Cross tapering (useless) Venlafaxine from (an excessive) 300 mg start.
225 mg for 3 days, 150 mg for 3 days, then 75 mg plus 20 mg Fluoxetine for 3 days, and 37.5 mg plus 20, then just the 20.
Coming off the tramadol was way, way, way fucking worse. Still doesn't make this fucking pleasant tho.
No one should be able to provide a taxonomy of suicidal feelings, FFS. I have been failed so often.

## "When to seek medical help
Always take withdrawal symptoms seriously. You should contact a doctor or mental health professional if symptoms are severe, unrelenting, or cause you significant distress. It’s critical to see your doctor if you get severe withdrawal symptoms. This includes any worrisome signs such as chest pain, fainting, confusion, uncontrollable tremors, severe mood changes, or thoughts of self-harm or suicide. Also, seek help if you experience alarming psychiatric symptoms (like sudden mania or psychosis) or if you cannot function in daily life due to withdrawal, or if you aren’t doing well psychologically. There is no shame in asking for help.

### For severe withdrawal symptoms
If symptoms become severe or intolerable, one safe strategy is to resume the antidepressant temporarily. [...]

Symptomatic management, such as the use of antihistaminic drugs for acute dystonic reactions, benzodiazepines for anxiety or agitation, and antipsychotics for hallucinations, can be used briefly if discontinuation symptoms are severe. [12]

In all cases, do not forge through dangerous symptoms alone; professional guidance ensures you remain comfortable, without distress, and safe. Withdrawal from venlafaxine can be challenging, but it is manageable with the right support. If symptoms become difficult or interfere with your daily life, help is available. Many people taper off safely with time, care, and good guidance. There's no need to endure severe symptoms alone."
https://recovered.org/antidepressants/venlafaxine-effexor/withdrawal

My first thought on LITERALLY ANY medical correspondence, whether capitalist or idealist, should not be "get my hopes down. The disappointment will hurt less."

Insert my usual Samaritans and https://www.mind.org.uk/ shout when I say:
Fuck all of you, suicide is not "always" irrational.

(But obviously, "preventable" does not mean "will be prevented". Still, if your crisis is something with one or two main factors, please talk to someone.
Even if your problems are complex and overlapping, you always deserve to be heard.
I don't blame you for whatever you decide, but find someone to speak to about it, at least once.)

If there's space on my ever-growing tombstone and / or 50 year digital webpage (cuz some nerd will archive something, I'm sure), add this to the list.

No one should have to provide their own taxonomy of suicidal feelings, FFS. I have been failed so often.

' NHS England’s medical director for specialised services, professor James Palmer, said in a statement: “This is why we have commissioned an independently led review into the operation and delivery of the adult gender dysphoria clinics, alongside work already undertaken to introduce new care models that are making significant progress in helping to bring down these very long waits.” '
Hey James Palmer, medical director for specialised services at NHS England!
Let us opt-in rather than you gatekeeping diagnoses. Adults can give informed consent (apparently), and teens already know how they are responding to their default puberty.
But whatever. What do dem queers know, anyhow?

https://www.thepinknews.com/2025/10/09/nhs-wait-times-trans-girl-suicide/

How come I want to play Tears of the Kingdom, but I instead write blog entries about knowledge exploration, then I stop being able to do that and just watch cat videos?

https://www.youtube.com/watch?v=ogFo_QFrtmU

All while profoundly suicidal of course. Of the 'venlafaxine withdrawals' kind, btw, not the usual philosophy on untreated chronic pain.