"One pill makes you larger
And one pill makes you small
And the ones that mother gives you
Don't do anything at all
Go ask Alice, when she's ten feet tall"
When a character takes medication for a mental illness, they might feel that something that made them unique is taken away
. Alternatively, the side effects make them miserable, or they might miss their friends
. It is also common both in reality and fiction for individuals with a mental illness to get on their meds, become functional, then decide they are "cured," or have some kind of epiphany
, or have found the All-Natural Snake Oil
, and decide they don't really need the medication anymore. So the character (or sometimes a parent/guardian) decides to drop the Blessed with Suck
meds, and live life insane but alive, often accompanied by a shot of the character throwing the bottle of pills in the trash.
In fictionland, this tends to result in, at worst, hangover-like withdraw and possibly a grudging admission that the medication helped, and at best, the pills having been only a Magic Feather
and it was all in their heads. Cue Crowning Moment of Heartwarming
and roll the credits.
Reality does not work this way.
In Real Life
, stopping medication cold turkey, particularly those for mental illness, is frequently followed not only by potentially lethal withdraw, but by the sudden return of symptoms, which are felt more
intensely because of the period of clarity. One common result of a person with severe OCD going off of their meds cold-turkey, for instance, is a self-destructive paranoid breakdown as they recall all of the "rules" they have broken and frantically attempt to make up for the unforgivable "lapse in responsibility" during the period in which their compulsions were suppressed.
Another common result is that in people who are taking SSRI antidepressants or atypical antipsychotics "off label," (e.g. as a treatment for pain or insomnia rather than for the mental illness they are primarily meant to treat), the withdrawal approximates the symptoms of said mental illnesses due to the drug's primary effect on the brain,
meaning that someone who is, for example, taking fluoxetine to "buff" their pain medications for fibromyalgia may end up suicidally depressed on sudden stoppage even if they have no history of depression, or who is taking quietapine for insomnia may well have a hallucinatory or psychotic episode identical to schizophrenia on sudden stoppage, even if they are not
schizophrenic. Unfortunately, with inexperienced persons or those unaware of these being drug withdrawal effects, they are often taken as a sign of the illness "being uncovered" or "being drawn out."
This, in turn, has a secondary unfortunate result in that sometimes, doctors (both real and fictional) who take this trope for granted will assume that anyone who doesn't want to take a particular medication is doing this. The situation is often more complicated: The medication isn't a Phlebotinum Pill
that makes all their problems go away, so the person may assume it isn't working. It may also be that it legitimately isn't working, or has unacceptable side effects: everyone reacts differently to different types of psychoactive medications, and certain medications can affect certain people's brain and nerve chemistry in ways that inhibit mental or physical performance. There are also some scenarios where people take medication for physical illnesses (such as cancer or diabetes or HIV/AIDS) and the medications are either difficult to properly maintain or are unaffordable. But such a scenario should always
be discussed with one's doctor (and a second opinion never hurts) rather than going cold turkey.
Covered in and used as a justification for Flowers for Algernon Syndrome
PLEASE Don't Try This at Home
. To repeat, in addition to the strong possibility that you're not
all better and you still need your meds, some medications can cause withdrawal symptoms if suddenly stopped (after someone has, for instance, decided they don't need the medication any more and chucked the bottle in the trash), which can range from the mildly unpleasant to the fatal. In most cases a doctor properly doing their job will readily listen to a patient having issues with their medication, including
financial problems. In many cases there are a range of options available, from reducing the dose to the minimal effective amount to carefully and gradually substituting or combining other medications until "a right fit" is found that suits the person's unique body chemistry and minimizes side effects. If the doctor and patient decide that the best route is indeed to stop taking a medication entirely, it is vital to "taper off" (gradually decrease the dosage) in a carefully monitored situation, watching for warning signs of a relapse or dangerous withdraw symptoms.
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- Doc Will Magnus, creator of the Metal Men, takes regular medication to treat his Manic/Depressive bipolar disorder with delusional episodes, but his 'stabilised' self is also less inventive. in 52, a group of Super Villain Mad Scientist types kidnap him, confiscate his medication, and set him to work, intending to get him to recreate the Doomsday Device Plutonium Man that he made the last time he went nuts. However, this does not lead to the results that the mad scientist types had hoped for, and Magnus winds up tearing apart their criminal organization from the inside.
"You shouldn't have taken away my meds! I told you... I do crazy things without my meds!"
- Todd Rice aka Obsidian of Justice Society of America and Infinity, Inc. averts this and knows he needs to take medication for his schizophrenia, and when he starts acting strangely his teammates wonder aloud if he's gotten off of it (turns out it was due to something completed unrelated).
- In Lab Rat, the prequel comic to Portal 2, Doug Rattmann avoids taking medication for his schizophrenia. In a subversion, however, he recognizes he needs it, but because he's running low he saves it for when he really needs it to escape. It later turns out to be Double Subverted though, as the Companion Cube he had been hallucinating was giving him advice and warnings. When he takes his meds, the Cube disappeared, and Rattman nearly dies because he didn't have the Cube to warn him about a trap.
- Count Vertigo of the Suicide Squad didn't take medication for his bipolar disorder not because he didn't want to, but because it doesn't help. When speaking to a psychiatrist, he explains that he'd tried practically every medication to help with his disorder, but ultimately none of them stuck. Ironically, he's completely cured as a side-effect of Poison Ivy's drugs, and refuses to believe it when told the first time.
- Mad Artist/Mad Doctor Batman villain Professor Pyg.
You look at me like I'm out of shape. Like I drank too much and forgot my medication. I'm an artist! Who can expect me to work on antipsychotics?
- Suggested by Rainbow Dash when she hears about Twilight's titular Illness in the fanfic of the same name. Twilight counters with a good part of the Don't Try This at Home disclaimer above. And one of the meds is a magic suppressor since it partly affects her illness.
- Like many mental illness tropes deconstructed in Brainbent when Sollux, who has rapid cycling bipolar disorder, tries going off his meds once. The results are not pretty.
- Garden State is something of a subversion, since its made clear he never really needed the medication in the first place. His father acted as his psychiatrist (which the film lampshades as very bad practice) and reacted quite emotionally to him pushing his depressed mother in a childish outburst just as the dishwasher door accidentally opened, which caused her to fall over and become paraplegic. The fact that the father was unwilling to accept it as a freak accident caused him to conclude his son had intense emotional problems; hence the unnecessary medication.
- Subverted in the movie Prozac Nation, the protagonist refuses to take her medication since she sees it as poison (she is bipolar). As a result, she loses her boyfriend, writes gibberish (writing is her passion), drops out of college and only gets better when she takes her medication, although she wonders if the medicated person is really her.
- In A Beautiful Mind (itself ostensibly based on John Nash's life), his anti-psychotic medication impairs his mathematical ability. Because of this, he ends up dropping it so he can continue his career. This is also subverted, since he mentions to his colleagues during the Nobel ceremony that he is taking the latest medications (probably due to the fact that modern medications have less side-effects). As well as that, when he's off the medication, he occasionally has to consult with people he's familiar with (e.g. his students) to make sure the things he's seeing are real. The Real Life Nash never got back to medication, and as a result tended not to be allowed to give speeches at his award ceremonies, for fear he'd go into anti-Semitic ranting. Ron Howard added the line to the movie specifically to avoid the negative implication toward anti-psychotic medications, but this has been decried by (some) mental health advocacy groups.
- In Observe and Report, the main character is a bit of a delusional blowhard while on his medication, but once he comes off it he becomes even more unhinged.
- Lampshaded/played with in Repo! The Genetic Opera. We never find out what Nathan's medicine was intended for, and it's definitely got some nasty side-effects given what it does to Shilo. And going off it may not have made any major difference - but we don't know that it really helped either, since Nathan is noticeably free-falling off the edge, if not actually leaping off of it, by the time the opera rolls around and he wasn't exactly the poster child for mental stability beforehand, and Shilo wasn't sick in the first place since Nathan was just trying to keep her in the house.
- A rare inversion in As Good As It Gets: Obsessive-compulsive Melvin starts taking medication for his disorder because Love Interest Carol makes him want to be a better man.
"I've got this, what—ailment? My doctor, a shrink that I used to go to all the time, he says that in fifty or sixty percent of the cases, a pill really helps. I hate pills, very dangerous thing, pills. Hate. I'm using the word "hate" here, about pills. Hate. My compliment is, that night when you came over and told me that you would never... well, you were there, you know what you said. Well, my compliment to you is, the next morning, I started taking the pills."
- Played straight in What the #$*! Do We Know!?, when the main character tosses away her anti-anxiety medication after she starts feeling good about herself.
- In Thor: The Dark World, Dr. Erik Selvig is seen with a big bag of meds after having "had a god in [his] brain" from The Avengers, due to thinking himself crazy (admittedly, he's not the only one). Upon seeing a flock of birds fly in an S-pattern, disappear at the start of the S-pattern, then reappear flying out of the sidewalk under his, Darcy, and Ian's feet, he quickly decides "There's nothing more reassuring than to know that the world is even crazier than you are" and dumps the meds in the nearest trash can.
- In Terry Pratchett's Discworld:
- Making Money: Mad Artist Owlswick Jenkins is healed via turnip transplant (which leaves him quite content, but creates a seriously troubled turnip), but, alas, he loses his artistic talent. He switches back and tries some non-radical coping methods instead.
- Thief of Time: Jeremy Clockson has a spoonful of medication every day, as his Igor reassures a man checking on him, without mentioning that he pours it down the sink once he found it suppressed his creativity. Of course, that creativity was being used by a manipulative benefactor to destroy the world. And then there's the fact that the last time he stopped taking his medicine, he beat his assistant to death with a hammer.
- In Isaac Asimov's short story "Light Verse", a robot that is malfunctioning is the creator of light sculptures. When its unique problem is "fixed", it can't create anymore. The robot's owner murders the scientist who fixed it, but it's noted that the victim (who has just realized that he's singlehandedly cut off what could have been a fruitful avenue of robotics research) utterly — perhaps intentionally — fails to defend himself.
- In The Phoenix Dance, Phoenix is bipolar and becomes incredibly creative in her "up" moods, so she starts taking less of her medicine to keep the good moods. Unfortunately, this just means that her bouts of depression come back, too.
- In One Flew Over the Cuckoo's Nest it is mentioned that the anti-seizure medication causes your teeth to fall out, which is a good reason why some of the patients don't want to take it. One gets the unfortunate side effect mentioned above, and decides he'd rather have the seizures; the other is terrified of having a seizure, and takes the medication intended for the first epileptic as well as his own to make sure he avoids it. In real life decreased salivation ("cotton mouth") is a side-effect of most psychoactive drugs of various kinds and daily use over a long period of time is likely to wreck your teeth.
- Serge Storms, the protagonist of the Florida Roadkill novels by Tim Dorsey, is supposed to be on quite a lot of anti-psychotic drugs. He often skips doses because they keep him from thinking clearly. When he skips doses for too long (Something that he is usually in the middle of doing in every single book), he goes on killing sprees.
- In the Experiment In Terror series, Dex frequently forgoes taking his antipsychotics; he prefers the mental clarity (despite the slight paranoia and hyperactivity) that comes with being sober.
Live Action TV
- An episode of Boston Public had a hyperactive genius piano player, who gets put on Ritalin and doesn't want to play anymore.
- Any and all Monk episodes where they try to cure Monk's OCD. He becomes really annoying and can't solve mysteries very well.
- Ally McBeal angsts that medication that takes away her hallucinations takes away her uniqueness.
- Law & Order:
- The original series was the first to explore this trope with the episode Pro Se. A schizophrenic man who has been off his meds for years kills about 8 people in a clothing store. When forced to take his medication, it's revealed that he is quite the brilliant attorney and represents himself, almost beating McCoy in court. When his sister comes forth with damning testimony, he pleads out and goes back off his medication. His reasons for not taking it are the reasons many people on anti-psychotics refuse to:
James Smith: I'm using every ounce of strength I have just to talk to you. I feel like I'm pawing through a wool blanket. I feel stiff, and like I'm half a mile behind everyone else. I get so damned tired. It takes so much effort, holding on to reality.
- A few criminals have tried to invoke this to avoid a conviction. One episode had a man suffering from parkinson's not take his medication for the trial. His constant shaking was both distracting and meant to show to the jury that it would be impossible for him to hold a gun steady. Another stopped taking his meds to induce himself into a controlled coma. Both attorneys argued that the court can't force their clients to self medicate. The argument was successful in the former, but not so much in the latter.
- Law & Order: Special Victims Unit:
- Several episodes featured schizophrenics of this type, who were usually forced to take drugs to testify after witnessing crimes. It explored both sides of this trope at different times. In one instance, the medication allowed the guy to get his life back together, and he eventually reunited with his estranged wife and son. Another episode had a different schizophrenic, who was so used to living with hallucinations that, when the drugs made them go away, he missed them so much he got depressed and killed himself.
- Then there's the episode where John Munch's crazy uncle (starring Jerry Lewis as himself) goes off his meds to punish himself for murdering a suspected rapist during a manic episode as a sort of mental Seppuku.
- Law & Order: Criminal Intent: Detective Goren, who has experience with mental illness in the family, spells out the faulty thought process that often leads to this trope (when it's not a conscious choice):
Goren: Only sick people take medications. If I don't take the meds, I'm not sick.
- "Haywire" in Prison Break loses his photographic memory (and perhaps his mathematical genius) when he takes drugs to treat his collection of mental disorders.
- Averted in New Tricks. If Brian "Memory" Lane stops taking his meds then, as he puts it himself (when he was speaking to a medicated schizophrenic), "I turn into Mr. Loopy, like you.". A couple of episodes demonstrated this; when he didn't take his meds, he was intensely manic and unstable, and thus no good at his job whatsoever.
- Leads to tragedy in more than one episode of CSI: Crime Scene Investigation.
- Tragic example: Heroes Season Two's flashback episode sees Niki trying to treat her Split Personality with medication, only to find herself as lively as a pile of seaweed. She surreptitiously stops taking it, and soon loses control of herself again, losing her husband in the process.
- Babylon 5: Human telepaths are required to join Psi Corps or take drugs which suppress their telepathy for the rest of their life. Unfortunately, the drugs have side effects similar to clinical depression. Ivanova despises the Psi Corps because her mother was a non-Corps telepath, and was eventually driven to suicide by her use of the drugs.
- Part of that may be because the drugs effectively deaden one of the senses that telepaths consider normal. Imagine if you were forced to take a drug that would make you unable to see, or hear, or taste anything.
- The entire premise of The United States Of Tara—She went off her meds to discover the cause of her DID.
- In Criminal Minds, Reid's schizophrenic mother forwent her meds when she was pregnant with him. She goes off them again during the timeline of the series in an attempt to remember an event from Reid's past.
- The episode "Haunted" is about a man who went off his antipsychotic meds (with the approval of his psychiatrist) in order to access repressed childhood memories. These memories end up being much worse than anyone had imagined, causing him to snap and go on a killing spree.
- The reason Billy goes off his meds in Six Feet Under.
- This is one of House' reasons to stop taking the Methadone, which cured his pain in the leg better than Vicodine, but he also felt that the lack of pain affected his deducting abilities. He uses the same argument in the first episodes of Season Six when Dr. Nolan insists in giving him SSRIs, he's afraid of losing himself and his abilities. He ends up taking them, anyway.
- In the episode "No More Mr. Nice Guy" occurs a little variation of this trope: House employees test a sample of his blood without his consent and discover that he has neurosyphilis. They assume that the effect of the disease in his brain is the reason House is such a huge jerk. They prescribe him with a medication. Suddenly he starts acting a little nicer. All the employees then start asking themselves whether they did the right thing or if he is going to lose what makes him so unique. In the end of the episode it was all a prank of House, of course.
Kutner: We gave Van Gogh chelation therapy. Turned him into a house painter.
Taub: Maybe not, maybe we just put Hitler on Ritalin.
- Duncan spends most of an episode of Veronica Mars avoiding taking his antidepressants. After jumping off a set of bleachers and injuring his head and then having an atypically vivid daydream, he ends up deciding that he's better off taking them after all. However, unlike many other examples, he actually consults a doctor regarding going off the medication.
- In Harper's Island, Henry's brother J.D. needs to regularly take multiple pills. Though he tends to stop taking them now and then because it makes him feel "foggy". When he's off his pills he tends to do irrational things, like gutting a deer's throat and leaving it on the hood of someone's car and smearing threatening messages on their windshield with its blood.
- Has happened to both Craig and Eli in Degrassi.
- Eli's storyline with his meds has been handled fairly realistically; the first thing they put him on made him feel completely emotionless (leading to this trope) while subsequent adjustments have brought him into better balance. He also became manic a few times while he was off them.
- M*A*S*H episode "White Gold": Col. Flagg is getting a self-inflicted wound in his head stitched and tells Hawkeye he wants no Novocain.
Trapper: You heard the manic.
- Happens on The L Word when Alice has a nervous breakdown after Dana breaks up with her. In her case, though, she was downing pills like they were Pez and finally became sick of how dependent on them she had become.
- The show Black Box is about a psychiatrist who herself is bipolar. One of the constant themes of the show is her frequent refusal to take her meds, resulting in occasional nights of "poor decisionmaking". She also starts hearing music and runs on the streets. This also strains her relationship with her boyfriend, especially when she admits that she cheated on him once after refusing to take the meds. And then again when she tries having rough sex with him while also off her meds, only for him to be put off. He later admits that he wasn't put off by her behavior, but by the fact that he found himself liking it.
- The Panda Bear song "Take Pills" is about getting off of antidepressants.
- The Switchfoot song "Mess of Me" states "There ain't no drug to make me well".
- The Wall directly mentions this in the form of Pink's BSOD Song The Wall Part 3. "I don't need no walls around me./I don't need no drugs to calm me!/I have seen the writing on the wall./Don't think I need anything at all!" By this point Pink has finally realized that he must come to face with the problems of his life that lead him to build the eponymous wall having been removed from the hedonistic lifestyle he built up as a rock artist to escape it, making this instance especially poignant. Somewhat justified in that even those drugs that aren't flat-out illegal are given to him by a quack who cares more about getting him back on stage than about his well-being, although in Real Life rehab overseen by a competent professional would probably have been a smarter option than self-administered cold turkey.
- Patton Oswalt has a bit where he says he went off of his depression medication because he didn't want to be burdened by it in case of a zombie attack. He describes his resulting depression like a pet dog being overjoyed to go outside and play.
- Diana from Next To Normal insists on this multiple times, most notably in "Didn't I See This Movie?", after her doctor recommends electro-shock therapy.
- Rebecca and Sara in Code Twenty One feel this way, with good reason.
- In Blood Brothers, this gets slightly twisted: Mickey wants to stay on his medication for chronic depression, but his wife and mother both pressure him to quit. His wife specifically tells him that she's depressed a lot, but doesn't need any pills to get over it!
- When we first meet Gary in Bully, he says he's taking meds for ADD and other problems. At the end of the game's first chapter, he says that he's gone off them and feels great. Because he's the main villain, this just ends up making him more unhinged.
- Realistically depicted in Fallout: New Vegas with Lily Bowen. Like most Nightkin, Lily has schizophrenia (she hallucinates that "Leo" is telling her to "do bad things") and sometimes goes into psychotic fits where she becomes violent and uncontrollable (such as when she's reduced to 1/4 health). However, she keeps some semblance of sanity due to her medication, but she only takes half the recommended dosage. You can advise her to keep doing that, take the full dose (which causes her to stop having psychotic fits, but makes her forget her grandchildren), or stop taking the medicine altogether (which causes her to have fits at 1/2 health, but buffs her stats permanently). If you tell her to stop taking the meds her ending shows that her sanity kept slipping until she became permanently stuck in the psychotic mode.
- In A Miracle of Science, Manny underdoses his anti-Science-Related Memetic Disorder medication due to it making thinking harder, but ends up going back on the meds once he gets caught. It's never explicitly stated how much Manny altered his dosage, but Prester remarks that you have to take the full dosage for it to actually work at suppressing his SRMD. It's a nasty situation; without the meds, his programming skills can practically twist the laws of physics. With them, he's mediocre at best. Of course, without them, he's also prone to making plans of World Domination, whipping out an Evil Laugh, and just generally being a Mad Scientist.
- Subverted in Goblin Hollow here. Penny describes her friend Tiffany who was weaning off pills, and committed suicide in one of her negative mood swings.
- In The Last Days Of FOXHOUND, Ocelot throws away his medication for Chronic Backstabbing Disorder just before finally beginning the series of betrayals he's been plotting for years.
- Homestuck: Gamzee Makara is a nice guy who considers everybody his friends and would rather eat toxic slime pies with imps than fight them. Then he runs out of slime...
Gamzee:"There is no more slime, brother. AND ANYWAY. Shit was motherfucking poison, didn't you know?[...] It rots you. RUSTS YOUR MOTHERFUCKING THINK PAN. And the floor all stares back at you through the motherfucking hole. BUT THERE IS NO HOLE NOW.
- In Sinfest, Fuschia spits out her medicine. Given that the problem is that falling in love is making her better, it ends better than most.
- One strip of Penny Arcade depicts Tycho looking over the last few strips he'd written while his Lexapro prescription had run out and marveling at his creativity. Gabe also called him out that during that time he was also "wrestling with demons of the mind".
- Discussed and deconstructed in one panel of this strip of Robot Hugs.