Tuesday, June 17, 2014

Harm Reduction Guide to Coming Off Psychiatric Drugs

I thought I would talk about coming off Psych meds. (I’m back on mine now! But man that was not fun and I wish I had this information before.) I found a really handy guide. This guide is mostly written from a voluntary point of view, for people that want to come off drugs or want alternative options, but the information is helpful to know if you don’t really have much of a choice either so that you can prepare yourself. Sometimes psychiatric drugs are necessary and it will be a lifelong process. Sometimes they’re a temporary measure. Either way is perfectly fine. All that means is there is an imbalance of chemicals or a misfiring synapses happening. It happens. I’ll probably be on my antidepressants for the rest of my life. They make me feel happier and healthier than I’ve ever felt in my life. If that means taking a tiny pill or two a day, I’ll do that gladly. However for other people this might not be the case or wanted, but they don’t know it. The information I’ll be sharing here is very interesting. However there’s simply a ton of information here so I’ll do this in a long series. If you’d like to read it at your own speed you can find it here: The Icarus Project. I won’t post all of it but I will post a lot of it. So here we go: 

Harm Reduction Guide to Coming Off Psychiatric Drugs
Written by Will Hall
Published by The Icarus Project and Freedom Center

Author’s Note

This is a guide I wish I had when I was taking psychiatric drugs. Prozac helped me for a while, then made me manic and suicidal. I was sick for days after coming off Zoloft, with counselors telling me I was faking it. Nurses who drew blood samples for my lithium levels never explained it was to check for drug toxicity, and I was told the Navane and other anti-psychotics I took to calm my wild mental states were necessary because of faulty brain chemistry.

I used many different psychiatric drugs over several years, but the medical professionals who prescribed them never made me feel empowered or informed. They didn’t explain how the drugs work, honestly discuss the risks involved, offer alternatives, or help me withdraw when I wanted to stop taking them. Information I needed was missing, incomplete, or inaccurate. When I finally began to learn ways to get better without medication, it wasn’t because of the mental health system, it was despite it.

Part of me didn’t really want to be on psychiatric drugs, but another part of me desperately needed help. My suffering was very serious – multiple suicide attempts, hearing persecutory voices, extreme mistrust, mizarre experiences, hiding alone in my apartment, unable to take care of myself, Therapy hadn’t worked, and no one offered me other options. I was under pressure to see my problems as “biologically based” and “needing” medication, instead of looking at medication as one option among many. For a time medication seemed like my only way out. It took years tolearn that the answers, and my hope for getting better, were really within myself.

When I finally left the hospitals, residential facilities, and homeless shelters I lived in for nearly a year, I began to do my own investigating. I started judging my options more carefully, based not on misinformed authorities telling me what to do, but on my own research and learning. That process led me to co-found Freedom Center, a support community in Western Massachusetts that brings together people asking similar questions.

Through the Freedom Center I discovered that I was denied a basic medical right: informed consent, having accurate information about my diagnosis and medication. I learned that mistreatment like I went through is often business as usual in the mental health profession. I came across research ignored by  {professionals}, which confirmed my experience: most professionals are uninformed about coming off drugs, and even frequently stand in patients’ way, sometimes ending up harming them.

This guide brings together the best information we’ve come across and the most important lessons we’ve learned at the Freedom Center and the Icarus Project. It’s not perfect, and I invite you to contribute your experiences and research for future editions, but it’s a guide that I hope can be helpful.

Introduction: We live a world that, when it comes to drugs, is quite crazy.

One the one hand there is the War on Drugs, which keeps some drugs illegal, overflows our prisons, and hasn’t ended drug use. Then there are the acceptable drugs like alcohol and tobacco, advertised everywhere with promises of happiness and success while causing widespread addiction, disease, and death. Legal prescription drugs such as stimulants, pain killers, and anti-anxiety pills are just as addictive and risky as street highs, with a doctor’s seal of approval. And then there are neuroleptics, lithium, and anti convulsant drugs, which have very risky adverse effects but help manage and dampen consciousness when people feel out of control, so we call them “anti-psychotics” and “mood-stabilizers”.

With drugs in the picture, lives are often at stake, whether from addiction, adverse drug effects, or the risks that go along with emotional crisis and madness. Combined with the confusing messages from society about drugs, the result is a lot of fear. Drugs become angels or demons. We need to stay on them at all costs, or get off them at all costs. We look only at the risks, or we’re too frightened to look at the risks at all. There is no compromise: it’s black and white, all or nothing.

That, right there, should be a red flag. As Borderlines, we know this kind of thinking is dysfunctional.

It’s easy to fall into absolutist thinking when it comes to psychiatric drugs. Pro-drug advocates focus on the hrisks of psychosis and extreme emotional states, while anti-drug advocates focus on the risks of taking drugs. But it is the belief of this guide, and the philosophy of our pro-treatment choice work at the Freedome Center and the Icarus Project, that either-or thinking around drugs is a big part of the problem.

Harm Reduction For Mental Health

Absolutist approaches to drug and sex education teach abstinence, “just say no,” and one way for everyone. They work for some people, but not most, and if you don’t follow the model you can end up being judged, not helped.

“Harm reduction” is different: pragmatic, not dogmatic. Harm reduction is an international movement in community health education that recognizes there is no single solution for each person, no universal standard of “success” or “failure.” Getting rid of the problem is not necessarily the only way. Instead, harm reduction accepts where people are at and educates them to make informed choices and calculated trade-offs that reduce risk and increase wellness. People need information, options, resources and support so they can move towards healthier living – at their own pace and on their own terms.

Applying harm reduction philosophy to mental health is a new but growing approach. It means not always trying to eliminate “symptoms” or discontinue all medications. It recognizes that people are already taking psychiatric drugs, already trying to come off them, and already living with symptoms -- and that in this complicated reality people need true help, not judgment. It encourages balancing the different risks involved: the harm from extreme states, as well as the harm from treatments such as adverse drug effects, disempowering labels, and traumatic hospitalization.

Making harm reduction decisions means looking honestly at all sides of the equation: how drugs might help a life that feels out of control, how risky those same drugs might be, and the role of options and alternatives. Any decisions become a process of experimentation and learning, including learning from your own mistakes and changing your goals along the way. Harm reduction accepts all this, believing that the essence of any healthy life is the capacity to be empowered.

Everyone’s Experience Is Difference

There is no formula for coming off psychiatric drugs. What there is, and what this guide presents, is some common experience, basic research and important information that can potentially make the process less difficult. Many people successfully com off psychiatric drugs, with or without guidance, while others find it very hard. Many continue on psychiatric drugs because the benefits are greater than the drawbacks. But many people end up staying on psychiatric drugs without ever exploring options, just because they don’t know any other way.

When we’ve relied only on doctors, television, and mainstream sources, it might seem impossible to imagine dealing with our emotional extremes without psychiatric drugs. Maybe we’ve never heard of anyone going through what we go through without medications. Maybe a prescription was the beginning of people taking our need for help seriously, and medications feel like the only way to recognize that our problems are severe and out of {our} control. And when everyone around us has come to view medication as essential to our survival, considering a new path can feel too risky to even try.

Many of us get help from psychiatric drugs, but might not understand how they really work or what the other options are. Some of us never found medications useful, or medications even made our problems worse, and we are ready to try living without them. Sometimes people are torn between the risks of staying on and the risks of going off, or we take multiple drugs and suspect we don’t need all of them. Others may want to off but it’s not the right time, or may have tried in the past, experienced a return of frightening symptoms, and decided to go back on for now.

            All of this will be discussed in upcoming posts!

Our paths to healing are unique. Some of us don’t need to make any life changes, letting time and patience make changes for us. Others may need to make big shifts in nutrition, work, family life, or relationships; we may need to focus more on self-care, expression, art, and creativity; adopt other approaches like peer support, therapy, herbalism, acupuncture, or homeopathy; or find new life interests like going to school or connecting with nature. We may discover that the first step is getting restful sleep; we may need structure to help get us motivated; or to stop taking any recreational drugs or alcohol. Our priorities might be to find a home or a new job; we may need to establish stronger support networks of trusted friends; or it may be important to speak up with greater honesty and vulnerability about what we are going through.

Okay, well I don’t know that I support herbalism, acupuncture, and homeopathy, but if you believe in it and it works for you, more power to you. Everything else is sounds advice and things I’ve touched on before. Taking control of our lives, living clean, kicking out negative influences that spiral us down, and eliminating harmful substances; all very good advice.

The process might feel mysterious and arbitrary, and an attitude of acceptance and patience is vital. Learning means trial and error.

Don’t be afraid to make mistakes. As long as you learn from something, it’s not a mistake.  The only way to learn if something works for you is to try it. If it doesn’t work, you can always stop and go back to something you’re familiar with.  Life is not an absolute. You get to continue trying things until you figure out what works best for you.

Because each of us is unique, it is as if we are navigating through a labyrinth, getting lost and finding out way again, making our own map as we go. 

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