Thursday, June 19, 2014

Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 2

Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 2
Written by Will Hall
Published by The Icarus Project and Freedom Center




Looking Critically at “Mental Disorders” and Psychiatry

Doctors put people on psychiatric medications for experiences labeled “mental disorders:” extreme emotional distress, overwhelming suffering, wild mood swings, unusual beliefs, disruptive behaviors, and mysterious states of madness. Currently millions of people world-wide, including infants and elders, take psychiatric drugs when they are diagnosed with bipolar disorder, schizophrenia, psychosis, depression, anxiety, attention deficit, obsessive-compulsive, or post-traumatic stress. The numbers are climbing every day.

For many people, psychiatric drugs are very useful. Putting the brakes on a life out of control, being able to function at work, school, and in relationships, getting to sleep, and keeping a lid on emotional extremes can all feel lifesaving. The sense of relief is sometimes dramatic and the medications can stir very powerful emotions, and even feelings of salvation. At the same time, the help psychiatric drugs offer many people can leave little room to see more to the picture: others can experience these drugs as negative, harmful, and even life-threatening. As a result, it is rare in society to find a clear understanding of how and why these drugs work, or an honest discuss of risks, alternatives, and how to come off them if people want to.

For me, I have this feeling of relief. I also now the feeling of feeling trapped and and of drugs being harmful and life-threatening when they’re the wrong drugs. Sometimes you don’t have many alternatives though so you can’t find better ones and then you’re stuck living a partial existence; not fully yourself, but not quite as tragic.

Many doctors and TV ads tell people that psychiatric medication is necessary for a biological illness, just like insulin for diabetes. They promote the idea that the drugs correct chemical imbalances and treat brain abnormalities. The truth is different however. “Biology” and “chemical imbalances” have become simplistic sound-bites to persuade people to put their faith in doctors and quick fixes. These words arein fact much more complicated and unclear. Biological factors (such as nutrition, rest, and food allergies) affect everything we experience: biological “cause” or “basis” plants the belief that medication is the key to solving our problems. To say something has a biological cause, basis, or underpinning can give a message that the solution must always be a medical one and that “treatment” has to include psychiatric drugs. Once people have a diagnosis and start taking medication, it is easy to think of medication as physically necessary for survival.


Okay, here’s a problem. While I do feel like drugs can often be helpful because I do actually believe there may be a chemical imbalance or a synapsis misfire in some cases (like mine where I am Major Depressive). I do NOT however, believe it should ever be a “quck fix” or a stand alone fix. Medication should always be combined with therapy. For people with BPD, it’s often an issue of Nature and Nurture. There may be a biological component, but it’s often majorly an environmental one as well. To overcome those issues and the maladaptive coping mechanisms we’ve learned to adapt to those things we need therapy and support to deal and heal from them.

Not only is there is no solid science behind viewing mental disorders as simple malfunctions of biology “corrected” by drugs, but many people with even the most severe diagnosis of schizophrenia or bipolar go on to recover completely without medication. The experiences that get labeled mental disorders are not “incurable” or always “lifelong:” they are more mysterious and unpredictable. For some people psychiatric drugs are helpful tools that change consciousness in useful ways, but they are not medically necessary treatments for illness. Once you acknowledge this, more options become thinkable. And the potential risks of psychiatric drugs come under greater scrutiny, because they are very serious -- including chronic illness, mental impairment, dependency, worse psychiatric symptoms, and even risk of early death.

Now this I will agree with. It is perfectly reasonable to expect that drugs are not the solution and that you can heal without them. Mental Disorders are often a product of maladaptive coping mechanisms that can be unlearned, or at least, recognized, and a better option of coping can be chosen.

In discussing “risks” and “dangers,” it is important to understand that all life involves risk: each of us makes decisions every day to take acceptable risks, such as driving a car, working in a stressful job, or drinking alcohol. It may not be possible to predict exactly how the risks will affect us, or to avoid the risks entirely, but it is important to know as much as we can about what the risks are. Looking at the risks of drug treatment also means looking at the risks of emotional distress/ “psychosis” itself, and making the best decision for you. Maybe psychiatric drugs are the best option given your circumstances and situation, or maybe you want to try to reduce or come off. This guide is not intended to persuade you one way or the other, but to help educate you about your options if you decide to explore going off psychiatric drugs.

How Difficult Is Coming Off Psychiatric Drugs?

In working with hundreds of people over many years, we have found there is no way to predict how the coming off process will go. There is really no way to know in advance who can and who cannot do well without psychiatric drugs, who can do well with fewer drugs or lower doses, or how hard it will be. We’ve seen people withdraw successfully after more than 20 years, people who decide to continue to take them after being on for just a year or less, and people who struggle with long term withdrawal.

Because coming off is potentially possible for anyone, the only way to really know is to try slowly and carefully, and see how it goes, remaining open to staying on. Everyone should have the opportunity to explore this. The study by MIND, the leading mental health charity in the UK, confirms our experience. MIND found that “Length of time on the drug emerged as the factor that most clearly influenced success in coming off. Four out of five people (81%) who were on their drug for less than six months succeeded in coming off. In contrast, less than half (44%) of people who were on their drug for more than five years succeeded. (Just over half of people who were on their drug for between six months and five years succeeded.)” Facing these unknowns means remaining flexible and learning as you go: coming off completely may, or may not, be right for you, but everyone can become more empowered.

I’ll be honest. I was very opposed to the idea of psych meds my entire life. I finally “gave in” about 3 years ago. After being forced off of them a month and a half ago, even after weaning down, and knowing a lot of coping techniques, I know my life and mental state is much more pleasant on them. I don’t necessarily need them for my BPD (through therapy I’ve learned how to cope effectively and communicate through those issues) but I do for my anxiety and depression. You know what? I am perfectly fine with that.  

I hadn’t even figured out the right medication to go on after 6 months, let alone the right combination. If I had tried to come off before then? I would have gotten nowhere. Being on antidepressants for less than 6 months when I’ve been depressed since I was 12… would also do next to nothing for me. It’s really all about knowing what is best for you individually.  Don’t let these statistics sway you from trying or staying on medication.



How Do Psychiatric Drugs Work?

Most people begin taking psychiatric medications because they are “distressed and distressing.” They are either experiencing overwhelming states of emotional distress, or someone else is distressed with their behavior and sends them to a doctor – or some combination of both. There are many labels for these states, like anxiety, depression, compulsiveness, mania, psychosis, voices, and paranoia, and labels change over time. Doctors tell people that their emotional distress is due to a mental disorder which has a biochemical basis, that their distress is dangerous and must be stopped (such as fears of suicide or claims of deteriorating illness), and that medication with psychiatric drugs is a necessary treatment.

I feel like this is slightly outdated and a little inflammatory. Often that distress can be dangerous… to that particular person themselves and their quality of life and in order to live a


happy and healthy life they would like those things to stop… And sometimes drugs are PART of the solution, but drugs should never be the ONLY solution. Drugs can’t change the things in your environment that are going wrong. Drugs can’t help you rethink situations and learn to cope better. Drugs can’t kick out the negative influences in your life.

Psychiatric medications act on the brain to alter mood and consciousness like any other psychoactive substance. Because many medications can blunt or control the symptoms of emotional distress – by either tranquilizing a person, speeding them up, numbing sensitivity, or getting them to sleep – they can take the edge off extreme states. They help some people feel more capable of living their lives. It is important to realize, however, that psychiatric drugs do not change the underlying causes of emotional distress. They are best understood as tools or coping mechanisms that sometimes alleviate symptoms and pave the way for change – but with significant risks for anyone who takes them.


True. Which is why they should always be combined with a self-awareness improving form of exploration. 



3 comments:

  1. One side effect that i've seen from Geodon is tardive dyskinesa. My friend clenching her jaw, in pain, in frustration. Makes my body clench just remembering

    ReplyDelete
  2. My struggle has been finding someone to help me with retraining/coping mechanisms who is good with ADHD. Of course, I suspect it isn't my *only* problem, but it is the one that can be best addressed with a combination of medication & therapy/coaching.

    Can't wait to see the new therapist next week. Maybe this time I can go in & just be honest about everything right off the bat & be *heard.*

    ReplyDelete
  3. Interesting read. To me, I have always been fascinated by the "placebo effect" when it comes to psychiatric medications. Take antidepresssants, for example. For years, no one ever questioned their efficacy. Doctors would see their patients get better, with few side effects, and keep writing scripts. But then numerous studies were done, and now if you look at the research, antidepressants are not shown to be that much more effective than sugar pills.

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