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From the Armchair
TALKIATRY’S MONTHLY MENTAL HEALTH NEWSLETTER
This month’s mental health tip
If you notice a shift in your mood, think about what else is different in your life or routine. Changes in sleep, stress, or physical health can all affect your mental well-being. Looking at the full context can help you figure out what you need.
Three things a psychiatrist wants you to know about stopping medication
With insights from:
Nicholas Tamoria, MD
Chief Psychiatrist
Do I still need this medication? It's a question that comes up often during treatment. Sometimes it's because a patient is feeling better. Other times, a life change, like planning a pregnancy, prompts a conversation about whether a medication is still the right fit. Whatever the reason, it's a decision to make with your psychiatrist, not on your own. Here are three things our psychiatrists want you to know if you're thinking about stopping medication.
Feeling better doesn't always mean it's time to stop
The absence of symptoms doesn't necessarily mean your medication is no longer helping. For many people, continuing treatment is what helps keep symptoms from returning. In fact, long-term maintenance medication is the standard of care for some conditions. That's one reason you should always talk to your psychiatrist before stopping medication or changing your treatment plan.
Stopping safely usually takes time
If you and your psychiatrist decide it's the right time to stop, many medications should be tapered gradually rather than stopped suddenly. Some can cause temporary discontinuation symptoms, such as dizziness, nausea, or insomnia, if they're stopped or reduced too quickly. A thoughtful taper plan gives your brain and body time to adjust. Your psychiatrist will also consider factors like the medication you're taking, your dose, how long you've been taking it, and your reason for stopping when recommending the safest approach.
It's okay if the plan changes
There's no prize for stopping as quickly as possible. If symptoms flare during a taper, it doesn't mean you've failed or that you'll need medication forever. Your psychiatrist may recommend slowing the taper, pausing, or reconsidering if it’s the right time. If you do stop and symptoms return later, going back on medication isn’t a step backward. Some conditions are episodic by nature, and restarting treatment when you need it is simply part of managing your mental health.
DEEP DIVE
Why a psychiatrist asks about your physical health
You booked the appointment to talk about anxiety symptoms, concentration issues, or challenging emotions. So why is your psychiatrist asking about your sleep, your exercise habits, and if you’re taking any vitamins? These questions can seem like a detour during a mental health evaluation, but they’re actually an important part of psychiatric care. Here’s why.
Mental health doesn't happen in isolation
The line between symptoms of a mental health disorder and symptoms of a physical condition can get surprisingly blurry. A thyroid disorder can drive changes in mood, energy, and anxiety. Low iron in anemia can cause fatigue and trouble concentrating that's easy to mistake for depression or ADHD. Hormonal shifts during pregnancy, postpartum, or menopause can unsettle mood, sleep, and anxiety levels. And chronic pain and sleep disorders can wear down emotional resilience over time.
If a physical condition is the reason for your mental health symptoms, it doesn’t minimize their significance. It just means your psychiatrist needs the full picture to figure out what's actually going on and what the best treatment is. For example, if someone dealing with suddenly debilitating anxiety is diagnosed with a thyroid condition, treating that underlying medical issue will often be more effective than any psychiatric medication on its own.
Your medical history affects your treatment plan
To recommend the best treatment, your psychiatrist needs to be informed about all areas of your health. Medications for physical health conditions, along with vitamins and supplements, can affect mood, energy, attention, or sleep. Some can interact with psychiatric medications in ways that change how well they work or how they should be dosed. Make sure your psychiatrist knows about everything prescribed by other members of your care team.
You should also expect your psychiatrist to keep asking about your health at every visit, not just during an initial evaluation. A new diagnosis of a chronic illness, surgery, pregnancy, or a stretch of bad sleep can all shift what’s going on with your mental health or what treatment should look like.
The goal is to understand you, not just your diagnosis
A psychiatrist’s questions about physical health are also reflective of a thoughtful, holistic treatment approach. Good psychiatric care looks beyond a diagnosis to see the whole person behind it. Physical health, relationships, daily routines, and life experience all shape mental health, just as mental health shapes them right back. Questions that seem unrelated to why you walked in are usually there to help your psychiatrist understand not just what you're experiencing, but why, which is equally important.
What to bring to a psychiatry appointment
The more complete a picture you share, the better your care can be. Here are a few things to jot down beforehand:
Any new medical diagnoses
Medications or supplements you've started, stopped, or changed
Changes in your sleep
Recent surgeries or procedures
Hormonal changes, including pregnancy, postpartum, or menopause
Anything else that's affecting how you feel physically
You won't always know which detail matters. That's your psychiatrist's job. Yours is just to bring the whole story.
If you're looking for mental health support, take Talkiatry's free online assessment to find an experienced clinician who can help.
ON THE SHELF
Book recommendations from our clinicians
It Didn't Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle by Mark Wolynn
Learn more about the conditions we treat
ADHD
Anxiety
Depression
PTSD
OCD
Bipolar disorder
Insomnia
Mood disorders
Postpartum
Substance use disorder
Children’s mental health
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109 W. 27th Street, Suite 5S,
New York, NY, 10001, United States
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