So, here’s the thing. If you are a danger to yourself or others, get some good Western medical attention and take those synthetic drugs. Our goal is to Do No Harm, and if you’re considering harming, well, then that’s not really working very well.
If you’re currently taking anti-depressants, please do not stop taking them cold-turkey. Or without the advice of your doctor. Or ever, if you don’t want to. Again, going cold-turkey off medication that your body has been trained to rely on? Not harm-less. This is especially true for someone who has been chronically ill for years and has most likely been taking some sort of mood-enhancing/regulating drugs for many of those years. Your body is probably not making much of your own hormones right now. Let’s go gentle and easy.
If you are taking more than one med right now, talk to your doctor about which one to go slowly off of first, over the course of months. And then target another one. Coming up with a plan will help you feel more in control and help you be a little more patient with your body. This is not a race and we need your body to start replacing the synthetics with your own natural version. Otherwise, you could end up in some unhealthy territory.
Slow also affords some time for those that love you to adjust to the changes you’re making. Hopefully they are supportive of your efforts, but even if they are, they may be wrestling with fear because they’ve seen you in a bad way in the distant or not too distant past. Be kind not only to yourself but to them as well. Slow is good.
Going forward, you can try to not include new medications if that sounds realistic and helpful to you. There might be a more holistic option to do the same work in a natural way for your body if you’re coming to a relatively healthy place overall.
Before you start to think about weaning off psychiatric meds, you have to have your physical body in a pretty healthy place. This is paramount. You need to have eliminated all processed foods, unhealthy and artificial sugars out of your system (this is super important), be using holistic tools for balancing moods and stress along with meditation and exercise techniques. You need to be a champ at positive self-talk.
And you need to have been doing all of those things successfully for long enough that they are second nature to you. This means many months, not days and weeks. If you are still struggling with serious mood swings, disordered thinking, insomnia, bouts of crying or mania, getting off your meds is not something you should be doing yet. Revisit the idea in 6 months. There is no shame or guilt in waiting. These are forgotten or stifled natural processes we are retraining your body to do and sometimes that takes significant time. In the meantime, work at supporting your body in detoxing.
What Meds do in the Body: Let’s go over what happens in your body when you take an antidepressant and some other prescribed medications.
We don’t really know, but it’s believed that depression is caused by too-low levels of neurotransmitters like serotonin, norepinephrine, and dopamine in our central nervous system.
An antidepressant works by affecting the neurotransmitters in your brain. Think of neurotransmitters as little messages that go back back and forth between cell receptors. So, imagine your brain’s cells, talking to each other via their receptors, sending notes back and forth, and none of them are very happy. You feel sad.
When the antidepressant gets the neurotransmitters to send messages that say, “Hey, things aren’t so bad, right?” and then after awhile, the messages might even get so good as, “Things are actually really pretty good!” then we know they’re working and you’ve hit on a good drug for your brain to work with. Some drugs work better with some brains than others. Some drugs won’t work at all for you. It’s safe to say they all come with a few or possibly many adverse side effects.
Because we don’t really know what causes depression, we’re just doing our best to solve the symptoms. Science has shown some success for some people using modern pharmacology (me included) and so that’s what we have to work with, but you should also know that we don’t understand why these drugs work. Not really. But, we’re really glad they do, when they do.
There are some drugs that do a part of the messaging pretty well, but they need a helper drug to boost what they do. Then you’ll have a second mood-enhancing drug along with the antidepressant. Double the fun, but double the possible poor side-effects.
Let’s take a closer look at how they work. One type is the SSRI class, which stands for Selective Serotonin Reuptake Inhibitor. Serotonin, a neurotransmitter, has the usual job to go through our brain cell receptors, passing the message, which sends a signal to the other cells that it had success, which creates a chain reaction of serotonin being released. Once it’s released, the new serotonin is hoping to also pass messages to more cells and be reabsorbed, but some of it will get lost in the mix. That process of reabsorbing and some getting lost is called “reuptake” and it’s what the SSRI attempts to negate. It goes in and stops the new release of serotonin from latching in place so there is more free-floating around in between cells in the synapses for a longer period of time. So “reuptake” doesn’t happen.
What this teaches our brains is that it doesn’t need to produce as much serotonin because there is always so much floating around in there. If we were to abruptly stop our meds, we’d feel the immediate effect of a significant decrease of serotonin because our brains simply aren’t creating as much of it anymore. We’re dependent on the SSRI.
Another type is the SNRIs, or Serotonin and Norepinephrine Reuptake Inhibitors. They work in the same way as the SSRIs, but now you’ve added blocking the absorption of norepinephrine as well as the serotonin.
TCAs, or TriCyclic Antidepressants work the same as described above, targeting the levels of norepinephrine and serotonin, and also block the action of acetylcholine, another neurotransmitter. This is a tricky class of drug, because acetylcholine’s job is to help us sleep well, wake up in the morning and think. This is one of the earliest types of antidepressant and hopefully you’ve found another type that works for you, because use of this type can be fraught with major side-effects.
Imbalances of acetylcholine show links to memory deficits associated with Alzheimer’s disease. Acetylcholine is the only neurotransmitter involved with our Somatic Nervous System, so it also helps our muscles work well, which means messing with it can give you an increased chance of seizures. The Somatic Nervous System consists of our spinal, cranial and the associated nerves. The cranial nerves carry all the information in and out of the brain regarding smell, vision, eyes, mouth, taste, ear, neck, shoulders and tongue. Taking a TCA class drug should be a major decision.
MAOIs, or MonoAmine Oxidase Inhibitors, are also early type antidepressants. MAOIs work the same as described earlier but they target norepinephrine, serotonin and dopamine all at the same time. They have some major food or other drug interaction issues because they kind of sweep all the stuff into one package, where more recent drugs target just one type of neurotransmitter. They are a little clunky, so hopefully you don’t have to take one of these, either.
Bupropion also affects serotonin, and norepinephrine, but its main target is dopamine. This is a drug used for many people with bipolar, because dopamine – too much or too little – causes mania or depression and cycling up and down can cause manic episodes or psychosis.
Antipsychotics mostly target what doctors believe to be excess dopamine, which is why you sometimes see them prescribed for people with bipolar tendencies even though they were more meant initially for people with Schizophrenia issues. When you combine them with an antidepressant that is targeting a different neurotransmitter, it can sometimes work better and it can sometimes be worse. It’s totally dependent on the person. We’re messing with brain chemistry here, people. You just don’t know.
Some of the side-effects you get with antipsychotics are different than with antidepressants, like excess saliva, being unable to stop moving your mouth/jaw (tardive dyskinesia) and maybe developing diabetes. Sometimes they are the only thing that can help your brain stop hallucinating and all the side-effects feel worth the risk.
It can be disconcerting and even scary to hear voices. It can feel like a war that you are fighting and it might be hard to imagine making peace with that and it possibly being a constant part of your life. There are Hearing Voices groups that meet for support, though, so please reach out and find those people if this applies to you. They use a blend of therapies to understand the voices and learn to live with them if it’s possible to do so, with or without medications.
Newer generation sleeping pills work on the GABA receptors in the brain. GABA (Gamma-Aminobutyric Acid) receptors control our levels of alertness or relaxation. The older generation, called the Benzodiazepines, include Valium and Xanax and hit a little harder than the newer ones and can be more addicting. Both generations can mess with your memory and cause you to hallucinate a little or have “confusional arousal,” aka sleepwalking.
We’ve also got TriCyclic Antidepressants being used as sleeping aids, (like Trazodone) when you’ve already got depression or all over body pain from a chronic illness. They are usually cheaper than newer class sleeping aids.
Weaning off sleeping aids can be a little brutal if you try to go fast, so go slow, my friends. Go slow.
So, final note: There is no shame in taking medication. There is no shame in being challenged with mental illness. The synthetic meds we take to help our brains will go in and replace what our natural hormones and neurotransmitters are trying to do. They usually come with a few to possibly many adverse side effects which fall anywhere on the scale from annoying to brutal. The longer we take them, the more dependent our bodies become on them. Sometimes they will inexplicably stop working and you will have to find new ones to take their place and that might be really hard.
Some of the side effects will mess with your stomach and intestines and that will also cause issues with your brain chemistry because your digestive system and your brain are connected. You will need to work a little harder at getting your digestion stuff under control and healing if you’re taking meds, but you can do it.
If you need them, take them. SSRIs and antipsychotics have saved my life in the past and if I had to do it over again, I’d take them again, side effects and all. They can be managed relatively safely under a doctor’s care through a pregnancy for both mother and child and have saved many lives. (Those mothers don’t choose to take those medications lightly during gestation and it angers me when I hear of people getting on their cases and calling them bad parents because they are choosing to keep their sanity while they love their child into the world.)
If you want to wean off your medications and you feel can do it safely, do it slowly, kindly, with the help and support of your doctor. You can do it with a relative low-risk of relapse if you go slowly and let your body adjust through each change. But, please, PLEASE stop weaning and/or go back on your meds if you ever feel you need to for your mental health. The people in your life that love and care about you will thank you.
Massage Something Good
Try massaging your ears to calm yourself or bring peace. Start with fingertips on the outside edges of both ears nearest the scalp at the top and work your way around the edges of the ear ending on the lobes. Rub and apply pressure at a comfortable level for yourself.