“But why are you tapering down?,” my psychiatrist asked during a recent follow-up, when I explained my determination to lower down one of my medications.
Why was I tapering down? Why did I want to get off medications?
I’ve been on a fairly steady regimen of medication for my mental and physical health since I got sober almost 10 years ago. Before that, drugs, alcohol, and an improperly adhered to rotation of psych meds made my life a blur of blackouts, breakdowns, and hospitalizations.
But it’s been awhile since I’ve felt the emotional angst of early sobriety: the crippling anxiety that gave me panic attacks when I entered a room, or the depression that seemed to make the world feel fake and far away.
I do things today that my twenty-something self would have scoffed at: jog, plodding slowly; ask friends about the details of their lives; and climb in bed early with a book.
““The use of natural as a synonym for good is almost certainly a product of our profound alienation from the natural world.” ”
So why am I still taking medication that stabilized me, when I’ve grown so far in recovery? Am I a different person today because I’ve outgrown my past, or am I a different person today because my brain chemistry is balanced by pharmaceuticals? And if I’m doing better than I ever have before, why would I want to change anything?
A sneaky, subtle part of my mind whispers to me that (as in everything I’m sold today) natural is better. From Whole Foods to Whole 30, processed is out. Organic is in. The demonized Big Pharma industry is out, and mushroom powders are in.
But this idea of natural as best can only go so far. Eula Biss notes in her book On Immunity, “The use of natural as a synonym for good is almost certainly a product of our profound alienation from the natural world.” Nature brings us hurricanes and plants with poison so potent a single seed can kill you. My brain, in its natural form, makes my stomach lurch with emotion at most music and suggests forgoing the trip to the grocery store for a day in bed. But yet, there’s a part of me that believes — natural is better. I need a regular reminder that despite our cultural narrative, for me, natural doesn’t always play out well.
“Medication isn’t always convenient or affordable, but that doesn’t mean that the best solution is to taper down or stop taking it.”
After a more detailed conversations with all my care team, I decided not to taper any further, for now. If you are considering getting off meds, the first step is a clear and candid discussion with your care team. Here are some talking points to bring to the discussion:
1. Talk with your care team about what you’re planning, and why.
Really if there is a single point to this article, discussing your tapering choices with your medical providers would be it. If you’ve adjusted your medication on your own, or aren’t taking it as prescribed, let your clinician know so they can give you the best treatment plan going forward.
2. Discuss your concerns about current side effects or potential effects of tapering.
If you’re uncomfortable about the medication you’re on (or if you’ve gone down a dark tunnel of Google searches late at night) talk with your clinician about your concerns. If you get flustered during medical appointments (like many of us do), write down side effects or concerns in a list and bring them to your appointment. Your doctor will always be a source of more up-to-date and accurate information than Facebook groups or Google searches.
3. Let your provider know if you’re experience pressure to taper.
Unfortunately, if you’ve revealed you are on medication, you may have gotten a question from a loved one like, “Why do you need that? You’re so normal!” or “Have you ever tried yoga?” If someone in your life is encouraging you to taper or change medications, your provider might be able to offer you educational materials to share with them.
4. Cover any barriers getting in the way of you taking medication as prescribed.
Medication isn’t always convenient or affordable, but that doesn’t mean that the best solution is to taper down or stop taking it. Many times, if you are struggling to afford treatment or get to the pharmacy to pick it up, your care team can help you find solutions.
Stopping any medication suddenly, from an antidepressant to an opioid, comes with unpleasant side effects. Communicating your desire to taper to your medical team will allow you to determine if it’s the right choice for you, and if it is, develop a plan for tapering together.
For now, medication is a part of my daily healthcare routine — it helps me thrive.
The goal of my life doesn’t need to be to get off meds. Physical and mental health, productivity, ability to connect with other people, and be a part of the world around me are much more important goals.
