Why do you go on medication, and why/when do you go off of it?

One of the questions that regularly come up to me has to do with the ons and offs of medication. When and why do you go on medication, and when and why do you go off of them? While the two are related, they are not the same.

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Why go on medication?

We go on medication simply put because we need it. There may be many factors which go into that decision. It may involve mood, basic functionality, self-image, the ability to handle situations or stress, being able to interact with other people, to keep us safe from ourselves or others. You know your own list. For myself, I knew I had to go on medication when I found myself hating the things that I love: my family, my wife, my vocation as pastor, even my hobbies and the things that I enjoy became a burden. I couldn’t handle living any longer, and so something had to change. While one can go the route of simply counseling or natural remedies, in my view and after much reading on the topic, I simply haven’t found any cure or natural remedy or counseling method that is more effective than anti-depressants. Can you go other routes? Yes. Can they be effective? Yes. But I don’t believe that they will work as quickly or as well as modern anti-depressants or anti-anxiety medication, and the body of research seems to continue to support that view.

That’s why I went on medication, both initially and that’s why I went on them the second time.

Why go off medication?

The reason we go off medication should be fairly simple: we go off medication because we no longer need it. Now that sounds very simple, but we often invest massive amounts of emotion and other negative energy into the decision to go off of medication. Here are a few that I see and hear pretty regularly:

1. I don’t want to become addicted.
2. I don’t want to be on medication for the rest of my life.
3. Taking medication makes me feel weak or out of control of my own body.
4. I don’t like the side effects.
5. I can’t afford to take them anymore (iow, money or insurance problems).
6. I have found a better alternative way of treatment.

Now out of that list (and I look forward to hearing yours), four of them are basically emotional responses to medicine (wants and likes and feelings), one is money based, the the final one is experimenting with others ways of treatment.

But remember that initial reason on why we go off medication: we go off medication because we no longer need it. Unless you are a doctor, it is very unlikely that you will be able to determine when you no longer need it, since the medicine working is what makes you have a normal, functional life in the first place.

So how do you know when you don’t need the medication? Here’s a tip: you can’t know by yourself. You’re not a doctor, you’re not a pharmacist, you’re not God. It takes outside evidence. It takes some level of expertise that most of us do not have. It’s why God gives us doctors and nurses and medication in the first place.

If you think you want to try going off your medication, I would suggest the following steps:

1. Wait a month.
2. Talk to your doctor about the possibility of going off medication.
3. Wait another month.
4. Talk to your spouse about it, and anyone else whom you trust that may have some wisdom on the subject.
5. Wait another month.
6. Talk to your doctor about it AGAIN.
7. Then come up with a reasonable timetable and a way of evaluating what changes happen as a result of going off the medication.

One thing is for sure. Don’t willy nilly try to do this. Don’t just decide you are going to “see how you feel” by stopping to take it for a while. That is just not wise.

If you are desperate, send me an email and we’ll talk about it directly. I’m happy to pool my wisdom/foolishness with yours.

Be at peace,
-DMR

16 thoughts on “Why do you go on medication, and why/when do you go off of it?”

  1. DMR-
    THIS is an EXCELLENT and well-thought out post. I am thankful to you.

    grateful to be, always, in HIS grip,
    HveHope

    PS: Your's is one of the most friendly 'blogs' of any I have visited. When we are depressed &/or in pain, the smallest thing can be insurmountable. For a non-techie like me, you have made receiving and replying to your 'blog' a breeze.

  2. DMR-
    THIS is an EXCELLENT and well-thought out post. I am thankful to you.

    grateful to be, always, in HIS grip,
    HveHope

    PS: Your's is one of the most friendly 'blogs' of any I have visited. When we are depressed &/or in pain, the smallest thing can be insurmountable. For a non-techie like me, you have made receiving and replying to your 'blog' a breeze.

  3. This is wise counsel. If you are feeling well (not necessarily euphoric) and are functioning, then the meds are probably, to some extent, the reason. Perhaps you don't need them any longer. But the strongly cautious approach of this blogger is correct. If they're working, then you are taking a risk by going off of them. Why experiment with your mental health? It's hard enough for many people to find meds that work consistently.

  4. This is wise counsel. If you are feeling well (not necessarily euphoric) and are functioning, then the meds are probably, to some extent, the reason. Perhaps you don't need them any longer. But the strongly cautious approach of this blogger is correct. If they're working, then you are taking a risk by going off of them. Why experiment with your mental health? It's hard enough for many people to find meds that work consistently.

  5. MDR I have attempted to go off my meds many times almost always with disasterous effects! I feel well, ask some dumb doctor (not a psychiatrist) what they think about going off and they say "do it"… then there is a quick downward spiral which effects not only me but my family. By the time I realize that I should NOT of gone off the meds, its too late. Call the doctor, get more meds and then wait weeks to "normalize" – I hate it! (almost as much as I hate being on the meds) I am afraid that I am one of the unlucky ones that is stuck on them… forever 🙁

  6. MDR I have attempted to go off my meds many times almost always with disasterous effects! I feel well, ask some dumb doctor (not a psychiatrist) what they think about going off and they say "do it"… then there is a quick downward spiral which effects not only me but my family. By the time I realize that I should NOT of gone off the meds, its too late. Call the doctor, get more meds and then wait weeks to "normalize" – I hate it! (almost as much as I hate being on the meds) I am afraid that I am one of the unlucky ones that is stuck on them… forever 🙁

    1. Not unlucky! Remember that the diabetic has to do the same in most cases. Just think of it as a daily reminder that God moves outside of Himself into His creation to accomplish salvation. It's how I think of my medicine!

  7. I appreciated BMC's comment. It just occurred to me, after reading it, that some people need glasses all their lives, some need wheelchairs, some need walking sticks (canes), others need hearing aids. None of these (at least to my mind) have the stigma that medications do. I, too, am one of those that may need (perhaps revolving) lifelong medications. My attitude has been one of resentment ('to have to take them'), than gratitude ('that there are meds that can help me function'). You have sparked my gratitude. Thank you.
    in HIS grip, HveHope

  8. I appreciated BMC's comment. It just occurred to me, after reading it, that some people need glasses all their lives, some need wheelchairs, some need walking sticks (canes), others need hearing aids. None of these (at least to my mind) have the stigma that medications do. I, too, am one of those that may need (perhaps revolving) lifelong medications. My attitude has been one of resentment ('to have to take them'), than gratitude ('that there are meds that can help me function'). You have sparked my gratitude. Thank you.
    in HIS grip, HveHope

  9. HveHope – I completely understand! I hate the stigma of it all – I often "don't tell the truth" about the meds that I am taking when I have to take them publically. Friends think that I either have a head ache, or that I am very good about taking a vitamin. My kids too (7, 5, 2) have NO idea – but I am sure they recognize the change when I am off them. HveHope, I realize that I have been on anti-depressents for almost 20 years (and I am in my mid-30's) – I share your gratitude for them… but only celebrate how they have helped me in the closet

  10. HveHope – I completely understand! I hate the stigma of it all – I often "don't tell the truth" about the meds that I am taking when I have to take them publically. Friends think that I either have a head ache, or that I am very good about taking a vitamin. My kids too (7, 5, 2) have NO idea – but I am sure they recognize the change when I am off them. HveHope, I realize that I have been on anti-depressents for almost 20 years (and I am in my mid-30's) – I share your gratitude for them… but only celebrate how they have helped me in the closet

  11. I'm still trying to figure out how "don't like the side effects" is an emotional response about what I may or may not like. I mean, if the side effects are minor enough that taking the meds easily outweighs the side effects, okay. But sometimes the detrimental side effects are greater than the benefits gained. Ditching the meds in that case doesn't seem an emotional response.

  12. I'm still trying to figure out how "don't like the side effects" is an emotional response about what I may or may not like. I mean, if the side effects are minor enough that taking the meds easily outweighs the side effects, okay. But sometimes the detrimental side effects are greater than the benefits gained. Ditching the meds in that case doesn't seem an emotional response.

  13. One that I would add for the ladies out there… most SSRI's are categorized as a Pregnancy Class C drug (though lately Prozac has been upgraded to Class B). Not to sound like a pharmacy drug label, but if you are planning on getting pregnant, are pregnant, or are breastfeeding, make sure to talk to your doctor!

  14. I see your point. However, there are lots of side effects that I don't like. But somehow I have to get past liking or disliking things and move toward a more stable way of evaluating the benefit/risk of various medications. Certainly there are times to go off medication. That's not the point. The point, rather, is that going off medication should not be a willy nilly, day by day, emotionally laden process. It should be done carefully, and in consultation with your doctor.

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