Choosing to come off of antidepressants is a deeply personal choice which unfortunately can often be misunderstood or stigmatized by both health professionals and our everyday social circles.
More than that, the choice to make any alteration to our brain chemistry is a fairly consequential decision in our lives. It may impact our emotional and physical states, relationships, career, and other areas of our life.
While being under the prescribing doctor’s care is almost always a good idea when making changes to prescribed drugs, these five questions may help you to develop a more holistic plan for coming off antidepressants if that is the choice you make.
What are you going to do when you have your next anxiety attack?
Depending on where you are in your mental health journey this question may seem moot. The truth about some antidepressants is that we feel like we don’t need them when they’re working best. Another way to look at that truth though is to consider that it applies to every coping strategy. When something works, we stop thinking about it. (Even when it does more harm than good, as may be the case with our antidepressants).
Consider how addicts view their drug of choice or how over-eaters view food. The strategy for dealing with an unwanted experience becomes so reflexive we eventually act on muscle memory more than conscious decision-making.
Coming off antidepressants shocks that whole process. Suddenly the coping strategy we’ve grown to depend on isn’t available anymore, and we’re once again facing the same beast that sent us seeking that strategy to begin with.
So what’s the next strategy? Try to imagine yourself in different potentially triggering situations, and then brainstorm your way through them. Going to yoga class might work at establishing a long-term healthier baseline, but it’s not realistic when hyperventilating in the bathroom at work. Give yourself a tool belt with as many different options as you can imagine.
How are you going to manage withdrawal symptoms?
This might be shocking news if you’ve never looked into coming off antidepressants, but the withdrawal period (sometimes lasting weeks or months) can be awful. By my reckoning, there are two components to withdrawal. First, there’s the new feedback we get from the body as it adjusts to life beyond a chemically induced altered state. Some people report the sensation of “brain zaps,” episodes of dizziness, mood swings, and more.
Second, there’s the potential intensity of reacclimatizing to our original symptoms. While you might have experienced anxiety or depression while taking antidepressants, without them, you’re experiencing the un-numbed version. It might be more intense than you’ve been used to for a while, or even worse than before.
How will you plan for, track, and address these experiences?
How do you know if you need to stop?
So here’s an uncomfortable part of coming off antidepressants. Sometimes you have to stop, restart the drugs you don’t want to be on, and wait to try again later. It happens to the best of us, and it’s no reflection on your character or strength as an individual if it happens to you too. People using any drugs for any reason often go through cycles of coming off of them. In this sense, antidepressants are no different than other drugs just because they’re prescribed or legal.
What experiences are your absolute limit in this process? What lines will you draw to protect your long-term health as you begin withdrawal?
What support systems will you engage while coming off antidepressants?
Building on the last question, who will help you through this journey? What professionals and more intimate connections do you need to engage? The obvious answer is that coming off antidepressants should be under the care whatever doctor prescribed them in the first place. But the less obvious answer is that lovers, family members, and friends are probably going to see you more than that doctor.
Who can you trust to give you objective external feedback about your emotional or physical state while withdrawing? What groups or communities might be able to help you feel safer and supported during this process?
What does long-term mental wellness look like for you?
Not a lot of doctors seem to want to ask this question. And that may be an important piece to why so many of us seek health beyond what conventional doctors offer.
Long-term mental wellness is more than just applying a prescription to a set of symptoms, or slapping a diagnosis over it all. How do you want to feel? How do you not want to feel?
Your vision for long-term mental wellness might include mitigation of certain symptoms or experiences, but it could also include aspects like finding time or a medium for creative expression, not being on medications for the rest of your life, eating healthier, sleeping better, or feeling more confident in yourself.
Write or sketch all this out.
Coming off antidepressants isn’t a choice in league with picking out a shirt for tomorrow. You’re making a life-altering decision here. Be certain you’re making the choice you want to move forward with, and that it fits into your vision for your long-term sense of self.
No one else can answer that question for you. Truthfully, no one else may even ask.