Red Pill, Blue Pill, Yes Pill, No Pill??

CW: mental illness, medication

After only 1.5 posts, several eons ago, I’m hoping to return to this blog. I dealt with more challenges this year than I usually have to deal with (as I think is true for very, very many people). But that actually means that this blog is even more important to me as a place to explore mental health, wellbeing, and personal development.

So, in my return I’d like to talk about a very controversial mental health topic (as if any mental health topic wasn’t controversial): medication. And I’d like to talk about this because it’s one of the reasons returning to this blog doesn’t feel massively overwhelming right now.

Before I begin, a couple of disclaimers:

  • Medication is NOT for everyone, by any means!
  • It’s VERY important to speak with a medical professional (as in, a psychiatrist or your primary care physician) about medication before taking it
  • Any medication CAN be dangerous
  • All of the above being true, this is an overall medication-friendly post

There are sooo many things I want to say about this topic, but this post is already really long. I’m going to stick to sharing a super-brief version of my own medication story and then talking about some of the common hang-ups people have and offer alternative ways of looking at things. At the end, I’m just going to mention how important it is to combine medication with other forms of support, for people who do go that route.

My own medication journey.

I’m going to start by telling you a little bit about my own medication journey. If you’ve never taken medication but are considering it, I think it’s good to have a realistic idea of what that process looks like by hearing other people’s stories. And if you are on medication, I’d love to hear how your own journey compares.

The first time my doctor recommended I try a psychiatric medication was in January 2021 because I was having serious trouble sleeping. And no wonder: my PhD thesis was due in a month and a half. The medication she prescribed (Trazodone) wasn’t for me, though, and I didn’t continue taking it. That summer, my doc returned to the topic because I was going through some exceptionally stressful circumstances and struggling to cope. That time she put me on Lexapro. I’d heard great things about Lexapro and knew it to be an effective, non-addictive medication with minimal (if any) side effects. Unfortunately, I had a similar experience as I did with Trazodone so I didn’t continue it either.

Fast forward to September that year: my doctor recommended I try Buspar. I tried it and I felt better very soon with no side effects. But I assumed I felt better because the major life stressors I’d been dealing with over the summer were basically resolved; I didn’t attribute it to the medication. Even though I felt better, my doctor recommended I keep increasing the dose to the point that it started interfering with my sleep. So, I stopped taking it. But low and behold, I started feeling anxious about a week later, around Thanksgiving. Somehow, I didn’t put two and two together until January this year, after I’d transitioned from anxious to depressed. I asked my doctor to put me on Buspar again, this time staying on the low dose.

Within a week, I started feeling better. My mood was up and I didn’t have that sensation of impending doom. I felt less overwhelmed by everything I needed to do and consequently I was more productive (back to blogging!). My self-esteem suddenly shot up and I even… felt proud of myself??? Like, even for little things???? Dude….

Sooo… should YOU take medication??

Believe it or not, the purpose of this post is NOT to encourage you to take medication; again, medication is most definitely NOT for every person or for every situation (and that’s a conversation for you to have with a mental health professional, not a total stranger on the internet). Instead, my goal here is to give you an opportunity to reflect on any doubts you might have about taking medication if you’re struggling with your mental health. For many people, there are very good reasons to not take medication. Other people, however, might be dealing with some hang-ups that are… less rational. Sometimes, confronting our hang-ups head on helps us understand how much they are really helping us.

I was not happy about my doctor recommending that I go on psychiatric medication. It made me worry about all of the things I’m going to describe below. And interestingly, some other people weren’t happy about my decision, either. From my experience, people’s (including my own) resistance to medication tends to revolve around two main themes: shame and toxins, so those are what I’ll look at today.

Pride & Shame

In this context, when I say “pride” I’m not talking about “I’m proud of myself for finishing my PhD!”. I’m talking “I don’t need anybody’s help, ever!” kind of pride. The kind that indicates shame.

It’s understandable that people feel ashamed of taking psychiatric medication, even though there’s nothing to feel ashamed of. Mental illness is massively stigmatized, which is ironic since so many of us struggle with it. So, it can be hard to accept that we have mental illness, especially to the point that medication is on the table. This was certainly one of my own barriers, which is surprising considering I’ve struggled with anxiety all my life and suggested to multiple friends that it might help them.

That’s not the only thing we feel ashamed of, though. Even if we accept that we’re unwell, a lot of us feel like we should “be able” to get better without medication. As if medication is cheating, or something. Again, I empathize a lot with this attitude from a personal standpoint. But it’s definitely not cheating.

I’d like to offer this metaphor for people who experience this kind of shame. Think about it like long-distance travel. When you go from one place to another, you usually take multiple forms of transportation, especially if you’re going long-distance. It might be reasonable to walk ten minutes to get groceries, but totally unreasonable to walk from San Francisco to New York. Even driving that distance is unthinkable for most people. Imagine feeling ashamed for taking an airplane across the whole United States because it’s the “easy way out”

Well, we can look at our mental health journeys similarly to this. Everyone wants to get from point A to point B, but the distance and the terrain between those two places are unique for each person. Some people might walk the whole way, some might use a taxi, some might drive to the bus stop, take the bus to the ferry, the ferry to the subway, the subway to the bike rental, the bike to the paragliding jump off point, etc. All of those modes of transportation represent different tactics that we can employ to get us from A to B in our mental health journey: therapy, meditation, journaling, socializing, manicures (you do you, babe), and so on. And sometimes, the distance we’re trying to go is far enough that it makes most sense to take a plane. That doesn’t mean that you have to take a plane, but… why wouldn’t you?

Toxins

For some people, the answer to “why wouldn’t you?” is that they feel like taking medication is exposing their body to harmful chemicals. I’d be willing to bet that this fear is a pretty instinctive impulse, and it’s not a bad one to have. It’s rational and important for us to be selective about what we expose our bodies to.

But at the end of the day, everything is a chemical (yes, literally everything!), and just because it was synthesized in a lab doesn’t necessarily mean it’s harmful for us. Similarly, just because something comes directly from nature doesn’t mean it’s safe: just think about how many lethally poisonous plants and animals are in the world! At the end of the day, a molecule is a molecule, and its origin doesn’t necessarily have anything to do with whether it is safe or dangerous for us. In fact, the whole idea of toxicity is relative: anything can be toxic at high enough doses (even carrots!), and anything can be non-toxic at low enough doses (even bleach! But don’t test this at home… bleach needs a verrrrrry low dose to be non-toxic!).

Psychiatric medications have been synthesized in a lab, but that doesn’t mean that they’re dangerous (assuming you’re taking them correctly). In fact, there is a very long, thorough, and systematic research process that highly-trained scientists have to go through to make sure they’re not dangerous. Many medications can have side effects, but what those side effects are and how severe they are depend on a lot of things: the person’s unique physiology, the issue they’re dealing with, other medications they’re taking, and so much more. In some cases, the person can’t take any medication at all, or just can’t take some kinds. In other cases, like mine, I had unpleasant side effects for some medications but not others. Many other people have the same experience. And it might turn out that there is no medication that is right for you, for whatever reason. But there’s no reason to be worried that medications are dangerous on principle.

I should also mention that there are SO MANY different kinds of psychiatric medications out there to treat everything from depression to schizophrenia. And to be fair, some of them do present more risks than others. Some are addictive, some are highly addictive, and some are much more likely to cause serious side effects. But that’s simply not true for all psychiatric medications. Research gets better every day and today, there very many safe options (again, assuming they’re used correctly). And for people considering the trickier options, it might be that for them risking addiction and side effects is worth the benefits of the medication. We can’t know what a person is going through on a daily basis to judge their decisions.

Enough ingredients to bake a cake

I strongly believe that people struggling with mental health should feel like they can consider medication without fear of being shamed for it (and, by the way, they should also feel that they can refuse medication without being shamed for it!). But medication probably won’t be truly effective if it’s the only thing you’re doing: remember, you still have to drive to the airport. As my therapist explained to me, medication can help you feel better, but it won’t change the mindsets and habits that perpetuated your mental health condition in the first place. That’s something that you can do through journaling, therapy, life coaching, maybe your religious practice, and so on.

Let’s use one last metaphor to illustrate this point. When you bake a cake, you always use more than one ingredient. The specific ingredients you use might differ: some cakes are chocolate, some are vanilla, some don’t have flour, some don’t use eggs. But you will definitely need multiple ingredients. In your mental health journey, it’s probably not reasonable to expect to feel better from using just one approach, like just medication or just meditation. But using a combination of the right techniques that work for you can make a huge cumulative difference.

I’ll say this again because I cannot stress it enough: I’m not encouraging anyone to take psychiatric medication. Instead, I’m encouraging you to reflect on the hang-ups you might have about it and how much those beliefs are based on reality. This is not just for people considering taking medication themselves, but also for their friends and family. It was very hard for me to see my friends push back against my decision to take medication, especially since it has had such a positive impact on my life. You deserve to feel better, accomplish your goals, and have a satisfying life, whatever that means to you. If the way for you to get there is with the help of medication, then don’t let any hang-ups get in your way. ❤️

If you’re struggling with your mental health, you absolutely deserve to feel better. Get in touch with your doctor or a therapist, even if medication isn’t the right choice for you; they can help you find other strategies to manage your mental health. You can also check out the National Alliance on Mental Health (NAMI) website for more resources. If you’re worried about hurting yourself or others, call the suicide hotline (USA): 800-273-8255, or use their chat or website services. You are loved and you are worthy.