Getting Oriented
In Taper, Part 2 of TWP’s Companion Guide to Psychiatric Drug Withdrawal, we’ll be laying out the nuts and bolts of how laypeople in the psychiatric drug withdrawal community report planning, setting up and embarking upon the safest possible taper. We’ll be shifting out of the more exploratory, subjective, and open-ended nature of preparation work and into a more technical and skills-based state of mind. A significant amount of scientific and pharmacological information lies ahead. You’ll learn more about the taper rates, schedules, and methods that laypeople use, and the various skills, calculations and techniques that they find essential along the way.
So as you consider the possibility of transitioning into Part 2, it is a good time to take stock and make sure that you’re feeling ready to begin those steps.
Reconsidering Some Key Risks
If you’ve arrived here, then presumably you’ve worked through the entire Prepare guide, and you likely already have a very good sense of whether you want to reduce or come off psychiatric medications and, if so, how well prepared you are to start a taper. However, you might still find it helpful to consider a list of the circumstances that people in the lay withdrawal community have identified as being the most problematic or risky for beginning a taper. If you recognize that you are in any of these circumstances, then consider going back to review the particular Prepare step where that issue was explored, and see if there’s anything more that you can do to reduce those risks.
Based on many layperson reports, the riskiest circumstances in which to begin a psychiatric drug taper include:
- Existing central nervous system destabilization caused by interdose withdrawal, previous attempts to reduce or come off psychiatric drugs, switching from one psychiatric drug to another, or irregular use of a psychiatric drug that the body has grown physically dependent upon. (Read more...)
- Ongoing struggles with alcohol or “illicit” drugs (Read more...)
- Generally weak health due to a diet out of alignment with the body's needs, or the presence of a physical illness. (Read more...)
- Problematic and unresolved issues with drug metabolizing that are related to genetics. (Read more...)
- Ongoing sleep problems. (Read more...)
- Lack of support – or active resistance – from family members and friends regarding the decision to taper. (Read more...)
- Tense or problematic relationships to prescribers—especially those involving previous forced hospitalizations. (Read more...)
- Recent major life changes such as a divorce, loss, or move.
- Intense stressors at work or home that already feel unmanageable prior to starting a taper. (Read more...)
Taking Stock and Making Decisions
So how does a person ultimately decide if now is the right time to start a taper? This is a very important, intimate and personal decision that will be unique for every individual based on life circumstances. If you’ve worked through the entire Prepare guide and you’re feeling very, very strongly that now is or is not the right time for you to taper, then it seems that you already have the right answer for you. However, in the experiences of many of us at TWP and more broadly in the layperson withdrawal community, it’s rare that anyone feels 100% certain and confident either way.
When faced with the decision of whether to stay on or come off their psychiatric medications, many people find themselves feeling unsettled and undecided. If you are grappling with questions, unresolved issues, fears or concerns, this is a very meaningful place to be in—after all, choosing to come off powerful psychoactive drugs that have been a part of your body and your life for a significant period of time is a big deal! Be gentle with yourself, and allow yourself to feel whatever feelings might be there. Here are some actions that others take when sitting with their uncertainty:
They return to any red flags or unresolved questions that came up for them while they were preparing for their taper.
Uncertainties about tapering are usually in some way tied to our beliefs, life circumstances, relationships, stressors, health, etc. As a result, many people find it helpful to re-visit the kinds of issues that are covered in Prepare, in order to identify where the red flags are for them, and try again to work through those issues in search of some measure of improved resolution.
Uncertainties about tapering are usually in some way tied to our beliefs, life circumstances, relationships, stressors, health, etc. As a result, many people find it helpful to re-visit the kinds of issues that are covered in Prepare, in order to identify
Many people find it extremely helpful to bounce ideas, worries, and questions off others who’ve “been there". That’s one of the reasons we created the Inner Compass Exchange.
They try to develop ‘nitty gritty’ practical solutions for specific concerns.
Some people just have one big, nagging concern that is on their minds, and for which they really want to develop a practical solution that addresses their own unique circumstances. In ICI's Help Hub, we’ve been trying to gather some of those more detailed “troubleshoooting” tips for particular circumstances and situations.
They recognize that tapering doesn’t have to be a 100% either/or, off/on issue.
The emotions that sit at the heart of our relationship to psychiatric drugs and our feelings about coming off them are strong and compelling ones—sometimes, so much so that they can box us into what feels like a black-and-white decision regarding the choice to withdraw. For example, many people find themselves feeling very anxious about coming off but simultaneously passionately wanting to, anyway, and so they give themselves only one of two options: to stay fully on forever or to come totally off their medications right now. But the fact of the matter is that there is an endless spectrum of gray in the middle. Some people decide to taper, but instead of starting right away, they plan for 6 months or a year out so that they can get themselves more centered and prepared. Some try out a temporary taper for one month as an experiment, after which they touch base with how they’re feeling and decide whether to continue for another month or not. Others try tapering as slowly as is practically possible, such as one-half of 1% of a current dose over a month, because that’s the pace that works best for them. For others, being totally off medications isn’t ever going to be right for them, but they decide that there’s a more optimal dose level that they would like to reach for. In some ways, many of us feel that some level of uncertainty is actually an advantage for maximizing the safety of tapering. Uncertainty makes you more likely to listen carefully and closely to the ongoing messages that are coming from within you and your body, and makes you more likely to be flexible in adapting to these messages.
As a final note, it can be useful to remember that good preparation for psychiatric drug reduction or withdrawal is never truly finished. We hope that the work you’ve done throughout Prepare will help you to become more oriented to your own inner compass moving forward and to have the safest possible journey – whichever direction you choose to go.
