Venlafaxine Withdrawal – What the Doctors Don’t Tell You

Lately, I have come off Venlafaxine (antidepressant) from the slowly lowered dose of 37.5mg on doctor’s orders. Ever since, I have been experiencing what I call ‘brain spasms’. They are also known as ‘brain zaps’ or ‘brain shocks’ and they are a symptom of Venlafaxine withdrawal.

However, no-one warned me about them. A brain spasm feels like an electric shock going through the brain, followed by a temporary sense of light-headedness. It is a jolt, like ‘seeing stars’ after a blow to the head, I can best describe it as ‘silt’ though my mother doesn’t understand that. These zaps were occurring every minute for the first four days but their frequency is decreasing now. Moving my eyes from side to side tended to set off a quick succession of them. It can take a month or so to be rid of them entirely.

Before discovering what they were, I believed the doctors were subjecting me to ECT (Electro-Convulsive Therapy) remotely. Indeed, during my year-long hospitalisation, the consultant psychiatrist was intent on forcing this ‘therapy’ on me until my parents made such an objection. Surely treating patients of other conditions in a similar manner would end up in court?

A Relapse?

I am aware of my relapse signature – the signs which occur when the illness worsens – but the occurrence of only some of these signs need not signify the start of a relapse. Before a major crisis, I tend to read the same passages of the Bible obsessively and repetitively; I vomit frequently; the voices become noisier; I write aimlessly and constantly; and I feel utterly overwhelmed by even simple tasks. At the moment, I vomit every day and I have taken to writing without purpose and with nowhere in mind. It rings a bell, hopefully not an alarm one.

These are some other common relapse warning signs which people may experience:

• losing interest in your appearance and activities
• feeling depressed or worthless
• having trouble concentrating or thinking clearly
• experiencing racing thoughts
• feeling distant from friends and family
• suddenly finding religion/spirituality extremely and unusually meaningful
• having trouble making even simple decisions
• having trouble sleeping/sleeping too much
• feeling tense and nervous
• eating much more or much less than usual
• feeling that others are planning to hurt/kill you or make you ill
• feeling no enjoyment from anything
• talking in ways which do not make sense to others
• becoming angry over little things
• having thoughts of hurting or killing yourself
• turning to alcohol or street drugs
• believing that parts of your body are changing or are somehow different
• feeling that your surroundings are strange or unreal
• feeling frightened for no reason

Each individual will have a unique pattern of symptoms which make up a relapse signature. If you have a schizophrenia-spectrum disorder, know your signature and know when to get help.

This is what I had written in a piece entitled The Book of Time:

There is a time to remember, and a time to forget; a time for contentment, and a time for regret. The arrow which struck King Harold in the eye in 1066 at the Battle of Hastings travelled through time and has got lodged in my eye. There’s something in my eye. How can you see to take the speck out of your brother’s eye when you have a log in your own? Indeed, it is harder for a rich person to enter the Kingdom of Heaven than for a camel to pass through the eye of a needle. I am the King of Diamonds. There is a time to be born, and a time to die. But one day, idly, with nothing else in mind, I killed time by writing. I have killed time. Now where is dear time, where oh where is time? How should I know? Am I time’s keeper, am I the keeper of time?

I wrote these words obsessively and repetitively until a whole notebook was filled. I am constantly preoccupied that I have killed time and, like Cain after murdering Abel, I half-worry over trying to hide the fact. ‘Am I my brother’s keeper?’

Loose Associations and Clanguage

It’s just everything is up in the air. When we were young, we had a rope ladder up a tree in our garden. Someone said I had poetry in my blood. They say that “blood is thicker than water” but that would be because of the clotting factors. From early on, my sisters and I were very close – often as thick as thieves. Though no-one knows the day or the hour; He will come like a thief in the night. I don’t want a knighthood; I want a full English breakfast. If a rabbit runs out in front of you, you have to brake fast. It is all safe and sound. I can hear people in London talking about me. Here, it is raining and summer. Somehow my arms are too long. I long for silence. I know it is people in London discussing me (“She doesn’t know she is born; she doesn’t know it is raining”, “She’s a high-wire church spire”) as the sound is Cutty Sark and the problem is built-up river silt in my head and ears.

A Beginning

Schizophrenia is believed to be an illness like any other and can occur in any family.

Roughly 1 in 100 people will develop schizophrenia in their lifetime but schizophrenia affects us all. Chances are you know someone who has schizophrenia - you may not even know it.


Many people with the disorder keep it quiet due to the current prejudice against those with brain disorders.

Schizophrenia generally strikes people in their teens or early twenties. Some people get well and never have another breakdown; others can have symptoms for the rest of their lives.

Schizophrenia is not:

• a split personality, and is not Dissociative Identity Disorder (formerly Multiple Personality Disorder)
• caused by bad parenting, personal or spiritual weakness, demon possession, poverty, or street drugs and alcohol

Treatment: Respect

Schizophrenia is a treatable brain disorder. Effective, early treatment is vital in managing it. However, medication is not the complete answer.

Recovery for people with schizophrenia also depends on a supportive and knowledgeable community.

Understanding the disorder is the first step in living with it.

Mind your language

The use of words, such as "schizo", "psycho" and "nutter", causes great hurt.
People with schizophrenia have feelings, too.

Schizophrenia does not equal violence.

Violence is not a symptom of schizophrenia.

The majority of people with schizophrenia are not dangerous, homicidal or aggressive. Studies have shown that with appropriate treatment, people with schizophrenia are no more violent that anyone else.

People get attacked everyday; others go out looking for a fight. Some people are violent; others are not. It is much the same with those of us who have schizophrenia.

For a Change

In treating schizophrenia early, effectively, and with compassion and humanity, we could:

• reduce homelessness
• reduce hospitalisation costs
• reduce the number of people with schizophrenia unfairly held in prisons
• reduce the drug abuse that can occur when people with schizophrenia have nowhere to turn to relieve their pain

What you can do

The way you treat people with mental disorders can make all the difference. For so long, so many people have been reluctant to speak out in support of those with schizophrenia.

• Know the facts
• Talk to someone with schizophrenia - you might have more in common than you think
• Show some respect!
  

Thought Disorder - What is it?

In hindsight, it is clear that thought disorder is present in both my speech and writings. Afterall, schizophrenia is known as a thought disorder. But what is thought disorder?


There are many parts which make up thought disorder in schizophrenia: disconnectedness, loosening of associations, concreteness, impairment of logic, thought blocking, and ambivalence.

When a number of ideas not considered to be linked by a brain without schizophrenia are strung together, this is known as disconnectedness. When there is a vague connection between the thoughts, this is termed 'loose association': "I was born in a hospital. Once, I saw a calf being born. A baby whale is called a calf. There was a whale that swam up the Thames." Clang associations (I call them clanguage) occur when the association is not based on loose logical connections but the words are tied by similar sounds: "My feet are aching. It is quite a feat to break a world record. We used to have an old record player. I have written a play. Today's the day."


Speech with topics completely unrelated leads to derailment. 'Word salad' is used to describe the fairly uncommon symptom of confused and frequently repetitive language, consisting of strung-together words with no apparent meaning or relationship. The words appear to have been tossed together like the ingredients of a salad.

Being unable to think abstractly, to shift from a specific concept to a general one, such as in explaining the meaning of proverbs, is called concreteness. A person with schizophrenia may suffer this and interpret meanings literally.

Impairment of logic interferes with day to day activities, such as planning a meal or following directions. It is as if logical reasoning had come undone.

In thought blocking, thinking gets stuck in midstream and the mind suddenly goes blank. Sometimes this is experienced as a withdrawal of thought by some external agency. Ambivalence comes when a person with schizophrenia holds two opposite contradictory thoughts at the same time.

People with schizophrenia may also make up entirely new words. These are called 'neologisms'.

Individuals with schizophrenia suffer different degrees of these disorders of thought.