Plus, your therapist can help you sort through your feelings about coming off meds or not—and give you their take on how much progress they think you’ve made. “Their opinion matters,” Dr. Siegel says. Which is why it’s so important to find a therapist who is fully credentialed and well-trained in using evidence-based techniques. (If you need help finding a great therapist, we’ve got some tips for you here.)
4. You have a strong support system.
Social bonds are crucial for mental health. So while we don’t have studies on this, it stands to reason that having healthy relationships generally puts you in a better position to transition off medication, Dr. DeYoung says.
When you’re still considering whether you’re ready to come off, sometimes getting the perspective of someone who knows you really well and who you deeply trust—like a partner, roomie-bestie, or family member—can be helpful, Dr. DeYoung says. How they think you’ve been doing isn’t going to be a deciding factor, he notes, since your experience of your mental health is most important. But it’s sometimes hard to see yourself 100% clearly.
Then, if and when you do taper off, it’s nice to be able to lean on someone during any bumps in the process (like discontinuation symptoms), as well as have them look out for you. In the event you start to relapse, “you may or may not be the first person to notice a change,” Dr. Siegel explains. He usually asks patients, “Would you be willing to let someone in your life know that you’ll be discontinuing your medication and give them permission to let you know if they see something concerning?” This isn’t necessarily standard practice, he notes. But Dr. DeYoung agrees that “having support or another set of eyes can be helpful.”
5. Your self-care is pretty solid.
Good lifestyle habits and self-care (like regular exercise, a good sleep routine, a healthy diet, time with friends, and activities you enjoy) can create a strong foundation that puts you in a better spot for tapering. “It can help continue the benefits that you may have achieved with that antidepressant,” Dr. DeYoung explains.
We don’t have studies showing that people who engage in greater self-care lower their risk of relapse. (And certainly, people successfully discontinue their antidepressants without paying special attention to this stuff, Dr. DeYoung notes.) That said, we do know these things generally support mental health, Dr. Siegel says. Dr. DeYoung’s philosophy: “Let’s do everything we can to raise the chances of you being successful getting off the medication and staying off the medication.”
How to bring up a potential medication change with your doctor
You might be wondering if your doctor should be the one to bring up tapering first. The fact is, some physicians will regularly reevaluate whether a patient should continue their meds or not while others will take a more conservative approach, Dr. DeYoung says. So some psychiatrists and primary care doctors may—as long as you’re doing well and not having side effects—keep renewing your prescription without revisiting the conversation, Dr. DeYoung explains.
If the question is on your mind, don’t hesitate to start the discussion yourself, Dr. Siegel says. He suggests saying something like, “I’ve been on these medications and doing well for a while. I’m not sure I still need to be on them. What do you think? How will we know when it’s time for me to come off?”
Whether your doctor thinks you’re ready or not, the conversation will be clarifying. You’ll get the expert recommendations and information you need to help you make the right decision, Dr. DeYoung says. And you’ll leave your appointment with a solid plan (or at least a next step) to start tapering—or the confidence that you’re staying on your meds for really good reasons right now.
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