I didn’t want to take mental health medication, but I needed it to save my life. When my first therapist diagnosed me with depressive-anxiety disorder, I had been unable to sleep for a little more than four days. The psychosomatic symptoms of my illness had made it impossible for me to fall asleep. Melatonin, Ambien, supplements — nothing worked.
I didn’t want to take mental health medication, but I needed it to save my life.
|
As the sleepless days dragged on, I felt like a slug someone stepped on. Eventually I was nothing but a stain on the sidewalk. I stopped showering and cried more than ever. My clothes became rags for sweat, tears and snot.
When I wasn’t weaping, I was lying in bed. I couldn’t do anything. My thoughts couldn’t transcend beyond ruminating on my state of exhaustion and sadness. Bodily functions, thirst and hunger were all that could get me out of bed. Even when they forced me to rise, the journey to the bathroom or kitchen was slow. Each step was like pushing through an invisible sludge.
My therapist said I needed something that would treat the root of the sleep deprivation: antidepressants. They worked well enough. My sleep was still crap, but I at least no longer felt like I was going to die. It was the beginning of my recovery from the worst point in my depression.
Despite what I owe to mental health medication, I am cautious about taking it again, and based on my experience, I rarely recommend it. Because I am a vocal advocate for therapy and open about my use of mental health medication for my depressive-anxiety disorder, friends often ask about my experience when they are considering mental health treatment options. It usually boils down to three options: therapy, medication or both.
My suggestion is always the same: If you can, go with therapy only. That should be your first choice. If you are in danger of dying, harming others, or losing functioning and productivity to the point of being unable to work or attend school, use medication.
Even then, don’t only take drugs. Rely on the bare minimum. Then connect with a therapist as soon as possible. If you can, get off the meds by working with a psychiatrist who has the skills and experience to implement a gradual reduction that will not harm you. Be patient, though. This process can take many years.
Sometimes this recommendation puzzles my friends.
“Don’t you take medication?” they ask. “You seem so against it.”
I’m not entirely opposed to medication. It saved my life. It also allowed me to sleep well enough to have energy and focus during the day. Mental health medication is an amazing scientific gift we should be open to. We should utilize it responsibly and in moderation.
I have spoken to dozens of people who lean toward medication because they believe it is an easier choice than therapy. Swallowing a pill everyday doesn’t seem like a big deal to them.
Sometimes people don’t start counseling because they believe they are opening up a huge can of worms, something that comes with too much baggage. They worry about the hard parts of therapy: opening up, digging into the pain, taking the time to make progress, maybe not finding the right therapist immediately, eventually leaving the therapist, etc.
I’ll admit these are challenges you can avoid by using medication only. Nonetheless, psychotherapy is actually more manageable than medication. It does not carry any risk of addiction or bodily harm.
Mental health medication can have unpleasant side effects, including nausea and vomiting. You might experience these side effects for weeks or months before the positive effects of the medication kick in.
Properly using mental health medication has its own administrative and procedural hurdles as well. If you want to manage the medication with better results and less risk, you’ll need to find a good psychiatrist. A primary care doctor isn’t enough because of ethical issues in working with a non-psychiatrist doctor to take mental health medication.
This psychiatrist will need to take your insurance. Both the medication and the psychiatrist fees might be difficult to afford. Even if you can afford them, it can be challenging to find time to commute and see a psychiatrist during business hours. In this sense medication carries the same inconveniences as traditional therapy.
Then there are the pharmacy visits and assisting the coordination between three parties: your psychiatrist, your health insurance provider and the pharmacists. The pharmacy hours and locations might not be convenient for you. Even if you have a convenient pharmacy location, it’s possible to spend more than an hour waiting in line and for the pharmacist to process the order or refill.
At first it wasn’t so bad. Most of the difficulty was anxiety from being off my meds for the first time. Then I started shaking. No matter how much I tried to bundle up, I felt cold and shivery. By the fourth day the shaking and chills were so bad I could barely work or talk.
|
Finding a decent psychiatrist where I live, in New York City, was surprisingly difficult. Of the few who would take my insurance, I was only able to set up an appointment with one. This took a while because he — like many elderly mental health professionals in New York City — did not use email. He only communicated by phone and only during business hours. It was an endless game of phone tag and voice messages interrupting my work.
Other than refilling my medication, he did little for my condition. He didn’t develop any strategy for continuing to reduce my symptoms or eventually wean me off the medication. When I asked for this service, he ignored me.
If you can’t obtain your refill in time because of administrative issues, there is a chance you will experience withdrawal. It’s one of the worst feelings in the world.
My experience has made me cautious about taking medication for mental illness
My journey toward withdrawal began when I dumped my first psychiatrist and used a primary care doctor instead. If he was only going to refill my medication, I didn’t need to pay him to do that. A doctor would do it for less money. This was not a good idea. I should have tried to find a better psychiatrist. Instead an unfortunate incident forced me to try it again.
Because of some unexpected insurance changes and staff transfers at the facility I called for my doctor-prescribed refills, I suddenly found myself without medication for four days. Therapy had helped me make a lot of progress on my symptoms, so I was able to sleep decently. Then withdrawal symptoms started creeping in.
At first it wasn’t so bad. Most of the difficulty was anxiety from being off my meds for the first time. Then I started shaking. No matter how much I tried to bundle up, I felt cold and shivery. By the fourth day the shaking and chills were so bad I could barely work or talk.
My boss noticed and offered to get in touch with the head of our clinical department. She got on the phone, worked some magic and helped me get the refill. It was hard for me to move around because of the shaking, so my boss grabbed a cab and drove me to the pharmacy. When I arrived at the pharmacy, the pharmacists commented on my state.
“We’ve seen this before,” said the chief pharmacist. “You should feel better once you take the pill.”
My situation seemed to be common. I imagined the pharmacists must have seen dozens of people like me come in rattling and panicking.
I have a new psychiatrist now, but the struggles haven’t stopped. We are figuring out whether I should try a new medication, try a different dosage, wean off, etc. It’s a game of trial and error where each error takes a toll on my body, mind and morale.
She’s competent and I like her, but she’s only human. No psychiatrist or doctor knows exactly which medications will work for which people and how well.
Why take the risk of going down a path like this and taking on the burden if you don’t need to? Of course, this is a decision you should make with consultation from your doctor or another mental health professional.
|
Last time we tried upping my dosage to see if we could improve my sleep further. It went horrendously. I became irritable, nauseous and numb to several emotions, including anger. Now I’m back on my regular dosage and awaiting the results of various medical tests my psychiatrist and I agreed were worth investing in. Hopefully they will give us an idea of what to do next.
My experience has led me to caution other people to weigh out whether you feel it is absolutely necessary. Why take the risk of going down a path like this and taking on the burden if you don’t need to? Of course, this is a decision you should make with consultation from your doctor or another mental health professional.
For me, therapy has not become a burden. I love going. I plan to go for the rest of my life. If I decide to quit, I can do so without any withdrawal or negative consequences. I don’t need therapy. I choose it.
Medication, however, is a source of stress and frustration in my life. I don’t need it to sleep, but I can’t stop taking it, not yet. If it was easy for me to get off it, I would’ve triumphantly thrown it in the trash years ago.
If you are living with mental health symptoms that are making it difficult to function or to work, and you wonder whether you should take medication, talk to your doctor. Before you take medication for mental illness, remember my story and talk to your doctor about any potential long-term consequences from the medications. And consider therapy. It’s not a quick fix it and at first it may not feel natural, but in my experience it is a vital part of my mental health treatment plan.
Photo by Parker Whitson on Unsplash