What Doctors Don’t Tell You About Psychotropic Medications, and Why It’s Not on Purpose
- Brainz Magazine
- Aug 18
- 7 min read
For nearly 14 years, I've helped individuals navigate the complex landscape of addiction in order to achieve recovery. Nicknamed "The Casual Counselor", my approach is unconventional but undeniably effective.
SSRIs. SNRIs. Mood Stabilizers. Replacement Therapies. Big Pharma: Here in America, if you’ve got any unpleasant symptoms related to, well, anything, there’s good news! We’ve got a pill for that. Oh, and if that pill has any unpleasant side effects, we’ve got a pill for that, too. Prescribers will start a patient off with a tiny dose to see if the psych med has a positive effect on their symptom profile, but with psychotropic meds, it takes anywhere from 4-6 weeks to really get a good idea about the efficacy (or lack thereof) of whatever the medication is it’s a veritable chemistry experiment, and it can be a frustrating process finding a medication that vibes with our personal issues.
When we find something that helps, or works, the tiny dose is typically increased over time, and then increased again, until the MD determines that you’re on what is described as a “therapeutic dose” of the medication, and the only thing you need to do after that is to make sure that you’re compliant in using that medication on a daily basis to keep the levels of the healing effect at the therapeutic efficacy in your bloodstream. An easy formula to follow, and one that can often be a game-changer and a lifesaver for people who struggle with unhealthy substance use or co-occurring mental health disorders.
What’s also common to see, as a treater, is the experience of meeting a new client who comes to me for the first time, and when I ask them if they're on any psych meds, they’ll often tell me that they’re on anywhere from 7 to 12 different meds. Here’s the thing, whether prescribed or illicit, when a human being takes, say, 2 different drugs, they’ve now created what amounts to a new medication altogether. It’s a story of how the medications contraindicate with one another. Often, when people accidentally overdose and die from the use of street drugs, it’s because they’re on a combination of a few different substances. If they had taken just a single dose of a single drug, they likely would have lived to fight another day. But when you mix a sedative with an opioid with a stimulant with a sleep medication, well, you get the point.
You’ve just created a cocktail that’s comparable to a Long Island Iced Tea, but with much stronger and immediate effects. It’s a perfect recipe for disaster, and it’s the reason that we need more psychoeducation about how both FDA-approved and illicit drugs affect the chemistry of the human brain. This is something that is not typically taught in schools. But you can learn about it from treatment specialists, people like me, who dedicate their lives to learning more about the neuroscience of problematic substance use.
But back to psych meds. When I was about 2 years sober, stone cold sober, I hadn’t taken a drink or a drug for close to 800 days, I found my way into a deep valley of major depressive symptoms. They were severe and came out of nowhere. There was no preceding event. It was just an aberration. Still, it was so bad that I couldn’t get out of bed, couldn’t shower, couldn’t feed myself, couldn’t attend my college classes in the evening, couldn’t go to the gym or recovery meetings. I was one hurting kitten. Though I had forever been resistant to SSRIs, I made the decision with my counselor to see a psychiatrist, and was prescribed an antidepressant. Within about 5 or 6 days, I was up and running again. My mood was still low, but the medication provided me with more resilience. More oomph. More get-up-and-go. It was a literal lifesaver.
My self-care improved dramatically, and I was back into the rhythm of my healthy routine.
Over time, I continued to see the psychiatrist, and we slowly raised the dose of my medication. Over the span of about a year, I had reached the maximum dosage, and I was doing great. I was working out regularly, maintaining my recovery, had a 4.0 GPA at school, was living an active social life, eating healthy, and just generally doing great. Awesome, right? Right! At least, for a while. What happened with me, personally, was that after about 3 years of being at the max dose, the positive effects of the medication started to plateau. I started to flatline.
Although I wasn’t hitting any low-lows, I also wasn’t able to hit any high-highs. There were no tears when I was feeling sad, though I could feel sad. There were no belly laughs when something struck me as funny, though I knew it was a great joke. I made the decision, with my doctor, that I was going to slowly titrate off of the medication, very slowly (over a year), get back down to the tiny dose, and then cease using it altogether. The alternative was to add another SSRI to the recipe to bolster the effect of the plateau, and I didn’t want to do that.
I wanted to learn how to deal with my feelings in a real, authentic way, the good, the bad, the easy, the hard, the sad, the happy, and so on. And I knew, if ever I needed, I could always restart my prescription if I ever hit another one of those severe depressive valleys. It was a good plan on paper. In reality, it was one of the more difficult experiences I’ve had in recovery.
Here’s what my doctor told me: “When you get back down to the intro dose, and stop using it, you’re going to feel fine, you shouldn’t experience any negative feelings whatsoever, and there aren’t going to be any withdrawal symptoms whatsoever.” That was comforting to hear. But, boy, was he wrong.
I stopped taking the SSRI, and I went through one of the most uncomfortable withdrawals that I’ve ever experienced as a drug user, and I’ve stopped taking just about every drug that causes chemical dependency known to man. Coming off the SSRI was worse than most of the street drugs that I quit cold turkey, despite the fact that I was told by a licensed doctor that I would “be just fine”. The symptoms were severe, despite coming off such a low dose after weaning down for a year.
Hot sweats, cold sweats. GI distress. Sleepless nights for the better part of 3-4 weeks. Brain “zaps”. Vertigo. Loss of balance. Short-term memory loss. Confusion. Irritability. Depressive symptoms. Anxiety. Loss of appetite. I was functional, but just barely. I was able to get up and go to work, but getting through the shift was an enormous challenge. I longed for a month on a deserted tropical island where I could at least feel like shit in something resembling a paradise. Sadly, I didn’t have the freedom and flexibility to do this.
Then came the post-acute withdrawal symptoms. They lasted for the better part of 6 months. They were comparable to the aforementioned symptoms, though not nearly as severe. But it took a long time before I started to feel “human” again. It was a long time before the tears could fall when I was sad, and the belly laughs would emerge when I’d hear a funny joke. They eventually came, and I eventually came back from it, but it absolutely sucked. That said, I hold no ill will toward the doctor.
The reason for this is that he didn’t know. He was just parroting back to me what the drug rep from Big Pharma had schooled him about the medication and its side effects, including those of physiological dependence and withdrawal. He was informed there was no evidence of either, and there’s a really good chance that he had never tried the medication for himself, so how was he to know? He had studied the reports (sponsored often by the drug manufacturers themselves) and read the brochures about the positive results of SSRIs, and he had seen many patients, myself included, benefit from them. No harm, no foul, no resentment.
But many people in this society still believe what simply isn’t true: just because it’s a drug that doesn’t come from “the streets”, doesn’t mean that it’s a drug that doesn’t have some unpleasant, or even dangerous effects, associated with its use, or what it feels like when a person decides to stop taking them.
Futzing with brain chemistry is futzing with brain chemistry. Whether it’s sugar, caffeine, unhealthy news content, junk food, psych meds, booze, or street drugs, when we use these different substances over and over again for years, our brains are going to get used to them. The formula of what we put into our bodies becomes our “new normal”, and when you suddenly remove them from the everyday routine, the brain gets upset. It’s upset manifests into symptoms, and depending on what the substance or behavior is, it will determine how intense the change will be, and medications, despite being FDA approved and deemed safe, can have serious ramifications on our physical, mental, and emotional well-being.
The lesson? Do your research. Read testimonials. Ask a lot of questions. Work with treaters you feel safe with, and who listen to you, and most of all: Approach with caution.
Read more from Joshua Bennett-Johnson
Joshua Bennett-Johnson, Licensed Addictions Therapist
After working for 7 years in an amazing clinic, I launched into private practice in 2018. I love my job. I can say that without reservation. Watching people rebuild their lives is something that is worth more than any dollar amount.
