Do treatment plans ever include getting off of medication? I was diagnosed with bipolar disorder 17 years ago. I’ve tried—unsuccessfully—to get off medications in the past. Now I am seeing a psychologist and changing my thinking and the people that I hang around with. I've been off medication for three months and feeling fine.

Any answer to this question has to start with a reminder that there are averages and there are individuals.

On average, we know that both depression and bipolar disorder tend to be less severe as people age. Community studies show that the rate of bipolar disorder or more severe depression is lower in older people than in younger or middle-aged adults. And long-term follow-up studies show that many people with more severe depression or bipolar disorder do recover—and no longer need medication or other professional treatment.

But the long-term path of mood disorders varies widely from individual to individual. While many people improve, some people do notice more severe symptoms over time. Most people taking medication for depression or bipolar disorder would prefer to eventually decrease or discontinue medication. That goal is possible for some individuals, but not for others. The likelihood of doing well without medication is certainly higher for people with less severe or chronic depression—and lower for people with more chronic depression or bipolar disorder.

You are most likely to be successful decreasing medication if all of the other parts of your recovery or wellness plan are strong. For most people, that plan includes:

  • Following a daily wellness or self-care plan; things you do every day to stay healthy.
  • Avoiding things that put you at risk, like alcohol or street drugs.
  • Getting support from peers, friends, and family.
  • Knowing your personal warning signs of mood episodes—and being honest with yourself when you notice them.
  • Finding health care providers you trust and being honest with them about how you are doing.

With careful planning, persistence, and hard work, some people will be able to decrease—and possibly discontinue—medication. However, mood symptoms can some back, even after months or years. If that happens, re-starting medication before symptoms get too bad usually leads to taking less medication (compared to waiting until things are very severe). Whatever your path, it’s important not to think of taking medication as some sort of failure—a sign that you aren’t strong enough or didn’t try hard enough. Blaming yourself for taking medication is like blaming yourself for having a mood disorder in the first place. And many of us know from experience how well that works.

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.