OP here, I had posted a lengthy explanation but while one of my comments appeared, that did not. Not sure why... I have a severe form of bipolar disorder. After I was diagnosed, I spent several years in and out of the hospital as my doctor tried me on almost every type of mood stabilizer and antipsychotic in existence. During that time, I was pretty much unable to function. After a long trial-and-error period, we found the medications I'm on now. I've been taking them for several years now and since then, I've been able to go back to school, succeed at my degree, get a job in my field, get married, start a family (after seeing the right specialists and taking all the necessary precautions) and lead a normal life. Considering how long it took to find the right combination and dosages of medication, my psychiatrist and I are both scared switching would upset that balance. Confirming our fear is the fact that every time we've tried to lower the dosage even slightly, I've started getting symptoms and we've had to bring th dosage back up. As to why I would miss a dose, it happens very rarely, but on occasion I've had to skip one because I needed to be 100% awake and present for something and knew I couldn't achieve that with the side effects of my medication. That being said, the half-life is long enough that skipping one dose, once in a while doesn't have a noticeable effect. I'm also very careful about not doing that if I feel fragile, because having dealt with my illness for over a decade now, I know my limits and want to make sure things never go back to the way they were before I was stable. I'm very grateful for having been able to find the right treatment and would never do anything to jeopardize it, like going off my medication without a doctor telling me to. I have no illusions about what's made me stable. It is a little scary, though, thinking that my body needs the medication that much...