In the fall of 2014 the author decided to quit the prescription medications she has been taking to treat her anxiety, depression and insomnia, and began the process of gradually reducing her dosages. In Going Off, a series of Anxiety posts that began in February, she has chronicled the challenges she has faced from both the drugs and the withdrawal. This is the final installment.
- Tell everyone close to you that you’re tapering off your meds. Tell them that if they think you seem down, they should speak up; you won’t get defensive. Yes, you’ve been defensive in the past. You used to think depression meant you were weak, or at least, you interpreted expressions of concern as accusations of weakness. But it’s time to change. Let your skin become not thicker, but more porous, so love can seep in. Let your friends stop by unannounced to make sure you haven’t spent the last three days in your blue fleece bathrobe, the one you gave an ex-boyfriend for his birthday a decade ago. It’s weird that you have that bathrobe.
- You might need to taper more gradually than your doctor thinks. Reduce one medication at a time, just a sliver, every couple of weeks at the most. Be gentle. For example, if you’re planning to cut your benzo on a Friday night, but you’re still having withdrawal symptoms from your last cut, or you see the aftermath of yet another shooting on the news, take your usual dose. You can always cut on Monday. Or next Monday. Or the next. It will take you seven months to get off of three drugs. That’s fine. That’s good. You got this. Mid-taper, you can always go back to your previous dose. Medicate if that’s what helps you make it through a day without hiding in the bathroom. The goal is to feel O.K., not to prove that you are O.K. without meds.
- There will be a period of hell for two to three days after each cut — dizziness, nausea, panic attacks, headaches, crying jags, strange symptoms like aching teeth. Some people experience extreme symptoms for months. For some people, the withdrawal proves impossible. You will be one of the lucky ones: Your teeth will stop aching. Your panic will subside. You won’t faint or vomit even once.
- Clean up your diet. Alcohol suppresses R.E.M. sleep. Trans fats and sugar cause mood swings — remember the time you sobbed on the subway when that guy’s backpack hit you in the face? That said, if you don’t have it in you to clean up your diet, if there are days when Cool Ranch Doritos are the best thing you’ve got going, then by all means enjoy. Buy the family-size bag. Pop it open, crack a beer, watch an entire season of “Dexter.” Forgive yourself for your hedonism. Forgive yourself for everything.
- Have someone you can call in the middle of the night. Here’s the upside of your best friend living in California: Your middle of the night is her evening. Her voice will feel like the first deep breath you’ve drawn in hours.
- If there’s no one to call, or even if there is, download hypnosis, meditation and relaxation apps. If the apps don’t work, do something else. Read your friend’s book that you were supposed to read eight months ago. Borrow your brother-in-law’s HBO GO password. Learn Spanish on your phone. They say insomniacs should avoid electronics at night. Forget that. What you want to avoid is panic. What you want to teach yourself is that you deserve better than lying alone in a dark room, imagining yourself buried.
- Take very good care of your free time. Don’t give your precious hours to that person you meet for coffee every three months who never asks you a single question — the one who holds forth about nothing but green energy. Tell her you’ve developed a coffee bean intolerance. You’re healing. She’ll live.
- Don’t undergo a breakup. But if you do undergo a breakup, know that you’ll be O.K. Don’t make lists in your head of things you could have done differently. No, you could not have altered your entire personality. No, you are not difficult just because you made requests like please don’t sometimes ignore me for two days. And if you are difficult, so what? Be difficult. You’re human; you’re not a compilation of the qualities that someone else declares attractive. If you find yourself composing self-blaming lists, write them down; that’s the only way to empty your head. The blank page can take the abuse. When it’s just you and your writing and the early morning, all is well — your coffee pot looks full, your vertebrae feel neatly stacked. This is how you return to yourself. Your boyfriend was not your antidepressant. Don’t vilify him, either. He’s just a person. He gave what he could.
- Everyone has an opinion about depression. Everyone has an opinion about psychiatric medication. If you tell people who don’t know you that you’re on medication, or that you’re trying to get off of medication, some might shout their opinions. At times, you’ll feel like you must have wronged them, if all this vitriol is landing on your head. But their reactions have little to do with you. You are all products of a society with arbitrary taboos, a society that has made mental health a fraught topic, that hasn’t learned how to talk about mental health without worrying about what others will think. Let them shout. They need to shout. Don’t be afraid. You have a right to voice your experience. Maybe it’s not just a right but an obligation — to fight this collective shame with your clearest, most honest words.
- The time will come when you wake each morning not woozy with dread, but excited that the sun is shining. It will be summer, your favorite season, and you will be 20 days med-free, eating only whole foods, stepping back into the world, a yoga mat strapped to your shoulder. Can you believe it? You’re going to be that person with the yoga mat strapped to her shoulder. You will greet yourself, the person you almost forgot, the person under the bandages. Before peeling back bandages, you have no way of knowing if the wounds are still open. You are so lucky: Your healing was done, as you suspected it was. You’re back, the person who is usually barefoot despite a hideous bunion, the person who can’t handle concerts or Saint Mark’s Place, the person who wishes she didn’t have under-eye circles, who wishes she spent less time thinking about her under-eye circles, the person who trembles visibly when she meets someone exciting, who can’t stop smiling at the subway dancers, even though you’re supposed to hate the subway dancers if you want to be deemed a real New Yorker. Say hello to that person. She was missing. She was depressed and then she was recovering from depression. She was pinned to her furniture. She was counting calories. She was horrified that her hair was falling out in her hands. She was drawing her curtains closed. Hello! Embrace your feelings of gratitude, for everything, for everyone, for the way people need other people, for the way they avoid eye contact and open their arms and lend books and coats and eat the baked ziti you make them for dinner. Yes, ordinarily, your gag reflex would activate at the mention of “gratitude,” but not anymore. Go outside. Feel sun on the soles of your feet. Buy broccoli from the outdoor produce stand. Why haven’t you ever done that before? Why did you think you had to go inside to buy broccoli? And then maybe you’ll be 40 days off meds, or 50, or it will be winter, and you’ll skip a week of yoga or you’ll cry for two hours or you’ll drink too many beers and that’s fine, you’re fine. That’s life. You’re letting go.
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