When You Stop Your Meds During a Pandemic
I was proudly moving towards an antidepressant-free life…and then a pandemic happened.
There was a time in my life when I was on the maximum dosage of two antidepressant drugs, sertraline (also known as Zoloft) and bupropion (Wellbutrin). While I understand psychiatric drugs are a hit and miss for many people, they were a godsend for my OCD.
Still, I didn’t want to depend on drugs for the rest of my life. Daily medications add up financially, and taking Wellbutrin made it impossible to drink at parties.
So when my OCD symptoms eased, I asked my psychiatrist to start lowering my dosages.
It all went well until the pandemic hit.
Coping with returning symptoms
Before I get deeper into writing, I want to make it clear that this personal essay is not medical advice. Never stop taking medication without doctor supervision. And definitely have a conversation with your doctor if you’re struggling to taper off your meds.
Back to my story!
I had read stories of people quitting their antidepressants because they think they’re cured, only to have their symptoms return. Perhaps snobbishly, I didn’t think this would happen to me. I had been on my meds for almost three years. Quite frankly, I had forgotten how bad my mental health was before I started them.
I had forgotten about the broken-tape intrusive thoughts on repeat, the tidal wave feeling of doom that I had committed some grave, unforgivable act because the worst will surely happen. I had forgotten about the yearnings for unconsciousness—anything to escape the mental distress.
In a way, I had been practicing with prescription training wheels. Now I had to take off my training wheels and ride into a pandemic battlefield.
Then, I noticed oddly familiar behaviours. I began taking long afternoon naps to “shut off my brain” — a common coping mechanism I had used before being treated. I also began ruminating about past things I had done in an unhealthy, repetitive manner.
At first, I was disappointed in myself. I thought I was healed, but like many mental health conditions, OCD can’t be 100% cured. Some semblance of it will likely follow me for the rest of my life.
So, I reminded myself that re-experiencing symptoms is normal. And despite the return of intrusive thoughts and odd compulsions, I was now better at fighting them than I had been three years ago. Three years ago, I had not attended OCD-specific therapy and I was not as skilled as I am now with anti-OCD strategies.
Taking off training wheels for the battlefield
While I was on medication, I had done an OCD treatment program where I practiced not giving in to compulsions. Medication helped me during psychotherapy because it “took the edge off” the intense anxiety many OCD sufferers feel when they resist their compulsions.
In a way, I had been practicing with prescription training wheels. Now I had to take off my training wheels and ride into a pandemic battlefield.
I also made an effort to review anti-OCD resources, strategies, and techniques, a lot of which I had stopped studying. Refreshing my knowledge gave me a better sense of control over my situation. For example, I was glad to be reminded that OCD can latch on to almost anything, and that people with OCD impose impossibly high standards of responsibility on themselves. This explained some of the intense feelings of guilt and distress I experienced over circumstances I had previously not felt as intense about.
If you have OCD too, you may want to take a look at OCD UK’s pandemic-specific resources as well as visit OCD Action and OCD L.A. These are all fantastic organizations with great resources.
Re-contextualizing mental health in a pandemic
Face it: we’re living in extraordinary times. This means our relationship with mental health may be very different than what it was pre-pandemic.
As a person with OCD, it’s difficult to not engage in germ-related compulsions during a pandemic. Why shouldn’t I scrub my hands religiously and scrutinize my every behaviour in public when that’s what health authorities are telling me to do?
But even in a pandemic climate, there is a line between healthy caution and unhealthy obsession and compulsion. A common recommendation I’ve read from many OCD experts is to adhere to government guidelines, but don’t go above and beyond. For example, scrub your hands for the duration of “Happy Birthday” but not for longer than that.
If imperfection is okay for healthy people, imperfection is definitely okay for people with imperfect mental health!
Now, I only have personal experience with OCD so I hesitate to give too much advice for other mental health conditions. Instead, I encourage you check out this page of expert and professional resources curated by the Anxiety and Depression Association of America. (It’s a pretty big and overwhelming list, so I suggest jumping to the “Helpful Articles, Community Partner Posts and Resources” section for some easy, entry-level light reading.)
The National Education Alliance for Borderline Personality Disorder also has a Covid-specific information packet to help you use principles of Dialectical Behaviour Therapy. I don’t have any experience with BPD, but I found the radical acceptance tutorial in this packet quite helpful when it comes to accepting uncertainty in my own OCD-ridden life. So I think DBT can be useful for other mental health conditions too.
For folks recovering from substance use, the American Psychological Association recommends recovery organizations that have implemented virtual options and/or using an evidence-based app like Connections. I’d also recommend getting familiar with harm reduction tips. I myself use the Grounded app to keep my cannabis usage in check.
Failure is OK
I have days when I successfully fight against my symptoms. I also have days when I give in to my compulsions or ask someone for reassurance. (Asking for reassurance is a big no-no for OCD recovery because for many, it’s a compulsion.)
But I try not to dwell too much on it. After all, we are all living in extraordinary circumstances. Just surviving is an accomplishment unto itself. I’ve seen plenty of articles, written for neurotypical people, that argue it’s okay not to be productive during the pandemic.
If imperfection is okay for healthy people, imperfection is definitely okay for people with imperfect mental health!
Remember: call your doctor if you need to
So far, my medication tapering has largely been okay. But I haven’t completely written off calling my doctor if I need them. I’m also open to revisiting meds if, after the pandemic, I’m still suffering.
If you’re struggling, it’s okay to call your doctor about restarting your meds if you think you need to. Just make sure to call their office before visiting in-person, in case they have protocols in place to minimize Covid-19 transmission.
In addition to getting help from your physician, you may also consider signing up for temporary psychotherapy to get over the pandemic “hump.” Many places are now offering tele-counselling.
If therapy is too expensive or inaccessible to you, join an online forum like r/OCD on Reddit. Forums do not substitute therapy, but they can offer camaraderie if you just want the company of people who understand your emotions. Coming across a meme you can say “true dat” to does bring a moment of relief!
If you don’t want to restart your meds because of financial constraints, it’s okay to ask for help. Be honest with your healthcare provider, and talk to your friends and family. There are likely resources in your area to help struggling folks at this time since so many people have lost their incomes. You are not alone.
All in all, going off meds during a pandemic has been…interesting. If you’re in a similar boat, remember that stopping mental health meds is challenging in the best of times. Congratulate yourself on your bravery and give yourself some credit for rising up to this challenge.
If you’re interested in more content about OCD, medications, and Covid-19, please feel free to check out my previous work in Invisible Illness here.
