Mental Health - Development of Stutter/Eye Twitch?

[OnlyMeHere]

Hi all, long time poster and reader of PPrune but didn't want to use my real username for obvious reasons... Hoping to seek a bit of advice from those more knowledgeable.

In the past few months I seem to have developed a stutter and irritating twitch of the eye-lids. I'm frequently finding that, for example, in a quiet office where I need to speak up and ask a question, the words simply will not come out. As hard as I try, I cannot physically get the words out of my mouth and just have to entirely scrap the question or try to rephrase it to get it out.

Additionally, I'm getting increasingly annoying twitches with both my eyelids which can last for days on end :ugh:

Now a bit of background info :\

Just over a year ago I dipped into a pretty severe bout of depression/anxiety with an unsuccessful suicide attempt, by overdose. I was on SSRI's for a while but decided to come off them myself and went for cognitive behavioural therapy instead. 12 months down the line I'm still struggling but feel a lot better than I was, except for my sleeping routine.

I struggle to get more than 4-5hours sleep a night and despite reaching out to my local GP for help, haven't really gotten anywhere. I was given Zopiclone for a short period of time from my GP but he wouldn't issue it again due to it's addictive nature. Losing my mind with my inability to sleep, I resorted to sourcing Zopiclone from other sources and have been a regular user of the drug for 9months or so. Usually don't take more than 7.5mg per week, usually just to try me into the shift routine for the week.

Could the sudden development of stutter/twitches be resulted to fatigue, stress, or drug abuse? Any insight would be greatly appreciated :ok:

[MrSnuggles]

OnlyMeHere

This is a very serious situation. As a fellow human being, unaware of the hoops you as a pilot need to go through, I still would encourage you to be open about this situation with your employer.

This is going to be a long post. I will try to make it readable; this is very important stuff.

You say that
Just over a year ago I dipped into a pretty severe bout of depression/anxiety with an unsuccessful suicide attempt, by overdose. I was on SSRI's for a while but decided to come off them myself and went for cognitive behavioural therapy instead. 12 months down the line I'm still struggling but feel a lot better than I was, except for my sleeping routine.As a person with experience of this stuff I will claim some things as as factual as can be:

1) If you really did have such a serious bout of depression going bordeline suicide, your absolutely best bet to conquer that is by using SSRIs. They need to be used, in my experience, at least one year after being declared depression free until you are "safe".

2) For severe depression all evidence point to SSRIs or SNRIs to be the primary choice for successful treatment. Mild depression can be successfully treated with CBT only. But going suicidal - bro, you're in the SEVERE category!

3) If you don't have a concrete starting point for your severe depression (like divorce/death in the family/other triggers) the possibility that your depression started much earlier than you think is very real and very likely.

4) If you still feel you are struggling, well then you're not free from it yet. Of course you will have sleeping problems. You are still having depressed functions.

In order for you to actually heal yourself you need to be open about this to your employer. To conquer this you need proper time off. You need proper health care, enough of this nonsense not taking medicines. Your brain chemistry is off. You need medicine to balance this, just as you would need medicine to balance out diabetes. It's nothing more strange than this. Your brain is just as chemical as the rest of your body, perhaps even more so due to all the strange things that goes on up there!

I struggle to get more than 4-5hours sleep a night and despite reaching out to my local GP for help, haven't really gotten anywhere. I was given Zopiclone for a short period of time from my GP but he wouldn't issue it again due to it's addictive nature. Losing my mind with my inability to sleep, I resorted to sourcing Zopiclone from other sources and have been a regular user of the drug for 9months or so. Usually don't take more than 7.5mg per week, usually just to try me into the shift routine for the week.Sleeping is one of the hardest areas to "fix" when you are still depressed. And, as I said, I would consider your symptoms to be those of continued depression. You need proper rest, much more than you think. You have broken your brain chemistry - that takes years to fix. It's not like a broken bone!

Zopiclone is great for short term usage. What you need is a long term plan. Right now it seems you have none. You need to get some sick leave - at least six months of doing nothing more than relaxing and getting your brain chemistry **** together. I needed two years to get MY **** together, so well, there's that. If you want to know more about my personal situation, feel free to PM.

However, I notice you take no more than 7,5 mg per week which leads me to your next question:
Could the sudden development of stutter/twitches be resulted to fatigue, stress, or drug abuse? Any insight would be greatly appreciatedI would really hesitate to call your 7,5 mg zopiclone per week "drug abuse". Unless you have used other addictive products combined with your zopiclone, or if you are extremely over the top sensitive to zopiclone, I would not consider that as a reason for your physical afflictions.

No, it sounds more like you are stressed out over this situation. It sounds like your body knows you NEED TO GET A GRIP and tries to tell you in all kinds of ways that you must take a break. Your brain chemistry is off balance, it sure as hell rubs off on other parts of your body too, especially if you don't acknowledge the symptoms as being part of the depression and the stress of feeling less than optimal.

I am also a bit curious about your reasoning not to try SSRI/SNRI but go for sleeping pills instead. I see that a lot in people with recurring depressions, they quit their SSRI/SNRI treatment and then they can't function and so they resort to truly addictive pills (zopiclone is classed a Class-IV narcotic in Sweden!) that just covers up the symptoms, but doesn't fix the underlying cause. Of course they relapse into depression because they think they don't need medicine for brain problems.

I promise you, SSRI/SNRI are not as bad as scientologists wants you to believe. They address what science so far has uncovered as one of the causes of depressed functions and mood, which is as close to the underlying cause that we can get right now. They are no magic pills and so you need to do your part of the work - you need to chill the **** out of every day, binge watch bad tv series or start your bonsai hobby. After some serious chilling you will get your sleep back without zopiclone. You still having sleeping problems and now physical manifestations are clear signs you should have continued your original treatment!

I am very adamant that you get proper treatment because without it you will suffer much longer and totally unnecessarily. If you are a big-jet pilot you might even endanger other peoples lives and you should never do that!

So, TL; DnR
DON'T BE LIKE LUBITZ! Get yourself to the best doc and sort this thing out. Take sick leave. At least six months. At least. Learn to knit or do some serious slow cooking meals or whatever low key activities you need. And stop this bull**** self medication when you can get proper meds from someone who knows what they are doing.

[Jodelophile]

I agree with Mr Snuggles and you probably know that you can fly under CAA/EASA rules on one of the approved SSRIs, citalopram, escitalopram or sertraline, by following the approved protocol, the algorhythm for this can be downloaded from the CAA website.

[Drussjnr]

MrSnuggles,
I think it's wrong telling him there is nothing wrong with Selective serotonin reuptake inhibitors (SSRI) You know how they work right? In the long term your body adjusts the amount of serotonin it produces - with an SSRI, this is less - This means when you come off the drug for a long time you're not going to feel happiness. New information shows that there may be some help using SSRIs if there is a severe shortage of serotonin, but the average person's depression cannot simply be related to a "chemical imbalance". These drugs can ruin people can should not be handed out like candy.

Now... before you shoot me down, in this case it is wise for him to be given a prescription for something like Sertraline or Citalopram. I also know it's hard to sleep when very stressed and i think that the OP should talk to their doctor about sourcing the Zopiclone. After prolonged use, the body can become accustomed to the effects of zopiclone, When the dose is then reduced or the drug is abruptly stopped, withdrawal symptoms may result. so it's important not to overuse. muscle cramps or discomfort are a common long term side effect, which could be your eyelids. More worryingly difficulty speaking is a common side effect of Zopiclone and i recommend that you seek immediate help.

I recommend you take time off work, relax yourself and get medication for a while. This situation is more common than you think and you are not alone. Ask your GP for more CBT and medication and get SIGNED OFF WORK. I wish you the best of luck in your recovery and i know it's possible so dont give up! :ok:

[MrSnuggles]

Drussjnr

Thankyou for your concern but I have first hand experience with severe depression and accompanying medication effects both short term and long term.

Developing physical symptoms are seen in severe depression, the chemical imbalance I was talking about. In this case I feel confident to suggest to OnlyMeHere that s/he should consider the SSRI/SNRI medication again. Exactly what brand or substance - that is extremely personal and needs to be discussed with a proper MD. Expect some trial-and-error period before finding out what works.

[Loose rivets]

Retired pilot, not a doctor.

So sorry to hear of your troubles. Some quick notes from a period of my life I couldn't sleep for two reasons: bad back and the complete :mad:-up of my life.

Zolpidem became my friend.

Zolpidem seems to be the most basic form of taking this quick sleeping tablet. I read that it interacts with the Benzodiazepine (receptors?) without being a true Benzodiazepine. This is good news as Valium can really ruin you life.

However, Ambien CR, the Controlled Release version so popular in the US, is associated with a 300% increase in road traffic accidents when driving say, to work in the morning. I can fully understand why if it's leached in until the early hours.

I took Zolpidem to allow my back to rest while it was really bad. That was a lot of years. However, I NEVER took 10mg. Half that on a bad day. Then half of that if I'd had a hard working day. (It's possible the drug is not evenly distributed, so be aware of that.)

In fact, working hard was the best sleep aid, and I could get spells of freedom from sleep problems this way, but insomnia is cruel, especially when there's not a single nice thought in your brain.


So, if you can get clearance to take basic Zolpidem - 5mg - with the other prescribed drugs, that might be the best option.

I ran some of the side-effects past a family member and he feels that it's fairly lightly that the loss of short-term memory is very real. However, poor sleep is even worse for memory - and now it seems, failure to purge neurons of waste is a major factor in poor sleep. The cleaning process, a relatively new discovery, only works while we're asleep.

Who knows, given the new findings, a better sleep pattern might just restore some other problematic disbalances. Wishful thinking, but it - sleep in its natural form - certainly won't do any harm.

This is where a total break is important, but sadly not everyone has the luxury of being able to take such breaks. Also, it has a lot to do with how much you like your job, i.e. the job could be therapeutic in its own right. But right now, it is obviously rather stressful.

Good luck.

[blue up]

It was explained to me that sleep is rather like the hour after closing time at the Library...

All those books come in and are dumped in a pile on the desk all day long. The Librarian is busy all day and doesn't have time to sort the returned books out so it is only at the end of the day after the door is closed (ie REM sleep) that there is time to sort the books, return them to the shelves and tidy them up. If you don't get long enough blocks of sleep, 2 hours x 3 per night minimum,your brain doesn't get time to process the info that has come in, assign it to somewhere in the longterm memory (bookshelves) and place a ticket in the filing system showing where on the shelf the book can be found.

Getting lots of QUALITY sleep allows the Librarian to stack the shelves properly and audit the stock list. Without it the pile on the desk becomes huge and the shelves become empty.

Sleep medication is like getting a Temp in to help you with the admin.