From The Beginning

I have had anxiety for as long as I can remember. Looking back on my childhood, I can see that it showed up in many different ways. I always needed my mum; I was the friend at every sleepover begging to go home in the middle of the night; I didn't like being away from home, and holidays made me feel so uneasy that I spent the entire time wishing I was back home.

Somewhere along the way, I developed emetophobia, which is the intense fear of vomiting and anything associated with it. I had my safe foods and refused to try anything new. I became afraid of crowds, germs, and certain places because of the possibility of being exposed to vomit. In my first few years of high school, I became very underweight because I was so afraid of eating, convinced that it would make me sick. I remember my brother having a stomach bug once, and I was so terrified that I slept on the trampoline in the backyard. I didn’t use the toilet inside the house for days until I was sure the bug had passed.

Emetophobia ruled my life for years and, at times, it still does. There is so much more I could say about this part of my journey, but we've got a lot more to get through, LOL.  If you’d like to hear more about my experience with emetophobia, I’ll be writing some blog posts about my journey with it.

In 2018, my doctor and I decided it was time to try an SSRI, and I began taking sertraline (Zoloft). This medication truly allowed me to live my life to the fullest throughout my early adult years. Although the emetophobia was still there, it no longer consumed me the way it once had. I stayed on sertraline for six years, right up until 2024, when my entire world changed and I was faced with challenges I never could have imagined over the next two years.

My mum and I in 2008

The Wrath of 2024…

How the year started...
How it ended

In 2024, I had been living out of home with my boyfriend for two years. Life was good. I was working, weightlifting five times a week, finishing my teaching degree, and planning my future.

Then, I started experiencing a whole range of physical symptoms almost every day. Dizziness, nausea, headaches, a racing heart, fatigue, sore muscles... the list just kept growing. By the end of 2024, I'd had COVID four times. Whether these symptoms and my eventual diagnosis were caused by that, I'll never know, but I'm sure it played some part in everything.

Long story short, before I knew it, my emetophobia had shapeshifted into full-blown health anxiety. I was convinced I was dying or had some underlying disease. Every symptom made me think I had the 'C' word.

I went to endless doctor's appointments. I saw an ENT, a cardiologist, had multiple CT scans, MRIs, ultrasounds, countless blood tests, you name it. And guess what? Everything came back normal.

I felt like I was losing my mind. I remember thinking to myself, "How can I feel so unwell when everything is normal?"

Towards the end of 2024, I made an impulsive decision that I shouldn’t have. Nothing was helping, and I had no answers, so my anxious brain came to a conclusion of its own: that the sertraline had suddenly become "toxic" and was causing all of my symptoms. Looking back now, I know that wasn't the case, but at the time it felt completely real to me.

I stopped taking my sertraline cold turkey.

My gosh, do I wish I could go back in time and stop myself from doing that.

For the first week and a half, I experienced a few brain zaps and some dizziness here and there, but nothing major. I remember thinking, "Wow, I've done the right thing." Then, about two weeks after stopping, I was hit by the most debilitating withdrawal symptoms I had ever experienced.

I'm talking presyncope, nausea, vertigo, tremors, migraines, temperature dysregulation, dizziness... all while my baseline anxiety came back with full force.

After two visits to the emergency department, we decided to restart sertraline. I felt okay again for a few days, but then the anxiety and physical symptoms returned. So what did I do? I stopped it again.

Looking back, I have forgiven my past self for the impulsive decisions I made surrounding my antidepressant. I was scared, desperately searching for answers, and doing what I genuinely believed was right at the time. I simply didn't have the education or understanding I have now about safely starting, stopping, and adjusting antidepressants.

What happened next?

Hello, POTS diagnosis.

POTS & Vasovagal Presyncope 

*Who I feel like at this point*

In 2025, I was starting a full-time teaching job, and I felt the weight of the world on me to get better before I started. My doctor suggested trying an SNRI, so I started 50mg desvenlafaxine (Pristiq). This truly did pull me out of rock bottom. I was able to eat and function, and I somehow, against all odds, began my full-time job.

It was still tough. I was still very symptomatic, and I eventually had to increase my dose of desvenlafaxine to 100 mg because my anxiety and depression were still breaking through. As time went on, I noticed my heart rate increasing more and more, and things that used to be easy, like exercising, became much harder. I knew something wasn't right.

I saw a cardiologist, and we did a tilt table test. This confirmed vasovagal presyncope and POTS. From there, I was given propranolol and told to drink more water. Well, the propranolol lowered my heart rate, but it also lowered my blood pressure too much, and I was experiencing orthostatic intolerance, weakness, dizziness, nausea, and heart rates of up to 180bpm just standing still.

I noticed that all of these POTS symptoms got worse when I increased my dose of the SNRI, and through my research, I discovered that the increased norepinephrine caused by SNRIs can worsen POTS symptoms. I tried managing my daily symptoms with aggressive fluid and salt intake, compression socks, and beta blockers. But the propranolol was lowering both my blood pressure and my heart rate, and the weakness I was experiencing every day made my life a living hell. So I knew it was time for a new plan. I began slowly tapering off the SNRI and found that my heart rate was beginning to stabilise a little more on its own. Walking up stairs at 100mg would send my heart rate to 180bpm, but on 50mg it was around 120bpm. Still not great, but this was a good improvement.

My POTS symptoms improved tremendously once I was back down to 50 mg. I knew I still needed more help with my anxiety, but now I also had to factor in my POTS. I was determined to find the right medication plan that would get me back to my normal self, so I decided to go back to an SSRI, considering how well I'd done on sertraline in the past.

Just when I thought the autonomic dysfunction, anxiety, panic, physical symptoms, and depression couldn't get any worse, what followed was the most challenging thing I have ever been through.

2026 & Antidepressants

The slow decline

Remembering how well I was functioning between 2018 and 2024 on Zoloft, I wanted to give it another try, so I started a very slow cross-taper from Pristiq back to Zoloft. I did this over 6–7 months, and it was rocky, but I was somewhat functional. I was still having intense physical symptoms and anxiety, especially when leaving the house. At one point, I ended up in the hospital thinking I was having a heart attack after increasing my Zoloft dose, but again, it settled. I was working full time and getting through each day despite the physical symptoms, but they started to take a toll.

I would push my way through a day of work, come home exhausted, and it got to a point where I would come home crying, eat dinner, and go straight to sleep just so I could make it through the next day. I started to isolate more and more, cancelling plans and stopping seeing my friends. I genuinely just didn't have the energy, and my anxiety around feeling physical symptoms only grew stronger.

In April 2026, I finally stopped Pristiq completely and was back on Zoloft alone. I managed to get my dose up to 75mg in June, but I just continued to crash. I was feeling so sick, so anxious, and had become totally agoraphobic. I couldn't even go for a walk around the block anymore because the symptoms and anxiety were so intense. I was convinced I was going to faint 24/7. I would check my heart rate and blood pressure over 100 times a day. It sounds absolutely ridiculous, especially to someone who has never experienced it, but in my mind it felt so real. I was living in terror every waking minute. So again, I knew I had to adjust the plan.

I went back to my doctor, and we decided to do a direct switch to Prozac. I was devastated that the 7-month-long switch back to Zoloft didn’t make me feel the way I used to, but I had to accept that my nervous system and my body had changed.

When everything fell apart

Just when I thought I had hit rock bottom, it got worse than it had ever been. For a month, I became bed-bound. I was so physically and mentally unwell. I had to take 3 weeks of sick leave. I was constantly nauseous, completely lost my appetite, and lost a significant amount of weight. I had bone-crushing fatigue that left me sleeping for 13+ hours a day. I was the weakest I have ever been. And with POTS, the deconditioning and weight loss only made things worse. I started to feel like I was dead while everyone else was living.

I was surviving. I was not living. I was stuck in a constant spiral of panic, DPDR, depression, and anxiety. Every morning I would wake up with the weight of the world on my chest, and my heart would already be racing before I had even opened my eyes. Getting out of bed each morning became the hardest thing I have ever had to do.

My favourite part of the day became going to sleep, because for a little while I didn't have to feel anything. Sleep was my only escape. But even that comfort was clouded by the dread of waking up, knowing I'd have to face another day trapped in a body and mind that I no longer felt safe in. It was a level of suffering I never knew existed, and it's a feeling I wouldn't wish on my worst enemy.

Why was I getting worse and worse? Why wasn’t the medication helping? Every morning I woke up hoping to feel even a slight bit of relief - less nausea, feeling a little more like myself, but nothing was budging. It had been over 3 weeks on Prozac, and I was feeling the sickest and furthest from myself and my life that I had ever felt before. I saw no light at the end of the tunnel. I truly believed I was broken, that I had broken my nervous system or my brain, and that there was no coming back from this. The good news?

I was wrong.

The Turning Point

As you can probably tell by now, I had spent almost two years relying on antidepressants to "fix" me, while completely neglecting my POTS management and anxiety behaviours. On top of that, I had kept my nervous system in a constant state of sensitisation through endless medication and dose changes. I couldn't understand why nothing seemed to be working.

So, I decided to do a PGx genetic testing panel to see how my body processes different medications. The results came back while I was in the middle of trying Prozac. For me, this testing was incredibly helpful because it finally gave me some insight into why my body was reacting the way it was. My results showed that desvenlafaxine was the antidepressant included in my testing that did not have a significant predicted gene–drug interaction.

Now, this test does have its limitations, of course. It only tells you how your DNA processes certain medications. It can't tell you how a medication will affect your pre-existing health conditions or how it will work for your specific psychological diagnosis. However, if you have been struggling to find a medication that works well for you or have been experiencing a lot of side effects, I would recommend looking into this. It may not provide all the answers, but it can help complete another piece of the puzzle.

With the guidance of my psychiatrist, GP and cardiologist, we made a new plan. The priority was to stabilise me because I was no longer functioning. We decided to go back to 50 mg of Pristiq and stay there. But this time, instead of relying on the antidepressant to do all the work, I was going to put in the work too.

I started thinking of Pristiq as something that simply kept me at a steady baseline so I could actually begin recovering. I doubled down on my POTS management by starting ivabradine, drinking at least 3 litres of water a day with electrolytes, taking salt tablets, and wearing compression stockings. From there, I was finally able to slowly start rebuilding my strength, my confidence, and my trust in my body.

I worked closely with my psychologist, psychiatrist and doctors and started putting the strategies I had learned into practice. I began with small exposures. Sometimes this was as simple as a 50-metre walk down my street and back, or getting out of bed in the morning and delaying checking my heart rate or blood pressure for 30 minutes.

Slowly, these small steps began to retrain my brain and teach it that I was safe. I even started working my way back into the gym, but it was a very slow process.

At first, I told myself I would just go to the gym and stretch on the floor for five minutes. That was it. The next day, I would stretch for 10 minutes. Then, the day after that, I would pedal on the bike for five minutes. Each day and each week, I slowly built up my tolerance and continued teaching my body and brain that movement was safe.

As I continued to stabilise and do some sort of exposure each day, I slowly started feeling more like myself again, and man, does it feel good. I still have a very long way to go, and there are thoughts, behaviours and symptoms that I am still learning to manage. And I’ll be honest and say that I’m not yet living as freely or as happily as I want to be, but I am so grateful to have made it through to the other side.

What I’ve been through has taught me so much. I find so much beauty and comfort in the simplest things that most people take for granted. When you’re healthy, you have a hundred problems. But when you’re sick, you only have one problem.

I know now that I can do hard things, and so can you.

If you are truly in the trenches right now and you feel like there is no way out, I promise you, there is.

My first week back in the gym after months of being too sick & afraid.

You can do hard things!