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A trap that some psychiatrists might get us into, really an unintentional error, is to try to relieve our suffering from side effects by reducing our dosage of antipsychotic or other medication. I call it a trap because it can be a "slippery slope," to reduce medication, one in which the slippage could cause a relapse.  

For someone suffering from medication side effects and additionally suffering due to large areas of consciousness being suppressed, there needs to be some kind of hope of things being better in the future. Thus, many of the most compassionate psychiatrists will try not to medicate excessively, and may try to reduce the suffering caused by excessive medication when we reach the point where we show signs of recovery.  

Taking medication should not be perceived as punishment. Ideally, medication is there to help a patient recover and to thus have a chance at building a life. When caregivers use medication in a context of punishment, something is wrong. When patients perceive that they are not being cared for and helped by use of medication, it becomes an impetus for noncompliance. Thus, excessive medication with no end in sight can ruin a person's chances at a meaningful recovery.  

On the other hand, the medication that I personally have needed, to be maintained in relative clarity as well as stability, has gradually increased over a thirty year period. Most psychiatrists would think of my dosages as "whopping." Yet, those high dosages seem to be what I need in order to do well.  

I'm kind of an unusual creature because in some respects, I am a glutton for punishment. Most people could probably not be happy on the dosages that I voluntarily take. I have sacrificed physical comfort in order to more aggressively treat my psychosis.  

Medication to treat psychosis is a balancing act. The dosage that might be needed in order to get and stay stabilized could cause some amount of physical suffering and other side effects. Medication can have side effects that adversely affect health, or other side effects, such as Tardive Dyskinesia, that create disfigurement and suffering. I've been lucky that I have been spared the worst of possible side effects.  

However, I have had side effects that have caused me to suffer physically--side effects such as muscle stiffness, dry mouth, a nasty drugged feeling, blockage of consciousness, and weight gain. These are things I have tolerated so that I could maintain some amount of reprieve from psychosis.  

The problem with reducing medication by too much is that a patient can slip into a partial relapse, and this can lead to worse consequences. When medication is lowered, it can produce a loss of insight into one's condition. In my past when I tried to lower my dosage of medication, I reached a point where I was partially delusional and believed I didn't need to keep taking medication.  

None of this is easy. If I had a viable alternative to taking medication, I would choose such an option.  

I recall a therapist talking of the "revolving door"--of chronically mentally ill people having repeated relapses, going in and out of the hospital repeatedly, and not having a good outcome.  

I had a friend who would go into a mental hospital under involuntary circumstances, would get stabilized and then would be released, and would immediately dispose of all his medication. He was a very good man when stabilized. But when he experienced a manic episode he was quite dangerous. He is not around any longer.  

Mental illnesses are serious diseases that can lead to a horrible level of suffering and possible death. The risk of treatment must be weighed against the risk of no treatment.  

I do not have the authority to tell the readers that they should or should not take medication or that they should lower or raise their dosages. When someone gets a mental health diagnosis, it is a life altering event, and there is no single solution that works for everyone.  

However, please be aware that there are risks to going too low or off of medication, and there are also risks of being on medication.