Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 4
Written by Will Hall
Published by The Icarus Project and Freedom Center
How Withdrawal Affects Your Brain and Body
In addition to placebo, all psychiatric drugs work by causing organic brain changes. This is why going off leads to withdrawal: your brain gets used to having the drug, and has a hard time adjusting when the drug is removed. It takes time to bring the activity of receptors and chemicals back to the original state before the drug was introduced. While doctors sometimes use confusing terms like “dependence,” “rebound,” and “discontinuation syndrome” (and there may not be dosage tolerance), the psychiatric drug action that causes withdrawal symptoms is basically the same as addiction. Tapering off slowly is usually best: it allows your brain and mind time to get accustomed to being without the drugs. Going off fast does not usually allow enough time to adjust, and you may experience worse withdrawal symptoms.
Important: the signs of psychiatric drug withdrawal can sometimes look exactly like the “mental illness” symptoms that medications were prescribed for in the first place.
When someone goes off a psychiatric drug they might have anxiety, mania, panic, depression and other painful effects. They can become “psychotic” or have other symptoms from the psychiatric drug withdrawal itself, not because of a “disorder” or condition. This may be the same, or even worse, than what got called psychosis or mental disorder before the drug was taken. Typically people are then told this shows their illness has come back, and that they therefore need the drug. However, it may be the withdrawal effect from the drug that is causing these symptoms.
This is why weaning off slowly is very important. And pay attention to how you feel each day over an extended period. Eventually withdrawal symptoms subside.
These withdrawal symptoms do not necessarily prove you need a psychiatric drug any more than headaches after you stop drinking coffee prove you need caffeine, or delirium after stopping alcohol shows you need to drink alcohol. It just means your brain has become dependent on the drug, and has difficulty adjusting to a lower dosage off it. Psychiatric drugs are not like insulin for a diabetic: they are a tool or coping mechanism.
However, when you have been on psych drugs for years, it can sometimes take years to reduce or go off them, or you may have long term physical or psychological dependency. Sometimes people on these drugs develop ongoing withdrawal symptoms, chemical brain injury, and damage. This may not be permanent, but sometimes people live the rest of their lives with these brain changes. Scientists used to believe that the brain couldn’t grow new cells or heal itself, but today this is known to be untrue. Everyone can heal: new research into “neurogenesis” and “neuroplasticity” means the brain is always growing and changing. Friendships and love, along with good lifestyle, nutrition, and positive outlook, will help nurture your brain and body to recover.
You may find that the goal of going off completely is not right for you at this time. You may feel better staying on your medication, and decide instead to just reduce or continue at the same dosage, and focus on new ways to improve your life. Follow your own needs without judgment or blame: get support for your decisions in the face of any feelings of shame or powerlessness.
Remember, any decision you make is okay.
Why Do People Want to Stop Using Psychiatric Drugs?
People are often told that no matter what the side effects, psychiatric drugs are always better than suffering from “untreated” mental disorders. Some doctors claim mental disorders have a “kindling” effect, that early medication is best, or that madness is toxic and medications are “neuroprotective.” These theories remain unproven -- though ongoing crisis and a life out of control can certainly be cumulative stresses. Doctors spread fears unfairly: while medications are key in helping many people, many others have found ways to recover without psychiatric drugs. Many report their lives are better without them. Everyone is different, but sometimes people do deal with “psychotic” states successfully without medication. Diverse, non-western cultures often respond to and understand these experiences differently, even seeing them as positive and spiritual. It remains a personal decision how to relate to madness.
This is definitely a very individual choice. I would say pay close attention to how you felt before and after the medication and make a decision based on that. A lot of people feel ashamed by the fact that they are taking medication at all, even though it does help, and just don’t want to have to say they are taking any. Personally I would work on confronting the feelings of shame and recognizing that these are valid feelings, but not constructive. If something helps than it is okay for you. However if it isn’t actually doing you any good, than it is certainly time to look at an alternative route.
It’s not an either-or choice between taking psychiatric drugs or doing nothing. There are many alternatives you can try. In fact, some problems that are called symptoms of “mental disorders” might turn out to be caused by the drugs people are taking.