Our complicated relationships with medications

capsules filled with sparkles

I can’t think of any other type of health condition that has as polarized a relationship with medication as mental illness.  In some ways, to medicate or not to medicate has become a moral issue, with various involved parties taking a stance based on principle.  Often this stance is very broad, making sweeping generalizations.  I recently read and reviewed the book Lost Connections, which argues that all depression is situational and medications should not be used.  Some people connect psychiatric medication use to violence, such as the incoming director of the National Rifle Association (NRA) who has suggested a link between school shootings and Ritalin (methylphenidate).  I’ve seen Twitter comments blasting people who wrote about the positive effects they experienced from medication.  We would never hear any of this kind of thing if we were talking about blood pressure medication, so why are there so many eager to shout from the rooftops when it comes to psychiatric meds?

My own view is certainly shaped by my professional training; I used to be a pharmacist, and now I’ve been practicing as a nurse for 13 years in mental health settings.  I understand how medications produce the effects (both positive and negative) that they do, and have the research literacy to separate the BS from legitimate information.  I look at medication as a tool, and any given medication may or may not work for any given individual, and may or may not be tolerated by that individual.  I have seen medication be life-saving for people, and it certainly has made a huge difference in my own illness.

In general it seems like people tend to speak up, both online and in person, more often about things that go badly for them than things that go well.  The same appears to be true with medication.  I’m a bit fuzzy remembering the details, but not too long ago someone had written a post about antidepressant withdrawal, and someone else commented about how venlafaxine is a garbage drug that no one should take because of the withdrawal effects.  I’m sure that individual’s experience was very negative, but it’s easy to see remarks like this about side effects and overgeneralize, making the assumption that they occur for all/most people taking the drug.  Unfortunately we don’t yet have a way of predicting who will respond to or tolerate particular drugs (although I’m sure the science will get there as the role of pharmacogenomics expands), but to allow treatment decisions to be based on people’s negative comments online doesn’t seem particularly helpful.

I suspect that some of the time meds are demonized because of poor clinical practice by prescribers.  If physicians aren’t responsive to the side effects people are having, ordering any necessary bloodwork, or prescribing drugs that are actually appropriate and effective for the condition being treated, those things don’t mean the drug itself is inherently bad.  Instead, it means that the prescriber is being irresponsible.  I can’t help but think of a blogger with bipolar disorder who was treated for many years with high-dose clonazepam, and then had it discontinued abruptly.  In my mind that is shocking malpractice and a gross misuse of a medication that is not even indicated for treatment of bipolar disorder (but can be very useful when used carefully and appropriately).

It’s also problematic when doctors prescribe a medication and make it out to be a sort of panacea that will fix everything.  We all know there’s a lot of different things involved in getting well, whether we’re on medication or not.  Psychosocial stressors and underlying trauma aren’t going to disappear with a wave of the SSRI wand, and that’s fine, but doctors should be open with their patients about what medications will and will not do.  If patients are coming in misinformed and expecting to pop a happy pill, the health professional has a responsibility to educate them about the nature of mental illness and its treatment.

As Shakespeare’s Hamlet might say:

To medicate, or not to medicate: that is the question:
Whether ‘tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them?

Where do you stand when it comes to medications?

 

Image credit: rawpixel on Pixabay

71 thoughts on “Our complicated relationships with medications

  1. LateNightGirl.org says:

    I’m scared of meds with all the horror-stories one hears. I am not informed like you are. The addiction part of it scares me the most, then the side effects. Having seen people walk around like zombies, switched off, I try as long as I can to not have to get on meds.

    Liked by 2 people

      • LateNightGirl.org says:

        Yes, and because the doc is the expert but is letting people down so bad. I rather try without meds as long as possible. I had a conversation online with a mother who lost her daughter who was only 10 yrs old. We were speaking on an online bereavement website about antidepressants because I was then (2015) in the beginning of my traumatic bereavement and was contemplating getting on antidepressants.

        The mother strongly advised me not to, because she went rather quickly on antidepressants shortly after her daughter died and was on it for 7 yrs. She said to me that when she got off it THAT is then when her grief started, because for 7 yrs she couldn’t grieve because she was in a blur on meds. I was glad for her advise because I went into full force trauma and grief without “delay” so-to-speak.

        Even though antidepressants may be helpful during grief, they should just “bridge” the intense time, and not take away from the importance of grieving.

        Liked by 2 people

  2. aguycalledbloke says:

    I steer clear of them in truth. I was prescribed something or the other last year after the previous something or the other wasn’t working, nor the previous one to that. What l don’t like is how it switches me off and flattens me like some kind of loose rogue elephant. So l opted for no more meds.

    During my 9/10 year breakdown, the docs prescribed me everything they could think of, and l hated losing my ability to think for myself. In order to beat that, l started self-harming and that kept me awake mentally. It is NOT the answer, but l don’t like what the chemical giants do to keep sufferers at bay.

    There is a much bigger game strategy in this subject than just the premise of this excellent post Ashley. I try where possible to not take any medication for anything.

    Even now l am in a lot of physical pain, and l have been prescribed to take 2 tablets of solpadol every four hours, but l can’t. yesterday was a nightmare, zombiefied, couldn’t function properly. So now l have only taken one this morning at 8, and l will take 2 before l go to sleep.

    I would rather have the pain and know l am alive and functioning in comparison to being unable to move properly and so called pain free.

    Liked by 2 people

  3. KD says:

    I have to say, I think my position on meds is changing. I’ve been trying for ages to find something that works and nothing for work the way I thought it should. Now I’m starting to think the problem was my perception of how the meds should he working. I have to remember they aren’t a magic cure, even if they just make things a little more bearable, that’s something.

    Liked by 3 people

  4. s.e. taylor says:

    Even though I have a few of my own medication nightmare stories, I am pro-medication when it comes to bipolar disorder. I think the reason it was such a rough road was, as you said, “poor clinical practice”. If i knew back then what I know now, I would of been able to better advocate for myself. I feel pretty strongly about people coming off of their meds for bipolar. It’s so common to not want to be medication compliant , that I worry when I read posts about going medication free, that it could influence someone to stop their meds. I’ve been know to get pretty upset with people. It’s a brain disorder and requires medication. I think we are responsible for managing our illness, and medication is part of that. So there is my point of view, it’s a strong one, and probably controversial. I’m not speaking to depression medication, as I think that is a much more complicated subject and is more individualized.

    Liked by 3 people

  5. sarahshealthmatters says:

    I can’t talk for psychiatric medicines or their prescribing but I did have to take a lot of painkillers during the past two years. I was on such high doses of fentanyl, oxycodone, tramadol and pregabalin all at the same time and it really affected my mental health. I couldn’t concentrate and was sent into a spiral of utter despair over the slightest thing.
    After being on them all for about a year and feeling pretty suicidal I couldn’t take it any longer so came off the lot and went ‘cold turkey’.
    Best days work I ever did, although it’s not something I would advocate for everyone as the side effects were horrific for months.

    Liked by 2 people

  6. Meg says:

    I take:

    Provigil 100 mg
    For most of my life, I’ve required 11-13 hours of sleep per night, and I know it’s not due to depression. (Not that I judge.) There have always been things I’ve wanted to do every day that I’ve never had time for because of the oversleeping. (And if I woke up earlier, I’d just go back to sleep.) God bless Provigil! Now I get 8-11 hours of sleep.

    Seroquel 50 mg (and more as needed)
    Another sleep problem I started having after a scary visit to the dentist involved my waking up after three or four hours of sleep and not falling back to sleep. This level of exhaustion was unmanageable. Seroquel keeps me asleep all night so I get the sleep I need. Also, this low dosage of it keeps me from being bipolar, like, ever. Go figure.

    Lexapro (which I just switched over to from Zoloft)
    If I’m not taking an SSRI, I get downright irrational and psycho. I’m not depressed, but the SSRI’s also work for OCD, and I AM pure-O (obsessive without compulsions), which manifests itself by turning me into a raving, scary monster. (Just run.) I get the worst side effects from taking an SSRI, but… holy shit. You just don’t want to be around me without one.

    Ambien 5 mg
    Pretty self-explanatory. I like to fall asleep at night. For years, I would stay up all night and sleep all day, which I hated, but I blamed my own laziness and inferiority instead of trying to find workable solutions. God bless Ambien!!

    Abilify 2 mg
    I’m not sure how this drug helps, but after having just switched antidepressants (which was pure emotional/hormonal hell), I’m in no position to mess around with it at this time.

    I needed meds for so many years but didn’t have good psychiatric care. When I think about the summer I wanted to spend at a really nice job I had, but I couldn’t get out of bed, I feel sad. So many good experiences wasted without the meds I have now.

    Liked by 4 people

  7. Luftmentsch says:

    I’m fairly pro-meds, which may be a bit surprising given that most of them do nothing whatsoever for me and the small number that do seem to work OK for a while then suddenly massively decrease in effectiveness or stop working altogether as soon as I’ve started trying to get my life back together. But I think they can be literal life-savers for some people, as they have been for me at one or two points.

    You’re right that people don’t view any kind of other meds the same way; as many people have pointed out, no one says that diabetics taking insulin are using a “crutch” or, worse, are victims of Big Pharma making up placebo treatments for fake illnesses. I know some people have bad experiences, but they shouldn’t generalise from their experience. Also, people tend to see meds, therapy and alternative medicine as either/or, which I’m not sure is helpful either, although price and interactions can make them either/or, I suppose.

    My worst anti-med experience was when I told my dentist I was still on meds (because they always ask that) and he asked why I’m still on them and why my religion doesn’t help me get over the depression. I should have asked him if I should stop brushing and flossing and just pray to God for good teeth…

    Liked by 5 people

    • ashleyleia says:

      I think it’s so inappropriate when health professionals voice an anti-medication stance like that. Perhaps we should throw the fields of medicine and dentistry out the window entirely and hit ourselves over the head with whatever holy book we happen to subscribe to…

      Liked by 1 person

    • 2angelsinmo says:

      Wow, your dentist’s said that? Hope he’s not your dentist’s any longer. Going through something similar, the religious views on us and meds. Ty for sharing.

      Liked by 1 person

  8. Felicity Thora Bell says:

    This is a really, really important issue. For myself, medication has only been helpful when my OCD was debilitating, but I eased off of it as soon as I could. For others—like one of my friends who has bipolar disorder—medication is necessary. They tried several “natural remedies” and meditation and yoga and eventually had to reckon that their natural lifestyle and medication could coexist, that it was best for their continued survival. A complicated conversation, and one that is far from over. Excellent points!

    Liked by 3 people

  9. Iggy says:

    I am pro-meds. I always have been, but at the beginning of my diagnosis my husband was anti-meds and wanted me to treat the bipolar with vitamins. So, I stupidly went off of my meds to prove a point. Vitamins are NOT going to help me. And after a year of being off meds, I of course had to go back on them. But my point was made. He doesn’t give me a hard time about my meds anymore. I don’t recommend anyone do that. That is just my story. It infuriates me when people think you can “cure” a mental illness holistically. But if that is how they want to approach their illness, so be it.

    Liked by 3 people

    • ashleyleia says:

      I think a holistic approach is good if it involves coming at the illness from multiple angles (including meds as appropriate), but the idea of vitamins as a cure-all for serious mental illness is such a load of crap.

      Liked by 3 people

  10. howikilledbetty says:

    I just wish that years (and years) ago I had been educated about depression … educated that there is more to it than a pill. But this was way before the internet where now we have all the information at our fingertips. I have learnt, mostly, what works for me and clearly for others too about self-help. But the problem is that in a ten minute slot at the doctors surgery there is no time to really talk through it all and educate the patients, and sometimes that’s when the patient is at their lowest and that’s not always the best time anyway. I remember practically putting my hands around the throat of one doctor who suggested that I read a leaflet and take a walk outside in the fresh air! Great post, as ever. Katie x

    Liked by 2 people

  11. wellcolourmeyellow says:

    This was a great post. I remember when I first ‘came out’ with the ‘hey Im on meds’ talk with my friends. Mostly I had a really good response. So this was interesting: The best responses (some exceptions always) were from people who saw me having intense panic attacks. The mediocre responses were from people who knew in-depth the severity of my bad mental health. The worst responses were from people who never saw it happen even once. And it really kinda sucks to have a best friend not even do sufficient research (or do a biased research) on medication, before telling me to stop taking meds and that it’s pointless and bad for me and to stop using my mental illness as a scapegoat.

    Great bloody post ❤

    Liked by 3 people

  12. suicidaltransgirl says:

    I am most definitely pro meds.

    I take:

    Zyprexa 17 mg
    Prozac 25mg
    Trazodone 200mg
    Lamictal 200mg
    Gabapentin 900mg

    Levothyroxine (for an underachieve thyroid which can lead to depression)

    In addition to these I take various other meds for the maladies of middle age like blood pressure and acid reflux.

    This combination has allowed me to stay out of the hospital for over 2 years and allowed me to live fairly independently in the community with weekly supervision from a case worker. Starting July 1st I transfer into a completely independent housing program.

    I have a love/hate relationship with Zyprexa. Out of all the different antipsychotic medications I have tried it has been to most effective in controlling my symptoms. That being said, I do have some side effects that are troublesome. Some days my hands shake so badly that I can’t hold a cup of coffee. Forget about even trying to put contact lenses in. Recently I have has issues with involuntary movements of my face and tongue. My psychiatrist thinks that I may be in the early stages of tardive dyskinesia.

    As much as I want to tell myself that I am doing better and don’t need the meds anymore, I know deep down that there is no way I could go completely unmedicated. Last time I tried that I was standing on a freeway overpass screaming at blue cars. I don’t want to repeat that.

    Liked by 1 person

    • ashleyleia says:

      Yeah meds are a necessity for me too. Lithium is my love-hate med. It definitely helps a lot, but the tremor can be quite bad sometimes. Still, going without meds is never going to be an option.

      Liked by 1 person

  13. Karen says:

    Over the years I have struggled with the idea of taking meds for something which in my case was triggered by adverse life events, I felt like a failure for not being able to handle these difficulties on my own. I wasn’t against meds, I just felt (in my perfectionist world) that I was better than that and could manage on my own.
    Now, I am very much in agreement with my doctors that meds are essential for me right now, and for the next few years at least. And that’s ok. And I’ll deal with withdrawal as and when.

    On the subject of venlafaxine, I have heard similar tales about coming off it, to the point that had I not been in such a bad place I wouldn’t have even considered taking it. But with so many anti depressants clashing with tamoxifen, my options were limited.

    Liked by 2 people

      • Karen says:

        That’s very reassuring, thank you. But as I’ll be on it for, and I quote, “at least three years after I’m feeling better”, it’s not something I need to worry about just yet… although I might start counting my three years from now! Heavens I’ll be 49 before I’m off it!!!

        Liked by 1 person

  14. J-Dub says:

    I like that you point out it is different for everyone. I hate that the horror stories online turn into a one size fits all X medication is evil. Speaking specifics on my case only. Prozac was not working anymore (if it ever really did). I gained weight enough to go up 4 sizes in 2 years (I do not know my actual weight because I will not step on a scale). I am not positive Prozac caused the weight gain because I am not physically active and my food choices are poor. My PCP took me off Prozac when I told her it was no longer helping. I am now taking Zoloft. So far no reactions in about 3-4 weeks. I go back 7/2 to discuss further. I am not sure if Zoloft is better but I wanted so much for it is be, I have told myself it is working. In the meantime I got a job and I am doing well at it. This alone has lifted my spirits and I feel good. Better than I have in years. Is that Zoloft or positive self-esteem? I also worry that my PCP is not the best for this but finding a psychiatrist in my area is almost impossible. Not seeing new patients or 6 month wait to see new patients. The ones available are walking freak shows. The stories I could tell but won’t.

    Liked by 2 people

  15. Sarah’s Thinking Again says:

    This post is like my brain most weeks. I take medication but I’m so scared of it & the medical team don’t help by often disagreeing with each other what’s best. With Borderline Personality Disorder they all agree therapy is best, it’s just such a long wait. Thank you for sharing. Glad it’s not just me that gets confused x

    Liked by 2 people

  16. Memoirs of a Mental illness says:

    I will be the first to admit that I struggle with taking the amount of meds that I do. I am asking for a reduction in them overall because I feel over medicated but I take a variety of meds for a variety of reasons. I personally believe that the less meds the better for me as long as I can remain stable.

    Liked by 2 people

  17. aliciajademx says:

    Totally agree, and another massive problem is people who take them for a few days and immediately disregard them as rubbish. In my experience I’ve started medications that have actually sent me the other way than they were supposed to for two weeks and after some perseverance they have helped.

    Liked by 1 person

  18. livingwithachaoticmind says:

    I used to hate medication and was non-compliant because half the time I believed I was doing great and didn’t need it, the other half of the time I thought they were poisoning me and trying to kill me. This wasn’t helped by the fact that one of my doctors when I was 18 prescribed 1800mg Lithium and wasn’t checking my blood levels. I ended up in the ICU for a week with severe Lithium toxicity, my levels were like 4.6 which is insane. Started shutting my kidneys down, seizures. It was a nightmare. And she didn’t seem to notice before I ended up in the hospital that I was shaking like a leaf and walking like I was drunk. She was a very nice woman but it’s a little scary that there are some professionals who don’t seem to know what they’re doing, it can be dangerous

    Aside from that, I’ve had mostly positive or neutral experiences with them. Some bad, but nothing to that extent again. I realized that I really need them and one of the medications I was on for 5 years probably kept me from ending up in a residential hospital.

    Right now, I’m a little frustrated with my current meds. I’m not entirely sure what’s been going on but something needs to be changed. Overall, I believe medications can be life-saving and are definitely helpful for many people.

    Liked by 1 person

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