Antidepressant medication is undoubtedly a life-saver for some people. My number one piece of advice where the decision to take antidepressant medication is concerned is to educate yourself, make an informed decision that’s right for you and don’t be too hard on yourself if you make some mistakes in managing this – I certainly have made a few that I want to share with you with the hope you’ll find it helpful and maybe even avoid making the same ones as me!
One of the things that I feel isn’t discussed enough is what happens when you’re ready to come off antidepressants. I hope that this post outlining my own recent experience will be helpful for you if you’re considering going on or coming off antidepressant medication yourself, or if you’re supporting a loved one with this. If you’re feeling vulnerable at the moment, please come back and read this article when you’re feeling stronger in case you find it triggering.
If you read my story last year about burning out and how I felt about being on antidepressants, you’ll know it was a difficult one for me to write and made me feel very vulnerable, as these personal posts continue to do. The good news is I’m improving and squirm a little less when talking about it now! 🙂 I was really resistant to accepting medication and felt the stigma when I was put on Citalopram by my doctor. After coming off six months later and going through awful and unexpected withdrawal effects, I was put back on them again – this time for over two years.
Coming off antidepressant medication
It’s now a month since I took my last antidepressant and you know what? I’d say it’s bloody tough – maybe more than you’d imagine – but it’s doable. You can do it. Even when it’s scary. Even when you’re not sure you’ll manage it. Even when life’s throwing curveballs. Obviously, it’s better to do it when life’s more settled if possible, but we can’t always predict these things!
I felt much better prepared this time. I consulted my GP and followed his advice to the letter, tapering since April so I would reduce through spring and come off in summer when my Seasonal Affective Disorder (SAD) symptoms are usually at bay. Things were feeling pretty stable in my life. I was ready!
Now, I’m pretty bloody-minded, I’m afraid. Some would say stubborn! I made my decision when I was coming off the medication and I wasn’t letting anything stand in my way! So of course… cue lots of unplanned big life changes to test my mettle! 😉 I was made redundant at the end of April. I got engaged in June. Then I went self-employed and am working to build two businesses. I’ve just been on a family holiday for the first time with my fiancé’s children and parents and I’m preparing to move house… all while tapering and suffering withdrawal effects – eeek! What did I say last year about lessons learned?!
I saw my GP again around two weeks before I was due to take my last tablet. I was managing the tapering pretty well at this point. His advice was mixed. One moment, on hearing about my life changes, “well should you be coming off them, then?” A resounding ‘yes’ from me as I was excited by my progress! To then, “well since you’re only taking 5mg every other day it’s nothing… just come off now.”
Hmm. This is the problem. I had a plan, and I stuck to it. I naively believed I’d have a much easier ride this time as I’d tapered over four months. I’d read up about it in advance this time and knew where I’d gone wrong last time. I knew to expect a bumpier ride as I got down to the lower dose. But I was only on what my doctor had called ‘a mini dose’ of 10mg to start with… so I would be fine, right?
Well, not entirely – but at least I had some previous experience with this! With hindsight, I can see that it wouldn’t really matter how much you’re on to start with as you’d have tapered down over longer, reducing your dose. As it turns out, coming off 5mg doses of a short half-life antidepressant can still give some people a rough ride!
I had all the same physical stuff as the last time I stopped – nausea, dizziness/vertigo, feeling disconnected from my body, sweating, pins and needles from shoulder to fingertips, brain fog and insomnia – delightful! I didn’t have the ‘brain zaps’ some people get, though – small mercies! These are pretty much the same symptoms I experience when starting them, too.
Did I mention that being the genius I am, I’d also very helpfully timed my last tablet to be a few days before a bout of PMS kicked in? Joys! Emotionally, the numbness I’d been experiencing lately while on antidepressants gave way to a flood of emotions – literally! I felt very tearful and fearful for a couple of weeks. This can be really scary if we’re not prepared for it because it can make us feel like we’re ‘re-lapsing’ into depression or anxiety.
We need better education about antidepressant withdrawal effects
I’m a bit of a ‘seeker’, so naturally, when I was feeling really awful I researched further to find out more about what was going on. What I read made me feel a bit better, seeing that what I was experiencing was ‘normal’. But in the thick of it, I also felt angry, to be honest – with myself mostly – and with my prescribing doctors. I’m not saying I was right to be annoyed – I just was!
I thought that while my doctors had been very insistent that I should take antidepressants, they hadn’t discussed with me just how difficult it can be for some people to come off them again. But then I reflected that maybe they didn’t understand it themselves. And I hadn’t educated myself fully before going on them, either. I’d put a drug in my body for a prolonged time without completely understanding the consequences and how tough it would be to stop. I felt really stupid. Worse still, I’d never been fully convinced that I needed them, especially as the weird autumn stuff happened regardless!
In a New York Times article I read, a couple of psychiatrists admitted that they only fully appreciated how tough it was to come off the medication when they did it themselves. Maybe this is the difficulty – just as you can never fully understand how depression or anxiety feels until you’ve gone through it yourself.
So, I think that while it’s brilliant that as a society, we’re starting to discuss mental health more, I’d love to see more education for everyone about antidepressants, their side and withdrawal effects. Mind is a good starting point – I’m really grateful for their website!
So, what have I learned, that I’d like to share with you?
I gave an overview of my personal advice based on my experience at the top of this article. I’m sure you can see the mistakes and lessons sprinkled throughout, too! Everyone’s different and ultimately you need to decide in consultation with your doctor what’s right for you individually.
However, here are some pointers I would give myself if I had a time machine and could go back in time:
Make an informed choice:
- It’s really important to educate yourself about antidepressants and their withdrawal effects. This allows you to make an informed choice about whether you want to take them or not. You’ll know what to expect when going on and coming off them, so be less worried about any side or withdrawal effects
- Don’t be afraid to ask your doctor for some time to think about it before being prescribed antidepressant medication. Know that you ultimately have the choice and it isn’t one to be rushed unless it’s a medical emergency
- Discuss with your GP whether you’ve tried all the alternatives – have you tried lifestyle improvements like exercise, eating a healthier diet and getting more or better quality sleep? How about talking therapy/self-help like Cognitive Behavioural Therapy (CBT)? Light therapy if it’s Winter Blues/SAD?
Prepare for coming off antidepressants:
- Plan carefully for stopping your medication when life feels stable, you’ve got a good support system and you’re feeling strong
- Prepare to taper for longer than your GP might first advise. You can cross-check with Mind’s helpline advisors if you’d like a second opinion, as they say this is common
- If you’re on a drug with a short half-life (I was on Citalopram; Sertraline’s even shorter) open a discussion with your GP about switching onto an antidepressant with a longer half-life (e.g. Fluoxetine). You could also ask about a liquid medication so you can reduce your dose by tiny amounts. Again, Mind can advise you about this
- Learn about and practice self-compassion and self-care so that you can show yourself kindness as you reduce and come off
- If you’ve already been open with family, friends and colleagues about your depression/anxiety and medication, you could let them know your plans so they can provide support and understand what’s going on
We all love a happy ending to a story, don’t we? While it’s still early days and I’m not counting my chickens just yet, I’m feeling loads better. 🙂 I still have a touch of insomnia, but everything else seems to have settled down.
What I hadn’t prepared for was the lovely upsides; things feeling more vibrant! I feel like I’ve had a big woollen muffler taken off my senses. I’ve found that colours seem brighter, music richer-sounding and I have a keener sense of smell and taste again. And yes, this does mean I’ve been going around smelling the roses!
I’ve also started to feel more connected to my feelings and intuition again in the last few weeks. Even when I’ve been tearful and anxious I’ve felt grateful in some measure. I really missed the sense of living that comes with experiencing feelings fully. That’s a difficult one to explain, but I hope you get some sense of what I mean!
As ever, the patience and loving support of my fiancé, friends and family have been instrumental in helping me navigate this transition – so much love coming your way! <3 I’m so grateful for you as readers, too – you continue to inspire me to keep showing up and sharing my lessons with you all.
I’d love to hear your thoughts and questions below in the comments, or if you prefer to email privately you can reach me on firstname.lastname@example.org