A Doctor’s Guide to Safely Quitting Antidepressants

There comes a time in recovery from a mental illness when you wake up one morning and say to the mirror, “I’m ready to end my treatment.” This is a time of celebration and achievement, putting all the skills you’ve learned from psychotherapy into everyday use. And for many, it’s also thetime to stop taking medication.

Diana Spechler’s piece in the New York Times, 10 Things I’d Tell My Former (Medicated) Self, is chock full of good advice for anyone suffering from a mental health concern who’s looking to change or discontinue treatment. While it’s hard to generalize about switching treatments or getting off of a certain medication, some advice bears emphasis.

First, the choice is yours regarding when to call it quits, just as with any aspect of your treatment. But you should do so in consultation with your treatment providers, who can help you avoid the common pitfalls many people experience when trying to end medication on their own.

Discontinuing a medication at the end of treatment can be incredibly difficult, depending upon the specific drug you’re trying to stop taking. Most commonly prescribed antidepressants, for instance, can be hard to discontinue because of the side effects you may experience as your dose is lowered. Doctors often don’t appreciate these difficulties, since many of them have never been on the medications they’re prescribing ― much less ever tried to get off of them.

Tapering Off of Your Medication

Tapering off a medication, or cutting the dose, slowly over a long period of time is usually the prescribed method for discontinuing many psychiatric drugs. The period of time can vary anywhere from four weeks to four months, and I’ve known people who’ve taken as long as a year to get off of certain medications. For some people and some medications, the tapering schedule may need to be long and slow ― and there’s little reason to rush it.

Just as it was important to find the right medication at the right dose to help in your treatment, finding the tapering schedule that works best for you and your body is important. This is not the time to blindly do as your doctor instructs, since your doctor may not know the withdrawal symptoms you’re experiencing (unless you’ve shared them with him or her). Be vocal, especially if you feel the agreed-upon tapering schedule is not working out for you. Call your doctor and talk to him or her if your withdrawal symptoms are too much. Your doctor can help you find a tapering schedule and dosage that will work better.

Healthy Body, Healthy Mind

All things connect to our moods: thinking ultimately comes not only from our brains, but also from our bodies. That is why exercise is so often recommended, because it’s an important component in helping heal your mind, too.

Good nutrition and diet are also valuable supports that can help build a healthy foundation for your mind to thrive on. While I don’t subscribe to the idea that you’ll benefit most from following a particular diet, I do believe that watching what you eat, cutting down on snacks and fast food, and making healthier choices in general results in feeling better. Ignore or discount the value of exercise and nutrition, and your recovery will be harder ― and longer ― than it has to be.

Sleep, too, is a basic building block for good mental health. Too many of us mistakenly believe we can “make up” sleep on the weekends, or tell ourselves, “I’ll get more sleep when the kids are older.” Neither of these things helps your mental health right here, right now. Make a commitment to fixing any sleep deficits or problems now, because you’ll enjoy the mental health benefits almost immediately.

Avoid Stress

Echoing Spechler’s advice not to undergo a relationship breakup while you’re stopping treatment, I’d take that one step further: avoid any and all stressful, major changes in your life. When you’re switching or discontinuing medications, keep the rest of your life as even-keeled and stress-free as possible.

This is not the time to plan any major life events, such as changing jobs, moving into a new home or apartment, or getting married. Keep everything else in your life as simple and stable as possible, since you’re going to need all your stress reserves to help you deal with the medication changes.

Reach Out to Your Emotional Support System

In the fog of depression or the hypervigilance of anxiety, we may not realize that our friends and other supporters are still there for us. As Spechler noted, whether it’s a friend across the country, or an online friend on Facebook or in some other emotional support group, you have a group of people who care about you.

You may need them a little more often during this time of transition — and that’s perfectly okay. Some people feel comfortable discussing such issues with their friends, while others prefer keeping them private. In either case, most friends will respond with compassion and empathy in your time of need — as long as you don’t overuse one friend’s attention too much.

In Conclusion

All good things must come to an end, including — for most people — an end to their treatment for a mental health concern. While it takes some thoughtful planning and care to end treatment and discontinue the medication that’s helped you recover, it’s also a great time to celebrate your achievement: You’ve beat it. And while it doesn’t mean you won’t need help in the future, for now the future is looking bright once again.

jmg_300aJohn M. Grohol, PsyD, is a pioneer in online mental health and psychology. Recognizing the educational and social potential of the Internet, in 1995 Dr. Grohol helped transform the way people could access mental health and psychology resources online. Pre-dating the National Institute of Mental Health and mental health advocacy organizations, he was the first to publish the diagnostic criteria for common mental disorders, such as depression, bipolar disorder, and schizophrenia.

Photo credit: Thinkstock

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