If you’re either going into recovery or are already going through treatment, working around medication can be difficult. At the same time, the National Institute on Drug Abuse suggests a comorbidity rate of anywhere from 40-60% between substance use disorder and depression and anxiety. This means that millions of people with substance abuse problems also struggle with depression, and many require antidepressants. If you’re one of them, you are not alone.
Depending on your situation, now may be a good time to get off antidepressants. The following article covers how you can do so safely.
Consult Your Doctor!
It’s important to consult your doctor and hopefully the original, prescribing physician before moving forward. If your move to quit antidepressants is doctor-recommended, feel free to skip this step.
Antidepressants like esketamine can be a valuable and sometimes life-saving medication if you need treatment, you likely want to remain on it. For example, if you are quitting antidepressants for any of the following reasons, you are strongly recommended to consult with your doctor before taking any steps.
No-Tolerance – Many sobriety groups utilize a “No-tolerance” policy for drugs of any kind, which can be especially challenging for people with anxiety and depression. If your recovery group has this type of policy and your doctor recommends that you remain on antidepressants, look for another solution such as SMART Recovery that doesn’t utilize this kind of policy.
Desire to be “Drug Free” – In some cases, drugs are a valuable and important part of treatment. If your brain doesn’t produce the chemicals you need to live a happy and healthy life, you likely need treatment in the form of medication. In some cases, you may be able to safely switch to another medication or to no medication, but this may not be possible. Consult your doctor.
Judgement – Peers, especially in the recovery environment, can be judgmental of individuals who continue using. This is often spurred by misunderstanding and stigma rather than a scientific look at what antidepressants are and how they work. Medication you need to live is medication and nothing to be ashamed of.
Get Your Questions Answered Now.
There are many very valid and legitimate reasons to get off antidepressants while in recovery. Some of these include that you may not need them anymore, you may be at the end of a period to work to see if they help, you may be interacting badly with side-effects, they may prevent you from receiving other treatment, and you may be experiencing other problems with them. In any case, it’s important to discuss your needs with your doctor and develop a tapering schedule with them to ensure you get off antidepressants safely.
The following advice is not nor does it replace advice from a medical professional and should not be taken as such. Consult with your doctor for full medical advice before changing, adjusting, or stopping your medication.
Antidepressants normally require tapering, or slowly reducing the dose over a period of several weeks to months. This is important, because most will cause severe withdrawal symptoms and might cause life-threatening symptoms such as seizures. Consult with your doctor to determine an appropriate tapering schedule, go in for checkups, and discuss your history of substance abuse with your doctor.
If you’re planning to be in rehab before, during, or after you taper off of your antidepressant medication, consult with your doctor to determine a schedule that best fits into your needs. He or she may be able to work out a schedule that doesn’t conflict with substance withdrawal. They may also be able to consult with the physician at your detox center to ensure you receive the care you need to stay healthy during withdrawal.
Taking Care of Yourself
Tapering off antidepressants can severely impact your physical health, so it’s important to manage your diet and exercise. If you’ve already been through rehab or recovery treatment, you’ve likely learned how diet and exercise impact your mood, energy levels, and ability to recover. If you haven’t, it’s important to pay extra attention to how you feel.
You are recommended to:
Exercise – Participate in a light activity such as walking, swimming, or cycling at least 30 minutes per day. Moderate exercises are also okay. Light-to-moderate exercise increases blood flow, improves oxygenation in the body, and works to release dopamine and serotonin, effectively boosting mood and energy levels. This process reverses after a certain point of exercise intensity because you utilize too much energy, which is why light-to-moderate exercise is best.
Eat Well – Eating a balanced diet is important for your mood and health. This is especially pertinent if you have been abusing a substance for some time, because substance abuse is strongly linked to nutrient deficiency through both gastrointestinal damage and poor dietary choices. If you’re unsure of your nutritional health, it may be a good idea to seek out a dietician.
Taking care of your body will improve your mood and energy, which will help you to safely navigate withdrawing from antidepressants.
Managing Your Mood
Getting off antidepressants will result in mood swings, will likely result in mood crashes, and may result in rebound, where your depression or anxiety return at full or greater-than-full force. It’s important to plan for these drops and to account for them, because negative emotions are strongly linked to relapse. If you’re already clean or sober, you may want to spend the time during tapering in a halfway home or other support group, have someone come check up on you, or even seek out a rehab facility where you can ensure you won’t relapse during withdrawal.
What can you expect? The side-effects of withdrawal are different for many antidepressants so it’s a good idea to consult with your doctor. If you expect moderate to major mood-drops, you should plan to have people around you, should plan what to do if you want a drink or to use to feel better, and likely want to take precautions in case those plans aren’t enough.
Getting off antidepressants is a long and often unpleasant process. Combining it with withdrawal or recent recovery will make that worse. If you haven’t been to rehab or are just into your recovery, it’s important that you be able to reach out and ask for help. Many recover facilities offer detox clinics where you will receive medical monitoring and support during withdrawal, which may be crucial to recovering safely. This is especially pertinent if you still have to withdraw from drugs or alcohol at the same time, as this may cause additional complications requiring medical treatment. Substance abuse will complicate withdrawing from antidepressants, so it’s important to exercise care and take extra precautions to prevent side-effects and symptoms during withdrawal.
Recovering from a substance-use disorder is a long process that will take years or the rest of your life. Struggling with depression or anxiety at the same time will complicate that recovery, but you can manage both at the same time. If it’s necessary to quit your antidepressants during recovery, you can do so safely and without relapse by going slowly, managing your mood, and ensuring you have the medical support you need when doing so. Good luck with your journey.