6 Ways I Survive 'The Sludge' Period After Starting New Psychiatric Medication


Editor’s note: Please see a doctor before starting or stopping a medication.

Nearly three months ago, I went back on medication for anxiety.

I had been on similar medication a couple years ago and worked with my doctor to properly wean off of them, to see if I could handle life with other coping mechanisms. I also live with obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). After finding a new therapist and going through a few more stressful situations, I decided I needed to add medication back into my life.

Most of us who take daily medication have experienced what I like to call “the sludge.” The sludge is the weeks to months where your body is getting used to a new medication. Side effects can include lethargy, digestive issues, brain fog, dizziness, apathy and so much more. My brain feels like it is trying to walk through concrete while the rest of the world keeps walking nearby with no problems. Often, this period affects daily life, and makes it difficult to function like you’re used to.

In my case, my doctor wanted me to try a different medication than I had taken before. It took a few tries to get the dosing right, and I ended up adding a second one to counteract lasting side effects of the first. What other people don’t realize is that you have to let your body even itself out between all of these stages, which can be anywhere from four to six weeks each time.

Having now been through this twice, I have come up with a few tips that have helped me survive “the sludge.” Here are a few things that have worked for me, and I hope will help you too.

1. Continue taking your meds.

If/when you begin to feel the side effects of a new medication, do not stop taking your meds without talking to your doctor. If you stop, you could cause some scary side effects, and end up having to go through these frustrations again later. Each time I pushed through the sludge, I evened out eventually and came out better on the other side.

2. Stay in contact with your doctor.

Similar to the above, be sure to contact your doctor with the side effects you are experiencing. I am so thankful my doctor requires an email two weeks after starting a medication or dose, and a follow-up visit four weeks after. After my second dose increase, I still wasn’t feeling like I was out of the sludge. I sent her an email and she sent a new prescription right to my pharmacy. Even if your doctor doesn’t require follow-ups, advocating for yourself and your feelings could help you get the best treatment faster.

3. Take advantage of work benefits.

If your employment benefits include paid time off, special assistance programs or other types of help, take advantage of those that may help you. I was able to take a few strategic mental health days to lay in bed and get through my worst side effects. I was also open with my boss that I was working through a medical issue, and how it may affect my performance until that happens. It was much easier to deal with difficult days at work knowing I wasn’t keeping it all a secret.

4. Get comfy.

When I don’t feel good, I hibernate. This means sweatpants, TV dinners, Netflix and a permanent butt-print in my couch. I always feel so much better when curled up in a warm blanket. Making sure you’re comfortable is often all it takes to turn a terrible evening into a tolerable one.

5. Rely on friends and family.

If you live with a partner, roommate or family, ask for their help during this difficult time. My husband and I usually split household duties 50/50. He has to pick up my slack on my hard days, making sure the pets are fed and things around our apartment look decent.

6. Lower your standards.

This was the hardest one for me to come to terms with. I am an overachiever by nature, and I feel completely useless when I’m too tired to put in a load of laundry or make dinner. I had to learn to be OK with (temporarily) seeing the dishes pile up in the sink, or not being able to take my dog for daily walks. As long as everyone in my life is fed and warm, I consider that a win. 

This time, I feel like I’m coming out of the sludge, and I know I’ll feel much better very soon. Then I can focus on why I started this medication — working to lower my anxiety and lead a more happy and productive life.

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