"I'm better now, so I'll come off the antidepressant"

This gets its own chapter because the stakes are different and because the NHS is unusually direct about it. You'll usually carry on taking an antidepressant for at least six months after your symptoms improve. Talk to your doctor if you want to stop. And in bold on the page, do not stop taking an antidepressant suddenly or without talking to your doctor first.

The reason is withdrawal. The NHS lists the symptoms, and they include headaches, feeling sick, sweating, dizziness, sleep problems and strange dreams, feeling restless or anxious or tearful, and sensations like an electric shock in the head. Most people get some symptoms when coming off, some get none, and for some they're severe, start weeks or months later, and last for months. The best recent count I've found is a 2024 review of 79 studies covering 21,002 patients, which put the rate of at least one discontinuation symptom at about 31 percent after stopping an antidepressant against about 17 percent after stopping a placebo, and the rate of severe symptoms at about three percent against under one. An earlier review of 24 studies found higher rates and longer durations, and the two disagree on the size but not on the existence of the thing.

Here's the part that matters for the feeling-fine test. The NHS page says that some withdrawal symptoms can feel like your condition coming back. So the reader who stops at three months, feels dreadful a week later and concludes the depression has returned may be reading withdrawal as relapse, and the reader who feels dreadful and concludes the tablet was propping them up may be right about that too. From the inside you can't tell. Horowitz and Taylor argued in 2019 that the short tapers guidelines used to recommend, two to four weeks, showed little benefit over stopping outright, and that tapers over months down to very small doses did better. The NHS now says the plan will usually run over several weeks or months.

None of that is an argument against coming off. It's an argument about how. The doctor who agrees a plan with you can slow it down if the symptoms bite, or go back up a step and try again later, which the NHS page says explicitly. The quiet stop has none of those options. It has a bad week and a guess about what the bad week means.