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Medications and mental health

In pharmacy school, we learned about the specifics of most of the major mental health conditions. We learned the diagnostic differences between major depression, bipolar disorder, and schizophrenia, for instance.

Of course, we also learned about all the medications used to treat these various conditions. What they do, how they work (or how we think they work), potential side effects. And as you might guess, all of this is very graspable from an intellectual standpoint.

You can learn these things and “get it.”

There is nothing, however, that you can learn intellectually, that will ever really, truly make you get the experience of being on these medications. Which is fairly unique to them I think.

I mean, you can learn about what blood pressure-lowering medications do and, to really get them, you don’t have to experience your own blood pressure lowering. Blood pressure, after all, is not something most of us associate with our selves. With who we are as people.

Medications for mental health, though? People these are mucking around with your brain! Your mind! The very essence of what we perceive as our selves. As who we are.

I’ll stop here a moment and say that I’m not going to dive deep into this particular discussion because it’s been done before and done well. My recent favorites are First, We Make the Beast Beautiful by Sarah Wilson for anxiety and The Noonday Demon by Andrew Solomon for depression.

But I will relate what I’ve been thinking about and experiencing in terms of this as well as one other really important point, which I’ll actually tackle first.

1. Resistance to medications.

The decision to start medication was a seriously tough one for me. It felt like throwing my hands up. Like saying I just wasn’t up to the task of going it alone. I give! Uncle!

But now, with just about 3 months under my belt, remembering this makes me kind of sad and more than a little angry. I realize that I suffered - needlessly - for a long time and I know I’m far from alone in this.

Even as I paid lip service to accepting my mental health reality, there was still an underlying current of belief that having to take medication indicated a weakness of character. That having a condition severe enough to need medication was somehow shameful. And that I really didn’t want to be seen as having a condition at all (see Be kind and let it ride).

And, of course, this didn’t just apply to me.

I have long advocated the notion that the mental health community, in general, is “too quick” to prescribe medication for mental health conditions, that medication should be a last resort for people who “really need it,” and that even with my educational background, non-medication options meant people were “really trying.”


I don’t get to choose what level of severity is the right one for a person to get treatment - whatever that treatment entails - and I certainly have no right to judge how much effort a person has to exert before they are deemed “worthy” of turning to medication.

Yes, I absolutely think that as a society we need to acknowledge and try to address what underlying causes of mental health conditions we can as well as the growing number of people who need medication for them because it’s the right thing to do, but that’s in the long-term. Frankly, none of that matters to the immediacy of someone struggling to get through the day.

We just have to relax our grip on what we think we know about other people.

2. Will medication change who I am?

As I said, this is a common question when you’re starting a medication to treat a mental health condition. I think it’s entirely legit and as with everything else, if it comes up it needs an individual answer.

For me, medication has not changed who I am. It has uncovered it.

I still have the same thoughts and the same emotions. I still react predictably to situations. The difference is that now I have those thoughts, emotions, and reactions and more easily let them go.

You see, I am a very anxious person, but even I didn’t recognize that for a long time because my anxiety is what my therapist describes as “contained.” Outwardly, I don’t appear anxious. I don’t have the energetic and sometimes frenetic way about me that many people including myself associate with anxiety.

My anxiety is ruminative. So-called because it’s like a cow chewing its cud (a cow being a ruminant animal). I can turn something dumb I said in a meeting a month ago into the end of my life as I know it by churning it over and over in my mind until I’m convinced that everything I say is dumb and that everyone knows it leading to awful depression.

It’s tedious and energetically draining.

It has also prevented me from totally buying the idea that thoughts and emotions are just temporary and that we need to be able to acknowledge them to allow them to dissipate. I often got a little needled when I heard tips like think of them like clouds floating across the sky because that wasn't my experience.

It was more like they were a Charlie Brown-style rain cloud hovering, clinging, only to me.

I mean, not everything got stuck on a loop, but certain things almost always did so I was keen to avoid them.

Now, with the aid of medication, that tendency has relaxed. It’s like I’m able to lift the needle over the scratch in the record so I can go on with the song. The scratch is still there - the little idiosyncrasy that is me - but it’s no longer the deeply carved groove that I can’t get past.

In other words, it’s made everything - even being me - just a little less hard. And in the end, couldn’t we all use a bit of that, however, we can get it?

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Oct 18, 2020

I love your perspective on medications and I've had similar thoughts and experiences - perhaps that's part of why we become pharmacists. So happy to know you and proud of your journey and strength. Be well my friend.

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