And is accepting medication different than taking it?
Attention to details has never been one of my strengths. It may come as a surprise (or not) for some people; having held various marketing management positions during my career. I believe that somehow, with extra efforts, I’ve been able to pay attention to the small stuff when needed. It’s never been perfect but based on the success and job promotions I got through the years, I can safely say that I managed in my own way, at that time.
However, in the past year or so, I began feeling more overwhelmed with work and started making small mistakes on a regular basis. Nothing really bad nor compromising for my employer but still they were there. For a recovering perfectionist and top performer like me, this was so annoying especially when it was my boss who was catching the imperfections. I could feel that something was different with me. It felt like my head was full, close to spinning. I also had more difficulty focusing and covering “all my angles”. Yet I kept on top of my work and personal life responsibilities, barely.
I asked myself: What is going on with me? What has changed? I started doing an inventory: I launched my own mental health consulting business, completed a few training sessions, quickly boosted my professional network, got involved in various projects and the list goes on. Even though I chose to engage in these projects, they fueled me with a mix of excitement, joy, stress and increased anxiety. The scariest part was that I perceived my small mistakes like I’m not good enough and never will be. Leading me to feeling depressed, tired and sad. Same feeling with my personal life i.e. not being able to do everything and/or correctly. That’s where the new skills I have developed during my recovery came handy. Thanks to my awareness practice (and my wife) who helped me raise a mental red flag on this internal chatter. Seems like the old patterns and negative automatic thoughts came back in force. So, I used Cognitive Behavioral Therapy (CBT) techniques, my daily mantra and meditation to deal with them. But was that enough? No, it was not. I needed help, so I booked an appointment with my doctor.
Not another mental health diagnosis and medication!
I always suspected living with a mild attention deficit and hyperactivity disorder (ADHD) that didn’t affect me to a point of challenging my everyday life (or so I thought). As mentioned earlier, I’ve been able to self-manage that condition for a long time. But a few years ago, I was curious to get some sort of confirmation and completed ADHD evaluation tests with my psychiatrist. Without any surprise, I checked most of the boxes on those questionnaires. Still, I wasn’t ready nor saw the need to take further actions then. Unfortunately, the day of no longer being able to manage that part of me, despite my numerous wellness tools, has come, as I turned 46!
In light of this “new” additional mental wellness challenge and potential need for medical treatment, I wanted to share my perspective on medication from both my own experience and from my observations helping others as a certified peer specialist. Medication is a huge stigmatized subject in the mental health world, not only for the individuals needing them but also for their loved ones and clinical providers. There is a lot of misunderstanding, misinterpretation, judgment, and fear involved. I’ve often heard: “Why won’t you just take your meds?”, “What is the big deal if the medication is supposed to make you feel better?”, “People with mental health challenges are so non-compliant when it comes to taking meds”.
What Medication Represented to Me
Here are some common myths and stigma around psychotherapeutic medication. While everyone’s experience is different, I hope you will gain a new perspective of what medication can represent for some people, like me. You will see that they can be much more than “just” meds.
1.The fear of no longer feeling like myself
Change in personality is a very common fear of people hesitating to get on a psychiatric medication. Studies and publications argue that it isn’t your personality that is changing but rather your feelings of depression and anxiety. So meds like antidepressants are supposed to help you be yourself again. Often, when people mention feeling like a zombie or over agitated on their new medication, the dosage may be wrong or the medication may not be the right one for that person. In my case, even though I was trying to blame my med for feeling different, I figured out that I was actually holding on to my “old” self. That was who I knew for all these years until I found the true me. The fear of no longer being able to identify with my past (extreme) range of emotions, of no longer being funny or impulsive was very present in my mind. I remember at that time my therapist challenged my concern by asking: “and where did the “old” Pat lead you?” (referring to my worst mental health challenges). That phrase changed the idealistic perception I had of the one I once was, and it helped me move on. It turned out that as I was progressing into my recovery. I was transforming myself for better using medication, therapy, self-help support groups and coping tools. I was confusing this positive change with not feeling like myself anymore. It was scary at first but then I came to appreciate who I was becoming: a better version of me, the true me I had dismissed for all these years.
Note: It is important to find with your doctor which medication is right for you. It may take a few trials before you find the one that helps you best with the less side effects. In my experience, some antidepressants made my symptoms of depression and anxiety worse, some others can make you feel numb or too agitated. Dosage needs to be adjusted to your own condition and situation. Everyone’s experience is different, but persistence and patience are key. Keeping an open dialogue with your prescriber during the process is necessary. Once I found the right medication, it really helped me. I’m still on it today and need it. It’s part of my toolbox.
2. The constant reminder that I’m a “sick”
Every morning at breakfast, I take my antidepressant. I know it helps me. I’ve tried getting off of it a couple times and it didn’t work out. My anxiety and depression symptoms would increase despite my use of multiple other wellness tools like mindfulness meditation, exercising, journaling and therapy. I would take my med as prescribed but it took me years to accept it in my min. Even though it helped me and gave me zero side effects, I would always question if I should take it, if I should stop it. Why is that? Through my own reflection, I realized that it was a daily reminder of my condition. Reminding me that I’m a patient, weak, ill, disabled, doomed. Which wasn’t true. The day I decided to change that perception became a huge positive turning point in my recovery. I chose to accept my medication because it helped me concentrate, take a step-back, see more clearly and get going. My medication is just one of my various mental wellness tools. That’s it. I am not defined by it. I am who I am: a resilient, strong, confident, happy, loving husband, brother, son and friend and the list goes on. I am a person that sometimes experiences symptoms of anxiety, depression and ADHD. I’m not sick nor a patient. I’m a human being who recovered from severe mental health challenges and who can achieve anything. And that’s just a piece of my great life.
3. The stigma around mental health
What will people around me think if they find out I take psychiatric medication? How will they perceive me? A lesser person? What if my spouse, partner, friends or parents have a negative opinion on mental health (or any) medication? These are normal questions and valid concerns. There is still a lot of stigma around mental health conditions even though we seem to have made some progress opening the dialogue during the current pandemic. Personally, being open about my condition and medication has reduced my anxiety versus trying to constantly hide it. Of course, a big part of my job is to share my story and break the stigma. Yet, I’m not advertising it for no specific reason and I’m intentionally being careful depending on the context.
4. The big “bad” pharmaceutical industry & their “pill pushers”
Unfortunately, psychiatric medication has had its load of bad press. Whether it is antidepressants or anxiolytics, the abuse of prescription levels by doctors and incentives by pharma companies were real. Practices have changed but there is still a need for educating clinicians who prescribe these drugs. How do they assess the person they treat? How fast are they to opt for a quick fix? Some people may also refuse to support the drug industry or doubt the medication’s efficacy or draw from bad experiences with previous mental health medications.
Regardless of our opinion on pharma companies, I think what helps is for doctors to treat the person as a whole while using active listening. Also, educating the public about the role of medication and how to be prepared for their doctor’s visit (list of symptoms, since when, frequency, intensity, list of health, lifestyle and life changes, list of questions for the doctor, etc). Medication isn’t a be all and all. It is a tool among many other tools in our wellness toolbox (like therapy, peer support, exercising, eating healthy foods, sleeping well). The hammer won’t get the portrait on the wall, it needs a nail and a person or two to do the job. Same with selfcare. Kudos, to doctors who ensure the person is well-equipped and not relying solely on the meds. Preferably, doctors would present the person with more than one medication option when possible. Lastly, both the doctor and the person would gain from openly discussing concerns, potential side-effects, interactions, and other possible risks related to the medication that is being considered.
5. The way we are…our own barrier
In previous columns I wrote how our environment and the way we were raised have influenced our beliefs and character. So, it applies to medication too. Honestly, I’ve never been a big fan of taking meds in general, even for small pain. I guess I didn’t like the thought of putting something unnatural into my body. I would prefer to tough it out or use other means like drink water, eat more fruits, take a rest or natural supplements. Plus, ignoring our injuries, pain and other health issues seemed to be running in my family. We’d tell ourselves: “no time for that, no complaining, just carry on”. After a while, we would end up at the doctor’s office or in the hospital because our situation worsened. Then, we’d take the meds (a bit late!). Same thing happens with my mental health challenges. I ignored stress, that turned into anxiety that turned into severe depression/burn-out and the way to a suicide attempt. At that time, I wrongfully thought I could push through the pain on my own. I didn’t want meds to “mess” with my personality and I wouldn’t admit I wasn’t well due to pride, stigma and my own perception.
So, how can we help ourselves and others?
First, keeping an open dialogue, using curiosity while putting aside our judgment would help better understand why the person is being hesitant to take (or stay on) their mental health medication. Kindly getting the person to open up by asking questions like: How do you do on your medication? Do you feel they help or make you feel worse? How so? How do you feel when you don’t take them? What are your concerns? Do you feel you have all the information you need? Secondly, validating the person’s experience by showing empathy and maybe sharing a piece of your own experience with a similar situation. Lastly, asking the person how you can help and support them in regard to their medication and overall wellness. It could be to accompany the person to their doctor’s appointment and help asking questions.
Through my own experience and while supporting others, I realized that there is much more behind what seems like a simple act of taking the medication. Now that I understand my own perceptions, fears and have been through the acceptance process before, I feel better equipped to welcome and accept my new ADHD medication or I’d rather say: my new wellness tool.