Medication until I can get my life on track. Good idea?
May 31, 2014 12:06 PM   Subscribe

Is it possible for me to go on anti-depressants and then go off them?

I've been struggling a lot with many aspects of my life. Love, friendships and career. I'm 28. Past incidents of hurt and emotional abuse (from childhood up until high school) have hindered and seriously flawed my thinking and self-confidence. I think very negatively about a lot of things. Expecting negative outcomes and etc..

I've been having a lot of trouble so I started seeing a local therapist a few months ago. I had no trouble talking about what I wanted to talk about and I feel very open when I go to a session. We've unraveled that I had a traumatizing childhood. And it's programmed my brain in a way that makes it very hard for to me to develop socially and professionally. We've tried CBT therapy but it hasn't worked much for me. I have been improving somewhat though. And I feel the therapy helps out a lot. But I've been suffering from bouts of very low moods lately. Especially when I experience a set back. A mood that makes it incredibly hard for me to socialize and put myself out there again. I'm not clinically depressed (I have no family history of it, and I'm in no harm to myself - I rarely ever think about suicide as a solution). And I rarely suffer from panic/anxiety attacks though I have had them in the past. But my therapist suggested that maybe I should go on very low dosage of anti-depressants so that it could help me push myself even further to make things better for myself. And to not be held back by constant low moods and depression.

So I guess I'm wondering if that seems like a feasible solution. I know people who take anti-depressants but they're clinically depressed and have been on them for most their lives. Do people take anti-depressants for a little bit and then stop? People who need to overcome their anxieties or depression but aren't clinically depressed.
I feel like it's something that I should think about. I want to make an appointment with my family doctor when/if I decide to take any medication.

Any advice/experiences would be appreciated. Thanks!
posted by morning_television to Human Relations (20 answers total) 5 users marked this as a favorite
Yes, people absolutely do this, and often with very good results. There's certainly no harm in talking to a doctor about your options before making a decision about how you want to proceed.
posted by decathecting at 12:09 PM on May 31, 2014 [2 favorites]

Yes, a lot of people use them to get stablised (so they can recognise what it feels like to be stable and not have distorted moods) and then go off them by maintaining that stability through exercise, healthy living and mindfulness (three things everyone should be doing anyway). It is true that it is helpful to "fake it till you make it" and medication adjusting your brain chemistry back to where it should be is absolutely a helpful and healthy way to "fake it".
posted by saucysault at 12:13 PM on May 31, 2014

Yup, sounds like a plan.

The only thing to be careful of is, some antidepressants have severe withdrawal symptoms. Never stop cold turkey. When you decide you want to stop, you should remain under medical care as the doctor helps you safely titrate down.

When you see your doctor, mention that you foresee yourself coming off medication after a short time and ask if you can perhaps be prescribed a drug with less intense withdrawal symptoms. Be aware too that antidepressants are not a magic bullet, and one might work but others might not. You might have to stick with it longer, or try more options than you are foreseeing right now. Good luck!
posted by lesli212 at 12:20 PM on May 31, 2014 [3 favorites]

Yes, you can do this, and it's better to start sooner rather than later because the longer you are depressed the more damage the depression will do to your brain and the more likely you will end up with depression as your default brain state. A lot of us who are antidepressant lifers might not have needed to take them forever if we'd only started taking them sooner...
posted by Jacqueline at 12:22 PM on May 31, 2014 [2 favorites]

I've done this. I've a similar background to yours, and struggled on with (what was in hindsight) pretty crappy mental health for many years until I hit a particularly difficult time and spun off into a particularly low spot.

After resisting initially I took up a pretty low dose antidepressant to help lift me up while I worked through the crap, all in all they worked pretty well in helping take the edge off things and concentrate on some of the bigger picture things going on with me, kept me social, active, and allowed me to study, work, go to therapy and do all the positive stuff that bolstered my self esteem.

The only downside was that they upped my bloodpressure initially and seemed to give me a bit of a nervous tremor which was slightly unnerving and killed my sexual appetites and abilities stone dead while I was on them but other than that things were fine, and with a few things resolved I came off them entirely about 8 months later with no ill effects other than a few headaches and a bit of brainfog.

As a previously paid up member of the stiff upper lip brigade I'd recommend trying them at least and seeing what you think, though the side effects were a bit odd the good overcame the bad by a large margin.
posted by Middlemarch at 12:27 PM on May 31, 2014 [1 favorite]

Yep. I know plenty of people who took them for a while and then stopped when they felt ready; I wouldn't be surprised if that's much more common than to stay on them forever. Depression isn't always chronic or cripplingly severe; in fact, it's sadly common for people to avoid seeking treatment because they don't feel "bad enough" - e.g. they still go to work with no problem, experience good moods occasionally, etc.

I've been on and off antidepressants periodically for nearly a decade, as my moods/insurance/budget have warranted. My latest "on" streak has been going on for several years, and I've repeatedly thought about going off them since I feel like I could take care of myself fine without them, but I also really like not being depressed and don't want to mess with a good thing.

I'd recommend trying medication for at least six months, since it can take a while for the effects to kick in and for any side effects to wear off, plus it helps to get your healthy thought processes and other good habits (regular sleep, exercise, etc.) well-established so you can continue them with no trouble as you wean off.
posted by Metroid Baby at 12:36 PM on May 31, 2014 [1 favorite]

Yes, I have done this a few times. I sort of view it like a cast when things are really bad, go on for 6-12 months while I am working on the bigger issue in therapy or just going through a really bad time, while the drugs themselves just help cope with the depression or anxiety so I can continue to function reasonably well in the rest of my life. For me personally this is the best way, as while I find the typical SSRI helps with anxiety and depression it also seems to narrow my emotional range in general, so once I feel like I got a handle on things I like to taper down and get off.
posted by ill3 at 12:55 PM on May 31, 2014 [1 favorite]

Yes, people do this. You also will hopefully be in touch with whoever prescribes the antidepressants (your therapist is doing that?) to make sure that things are going well as you're adjusting to them and as you get to the correct dose and then in periodic check-ins along the way -- you won't just be cast adrift with some pills (or so I hope, and that's been my experience).

I'm not clinically depressed (I have no family history of it, and I'm in no harm to myself - I rarely ever think about suicide as a solution). And I rarely suffer from panic/anxiety attacks though I have had them in the past.

I'm not saying that you *are* clinically depressed, because I have no idea, but suicidal thoughts aren't a symptom of clinical depression for everyone, not everyone who develops clinical depression has a family history (or known family history) of it, and depression isn't always co-morbid with anxiety. It raises a red flag for me that these are the things that you mention to as evidence that you're not depressed. Again, not saying you are -- I don't know you and I'm not a doctor -- it just perks my ears up that these particular symptoms that you mention not having, happen to be symptoms that you wouldn't necessary have even if you were clinically depressed.

Since you're having some questions about diagnosis and medication, maybe it would be a good idea to make an appointment with a psychiatrist? For a lot of people, that's who is in charge of prescribing and monitoring medication anyway, and then they see a separate therapist for talk therapy/CBT/etc -- in that situation, the psychiatrist is just to make sure that you're getting the right medication, everything is going OK with it, etc. I think that even just talking about this with a psychiatrist and having a psychiatrist monitoring your medication might clear some things up for you. I also think it might be a good idea to have someone who can answer those questions and be really clear with you about the medication/medical side of this, because some people have bad reactions to antidepressants (or particular antidepressants), and in case you happen to be one of those people, it might be good to have someone who is very up on the medication side of things in particular monitoring you.

You also don't need any diagnosis to get anti-depressants, being prescribed them isn't a de facto diagnosis of depression anyway. They're used for a lot of reasons and in combination with a lot of things, depending on the person/context. I mean, people take Wellbutrin to stop smoking, for goodness sake. I just say that in case you want to avoid them because you don't want to give yourself a de facto diagnosis by trying them.

This is just my two cents based on my and my loved ones' experiences, though, so of course YMMV.
posted by rue72 at 12:56 PM on May 31, 2014 [2 favorites]

Absolutely this is a thing. After having some fairly serious depressive episodes off and on since childhood, I went on antidepressants in my late 20s to stabilize myself through the end of my marriage. I stayed on them for several years as I gradually built a new life, gained more insight, and developed healthier coping skills through therapy. Eventually I slowly tapered off them; that was about seven years ago, and though I have certainly had some ups and downs since then, I feel far better equipped emotionally and personally that I was before I went on antidepressants.

I think you're on the right track -- all the best to you.
posted by scody at 12:58 PM on May 31, 2014

IANAD, but I want to nth that this is something people definitely do, although at least some people do experience "discontinuation syndromes" when coming off the drug, so that's just something to be aware of.

With that being said, you might be interested in this New York Times article. It looks at our evolving understanding of the underlying mechanism of depression, starting with the early theory that depression is related to a "chemical imbalance" in the brain which SSRIs (the most commonly prescribed antidepressant) fix, although the psychiatric community is now moving away from that idea.

More relevant to your situation is the last couple of pages which discuss a growing body of evidence pointing to a different mechanism of action. It has already been demonstrated (the classic Aplysia/sea slug sensitization experiments come to mind) that serotonin aids in the development of new neuronal connections which lead to the formation of long term memory. As this article discusses, there is newer research which shows that SSRIs may work by stimulating nerve growth in specific parts of the brain, and that this might be their primary mechanism for relieving depression.

Anyway, this is all pretty theoretical, and I'm by no means an expert or up to date on the latest research, but I just wanted to mention this because if this turns out to be true, then that would really support the idea of taking an antidepressant to do just what you're interested in: short term therapy to aid you as you develop new thought patterns and coping strategy.

I definitely think this is worth looking into further for your situation, although I would recommend working with a psychiatrist, not just your GP. You can certainly meet with your family doctor first to discuss this, but if this is something you decide to move forward with, a psychiatrist would most likely be a better choice. Your GP or therapist can probably give you a referral, although if you don't feel comfortable with the first person you work with, you should definitely shop around. Good luck!
posted by litera scripta manet at 1:44 PM on May 31, 2014 [2 favorites]

Yes, I have done this, and it's possible I will again in the future. For me, "a little bit" was about five years, and then I took six months to taper off them. I would recommend not being attached to a specific length of time, except for giving them at least six months to work like Metroid Baby suggests. I'd also recommend having them prescribed by a psychiatrist. (Or similar mental health meds specialist person -- my therapist's office at the time had a psychiatric nurse practitioner, so that's who I saw. They knew the pros and cons and differences of all the possible drugs, which you can't necessarily expect from a family doctor. Later on when I tapered off, I just had my primary doctor adjust my dose, but if I were to decide to go back on meds, I would call a psychiatrist.)
posted by clavicle at 2:33 PM on May 31, 2014

Definitely. I was on an anti-anxiety pills for a month while I started & built up on zoloft, took just the zoloft for another year or so, then tapered off zoloft over a month's time with minimal repercussions due to withdrawal. It was the medicine I needed to get my life back on track.
posted by samthemander at 3:19 PM on May 31, 2014

My only warning would be to prepare for withdrawal symptoms when you do quit. Be sure to taper off with the help of a professional who has access to all the varying doses you will need. I've been on anti-depressants for probably 20 years and when I tried to stop them years ago I never did get over my withdrawal syndroms. I haven't tried recently, so it may be the protocol has improved, and it may be that taking them for a short duration makes all the difference.
posted by bluespark25 at 4:17 PM on May 31, 2014

Yes, you can. However, I don't know if this is the best thing for you, because IANYD. It may be the case that psychiatric medication would help, but not anti-depressants as such.

Also, you are not your doctor, either. You may or may not have clinical depression - the reasons you listed for not having it do not encompass all of the diagnostic criteria for the different types of clinical depression that people can experience. Further, sometimes depression is a symptom rather than the entire root problem. And even further, anti-depressants are not always the best treatment for each person's depression.

Definitely check this out - medication might be able to help, and that would be great! But please try to find a qualified psychiatrist who will work with you and your other doctors, and who you feel you can trust.

Good luck!
posted by Verba Volant at 4:50 PM on May 31, 2014

It is also possible to try anti-depressants, discover they have awful side effects and stop them almost immediately. You are not stuck on them even in the short to medium term in this instance. Just involve professionals in the process.
posted by deadwax at 8:24 PM on May 31, 2014 [2 favorites]

Most definitely, I would say this is a good idea. Back in 2011, I went on a low dose of generic Zoloft for anxiety for about six months, and that short-term low dose was enough to cure me of a mild phobia/anxiety trigger up until the present day. Following a nasty car accident, I couldn't drive on the highway without white knuckles. After the Zoloft, I can drive like a "normal" person again.

There were some mild side effects during treatment, but also a lot of positive side effects I didn't plan or hope for--the biggest one being an ease to mild social awkwardness. I didn't think I struggled with social anxiety, but I will say this: no longer did I dread bumping into my boss' boss' boss in the checkout line at the grocery store. It was nice!
posted by magdalemon at 10:59 PM on May 31, 2014

I was scared of going on medication at first - I was afraid I would become dependent upon them, that I'd be another lifer on pills to function.

I was wrong. That fear was part of my depression, my own brain working against me. They can give you the perspective you need to figure out what's making you depressed, and hopefully change some of it, and take other steps to combat it that are impractical to do when depressed.

I have lowered my dose from the peak I ended up at, and while I still am on them, I do plan to come off them completely when I'm ready. There are side effects, but they do lessen over time, and it can take a few tries to find the right one, and the right dose that works for you. I found the medication also helped me take more away from therapy, and the two together has changed my life substantially for the better.

Certainly, withdrawal symptoms are very different between different drugs, so some will take more care to lower the dosage until off completely while others can be stopped relatively easily, so it is definitely possible, even common, to do so. As the others have said, just do so under competent medical supervision, and it should work out.
posted by ArkhanJG at 3:26 AM on June 1, 2014

Adding to the chorus of "Yes, this is a good idea."

Couple things to bear in mind:

- most antidepressants take about six weeks to start functioning effectively. In my experience, this is also when you will feel the worst of the side effects.

- Different antidepressants work for different people. You may need to experiment.

- Do not ever quit antidepressants cold turkey. Trust me on how awful it feels. If/when you feel like going off them, do so under the supervision of your doctor, and taper off slowly.

Kudos to you for taking your life in your hands and making it healthier.
posted by feckless fecal fear mongering at 7:37 AM on June 1, 2014

I think this is a bad idea (and I used to work for a pharmaceutical company). First of all, antidepressant drugs don't work very well -- they are essentially glorified placebos. This is a "dirty little secret" that's been known for quite some time. See, for example, this excellent article from Mother Jones magazine. For a more-recent (and longer) analysis, see The Emperor's New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch.

What's worse, though, is that antidepressant drugs have bad side-effects. A notable one is that they make it less likely that you will make a full recovery from your depression. This disturbing phenomenon is called "tardive dysphoria", and you can read about it here. Other common side-effects include weight gain, insomnia, sexual dysfunction, etc.

I would stay away from antidepressants. There are much better, safer, more-effective ways of treating depression.
posted by alex1965 at 12:32 PM on June 1, 2014

Many years ago I took a mild anti-depressant for about 8 months. Then I decided that I didn't want to live my life medicated, so I stopped with the medication and got into therapy (I saw that you are in therapy). So yes, this is a thing that can be started and stopped (as others said, with your doc's supervision).

I definitely experienced some of the side effects that alex1965 mentioned in the post above, which were a factor in my decision to discontinue using them.

At the time my GP was someone I have since come to refer to as my prescription doctor. His answer to everything was to write a script, without actually addressing the larger causes of my problems. If I had known more then about how diet and nutrtion affects brain chemistry I would have addressed my issues from that angle first.

So, definitely get checked out by your doc, get bloodwork done and see if you have any deficiencies. Take a multi, maybe some extra vitamin D and a B complex, and for goodness sake, take it from me, if you drink alcohol at all, stop drinking for a while. I am generally a happy drunk, so it took not drinking for a while for me to realize that alcohol truly is a depressant - in the long term - even if I temporarily feel happy when I'm drinking. (Side note, I also figured out that too much sugar in my diet has a hugely negative impact on my moods).

Best of luck.
posted by vignettist at 5:00 AM on June 2, 2014

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