For the last 5 weeks, I have been psych med free. I’m kind of ecstatic.
I’ve been on some kind of psychiatric medication since I was 14 years old. I’m 37 now. For nearly 23 years of my life – the majority – I’ve lived under a kind of haze. At one point, I was on 13 different medications. When I started this withdrawal process almost 6 years ago, I was down to 6. I was told by various doctors throughout the time I was on meds that I wouldn’t be able to live without even one of my medications, that I would surely spiral out of control and become depressed or manic and have to be permanently hospitalized. Yet the last 5 years have contained some of the most objectively stressful events of my life, and I’ve managed to maintain my stability with a decreasing amount of meds in my system. One of the things that helped me greatly was to read sites about the withdrawal experience, like Beyond Meds and Surviving Antidepressants. So, I wanted to talk about my withdrawal process here, in the hopes that my story can help someone else, too.
First, though, I want to give a bit of background to why I was on meds in the first place. I no longer put much stock in psychiatric diagnoses, but for context, mine at the time I started withdrawal was bipolar I with psychotic features and an anxiety disorder not otherwise specified. Although personally, I think I was probably just clinically depressed rather than bipolar, and that the symptoms I exhibited which led to my expanded diagnosis were triggered by SSRIs. I am a sexual assault survivor, and due to unresolved trauma, when I was 14 I attempted suicide. This led to my entry into the psychiatric system, and it led to the introduction of psychotropic drugs into my brain chemistry. I developed both manic symptoms and psychotic symptoms after being put on Zoloft as an inpatient. However, rather than discontinue the medication, my doctor put me on additional medication because he saw the symptoms as an endogenous illness rather than an iatrogenic effect. I’ll never be able to prove that my so-called mental illness was induced by drugs, but given that I’ve come off them successfully, I definitely think I’ve proven that the severity of my illness was greatly exaggerated.
Fast forward to September of 2011. After an adjustment to one of my medications, I started having mixed episodes. For those who haven’t had the pleasure of becoming intimately acquainted with the psychiatric descriptors for various emotional states, a “mixed episode” is symptoms of mania mixed with symptoms of depression. Me having a mixed episode wouldn’t be that big of a deal if it hadn’t occurred right after the med adjustment, and if it hadn’t been followed by my psychiatrist recommending we add yet another med to my regimen to counter this new side effect. With that recommendation, something clicked in me. Maybe I was primed to be open to change because I was going through a divorce and I had been underemployed for 2 years and shit was pretty hard right then. Who knows. But I knew it was utterly ridiculous to take another medication to counteract side effects from raising a dosage, rather than just lowering the dosage. And after a bit of reflection, I recalled that every medication I was put on, besides the Zoloft, was basically prescribed according to the same logic. Therefore, the only way to figure out what my actual problem was would be to completely withdraw from all the medication I was on. So I told my doctor this, basically, because I was cool with him and I always spoke plainly to him. I told him I wanted to come off my medication, I told him why, and I asked for his advice on tapering. I knew you shouldn’t just cold turkey psych meds, and I knew the longer you were on a med, the longer you should take to withdraw. I wanted to start with the Geodon I was on, because tardive dyskinesia terrifies me, and I was sure I was a ticking time bomb what with having been on neuroleptics for over 20 years. His suggestion? Switch to Seroquel, then taper over a period of a month.
I was shocked. Seriously, bruh? Do you want me to get TD?
At that point, I knew I needed to find another doctor, because he wasn’t going to be able to give me any real guidance through the process. I figured I’d be doing a lot of the research myself on what was best, but I wanted to work with someone who at least understood that slower is better. After shopping around (and encountering one naysayer who refused to take me as a patient and said he doubted I’d be able to come off the meds successfully), I found a doctor who was willing to help. He gave me a special compounding pharmacy prescription for liquid Geodon so I could taper with tiny doses. I felt that going very slowly would give my brain time to recover and not develop a dopamine hypersensitivity. I had reduced my Geodon on my own while I was looking for a new doctor, and I eventually developed some neurological symptoms (twitching, tremors, muscle spasms) that fall under the broad umbrella of tardive dyskinesia. I was scared shitless. I was so sure that it would eventually progress into something obvious, that my life would be ruined. And I had to deal with that very real depression and anxiety while my neurotransmitters were going absolutely haywire.
The panic I experienced over the possibility of being disfigured forced me to develop strategies for dealing with anxiety about the future, and learn how to avoid catastrophizing. Those strategies helped me deal with later crises in a productive way, when I had even less medication to bolster me. I never ended up getting full-blown TD, but I still have twitches and tremors and various mild neurological problems. I have to avoid things like coffee and excess sugar (tea is okay for me, presumably because of the l-theanine), because the twitching is exacerbated by stimulants. I also have to wear a sleep mask at night because my eyes have trouble staying closed if they can sense any light.
I’m not going to go into a ton of detail about what I did to support my withdrawal because it lasted for like, 5 years, and a bunch of other stuff happened in my life that’s somewhat unrelated. Maybe a post dedicated to all the minutia of withdrawal will materialize in time, but until then, here’s the meat of my survival strategy. In the beginning, I journaled every day so I had a record of any slow descent into madness. I ate well, slept for at least 7 hours a night, exercised, and managed my stress. In addition to quitting coffee and excess sugar, I quit smoking weed. I didn’t start smoking weed again until I had been free of Geodon for almost a year. I already didn’t like drinking, so I had no problem avoiding alcohol. In general, I tried to give my brain the tools it needed to repair itself, and abstain from any additional chemical interference. Eventually I felt comfortable making periodic exceptions, particularly after the Geodon withdrawal was over and it was clear I wasn’t going to be permanently disfigured or disabled. But that drift towards health was permanent. The mindset change — from accepting a lifelong identity as a permanently mentally ill individual, to actively shedding that identity and embracing a new identity as someone who might have some mental challenges but has learned to work around them — was permanent.
My tendency to analyze, my love of thinking, and my deep concern for the environment and human society are traits that led to my being diagnosed as mentally ill. Not because the psychiatric establishment is out to suppress free thought or something, but because those traits, left untrained and unchecked, can lead you to depression. Combined with the trauma of being sexually assaulted as a child and the intellectually oppressive nature of the Christian school I attended for elementary, I was doomed without some kind of intervention. The withdrawal process forced me to create a framework where those traits that led to my diagnosis could also get me out of it. My love of thinking was employed in the service of self-reflection and improvement. My tendency to analyze was focused on analyzing my habits and actions and deciding what needed to be changed or eliminated to improve my mental health. And I realized that in order to support my mental health, I needed to take actions that were in sync with my deep concern for the environment and human society. I needed to live in accordance with my values, because when I did things that were counter to them, I felt discontent.
So, I set about determining what my values were and how I could best live up to them. I started a vegetable garden because I found that a connection with nature and the food I eat is essential to my psychological and physical well-being. Gardening led me to consider how learning to work with nature to feed yourself could improve the lives of oppressed people who have so often been forcefully disconnected from nature. I became passionate about food justice, access to green space, agricultural self-sufficiency for minority neighborhoods, and other issues that combine environmental preservation and conservation with social justice. And I changed my major to sociology because I decided that I wanted to get a degree that would help me further my dream of a better society rather than just help me make more money.
Despite the detour my life took as a result of having been put on psych meds, I don’t advocate the abolition of psychiatry, and I’m not evangelizing against all meds. I think pharmaceuticals have a place, and that sometimes people might need meds to help them out of a tough situation. I just think that choice should be an informed one, and I think meds should probably be a last resort. Kids and adolescents should not be put on drugs if at all possible because their bodies and minds are still developing. I’m lucky I was able to emerge from the other side of my experience relatively unscathed, against the odds. Not everyone is so fortunate. Now, I’m looking forward to living the rest of my life unencumbered by meds, rediscovering my mind and experimenting with different ways of managing difficult emotions without pharmaceuticals.