9 Months After Antidepressants

It’s been about 9 months since I completely stopped taking antidepressants, so I thought I would write an update/ponder on the issue. What follows is a summary of my experience and the issues it has raised.

Pill packets

There has been no dramatic change.

Browsing the internet, you would be forgiven for thinking that people fall into two categories: those who are anti-medication for mental illness and those who advocate taking anything you can get. The impression you get from this divide is that coming off antidepressants after over a decade will have a drastic effect – either you will feel awesome all the time or you will crash back down to the worst manifestations of your mental illness. This did not happen for me.

In fact, not taking antidepressants feels the same as taking antidepressants. I still get bad days, but I also have many good days. Managing my mental illness is a learning curve, but I’m finding and implementing more coping strategies. My hope that I would drop a lot of weight instantly did not (alas!) come to fruition. It turns out my fat has more to do with comfort eating and (lack of) portion control than medication…

Please note that I did not suddenly stop taking antidepressants. I discussed it with my doctor and gradually reduced the dosage over approximately 4 months, regularly meeting with my GP throughout the transition

 

It’s a personal choice, not a political statement.

I don͛t fall into either of the categories mentioned above: I’m neither anti-medication nor fanatical about antidepressants. Like most people, I suspect, I regard antidepressants as a useful tool which should be used to treat mental illness when it is needed and effective. My definition of “need͛” is when mental illness is affecting your ability to function”normally” which will be different for everybody, because it depends on what “normal” means for you. I also advocate using antidepressants in combination with other treatments where possible and appropriate, especially talking therapies.

I have no agenda in choosing to stop taking antidepressants. I decided it was something I would like to try for myself, to see how I coped without them. I’m not urging other people to do the same; nor am I urging them to keep taking medication.

Choosing whether or not to take medication – any medication – at any given time is a personal choice. I don͛t judge people for taking antidepressants, which is partly why I find it difficult to respond when people congratulate me for stopping my medication. A lot of people try to place a moral value on taking or not taking antidepressants, but this is unhelpful and damaging. You are not letting anyone down or doing anything wrong by taking medication. Neither are you letting anyone down or doing anything wrong by choosing not to take it.

You have to do what works for you. For me, that has involved a lot of trial and error in finding the right type of antidepressants and the right dosage at various times in my life. If you (and your doctor) think you might benefit from medication, give it a fair shot – and don’t expect it to work miracles. The media loves to call antidepressants “happy pills” but they rarely have the effect of increasing your mood to that extent, let alone giving you instant happiness in a deep, meaningful way.

You may experience side effects, but you may not. Some people claim that the possible side effects are a strong reason not to take antidepressants, but this disregards the fact that for many people,
side effects are mild and/or temporary – or may not manifest at all. You also need to weigh up the side effects against the benefits of medication, as with medication for physical conditions.

Personally, I believe the side effects I experienced were minimal compared to the improvement in my mental health. In fact, the only major problem I have had with antidepressants is certain types and/or doses not being effective. Seek advice from your doctor, be prepared to experiment and ensure your expectations are realistic.

Withdrawal symptoms also vary a lot from person to person. I didn͛t notice any, so can’t comment much on withdrawal symptoms in relation to my own experience, but it’s something you must
consider when deciding whether to stop taking antidepressants. I waited until I was sure I could cope with any withdrawal symptoms before coming off medication; I needed to know I was in the frame
of mind where I could recognise them as physiological or neurological effects, rather than personal affronts, and seek help if required. Again, it’s a case of experimenting to see what works for you – you may need to reduce your dosage more slowly in order to reduce and cope with withdrawal symptoms.

 

Antidepressants are an important part of my story.

I don’t think I would be alive without antidepressants. They took the edge off the worst points in my life and got me through. I still had really bad episodes of depression, including times when I was suicidal, but they would have been worse and longer without antidepressants – as I found out when I was in my late teens and came off medication too soon because I felt ashamed that I needed them. That͛s why nobody should try to shame someone for taking antidepressants: not taking them could put their life at risk.

Antidepressants provided me with a useful stepping stone, allowing me access to other ways of managing my mental health. Without them, I would not have been well enough or motivated enough to discover strategies which I now find useful, like exercise and meditation. I would not have been able to access treatments like drama therapy and counselling, which have had a massive impact on my wellbeing.

I have been able to achieve long term goals because I have taken antidepressants. I would not have gotten through university without them or learnt to drive. Even trekking to Machu Picchu last month would not have been possible if I hadn’t taken antidepressants; I could only go out walking alone to train because medication boosted my mood enough to make it a possibility in March last year. I will reap the benefits of antidepressants for the rest of my life, even if I never take them again.

 

Stopping antidepressants is an achievement.

I have recently been able to acknowledge that coming off medication is an achievement: not in itself, but because it͛s a sign that I’m managing my mental health well. This is a marked contrast to the attitude I had in my late teens, when I was first diagnosed with depression and thought I needed to stop taking antidepressants no matter what the cost. Back then, I was preoccupied with trying to convince everyone I was fine and terrified of the stigma surrounding mental illness. Nowadays, I battle that stigma and realise it͛s okay to admit that I need help.

This change of attitude is critical – it means that when my mental health dipped at the end of last year, I sought help. I had the confidence to ask for the type of help I wanted (counselling), without either returning to medication or ruling it out. I also recognised the importance of the strategies which had enabled me to stop taking antidepressants, returning to them as soon as I was able.

My initial response to being congratulated for stopping medication was to be defensive. I thought it meant people were judging me for needing antidepressants. I have come to realise that their congratulations are shorthand for “well done for managing your mental health on your own terms and working hard to get to this point.” It acknowledges my strength throughout my journey, rather than implying I used to be weak.

I was also wary about accepting congratulations because I was afraid I would relapse. I regarded coming off antidepressants as an experiment, rather than a milestone. However, I was believing a fallacy: that people would rescind their congratulations if I returned to medication. Again, I was placing the emphasis on the antidepressants rather than my own frame of mind and efforts to self- manage my mental health. People were congratulating me for reaching a point where I could experiment with not taking medication; even if I take antidepressants again in future, I have still attained the achievement for which I am being congratulated.

 

My experience doesn’t imply judgment of others’ experiences.

I struggled to be proud of coming off medication because I was afraid it would be misconstrued as judgment of both myself and others for taking medication in the first place. That isn’t true. In fact, I believe people should be congratulated for deciding to take antidepressants, as well as deciding not to take them, because asking for and accepting help is difficult.

I’m glad I was able to stop taking antidepressants because it was the right decision for me. It͛s not the right decision for everyone. I’m not under the illusion that it makes me a better person or better at managing my mental health than someone who takes medication. Comparing people in this way is unhelpful and cruel, because mental illness varies from person to person – especially when many of us have been diagnosed with more than one condition. Even when symptoms appear similar, the causes and effective treatments can be vastly different.

 

It’s still early days.

9 months seems like a long time in some ways, but represents only 5% of the time since I was first diagnosed with a mental illness. It͛s less significant when you consider that I was experiencing symptoms for at least 5 years prior to my diagnosis. My mental health has improved over the past couple of months, but I don͛t know what the future will bring – I could deteriorate and need to take antidepressants again. If I do, it won͛t signify failure.

All I can do is wait and see what happens, managing my mental health as well as I can in the meantime.

These 9 months have been challenging, but they have also been revelatory. I have coped better than I thought I could, both with little things like walking on my own and big things like trekking to Machu Picchu. I discovered that I can survive a bad episode without medication. I realised how big an impact physical activity has on my mental health when illness prevented me from exercising. I learnt the importance of small acts of self-care, like eating proper meals and making sure I do things I enjoy.

Most of all, I found that not taking antidepressants is not much different to taking them – for me, at this point in my life. There have been no miracles and no disasters. Just me, living and coping as best I can on my own terms.

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