the insurance plan I was covered under from my parents wouldn't pay to keep me there. I was out in like 5 days lol. I was not in a laughing mood then, but looking back I can't help but laugh at that situation. I was concerned I might be there for god knows how long and our screwed up medical system comes to my aid. While I was there I got prescribed paroxetine. Actually I think it was Zoloft, then my family doc gave me the paroxetine at a later date. Because I was still on a "rebellious bender" so to speak I basically just threw the Zoloft away without even giving it a chance.

For several months I actually went back on to the opiates, and I don't think I would've stopped if it weren't for the scary event I had take place. I had a situation where I actually fell out, and had a temporary loss of consciousness. I was really messed up that night, but looking back I don't think it was a "true OD." I was actually moving stuff while in a squatting position, and I was like that for more than a few minutes. When I stood up suddenly I think while being under the influence of the opiates I had a hypotensive episode where my blood pressure dropped too low. That's really the only thing I can think of. I went to the docs and got checked out, everything seemed fine then.

I decided to dial that stuff back after that. I never went off cold turkey or anything, but I seriously dialed back how f#$%ed up I was getting. And eventually I stopped completely after our source for the pills dried up. I was around 19-20 at this time when some things started to change. When I was using the drugs heavily I actually lost some weight and was lighter than I was in my high-school days. Backtracking a little, I probably should've mentioned my educational situation. I quit normal public school at 16, and I was actually not in school anymore at 17 going onward. I was still technically "doing school," but I was doing home-school and it was easy to get my stuff done early and then do whatever I wanted. So back to my original point, while I was heavily into the opiates I lost some weight and was thinner then I was in high-school. Not in a healthy way mind you, as opiates suppress appetite and make you less hungry, even when you actually NEED to eat.

But since I was always kind of a heavy kid in school I mistakenly perceived the weight loss as a good thing. But when I stopped the opiates I started eating more and I was already gaining it back. That made me to start reflecting on my situation. Not only my prior stents with drug use, but just not taking really good care of my body. I ate a lot of crappy foods and didn't move around much. Opiate users aren't exactly active if you know what I mean. I decided I would try and get the weight off the "healthy way" this time. I started doing that low carb thing, and walking 3 miles everyday. I always enjoyed long walks the few times I did do them, so I thought that would be the easy part if I could nail the dietary stuff right.

Things started to change in a very odd way at this point. I ate basically salads with low-calorie sugar free dressings and lean proteins like chicken breast. Lots of guacamole too, I loved that stuff, still do in fact. I just didn't eat it with chips, mostly with veggies. The walks were easy to do to. The weight came off kind of easy actually. I know overweight people reading this might get irritated at hearing this, but if there's one "good" thing I can say about keto diets its, if you actually follow them strictly (and I did), you WILL lose the weight. Now the bad news. I was losing weight all the while feeling literally the WORST I've ever felt in my whole life.

Whole new bags of symptoms that I was never dealing with beforehand. Anxiety, cognitive impairment (couldn't focus), very very bad insomnia. I was also still smoking weed, but the weed would make my symptoms considerably worse. So I eventually tapered down to basically only smoking a couple hits with my friends. Not doing any drugs when I was alone at this juncture. This was quite possibly the most annoying time of my life. I would see people who hadn't saw me in a long time, and they'd comment how great I look, while I was feeling like complete $%^$. My blood pressure also got pretty high during this period as well. And the worst part of it all is the fact I waited so so long to change things up in my diet.

I just figured nothing could be wrong from a dietary perspective because of how much weight I lost. Gotta be healthy right? Wrong. Anyways I ended up having what I thought was a pretty serious medical emergency. I started to not be able to breathe well. It got to the point that one day I was having what I call a "spell" while I was sitting in a chair. I just started taking large gasps of air and it felt like I was getting anything. My arms started drawing up and I couldn't speak. I literally thought I was having a stroke or some s%$&. Anyways the ambulance came and picked me up, gave some IV fluids and sent me to the hospital to be checked out. They ran several different tests. A chest x-ray, EKG, a couple more things and guess what? Nothing was abnormal. I was glad but also frustrated. How can you get a clean bill of health after an incident like that?

This problem actually persisted, just not to the point of being drove to the hospital in the back of an ambulance. But this was bad enough it was effecting daily activities. Naturally I didn't feel like walking anymore. I mostly just sat around playing video games, bored as hell. I did end up going to the doctor to ask about something for my anxiety and insomnia. The funny thing was my doc thought I was hustling her for more Xanax. I went to a walk in clinic first, and they gave me a temporary alprazolam script and said to visit my family doctor as soon as possible. Not that I actually wanted it, I just genuinely wanted this feeling to go away. When I would take the xanax it helped some...emphasis on some. That breathless panic attack thing wasn't helped much, but I noticed it would take just enough edge off to get some sleep. But I knew it wasn't a long term solution, I didn't even want to be stuck on benzodiazepines. I knew about benzo withdrawal and I'd been told by several people it was way worse than opiate withdrawal, and opiate withdrawal is NOT fun. So I wanted no part of that.

Anyways my doc thought I was hustling her, so I got no xanax from her. Instead this was when I was prescribed the paroxetine and also trazodone at nights. I actually thought this would help, I really did. Well not only did it not help it made my problems exceptionally worse. After about a week, it got so bad I was at the point I couldn't only not sleep, I couldn't even lay down and stay still. I was involuntarily twitching, felt extremely uncomfortable, could barely breathe at all. I was actually breathing, but it just felt like it wasn't helping. Very odd sensation, I can only assume this is what asthmatics feel like. I sympathize with them greatly now.

I didn't stay like this long because I discontinued the drugs quickly. All this happened in a consolidated time window, a window where I knew the only changes I made to my routine recently was the addition of these drugs. So I knew one, or both, had to be the issue. After quitting the SSRI (and trazadone) my problem wasn't as bad as it was that night I was twitching and couldn't stay still. But I still felt pretty bad, and I was taking a lot of that xanax I was prescribed at the clinic. Basically ran through my whole bottle at this time. Had like two 0.5s left after this bout. I assume since SSRIs take a while to wear off, I was still experiencing some residual effects from the medication.

Not that I was cured by any means, but after about 12 days of not taking any SSRI I felt pretty much like I did before I got on them. Still bad, but not insanely bad. This was when I finally got my first inclination that my problem may be related to serotonin. I new how those drugs made me felt, and I also knew weed was making me feel bad whenever I used it, and it also increases serotonin. I didn't let this thought linger much though, because I knew my problems didn't start with cannabis usage. They actually started not too long after I cleaned up my diet to go keto. But I still didn't think that could the issue. This is where things get kinda blurry from a timeline perspective. I can't actually remember how much time passed during the phase. It had to be a couple years though, because I was around 23-24. I was just enduring my situation up until this point when one day I decided to go all out and have a famous breakfast that I always loved but hadn't eat in years because of my low-carb lifestyle...oatmeal.

Lots of carbs in oatmeal, but I was at a good weight at this point and I'm not a diabetic, so what's the harm to cheat a little right. Well, my friends, after eating carbohydrate for the first time in years I felt better than I'd ever felt in my life I think. Not even an exaggeration. I spent so long in a persistent state of bad sleep and bad respiration I just accepted it as my life now. After eating carbs, I could breathe clearly and it felt amazing. My sleep, although not perfect, was considerably better that day. This was when the light bulb just clicked for me. I knew my diet had to change. I also knew I needed to smarten up, from a technical standpoint. After the dead end with my doctor regarding the SSRI's I'd basically lost all faith in the medical system. If my problem was going to be fixed it was going to be up to me.

I started googling all kinds of crap, lol. The vast majority of which not relevant. But after looking up some odd combination of stuff, I can't even remember what it was. I think I did a keyword search like "serotonin" AND "bad" or something like that. You'll have to forgive me it's been years and I can't remember. But I eventually arrived at this guy named Ray Peat. He had/has a website where he wrote tons of stuff on sugar, serotonin, estrogen, carbon dioxide, etc. This was when I was first introduced to bioenergetics. And things were slowly going to start getting better for me. First and foremost, I don't think everything this guy wrote about was necessarily correct. I want to mention that on the outset because this guy actually has his own forum dedicated to him, and has a cult following of sorts. I say of sorts because it's not actually a real cult, but people do weird s#$% like eat liquid based diets. Not all of them, but it's just important to know not everything in this corner of the world is going to be useful, you can certainly be led off point.

But keeping with this guy's articles and newsletters, it became quite clear to me he was a borderline genius WAY ahead of his time in regards to his views about serotonin. He helped me tie SO much stuff together. Dots I would've never connected on my own. For example, about how low carb diets lower the respiratory quotient, and we retain less CO2. And CO2 is one of the body's natural serotonin antagonists, and likewise serotonin can act to facilitate an enzyme called carbonic anhydrase, lowering CO2 even more. When carbon dioxide runs low enough you begin to hyperventilate and not get enough oxygen. So ketosis can become a very real problem for certain folks, me being one of them. And all the serotonin drugs was just compounding this issue even worse.

I started experiments with all sorts of anti-serotonin agents after this. Varying degrees of success. The antihistamines like cyproheptadine would work well be on the backend cause some pretty intense drowsiness. I also quickly learned that receptor antagonism may not be the best way to treat the situation anyways, you know, due to upregulation and such. So my favorite way to control serotonin now days is to just use BCAA powder and also sometimes gelatin as well. I rather attack it at the base level, and just control how much tryptophan is being absorbed through my diet.

I also don't really consider myself cured yet, I've came along way from feeling terrible, but I do still have some issues (notably libido) that isn't quite where I'd like it to be. I am single though, so it's not like I'm in a rush for a quick fix. I'm personally afraid that long term exposure to elevated serotonin may cause permanent damage to libido that can't ever be completely fixed. I'm not sure. Either that's the case or my problem isn't solely related to serotonin. In case of the latter, I've been exploring other things. Like trying to increase my nitric oxide and histamine. Varying degrees of success. I've also experimented with pregnenolone, DHEA, testosterone, and DHT. The sex steroids do make me feel good, but I can't really say for sure if they've done much in regards to libido, at least in the dosages I've used them. I really judge my libido based off my morning erections. If I don't have morning wood, or not strong morning wood, I consider my problem to be unfixed. And based on some of the things I've tried, they either don't help, or they help at first, but I can't seem to keep it going. But this is where I'm at now, and I look forward to continue growing.

[TalkingAnt]

Crazy story, sorry to hear all you've been through. Did you have sexual dysfunction before taking SSRIs? Did you notice a rapid onset of sexual dysfunction after starting the SSRIs that persisted for >6 months after stopping? If not, you may have dodged a bullet and your problems may not be related to PSSD. Even if they are, the situation is more complex than just serotonin. Many people have toyed with serotonin modulating agents over the years without much success.

Your chronic anxiety and insomnia remind me of myself. I thought they were related to PSSD, but when my PSSD went away, they were still there! And they definitely can impact libido.

I had "panic attacks" where I felt like I was out of breath all the time, despite being in good shape. My heartrate would be elevated and I was very sweaty. My stomach felt slightly upset all the time. I thought I may have had yet another disease. This all went away when I addressed my anxiety- my insomnia as well.

They key is to practice being fearless. First you must logically understand that there is no threat. Once I understood my symptoms could be explained by anxiety, I no longer had a logical reason to worry about them, analyze them, fixate, etc. Then you must find what thoughts or situations trigger the anxiety. It could be worrying about your health, or future, etc. I had those, as well as worrying about sleep, which paradoxically caused insomnia.

Once you uncover what your underlying fears are, you practice self-assurance and nonreaction. If you feel anxiety and do something in response to it, you reinforce to your brain that the trigger was actually a threat. But if you do nothing, your brain will eventually become desensitized to the anxiety trigger.

I adopted a mantra-based approach. When I noticed the anxiety I would deploy self-assurance and say things like "be fearless," "youve got this," etc. This helps one have a willingness to experience the anxiety rather than frantically trying to make the anxiety go away, which makes it worse. I would also practice nonreaction by saying "there's nothing to do about that" and refocus my attention to the present. Because if you focus on worrying thoughts than that counts as reacting to or feeding the anxiety. So ask what would you be focusing on if you did not have anxiety, and do that.

It is not easy and it takes time, but once you get the hang of it, it's a very powerful method.

I am also really into secular Buddhism which helped a lot. I can recommend Joseph Goldstein's podcast "Insight Hour" and the book "The Art Of Living" by Goenka (specifically the parts about equanimity).

The book "Untangle your Anxiety" by Joshua Fletcher goes into more detail on anxiety physiology and the fearless method.

The Sleep Coach School youtube channel helped me with practical tips to overcome sleep-related anxiety.

[Y2Kyle94]

Thanks, I appreciate the advice. I actually think my issue started before I got on SSRI medication. It's so hard to explain how uncharacteristic anxiety was for me before this problem arose. I never used to get panic attacks. It's like I did something one day that just flipped a switch that I can't turn off now. I'm grateful for the references you provided, especially the sleep coach thing. I'll look into those. Sleep is still one of those issues that's kinda prevalent even today. It comes and it goes, some days are better than others. Certain meds or supplement stacks can worsen it, and force me to tweak some stuff. One thing I've noticed that's been helping me of late has been binaural beats, specifically the alpha, theta, and delta waves.

The main thing I noticed was how much worse the SSRI medication made everything. It was like if my problems were a car speeding down the road, the SSRI's were like stepping on the gas pedal. All my symptoms would become "enhanced." Also at my worst, I would get additional symptoms, like the muscle twitching and the inability to stay still. I was pretty convinced based off my symptoms and what I was taking at the time I had some sort of serotonin syndrome. And stopping the medication helped to alleviate the worst aspects of that (along with the occasional xanax).

I most certainly believe the situation is more complex than just serotonin. At least my experience is I think. I'm not entirely convinced prolactin and endorphin dysfunction isn't playing a role too. Could be very likely considering my prior stents with opiate abuse. Causing an opioid blockade with naltrexone has helped the libido and erection quality some as well. The problem with naltrexone is it seems to make my sleep worse, at least most of the time.

I also responded to a treatment course I did for histapenia, or low histamine due to copper overload. It's basically treatable with a combination of zinc+manganese, high protein diet, and occasionally, if need be, direct supplementation with the amino acid l-histidine. One of the neuro imbalances cause by histapenia is high serotonin. The copper overload can mimic estrogen toxicity too, so when I tried adding an OTC aromatase inhibitor into the mix I noticed a markedly better response to the anxiety situation. But it didn't do much for erection equality.

I'll admit I'm still at a loss in many respects. I feel better but it's kinda like a jigsaw puzzle that's only 65% complete, and the last 35% is very difficult to figure out. My next stop was to see if I could possibly resensitize my NMDA-glutamate receptors with a combination of d-aspartic acid and sarcosine. As this is important to fix when you want to reap the full effects of nitric oxide, especially the neuronal nitric oxide (nNOS). From the extensive reading I've done, it seems nNOS is the major player in eliciting spontaneous erection activity from visual stimulation. Basically the type of erection you get when you see something you like, and it happens without you even touching anything. That's been a MAJOR issue for years to me, not being able to get an erection without having to try really hard with hand stimulation.

[Determined-Mind]

You've tried a lot of things, and that's interesting.

I also plan to target glutamate. Magnesium L-Threonate could be an option. Threonate is known to significantly improve magnesium absorption.

I also found a positive report for sexual anhedonia on the daily use of topical magnesium on the thighs read the testimonial.

Opioids may also be involved in erectile dysfunction. One person has had success with naltrexone + hops https://coda.io/d/Treatment-options-for ... PEX#_lufTl

* Xanthohumol, a natural product derived from hops, as great potential for improving glutamate-related nervous system diseases https://pubmed.ncbi.nlm.nih.gov/31816340/

If you ever feel like voting for the substances tested and their changes (or not) you can use this table : https://coda.io/d/Treatment-options-for ... Onz#_luLkG