Last week, I was at a party where a woman was talking about how terrible psycho-pharmaceuticals are and how she really feels for people who have to take them. I was recently sent a beautiful New Yorker article about a woman’s journey with mental illness diagnosis and the difficult, no man’s land process of tapering off of mood stabilizers. I was also recently told to watch a piece on Democracy Now about a pharmaceutical recall and the unregulated manufacturing of generic pills. 

As someone who takes a combination of antidepressants, this type of information is always particularly hard to swallow. It’s also rare that I have the impulse to chime in during these conversations or information exchanges to boldly say, “But I take psycho-pharmaceuticals, y’all! Behold how well-adjusted I have become!” 

In part, this is because I feel shame and uncertainty about being on meds. I also assume such a proclamation would set off one of those perverse Murphy’s law scenarios in which I accidentally light one of these people on fire the next time I saw them.

It took me some time, about four years into my sobriety and a lifetime of struggling with my moods and feelings, to commit to giving medication a try. 

Before I took meds, I felt like a grief-stricken wild animal most of the time, dealing with extended bouts of depression and feelings of panic on a day-to-day basis. I was also going through a difficult time in my personal life, which is probably something to take into consideration. I had been working with a therapist who was trying to help me approach my mood swings and depression through nutrition and supplements. When I continued to struggle, I went to a psychiatrist, got on meds and, for awhile, my emotions regulated noticeably, and my moods stopped flipping so drastically. 

The shift felt significant and revelatory. I didn’t know it was possible to feel somewhat normal most of the time. 

I didn’t know it was possible to feel somewhat normal most of the time. 

Eventually, the benefits seemed to plateau. My symptoms of depression and anxiety are still something I experience frequently and with full force. I’ve added things and changed dosages with varying degrees of success. It hasn’t been a total nightmare, as these things go, but my depression and anxiety persist enough that I wonder if they have stopped working or if there is something else I should be trying. 

I’ve had ketamine suggested to me, which I’m reticent to try, and I recently started EMDR. I am concerned about the impact of pharmaceuticals and their long-term impact on my health but I take them anyway. It’s a choice I make each day because I am afraid that my mental health might plummet to where it was before I started.  

I know I’m not alone in my ambivalence.

According to the American Psychological Association, the use of antidepressants is on the rise. About 12.7% of the population over the age of 12 take these drugs. But there is still major stigma and criticism of “being medicated” despite the prevalence. And a lot of people resist taking medication, as I did for a long time and might do again. Dr. Jessica Esposito, psychologist, Ph.D., and a member of the Alma mental health co-practicing community in NYC, tells The Temper that the historical oppression of the mentally ill and current stigmatization contribute a lot to the resistance of using medications. “As such, many clients state that they want to try therapy first to see if they can manage their mental health symptoms ‘on their own.’” 

“This type of language makes medication sound like a weakness, when in fact individuals often need medication to help treat mental health symptoms — much like someone would need antibiotics to treat an infection,” Dr. Esposito says. “Ultimately, the goal of medication is that it can help to reduce clients’ suffering, and allow individuals to engage with therapy in a different state of mind.” 

“I think the stigma or resistance in using psycho-pharmaceuticals stems from the stigma associated with mental health illness,” Dr. Esposito continues. “When looking at physical health, there is considerably less stigma associated with taking medications to treat ‘visible’ conditions. As a society, we continue to struggle with validating mental illness as ‘real’ because of the invisible nature of symptoms. I strongly believe that medication is a personal choice. In order for medication or any mental health treatment to be effective, the client must feel that it has the potential to reduce their symptoms and improve their quality of life.” 

“I think the stigma or resistance in using psycho-pharmaceuticals stems from the stigma associated with mental health illness.”

Dr. Esposito says that a critical aspect of making a successful psychiatric referral is to make space for understanding clients’ feelings around medication, such as fear and shame, in addition to exploring overarching societal stigmatization and imbedded cultural values. 

Dr. Esposito adds that if someone does not feel comfortable with medication, there are other options for treatment, including individual or group psychotherapy, which can help to process emotions, create insight, and develop skills to better manage symptoms. “Emerging forms of treatment are often more focused on the body as an effective way to address mental health issues,” she says, mentioning exercise, diet, physical therapy, pain management, aromatherapy, yoga, tai-chi, acupuncture, cupping, meditation, and massage as examples of alternative or holistic forms of medicine. 

I certainly agree that using pharmaceuticals for your mental health seems to cause a great deal more judgment than taking heartburn medication or antibiotics. This is a painful part of taking antidepressants for me, even as someone who has experienced some relief taking them. But I’ve also experienced the challenge of being heard as a patient who feels conflicted taking medication. 

I’ve had to switch psychiatrists four times, and it can be challenging to monitor efficiency and side effects even with a doctor you trust.

It’s a frustrating process to find ones that work for you, and the conversation about a long-term treatment plan is often disconcertingly open-ended. I have also experienced the quickness and flippancy with which meds can be prescribed. I’ve had healthcare providers — who were providing me with prescriptions — tell me about their negative views on psychiatric drugs. I’ve had to switch psychiatrists four times, and it can be challenging to monitor efficiency and side effects even with a doctor you trust. The psychiatrist I see now costs $250 an hour, and I get financial help to see her. Almost every time I go, I have her remind me why medication is something I’ve committed to trying. We have to really talk it through. 

I incorporate a variety of other methods of mental healthcare into my life. 

I exercise multiple times a week, I meditate, I go to therapy, I just live my life. I like to believe one day I might just burp and dislodge whatever form of mental or emotional turmoil I have inside me and throw it in the trash. But the thing about being someone in substance abuse recovery, who copes with mental illness and has a major trauma history, is that there might not ever be an X factor. That can be really difficult to contend with some days. I like to think the more I am in acceptance of the breadth and variety of care I need, the easier it’s all going to get.