Third month at the same dose and my clinic is entirely relaxed about it

Started 2 July 2025 · 7 replies · 226 hearts · read 3.9k times

InêsPorto, PT · 2 July 2025

about a year ago

Porto. Small steps only, it says under my name, and I want to explain what that has actually looked like because I spent a long time thinking I was doing this wrong.

I have been at the same dose since April. Three months. When I went in expecting a conversation about going up, my doctor looked at the notes, asked me four questions — was I eating, was I sleeping, was anything frightening me, was I doing the walking — and said, in Portuguese and then again in English because she could see my face, that there was no prize for the higher number.

What I feel is a strange mixture. Relieved, because the two weeks after my last step were the worst fortnight of the whole year and I did not want to repeat them. And also, underneath, a nagging sense that I am not really doing it properly. That the people going up every four weeks are in the real programme and I am in the remedial group.

I know that is nonsense when I read it back. I would still like to hear from people who stayed put for a long time, because everything I read online is a ladder and nobody writes about standing on a step.

TomásFacilitatorLisbon, Portugal

Inês, your doctor asked the four questions that matter and then told you the truth. I would keep her.

Slower is not failing, and I will keep saying it in this circle until nobody needs to hear it. The schedule that comes in the box is a schedule, built for trials and for convenience, and plenty of people do better on a longer one. That is a conversation between you and her — which you have now had, and she was clear.

The remedial-group feeling is worth naming though, because it is doing something to you. It is comparison arriving dressed up as diligence. This circle exists because that feeling is so common it needed a room of its own.

45me too 12

StefanZurich, CH

Zurich. I went the other way — up too fast, then back a step, and everything improved. Nine months on the step I came back down to and no plans to move.

The thing I would say to the nagging voice: the higher dose is not the treatment. Whatever dose you are actually able to keep taking is the treatment. A dose you abandon in month four because it made you wretched does nothing for you at all.

38me too 9

BoWhitby, UK

Cold swims and a slow titration, so I am in the right room. Fourteen months, two increases, both of them about ten weeks later than the schedule suggested.

What I notice is that the slow route made me much less frightened of the medicine generally. I never had a fortnight bad enough to make me dread the injection, so I never built up the flinch that some people describe.

26me too 5

DoraUtrecht, NL

Spreadsheets are how I cope, sorry in advance, and here is the useful bit of mine. I tracked the two weeks after each step for a year and the pattern was identical every time: three rough days, four dull ones, then normal. Knowing that made the steps survivable, because on the rough Tuesday I could look at the sheet and see the previous four rough Tuesdays that had ended.

I have no view at all on how fast anyone should go. I do think the planner here is worth an evening if you like knowing what you are walking into.

24me too 4

AleksLjubljana, SI

Small country, small supply. I am a slow titrator partly on purpose and partly because Ljubljana decides for me some months, and I have made my peace with that by deciding it is a choice.

Not everybody in this circle chose to be here. Some of us are here because the pharmacy was empty in March. It works out much the same.

31me too 7

BodhiByron Bay, AU

Byron Bay, slow living, slow titration. The ladder framing gets everywhere and it is worth noticing where it comes from — it is the shape of a leaflet, not the shape of a life.

Standing on a step is a real place. I have been on mine since summer and the only thing that has changed is that I stopped checking whether I should have moved.

22me too 6

InêsPorto, PT

Comparison arriving dressed up as diligence. Yes. That is exactly it and I am going to be watching for it now.

I am staying put. My doctor is relaxed, I am eating, I am sleeping, I am doing the walk along the river most evenings. There is nothing in that list that needs fixing.

40me too 5

Facilitator note — Tomás

Facilitator note — Tomás. This is the conversation this circle was built for, so let me put the boundary down clearly one more time.

Nobody in here will tell you what dose to be on, including me, including the members who have been doing this for two years and know a great deal. What we can do is tell you that staying put for months is common, that many prescribers are comfortable with it, and that the fortnight after a step has a shape you can learn. Take all of that to the person who writes your prescription and let them decide with you.

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