Riding the emotional rollercoaster: What happens when you say goodbye to antidepressants?

Thursday, June 5, 2024.

The journey of coming off antidepressants can be as turbulent as a rollercoaster ride, filled with unexpected twists and turns.

A recent study reveals the social and emotional upheavals that accompany the physical symptoms of withdrawing from these medications.

As anyone who has tried to stop antidepressants knows, the process isn't always smooth sailing.

Anxiety, dizziness, headaches, and nausea are just the tip of the iceberg. The study found that these physical symptoms are often accompanied by social and emotional difficulties.

Abruptly stopping antidepressants, rather than gradually reducing the dosage—a method known as 'tapering'—tends to make the withdrawal process much harder. Unsurprisingly, those who quit without a doctor’s supervision faced even more challenges.

Overwhelmed Emotions and Social Disconnect

The study, based on in-depth interviews with 20 folks who had discontinued SSRIs like Prozac, sheds light on the profound impact of withdrawal on well-being. Mr. Raqeeb Mahmood, the study’s first author, notes:

“From these interviews, it became clear that the lived experience of withdrawal significantly impacts individuals’ well-being. The participants emphasized that withdrawal is not just about physical side effects, but it also affected their emotional, cognitive, and social functioning.”

After coming off antidepressants, many participants reported feeling overwhelmed by their emotions.

They described a sense of detachment, reduced empathy towards others, and difficulty enjoying social interactions. This emotional turmoil often made social situations feel like a chore, leaving people just "going through the motions."

The Physical and Emotional Toll

While the psychological symptoms were significant, the physical symptoms could be equally challenging.

For some, these physical effects were short-lived, but for others, they lingered for weeks or even months. Mahmood explains:

“Some symptoms were so severe, family and friends of the person coming off medication encouraged them to go back on it.”

Interestingly, the toughest times were not always immediately after stopping the medication. Some found the initial weeks most challenging, while others faced more difficulties several months later. Many tried to navigate this process without any professional support, which only added to their struggles.

A Cry for Support

The study participants expressed a clear need for better emotional support from their GPs and emphasized the importance of flexible tapering schedules. Mahmood adds:

“They also mentioned the importance of people timing their withdrawal attempts for less stressful or busy periods in their lives, to give them a better chance of coming off them without experiencing significant difficulties.”

The Social Challenge

Dr. Graeme Fairchild, a co-author of the study, highlights the social impact of withdrawal:

“Some of the people described social situations as feeling like a chore—they felt as if they were just ‘going through the motions’ of regular life.

They also talked about being more difficult to live with or felt that their partners or family members wanted them to go back on their medication.

These impacts of antidepressant withdrawal on people’s social relationships are less widely known but need to be communicated to patients considering coming off their antidepressants.”

Dr. Katherine Button, another co-author, underscores the strain on close relationships:

“Over half of the participants described withdrawal negatively affecting their relationships with others, with family members getting the brunt of their increased snappiness, for example.

This is an important finding as family members are often a key source of social support, so being prepared for these potential changes may help both the patient and their family navigate the withdrawal process.”

Finding the Silver Lining

Not all changes were negative.

Some participants reported enjoying the return of their emotions to a more natural state after being dulled by the medication.

They also found it easier to recall positive memories, enjoyed weight loss, and discovered that exercise helped them cope with withdrawal.

Final thoughts

As we consider the human experience of getting off antidepressants, it's important to ask: How can we better support folks through this challenging transition? Certainly couples therapists need to ask about this.

How can empathy and social awareness be enhanced to help both patients and their loved ones navigate the emotional rollercoaster of withdrawal?

I like these questions. Perhaps if we make a good-faith effort to grapple with them, we might improve the journey for those saying goodbye to antidepressants and help them find stability in the midst of turbulence.

Be Well, Stay Kind, and Godspeed.

RESEARCH:

Mahmood, R., Wallace, V., Wiles, N., Kessler, D., Button, K. S., & Fairchild, G. (2024). The lived experience of withdrawal from Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants: A qualitative interview study. Health Expectations, 27(1), e13966. https://doi.org/10.1111/hex.13966