Medication Fears

/

Prescription drugs. Left on their own those two words inspire far more fear than joy.

It is striking that we have gone from celebrating drugs like penicillin to a remarkably misplaced suspicion of vaccines in less than 100 years (penicillin having been invented in 1928). In the midst of an opioid epidemic decimating lives, kids swapping Adderall to boost concentration on exams, and somewhere between 48% and 66% of Americans on at least one prescription medication — having to take medication still inspires a considerable amount of fear, uncertainty, and doubt.

I don’t recall being fearful of starting a psychiatric medication when I was first prescribed Paxil in 2006, but as a few people learned about my reliance on a selective serotonin reuptake inhibitor (SSRI) certain questions bubbled to the surface:

  • Aren’t you worried about the side effects?

  • Doesn’t taking psychiatric drugs mean you’re not really you when you’re on them?

  • Don’t they dull your creativity?

My starting dose was very low, about 20mg per day. I didn’t experience any side effects. Part of that may be attributed to my age and health at the time. I was eighteen and incredibly healthy after years of lacrosse and martial arts. What I did experience was a cessation of my negative thoughts after about two weeks. Walking across campus to class I stopped in my tracks as I realized I wasn’t thinking. I didn’t have a bad thought in my head! This was incredible because I had become accustomed to juggling numerous horrible and terrifying thoughts since I was fifteen. After a couple of minutes, I came out of my pleasant reverie and practically floated to class in the best mood I had felt in years.

That is not to say I didn’t experience side effects as my treatment plan was modified over time. Here is what I’ve been prescribed over the past fifteen years for my depression and anxiety:

  • Xanax

  • Vistaril

  • Effexor

  • Lamictal

  • Seroquel

  • Deplin

  • Zyprexa

  • L-methylfolate

  • Hydroxyzine

  • Paxil

  • Cymbalta

  • Lexapro

  • Abilify

  • Prozac

  • Wellbutrin

  • Rexulti

  • Pristiq

  • Symbyax

Currently, I take the following:

  • Prozac, 80mg (depression)

  • Rexulti, 0.5mg (depression)

  • Vistaril, 25mg (anxiety)

  • Trazodone, 50mg (as needed for sleep)

If my list of medications hasn’t made it clear — I have treatment resistant depression. Much of my adult life has been a search for the correct drug combinations and dosages. As I walked this path, I experienced a host of unpleasant side effects from different medications. Some drugs did dull my feeling of connection. I wasn’t numb, but I felt distant from other people. Weight gain was a big one. I ballooned from 145 to 195 pounds while on Seroquel. The most consistent side effect has been sexual. A significant delay or a complete inability to achieve orgasm.

Any one of those could be cause for someone to avoid psychiatric medications, let alone a combination of them. The question I had to answer was: Do the results from the medication outweigh the side effects? In my twenties, the answer was no, and I stupidly cold-turkeyed the medications I was prescribed. This led to a predictable crash landing in a hospital. Pro tip: DON’T come off psychiatric medications without a psychiatrist’s supervision! Today, I’m stable on my medication regimen. My body tolerates a high dose of Prozac exceptionally well, and I’ve come to take only half a pill of Trazodone when I have difficulty sleeping. My psychiatrist says that I’ll probably drop the Prozac dose over time, but since I’m just under a year since my last hospitalization we’re not screwing around with what’s working.

To the query about whether I’m not really me on medication — I’m not me. I’m an improved Gordon. Version 2.0 doesn’t want to kill himself. The medication gives me space from my depressed and anxious thoughts. Allowing me to use my CBT and DBT skills to maneuver around any negativity that comes at me.

Lastly, I think this blog is evidence enough against the idea that psychiatric medications dull creativity.

I’d love to not be on medication, and I bet diabetics don’t want to inject insulin, and I’m certain cancer patients would rather not take chemotherapy. Those of us requiring a prescription for an ailment don’t have to like the treatment, but we do need to follow it. There is no difference in this philosophy between depression, diabetes, and cancer. The differentiator in our society is the stigma of psychiatric medications. No one demands a type 1 diabetic to produce insulin through sheer willpower, yet I’ve been told that my reliance on an antidepressant means I have a weak constitution. No one tells a cancer patient that maintaining a healthy weight or lustrous hair is more important than killing their cancer cells, but I’ve been told that it’s more reasonable to be skinny and depressed than it is to be fatter and not depressed.

Fear in treatment is commonly explained as False Evidence Appearing Real. The fears over medication use are false. They derive from the hydra of myths, stigma, and uncertainty. I take medication because otherwise I am at an unacceptable risk for self-injury due to unmanageable depression. Death can be a side effect of that self-injury, and I intend to keep that side effect far away from my daily experience.