“I’m Tired of Taking These Pills!”
You want to stop taking your medication. It’s too expensive. You’re feeling the stigma at the pharmacy, thinking people are looking at you differently, wondering why you’re taking them. You’re sick of the side effects. You’re tired of having to put up with so much to get a little relief.
You say you really needed them at one time, but that time is long gone and you’re better now. Well, maybe you can stop and maybe you shouldn’t.
When You Should ‘Just Take Your Meds’
If you’ve been accurately diagnosed with either Bipolar I or II Disorder or Schizophrenia, you know there are special challenges you face taking meds on an ongoing basis to manage a chronic condition. Cost, side effects, and stigma are just a few.
If you don’t like the side effects of your medication or you want to explore something different, then please do speak to your psychiatrist or therapist. If you want to manage psychosis without taking meds, you need special support. See BeyondMeds.com for more information, links, and resources related to medication-free recovery from psychotic symptoms.
When You Can Start Thinking About Stopping
If you have been taking an anti-depressant for a medical or mental health diagnosis, you should know there are some optimal conditions under which it may be okay for you to consider working with your doctor to begin stepping down off of your anti-depressant :
1. You have been taking meds for at least 12-18 months. Stopping anti-depressant medication before this period of time increases the chances you will have a relapse of your mental health symptoms. You don’t want a relapse. If your meds are working and it hasn’t been 12-18 months, don’t stop taking them just because you are feeling better.
2. Your symptoms are mild or gone now? If you are still experiencing mental health symptoms that fall in the moderate to severe range (meaning you are having difficulty functioning on a daily basis, are having difficulty thinking and concentrating, have thoughts of death, and want to be alone more than usual), then this is NOT the time to stop taking your meds, even if you feel they aren’t helping.
Instead, tell your prescribing doctor what you are still experiencing and state that you need more effective treatment.
3. You have received a course of CBT. Research indicates that a combination of cognitive-behavioral therapy along with anti-depressant medication is more effective than taking medication alone. If you have been trying to feel better without seeing a licensed psychotherapist, do yourself a huge favor, and get an appointment scheduled today.
You will learn long-term strategies to deal with stress, manage your symptoms, and cope with your problems more effectively now and for the rest of your life. There is not a pill out there that can do this for you. Once you’re off the meds, you will have your new set of coping skills from therapy to see you through.
Some Important Considerations
As you work with your doctor to titrate or step down to lower and lower doses of your medication, it is helpful if you keep a log of your symptoms to note if any are returning or worsening as you lower your med dosages. For example, if one way you know your depression is worsening is that you want to go to your room and be alone instead of socializing with people, be sure to assess every week whether this behavior is increasing, decreasing, or staying the same.
You can stop at the lowest possible dosage that keeps your symptoms manageable. That will be your “maintenance dose,” and it can be much lower than the “therapeutic dose” that was required to get your symptoms under control.
Never stop a psychotropic medication without consulting with your prescribing physician.
Stopping some meds “cold turkey” can induce a withdrawal syndrome that can feel as bad as any symptoms you had.
Freedom From Medication
Sure it feels great to be medication-free. If you don’t need anti-depressants to function in daily life, then you’re much better off not taking them. However, if you are suffering from severe depression, OCD, or PTSD, and you find you function better with medication, then not taking your medication is like depriving yourself of oxygen and expecting yourself to still be able to breathe well. It’s just not fair.
So… be fair to yourself. And be smart. Look at the conditions under which you should consider stopping meds first, and carefully assess with your doctor whether they are necessary for you. If you can stop taking them, learn how to step down off your meds in a safe and healthy way. What matters most is your mental health.
Here’s more I’ve posted about taking Psychotropic Medication and effective ways to manage Bipolar Disorder.
Dr. Anita Sanz, PhD, Psychologist
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