In my last post, I asked what it means for your “illness identity” when you take a medication that manages your psychiatric problems so that they go away or are no longer problematic. “Does a formerly “severe” mental illness become “mild” or “moderate”?” I asked “Does it disappear entirely?”

It’s often said that these disorders can’t be cured – they can just be managed. Medications are one way of managing them. But the fact is, few people like taking psychiatric drugs. They have unpleasant side effects, they get us deemed “weak” or make us feel like we’re leaning on a crutch, they even change our identity and sense of self.

Therefore, we need a reason to keep taking what we’ve been prescribed. A diagnosis and, more specifically, the presence of troubling symptoms, serve as the justification. The irony, though, is that once these troubling symptoms go away, it’s hard to see why the drugs are still warranted.

This is the core conflict, I think, at the heart of medication non-adherence – the reason that people are so frequently tempted to reduce the dosage of their medications or go off them altogether.

In some cases, we just want to see if we can tough it out on our own, without pharmaceutical help. But, I think, many of us also just want to see how we’d fare without medication because we’re curious about whether our original problems are still there – whether they’ve disappeared, or are just lying latent, temporarily suppressed by meds.

We want a reminder that our meds, which create so many complications, existential and practical, are worth it. The weird irony is that having a diagnosis helps justify the need for the meds, but that the meds, if they help suppress symptoms, eliminate the main justification for their use.

Some people may find it almost validating to go off their medication and experience a return of symptoms. But in my personal experience, and my experience interviewing my peers with extensive histories of medication use, the pain of the relapse outweighs the reassurance that the meds are necessary after all.

I’ve tapered off my medication for depression and anxiety numerous times now – both under a doctor’s supervision and on my own – in the 11 years since I began pharmaceutical treatment.

The latest experiment came a month ago, when my neuorologist and psychiatrist agreed I should decrease my dose of Wellbutrin, an antidepressant, and go off Prozac altogether, in part to avoid interactions with other drugs the neurologist was prescribing for my migraines and in part because we all agreed it would be nice if I could whittle down the alarming tally of prescription medications I take.

In addition to these reasons, though, I had my own private motivation. I wanted to test whether I needed the meds in the first place. It had been a very long time since I’d felt anxious for any extended period of time, and that was, after all, why I was taking the Prozac. Going off it then, seemed plausible.

It’s been a month now, and I can feel my anxiety creeping back. I feel a little bit validated, yes, that I still have “problems” – that I’m not just one more needlessly medicated young patient. But mostly, I just feel anxious, overwhelmed, shaky and self-critical, those same old symptoms I’ve felt in the past. If they persist despite vigilant self-care – careful attention to my diet, exercising, practicing mindfulness, etc. – I’ll probably have to rejigger my medications yet again.

Photo credit quinn.anya

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