Hi, I'm MikeX

My sertraline journey — nearly two years on 75 mg, now starting to taper. I'm an autistic hsp (sps) noise trauma victim. I started sertraline in December 2024 because I was struggling badly with my mental health and functioning. I had hoped it would give me some meaningful improvement and make life more manageable. I started at 25 mg, then increased to 50 mg. I stayed at 50 mg for roughly three months before increasing to 75 mg in May 2025. I have now been taking sertraline for nearly two years in total, with the majority of that time at 75 mg. The experience has been complicated. The first few months were actually extremely difficult. My mood became very low and I was crying almost every day. Eventually, I reached a settled medicated state, and there were some improvements but I wouldn't necessarily call this therapeutic benefit. I stopped crying, my dreams became more pleasant, the world sometimes looked less bleak because I was able to start painting, and possibly I became somewhat less reactive to noise. There were also periods where I felt noticeably better, although they were generally short-lived rather than a sustained transformation. At the same time, I never felt that sertraline had simply “fixed” my depression. My mood has generally remained quite low and fluctuating, and I've continued to have significant problems with fatigue, anxiety, sensory overload, sleep, and functioning. I have also experienced various physical and mental side effects. Over time I became increasingly unsure whether 75 mg was actually helping enough to justify staying on it. At times it seemed to make me feel almost overstimulated — more “switched on” rather than genuinely energised. I have also wondered whether some of what I had interpreted as benefit was actually just a mixture of partial medication effects, adaptation, and normal fluctuations in my circumstances. Eventually I decided that I needed to reassess the medication rather than simply continue indefinitely. I have recently reduced from 75 mg to 62.5 mg. Since making that reduction, I've noticed changes in my sleep and nervous system. I've had some unusually early awakenings where I felt very alert, and my sleep has become more variable. I've also experienced some strange phantom-noise/sensory phenomena that I don't normally experience to the same degree. The difficult part is that I don't know yet what any of this means. It could be withdrawal from the reduction. It could be my underlying problems returning. It could be my nervous system adjusting to the lower dose. It could also be a combination of those things, alongside the ordinary fluctuations in my sleep and environment. That's what I'm trying to understand. I'm particularly concerned because I've been taking sertraline for such a long time. I don't want to rush the taper, but I also don't want to end up indefinitely waiting for some mythical point where every symptom disappears before I am “allowed” to reduce again. My intention is therefore to go much more cautiously from here, with smaller reductions and enough time to see what actually happens rather than following a rigid timetable. I'm interested in hearing from people who have taken sertraline for a long period, particularly people who were on around 50–75 mg for a year or more and subsequently tapered slowly. I'd especially like to hear: How long you were taking it. Your dose and dose history. How you made the reductions. What happened after each reduction. Whether withdrawal symptoms appeared immediately or later. How you distinguished withdrawal from your original symptoms. How long it took before things became reasonably stable. Whether you eventually found that smaller reductions made things easier. And, importantly, what happened in the end. I'm not looking for someone to tell me that everything will definitely be fine, or that I'm definitely going to have prolonged withdrawal. I know nobody can predict that. I'm trying to get a realistic picture from people who've actually been through it