If we were prescribed a course of antibiotics to treat an infection, the question of whether or not to take the tablets probably wouldn’t cross our minds. After all, medication is designed to make us feel better, right? Why then, is it such a different story when tablets are being prescribed to treat our mental health? I’m going to focus on addressing some of the possible reasons for which people may choose to avoid psychiatric medication, using my own personal experience as a baseline.
Psychiatric medication, just like the general topic of mental health, carries a huge societal stigma. For years, films and television programmes have associated antidepressants and antipsychotic drugs with mental institutions and insanity, painting the idea that medication is reserved only for the most unwell and mentally disturbed individuals. Although this association has been somewhat diluted over the last couple of decades, we’re a long way from speaking about psychiatric medication as openly as we would paracetamol or other over-the-counter tablets. This stigma can in itself be a crucial factor for people deciding whether or not to accept a prescription for an antidepressant, mood stabiliser or sleeping pill to help with their mental health.
If they don’t see depression as an illness, how are they going to understand that I need medication to make me feel better?
Will they think I’m crazy?
Am I weak because I can’t just ‘get over it’?
Not only is there the worry about what others will think about your choice to take medication, but many people need to convince themselves that it’s the right choice. Agreeing to take medication also means agreeing that something is wrong and deciding to accept help. When someone isn’t undergoing talking therapy or taking medication, it’s easier to brush everything under the carpet and pretend that things aren’t as bad as they really are; the moment you accept help though, is often the moment that you admit to yourself that you might need it.
Accepting help requires you to swallow your pride and is something that takes an awful lot of courage, but it can often bring about feelings of weakness, guilt and/or shame. Couple these negative thoughts with the initial low mood/anxiety and things become even more difficult. Depression has a very clever way of convincing you that you’re unworthy of care and love, that you don’t deserve help and that you in some way deserve to feel like you do. Anxiety, on the other hand, can make you question whether you actually need the tablets, whether or not they’ll have a bad effect on you and whether you’ll become dependent on them. In the end, accepting medication when your head is screaming at you to reject any sign of help or care and to avoid the unknown, is by no means simple.
Accepting medication is one thing. Physically taking it is another. And continuing to take it every morning without letting your thoughts convince you otherwise, is another thing altogether.
At sixteen, I was worried about what others would think and I was a long way from accepting how bad things were, but the thing that worried me the most was that medication would, in some way, cloud my judgement of reality. I’d seen so many programmes about people in mental health institutions who looked dazed, disorientated and as if they were a million miles away from the world around them. My struggle with dissociation meant that I was already feeling disconnected from reality and the thought of feeling anymore robotic or spaced out, was terrifying. I didn’t want to feel like I was feeling, but nor did I want to merely cloud reality with some kind of superficial happiness.
Looking at medication from a more practical perspective, things weren’t any more appealing. Aside from having to remember to take a tablet or two every morning, psychiatric medications are renowned for their very off-putting list of side effects including an increased risk of suicidal thoughts, initially worsened symptoms of depression and anxiety, nausea, headaches, weight-gain and insomnia. Sounds tempting, doesn’t it? In actual fact, the side effects weren’t a major concern for me (a headache or two seemed fairly minor in comparison to the daily torment in my head) but the uncertainty as to whether they were even going to work or not, definitely was a concern. I was told many times that it wasn’t certain that the first medication would have any profound effect and, for a non-gambling girl, I wasn’t really up for going through several weeks of feeling worse just to find out that it was all for nothing.
Essentially, the cons of taking medication seemed to far outweigh the alleged benefits. I was keen, as were my doctors, to follow a more holistic approach to recovery. I was young and had never experienced any trouble with my mental health prior to this episode and so I was optimistic that I could ‘just get through it’ without help. However, regardless of all concern, there came a point where there was no longer a choice and medication was the only option…
When you’re so entangled in the grips of depression, it can be impossible to engage in talking therapy. I sat through hours of talking therapy during which I’d sit and stare into the distance, unable to even process the therapist’s words, never mind engage with them. My mind was horrendously full of nothing. I barely had the energy to string a sentence together, I wasn’t interested in exploring the things that could be making me feel as I did and I wasn’t entirely sure that I wanted to get better. It was at this point that I needed something to help to lift the fog and put me in a better place from which I could engage in my own recovery. Medication, at that time, was a lifesaver.
Accepting medication doesn’t mean that you’re signing up for life and it doesn’t mean that you’re any less in control of your own recovery. Yes, the list of side effects looks like a recipe for disaster and yes, it might be a game of trial and error before you find a medication that suits you, but when you have nothing to lose, it may well be worth a try. I can’t say that my recovery would have been any easier or quicker had I accepted medication when it was first prescribed to me, but I’m pretty sure it would have been a smoother ride had I followed my doctor’s advice with regard to taking the tablets properly. It is hypocritical of me to say it, but hopefully it will make at least one reader reconsider…whatever you do, don’t stop taking your medication without talking to your doctor and reducing gradually. Too many times, I’ve ended up in a worse off position owing to the fact that I acted on fleeting thoughts that convinced me that medication wasn’t the right option.
Don’t be ashamed for taking medication, don’t give up hope before you’ve given it time to work (a few weeks, at least) and don’t feel like you can’t talk to your doctor about your concerns, doubts and opinions on medication – it’s your choice and it’s your recovery that’s the most important thing.