How do I look after myself as I come off?
Choose a good time to come off
Coming off medication may be difficult and, if so, it may be hard to do other things at the same time.
If you currently have stressful things to cope with in your life, it may be best to not also try to come off medication, but to wait until things have settled down.
Stresses might be:
- moving house
- a new baby in the family
- serious illness of a family member
- job instability.
But coming off may be just one part of a whole lifestyle change that you are undertaking. If you are consciously taking control and revising other aspects of your life – e.g. finding new interests, perhaps meeting new people – all this may also help you to come off.
It’s important not to replace your medication with alcohol or street drugs.
Plan your withdrawal
Having a personal withdrawal plan for reducing your medication over a number of weeks, months or even years can help you to stick to your original aim. You can always modify this as you go along, depending on how you progress.
Tell people close to you
Explain to your friends and family what you are planning to do and how this may impact on your mood and emotions.
If your feelings have been suppressed by medication, explain that it may take some time for you to get used to feeling emotions fully again.
Tell them about withdrawal symptoms, so that they understand what is happening to you, and can help you to cope.
Prepare an Advance Decision
An Advance Decision is a legally binding document, also known as an ‘advance directive‘ or ‘living will’. In it you can say how you would like to be treated if, for example, you have a serious crisis during the withdrawal process.
If you make an Advance Decision, you need to make sure that you give a copy to someone you can trust. Also give a copy to your doctor or psychiatrist, providing they are in agreement with your plan to come off medication.
Get to know your triggers and warning signs for crisis
Many people get to know what situations they find stressful, and either avoid them completely or prepare themselves carefully so as to minimise the stress. You, your friends or family members may learn to recognise warning signs which suggest you may be becoming unwell. Keeping a diary may help you to spot any patterns.
Monitor your mood
Monitoring your mood during the withdrawal process can help you to spot subtle trends that might otherwise get overlooked. You could use:
- a diary
- an online tool such as Moodscope (see moodscope.com for details)
Recording any side effects can help you to remain objective and recognise any less obvious patterns.
“I’ve tried to come off my medication because I’m scared about what the medication is doing to my brain, and whether it is changing who I am as a person.”
Trust your own feelings
If you feel that something you are experiencing is a side effect of medication or a withdrawal effect, take this seriously. Other people may think that your symptoms indicate that your illness is coming back, but you may feel sure it is not.
If you are following a programme of slow dose reduction and you reach a difficult phase, don’t be afraid to slow down, or to stop at the dose you are on for longer than you had planned. Adapt your plans to fit your experience.
Learn how to look after yourself
- Don’t be afraid to say ‘no’ if you feel something will be too much for you.
- Ask your friends or family for help, if that’s what you need to keep well. For example, you may find it much easier to keep an appointment if you have someone to go with you.
- Use a comfort object. If you have to do something you find stressful, it might help to take a particular comforter with you (for example: a scarf, a special stone to hold in your pocket, a teddy or whatever works for you). Don’t be afraid to use such things if they help you to cope and get on with your life.
Look after your diet
You may find it helps to:
- eat regularly, starting with breakfast
- avoid sugary foods and drinks because they cause big fluctuations in blood sugar which can cause mood swings and anxiety
- be aware of foods and drinks that trigger depression or other mood changes in you.
Keeping a diary of what you’ve eaten may reveal reactions that you weren’t aware of.
Get enough sleep
Sleep is one of the most important factors in maintaining mental health. If you are coming off medication and one of the withdrawal effects is sleep disturbance, you may have to be prepared to put up with this for a while. You could find ways to minimise the ill effects, however.
This can help to reduce stress and anxiety, and can be prescribed as a treatment for depression.
Taking exercise out in the fresh air, in the country or the park is most effective.
Be prepared to change your plans
Coming off can sometimes be a big disappointment if it doesn’t bring the improvement you hoped for, or you find you can’t manage without medication after all. But even if you don’t manage to come off completely, you may succeed in reducing your dose, and this could make a significant difference to how you feel.
In fact, trying to come off a particular medication can be a good way of finding your ‘threshold dose’. This is the lowest amount of medication required to relieve your symptoms and keep you well.
You can also consider trying again at a later time. The fact that things did not go as you wished this time does not mean that they never will.
Some people find out that they are happier taking medication after all. This is also helpful to know: it may be easier to get on with the rest of your life once you have accepted that medication is part of it, and you feel that the decision was yours rather than your doctor’s.
“I hope I can come off medication completely one day.”