Antidepressant withdrawal: find out what to expect and how to manage it

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When the time comes to end a course of antidepressants, many people face concerns about what’s next. So we’re laying out what to expect

Antidepressant withdrawal: find out what to expect and how to manage it

“I have experienced anxiety since childhood and developed depression in my 20s, after the birth of my second child. Following my divorce, I became more affected, at times struggling to cope with my work which involved travelling around the UK delivering training in, ironically, mental health and exercise. Eventually, I went to my GP, who recommended antidepressants and counselling.”

Sarah Bolitho’s story is likely to sound familiar to many. In the UK, the latest NHS statistics from January to March 2021 show that there were 20.2 million antidepressant drugs prescribed, a 1% decrease from 20.5 million items in the previous quarter, and a 3% increase from 19.6 million items for the same quarter in 2019/20. They’re incredibly common, and yet mental health stigma means that there are often unanswered questions about the experience floating around.

One such question is what to expect when you end a course of antidepressants? The length of time an individual will need to take antidepressants varies from person to person, and while one may take them for up to six months, another may continue to take them for five years, or more. But how can you tell when the right time to stop taking them is for you? What should you expect? And how can you do it safely? Read on to find out. But, first, we need to take some time to get to know what we’re dealing with.

What are antidepressants?

“Antidepressants are medications prescribed for depression, anxiety disorders, obsessive-compulsive disorder (OCD), and some other mental and physical health conditions,” The Royal College of Psychiatrists tells us. “There are almost 30 different kinds of antidepressants. We don’t know for certain how antidepressants work, but they affect the activity of certain chemicals in our brains called neurotransmitters. These pass signals from one brain cell to another. The neurotransmitters most affected by antidepressants are serotonin and noradrenaline.”

And antidepressants can make a huge difference in individuals’ lives. A six-year study by the NIHR Oxford Health Biomedical Research Centre, that looked at the results of more than 500 trials, found that around 60% of people respond to the drugs by two months, with about a 50% reduction in their symptoms.

When is the right time to stop?

From week five of taking them, Sarah recalls feeling more positive, and she noticed that her symptoms were reducing. She had also started counselling at this point, and was gradually starting to identify areas in her life that needed to change, and develop new coping skills. She continued to take the medication for about three years before she decided to speak to her GP.

“I was concerned about coming off the medication, as I was not sure if I would experience depression again, or what the effects of withdrawing would be,” she shares. “I am thankful that I was given good advice to do this slowly – I’m so glad I took the time, as it gave me the confidence that my symptoms were gone and that I could cope.”

According to The Royal College of Psychi

What can Greek philosophy teach us about the art of happiness?

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How the ideas of an ancient Greek philosopher could help you find true inner joy today

What can Greek philosophy teach us about the art of happiness?

For the vast majority of people, the desire to be happy is one of the core motivators in this life.

Whether we consciously realise it or not, the reason why we work towards certain financial, career, or personal goals, is generally because we believe that achieving these things will help us to become happier than we are now.

And it is the same story with our relationships, social activities, hobbies, interests – and even for when we might decide to just sit around the house all day long, doing nothing.

Yes, we may sometimes seem to make decisions that are not necessarily good for us at all in the long-term. But, even here, the core reason is often because we are simply pining for an as yet unrealised form of happiness.

But this is the problem: the more we pursue happiness in any of its forms, the more we realise just how difficult it is to really hold on to.

What can Greek philosophy teach us about the art of happiness?

I’m sure we have all experienced times when that success we worked so hard for turns out to be, somehow, not as good as we always imagined it to be. Or when a short-term pleasure never quite gives us that lasting happiness that we really need.

So, with that being the case, it is really no surprise that many of us may feel completely lost when faced with the question: “How can I be happy?”

The truth is, happiness means different things to different people – and (sadly) there is no universal key to finding it.

However, we can still give ourselves the best possible chance of finding real happiness by approaching our life in a more philosophical way. And, this is the main purpose of this article. To dive a little deeper into the real ‘art of happiness’ via the insights of an ancient Greek philosopher known as Epicurus.

Now, just as a quick side note, if you have heard the name “Epicurus” or “Epicurean” before, then it may well have been in the context of describing someone who is hedonistic, or living a life of excess.

And, in fact, even since the very earliest days of Epicurean philosophy – which started in a modest garden academy around 300 BC – this has been one of its most common misrepresentations. Because, of course, if we live our life only with the goal of being as happy as we possibly can, then there is a good chance we might stray increasingly towards a life of endless partying, overindulgence, and pleasure-seeking, forgoing all other personal responsibilities.

However, when it comes to Epicurus’ real thoughts on living a happy life, the message could not be more different. Yes, he advocated for happiness being our ultimate goal in life. But he also insisted that the best way to actually approach this “pursuit of happiness” is always with a philosopher’s mindset.

In other words, this is not about living with total abandonment. Rather, it is encouraging us to approach every situation – and every temptation – with a discerning mind. Asking: “Will this particular pleasure really bring me lasting happiness? Or will it only bring temporary pleasure, which might lead to negative outcomes in the long run?”

As an example, let’s consider someone who enjoys playing video games in their spare time. If they use this hobby as a way to connect

10 cosy songs for an uplifting autumn playlist

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Set the mood with these cosy, uplifting songs for your autumn playlist

10 cosy songs for an uplifting autumn playlist

Flickering tea lights, steaming hot drinks, piles of blankets, and crunchy walks over fallen leaves – autumn conjures up a variety of seasonal delights. And while the darker seasons can come with wellbeing challenges – such as seasonal affective disorder, or ‘winter blues’ – it also offers us the chance to ‘get cosy’, something that prompts strong feelings of belonging, safety, and relaxation.

We all know just how powerful music can be when it comes to setting a mood. So, we’ve gathered together 10 of our favourite cosy songs, to help you create an uplifting, homey vibe this autumn.

1. ‘Flightless Bird, American Mouth’, Iron and Wine

You may be thinking, can a song about lost love and forgotten dreams really be described as ‘cosy’? The answer? When it’s by Iron and Wine, absolutely. Be carried by the swing of this song, and lifted by the beautiful harmonies.

2. ‘’Tis Autumn’, Nat King Cole Trio

The title says it all, really. The perfect track to sit back and take a breather, or to lull you through a cosy catch-up with a loved one, the soothing tones of Nat King Cole never fail to set the mood.

3. ‘Meet Me in the Woods’, Lord Huron

OK, let’s bring the energy levels back up a bit. ‘Meet Me in the Woods’ has that driving beat that takes you straight back to road trips down orange and golden country roads, combined with a wistfulness that is so in tune with this time of year.

4. ‘Buckets of Rain’, Bob Dylan

A love song picking up on, and celebrating, all the tiny details that endure one lover to another – a reminder that the small, everyday things can be so special. On rainy days, this is the perfect track to ponder on.

What is adult bullying and how can we address it?

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We typically associate ‘bullying’ with childhood. But, unfortunately, this insidious behaviour can be found in adult life as well. It’s time to call it out, and explore ways to challenge it

What is adult bullying and how can we address it?

There are very few people in the world who haven’t experienced bullying at some point in their lives.

Adult bullying is often subtle, may be difficult to detect, carried out under the radar, and can make you question yourself. This can be discrimination, micro aggressions at work or in a relationship, racism, homophobia, or anything that makes an individual feel unsafe or excluded.

How bullying impacts a person

Targets of bullies often report a significant impact to their mental, emotional, and physical health, and ability to engage socially.

On an emotional level, the impact could include:

  • Low mood
  • Tearfulness
  • Anxiety attacks
  • Panic attacks
  • Depression
  • Reduction in self-esteem and confidence
  • Long-term impacts include agoraphobia, and more

The physical symptoms of bullying include:

  • Becoming hyper vigilant to threats of danger
  • Palpitations
  • Nausea
  • Stress
  • Sleep disturbance
  • Appetite increase or suppression
  • Irritable bowel syndrome (IBS)

As a psychotherapist and coach, I’ve frequently seen clients present with trauma and PTSD as a result of prolonged exposure to stress and fear.

Trauma can be caused by any significant or negative repeated event throughout a person’s life, and is often as a result of feeling helplessness and powerlessness in a situation. This could be direct trauma (such as experiencing a life-threatening situation, witnessing death, being attacked or abused), or indirect trauma (witnessing someone else being threatened with harm, or injured, or killed, either in-person or on the news, or in a film). Such situations activate the body’s autonomic nervous system, which prepares us for fight, flight, freeze, or fawn responses. This is absolutely natural; we are programmed to respond like this. We are incredibly resilient human beings, and a trauma response is proof that our minds and bodies are working as they were made to.

These natural responses become problematic when the biofeedback system is activated by other threats, or by rumination over what happened. The brain doesn’t know fact from a remembered memory, and so behaves as if the incident is happening again.

Where does adult bullying occur?

Everywhere there are people, is the short answer. At work, we experience gossiping, rumour mills, micro aggressions with racism, sexual harassment, being overlooked for promotion, or intentionally excluded – the list is endless.

At home, there could be an overbearing spouse with demands, criticisms, or verbal or physical violence – please note, help is available if you are in this situation. Then there are family members who lie and cause fights, then sit back with the popcorn.

You might find yourself in public being heckled by strang

I can’t afford therapy – What do I do now?

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If you're looking for help but can't afford private support, you still have options. Here we look at some alternative routes you can take

I can’t afford therapy – What do I do now?

At the time of writing, we’re existing in a very strained time. More people are struggling financially as the cost of living crisis escalates. This in itself is taking a toll on mental health for many.

Even without this crisis in the picture, it’s important to recognise that paying for private therapy is inaccessible for some.

This doesn’t mean you don’t have options though. Here we want to talk through the different routes you can take to look after your mental health without spending more than you can afford.

Look into counselling on the NHS

This is the first route a lot of us go down. If you’re registered with a GP, you can access therapy for free through the Improving Access to Psychological Therapies (IAPT) programme. The types of therapies you can access in this way will depend on your individual needs, but include cognitive behavioural therapy (CBT), guided self-help (where a therapist supports you as you complete a self-help course, using a workbook or online) and counselling for depression (a specific type of counselling for those with depression).

There are several different ways your therapy may be delivered, from one-to-one and group sessions, to over-the-phone therapy and self-help courses. Going to your GP in the first instance can be helpful as they often suggest a therapy type and refer you. You don’t however need a referral from your doctor to access these therapies.

You can easily self-refer directly to a therapy provider in your area. Depending on where you live, you will need to be over the age of 16, 17 or 18 to do this. If you’re younger than this, you can get support from your local child and adolescent mental health service (CAMHS).

If you do self-refer, you’ll need to contact the therapy provider and they’ll come back to you within a few weeks to give you an assessment (usually done over the phone). This is where they’ll ask you for some more details of what you’ve been experiencing so they can understand how best to support you. They will then let you know when your first appointment will be.

What can be a barrier for some people on this route is the waiting time. The amount of time you’ll have to wait to get treatment will depend on a number of factors, including where you live. If the wait is long and you need help sooner, you may want to look into the other options below.

Consider low-cost therapy

There are some private practices and organisations that offer low-cost therapy. This may be a blanket fee for everyone, or they may offer concessions for those on benefits or low-income households. Never be afraid to ask about these when researching private therapists, while some will advertise them, others will work on a case by case basis.

You may also want to think about reaching out to therapy-training providers to see if trainee counsellors offer reduced rates. Trainee counsellors will need to complete at least 200 hours of therapy work before graduating, s