1) Don’t decide to discontinue your antidepressant
if you are going through a particularly stressful period in your life.
Antidepressant withdrawal can be a major stressor itself, and withdrawal symptoms
seem to be more extreme if you are stressed to begin with. And don’t enter into a stressful situation if
you are in the middle of withdrawal. Just don’t go there.[i]
2) Anticipate and assume it will go well, but be
prepared in case it doesn’t. Studies suggest at least 20% of people have no
problem getting off their antidepressant. Most people go through several days
with mild to moderate symptoms when decreasing their dose. Physically you might
feel a bit achy, dizzy, have a headache, and/or feel a bit nauseous.
Emotionally you’re likely to be anxious and snappy—think PMT. You are also likely to feel
tired. A few folks have a much rougher time. See my last post, and Dr Glenmullen’s checklist for a more complete list of possible withdrawal symptoms.
3) Get yourself a support team. Let your spouse/parents/kids,
close friends, and possibly co-workers/colleagues know that you’re altering a
medication and that you might not be quite yourself during the time it takes
for your body to adjust. If you’re not going to get support for coming off the
meds from someone, figure out how you want to deal with that issue before you
start the withdrawal. Some folks believe that having withdrawal symptoms means
you need to take your antidepressant.
It doesn’t. (That’s the same logic as
saying smokers who have trouble getting off cigarettes need to smoke.)
4) Even if you feel grotty, get out and get some
exercise every day. Go for a walk, or a swim, or a bike ride, or a run. Take the
dog for a walk. Shoot some baskets. Throw some snowballs at a tree. Get some
fresh air and work your blood cells and heart and muscles a little bit. You
will feel better for it. Promise.
5) Eat light and healthy. Increase your intake of
vegetables and fruits to increase antioxidant levels. Don’t add a bunch of vitamins
or supplements, though. Some folks have reported reactions to supplements during
withdrawal. And listen to your body. If certain foods don’t agree with you, don’t
eat them.
6) Drink plenty of water. It not only hydrates your
body, but also helps flush your system. I haven’t read anywhere about tea or
coffee so can’t comment on whether they help or not. (If you have some experience
with this, your feedback would be appreciated!) I’d say if you are a regular
coffee drinker, going off coffee might give you coffee withdrawals (yup, they’re
real) and that wouldn’t be good. Green tea provides antioxidants so that is
probably a good choice. Follow your instincts here.
7) Avoid recreational drugs and alcohol during withdrawal.
You probably won’t feel like drinking or doping during withdrawal anyway, but
some people seek anything that might help calm them down if they get feeling
agitated during withdrawal. If your emotions are bubbling, the last thing you
need is something else to jerk your emotions around, and substances that loosen
inhibitions can be seriously bad news if you’re a bit volatile or vulnerable to
begin with. I know one ordinarily quiet and gentle person who, after several drinks during
withdrawal, took off after his step-daughter’s boyfriend with a 2x4—the young
man had enough good sense to run!
8) Take up meditation, or at least learn the “Freezeframe” technique that comes from the Heart Math folks. Both are outstanding for
keeping calm and lowering stress levels. Use them daily, more than once a day
if you can.
9) Laugh. Every day. Even if you have to pretend to
laugh, laugh, and after a while it won’t be so “pretend”. Watch a funny movie
or read a funny book. Take up laughter yoga. Laughter is good for your heart,
your immune system, your blood flow, your blood sugar levels... Really, it has
no downsides at all. And regular bouts of laughter WILL make AD withdrawal
easier.
10) Count your blessings. Be grateful, and be aware
of being grateful. Do this every day, several times a day. When you appreciate
the small, positive things in your life, you bring your attention to those
things, and that helps your immune system, and helps your body to heal. Even if
it’s hard to think of something positive, make the effort. Be grateful for a
sunset. For the warmth and flavour in a cup of tea. For kind words from your
spouse, a “well done” from your supervisor, a few hours of uninterrupted and
peaceful sleep, for not feeling as dizzy today as you felt yesterday. Really FEEL that gratitude. Don’t kneecap
your gratitude by adding a codicil like “It’s about time!” or “I’m glad to feel
better today than I did yesterday but I’m still sick and tired of being sick and
tired.” Just focus on the good stuff.
If you haven’t read my other two posts on antidepressant
withdrawal, check them out:
Antidepressant Withdrawal looks at what withdrawal effects may
occur when you stop taking your antidepressant and why they occur.
How Long Does it Take to Get off Antidepressants gives
tapering advice.
For more information on psychiatric drugs and alternative ways to understand and resolve a variety of mental health issues, see my new book Reframing Mental Illness.
For more information on psychiatric drugs and alternative ways to understand and resolve a variety of mental health issues, see my new book Reframing Mental Illness.
[i]
Frank Streicher did. He shares his story about what happened on his website: “after about 4
days off the stuff and at the height of withdrawal, I put myself in the worst
possible position. I reffed a high school basketball game between two of the
best teams in the city. I was partnered with the worst ref in the league, and
the game went into double-OT. Packed gym, people screaming, coaches yelling.
Big mistake. The things that people say that normally roll off you, hit you
like daggers when you're in withdrawal. The losing coach (who I'm surprised is
allowed to work with kids) wouldn't let it go and kept at us long after the
final buzzer. I'm a big enough guy to have ripped this coach in two. It took
every ounce of determination I had to turn and walk away from that guy. I'm not
a tough guy, but had I turned on him, I'm sure I would have killed him. I was
that frayed. I went home and trashed my bedroom. I laugh at it now because it
was my only opportunity to act like a 70s rock star with a valid excuse. I had
to go back on the drugs before I hurt someone.” Frank’s website,
quitpaxil.org, is a useful resource. Paxil (Seroxat, paroxetine) is one of the
harder antidepressants to get off.
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