It’s the phone call every practitioner in this work eventually gets. A client, a few weeks into coming off their medication, says the words: it’s all coming back.
What you do next matters more than almost any other moment in the taper.
Read the situation one way and the client returns to the medication, often for years, convinced they can never come off. Read it the other way and you hold them through a rough but temporary passage on the way out.
The problem is that the two states look nearly identical from the inside.
The client can’t tell them apart. Most prescribers were never taught to tell them apart. In this clip, Dr. Rabin gives you the distinction he uses in his own practice, and it fits in a single question.
Is the feeling coming back across the whole spectrum, or only on one end?
Remember the window from earlier in this series. When someone comes off a serotonergic antidepressant, the window that was narrowed begins to open again — and it opens from both ends at once.
Feeling floods back on the difficult side and the bright side together.
More tears, and more laughter. Harder lows, and moments of delight the client hasn’t felt in years. That whole-spectrum flood is intense, and it is normal. It’s the window doing exactly what it’s supposed to do.
A return of the original condition looks different, and Dr. Rabin walks through the specific signs in the clip. The short version: nothing comes back on the bright side at all.
One distinction, one minute, and it changes what you say on that phone call. Press play.
SSRI Deprescribing & Psychedelic Readiness Certification
Learn the full protocol directly from Dr. Dave Rabin. Six live 90-minute sessions, six facilitated labs where you work real cases, and pre-publication access to his clinical deprescribing manual. Three months, starting October 7. 7.5 CE credits available for eligible clinicians.
SEE THE FULL CURRICULUM →
Next in this series: “Has this ever happened to anyone here?” Dr. Rabin has asked one question of thousands of practitioners over years of teaching — and in almost every room, one hand goes up. What that hand means for anyone combining this work with medication.
