Ashley is an experienced mental health nurse and former pharmacist. She blogs about mental health and lives with major depressive disorder.
There are a lot of people out there who are anti-medication for one reason or another. They may have had personal negative experiences taking meds, they may believe that mental illness is caused by trauma and can only be treated by addressing that trauma, or they may view medication as something that's artificial and toxic and therefore shouldn't be put into the body.
Despite the arguments against psychiatric medications, though, they can and do save lives. Mine, for example.
I was already a health professional by the time mental illness intruded on my life. I started off as a pharmacist, decided that wasn't the right fit, and became a nurse. I had already been working on a psychiatric ward for 2 1/2 years when I was first hospitalized and diagnosed with depression.
When I started taking medications myself, it wasn't something that bothered me. I knew from my professional background what the meds were and how they worked, and I think that went a long way in overcoming that psychological barrier a lot of people face when deciding to take medications.
After my second severe episode of depression, which involved three hospitalizations and a suicide attempt, I realized that medications were probably going to be a lifetime proposition for me. I've been tried on quite a few different meds over the years, and have finally settled on what seems to be the best combination. My illness has become treatment resistant, meaning it no longer responds fully to treatment, but the meds still play an important role in managing my mental health.
Despite being very pro-medication as an option, meds aren't right for everyone. Side effects can be problematic, and that calls for responsive health professionals who are prepared to listen to their patients and make changes so that the benefits outweigh the negatives.
One thing that frustrates me is the "natural is better" perspective. There is nothing inherently safe about something that is "natural"; there are plenty of naturally-occurring poisons. There are also plenty of synthetic things that we consume as food on a regular basis. Overly reductionistic arguments like that around natural vs. artificial simply aren't useful, and it's much more productive to consider risk vs. benefit not just for specific drugs but for specific drugs in specific individuals.
Why people take meds
For some mental health conditions, medications are not the first line treatment. Psychotherapy may be more effective than medication, such as in PTSD. In mild depression and anxiety, medication does not offer an advantage over psychotherapy. In some conditions, though, and particularly in more severe cases, medication is the most effective treatment. Often the combination of medication with other treatments, such as psychotherapy, yields the best results.
When people take medications for physical ailments, there seems to be far less stigma compared to taking medication for mental illness. While there is some inappropriate prescribing as a quick fix to avoid dealing with the real problem, the vast majority of people who are taking psychiatric medications are on them because their illness isn't manageable in other ways.
Mental illness can be severe and have a profound negative impact on overall functioning. The reality of taking medication is that it doesn't work rapidly, and on its own it's typically not enough. People with mental illness are used to trying whatever they can to get their illness under control, and if medication is something that helps, well, power to them.
Antidepressants aren't just for depression, and antipsychotics aren't just for psychosis
major depressive disorder
psychotic disorders (e.g. schizophrenia)
What meds can do
For the most part, antidepressants affect three key neurotransmitters in the brain: serotonin, norepinephrine, and dopamine. The idea that depression arises from a deficit of serotonin in the brain is overly simplistic and inaccurate, but altering neural signalling involving these neurotransmitter does have a beneficial effect in depression.
Antidepressants take 4-6 weeks to take effect. Mood stabilizers and antipsychotics also take time to work. The only type of medication that works well rapidly is the anti-anxiety class of medications called the benzodiazepines, but they're associated with tolerance and potential addiction. What this means is that treating a mental illness with medication is a commitment, not a short-haul race.
Medications are most likely to be effective in more severe forms of illness, but even then, not everyone is going to respond well to meds. Most people do best with a combination of different treatment strategies. Often combined medication and psychotherapy work better than either alone.
While medications can press reset on brain chemistry, they don't address other underlying vulnerabilities. Combining medication with treatment strategies targeted at those other vulnerabilities can improve chances of recovery and maintained wellness.
What meds don't do
Medications aren't happy pills. They're also not curative. They're not a quick fix, and on their own they are seldom enough to achieve wellness.
Medications don't somehow change the way a person thinks, change their personality, or create some sort of artificial happiness. Wellness that comes in part from taking medication is not inherently less valid than wellness achieved through other methods.
The goal of prescribing medication is not to create drugged out zombies. Yes, some health professionals are less responsive than they should be in managing side effects, but zombification is not the goal. When someone is taking the right med(s) for them, ideally they should not feel medicated at all; they should just feel "normal".
The reality is that people do experience side effects, but there should always be a weighing of risks and benefits in each specific situation. Sometimes a certain level of side effects is an acceptable price to pay for the benefits gleaned from the medication. Personally I have gained weight and have a tremor because of my medications, but I have no problem putting up with that given the beneficial effect my meds have on my illness.
The whole picture
Medications alone are not enough to recover from mental illness, and it doesn't work very well to pop pills and just sick back and wait to feel better. Recovery requires a whole picture approach. The more tools someone can have in their recovery toolbox, the more likely they are to progress in their healing journey. Meditation, physical activity, social contact, self-care, and relaxation are just a few examples of pieces that can be included in a wellness plan.
Certain levels of stigma may be higher for some types of medications than others, but without having an understanding of the underlying pharmacology the names for certain classes of medication aren't particularly meaningful. The antipsychotic class in particular tends to be associated with strong stigma, but these medications are commonly used for bipolar disorder and major depressive disorder.
Stigma is often based in fear, and fear often comes from lack of knowledge. Having a greater understanding of what medications can and can't do is a great way to become empowered to make the best treatment decisions possible.
Only by speaking up as people who take psych meds will be able to really make a dent in stigmatized attitudes around medication. I take meds, and they help me but do not define me. How about you?
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Ashley Peterson