By Mena Mirhom, MD
“It felt like putting on glasses for the first time.” That is how one of my patients recently described the experience of being on medication. “I didn’t think it was possible to just walk around and just see the day as it is. I guess this is what it’s like for people who don’t have depression and anxiety.”
Taking medication is a big step for many people and certainly comes with its share of hesitation. One of the most common discussions I have daily revolves around the misconceptions about psychiatric medications. It is healthy to want to be an informed patient and to have your questions answered by a trusted professional. Not everyone who struggles with depression or anxiety needs to be on medication, but for the folks that do, it can literally be lifesaving.
Here are some of the specific questions that people often ask.
Will it change who I am?
Medication does not change your personhood or personality. When we struggle with symptoms of depression or anxiety for many years, it can often feel like it has become a part of our very being since it is all we know. But beneath those symptoms are our real selves. The things we love, our hopes, dreams, and goals are not altered by medication.
What medications can do is remove the barrier that prevents us from pursuing those things. These medications do not have the ability to fundamentally alter who we are. They do help us feel more like ourselves.
Am I going to be a zombie?
The first-line treatment of medications for depression and anxiety simply do not work this way. The aim of medication is not to numb us to pain and have us feel like “zombies,” but rather it is to remove the fog of symptoms that make us feel overly anxious most of the time or experience debilitating depression.
Some of these medications can actually help a bit with sleep, which is a benefit for patients who have insomnia. However, the majority of medications that are first-line for depression and anxiety, which are in the class of SSRI or selective serotonin reuptake inhibitors, are not sedating.
Will I be addicted to it and take it forever?
These mentioned above are also not addictive or habit forming. Although they should not be discontinued abruptly, they do not produce a physical dependency and you can slowly stop taking them. With the opioid crisis that we have experienced as a nation, it’s prudent to be cautious regarding medication addiction. However, the way these medications work is far different from the medications for pain. These medications do take a few weeks to be fully effective, but this does not mean that they should be taken forever. With careful monitoring, you should reevaluate the need for medication with your doctor periodically.
However, one of the classes of medications that are sometimes prescribed for anxiety is the benzodiazepines. These medications can be habit forming and should only be taken on a short-term basis. They can be very effective during a panic attack and are considered first-line for them.
Does this mean I’m weak and can’t do this on my own?
Although we do not ask ourselves this about pain or infection, this is a common sentiment regarding depression and anxiety. We often feel that we should be able to control these symptoms ourselves and our inability to do so feels like a personal failure. In reality, this same logic is certainly true for a bacterial infection. Why can’t our immune system just handle it? Why does it need the assistance of an antibiotic? No matter how hard I try, that pneumonia I have will not respond to my willpower.
Perhaps we can reframe this to recall that our bodies are in fact imperfect and can be frail. Instead of dreading the role of medication that can assist our immune system, our cardiovascular system, or our brain, maybe we can embrace it as a gift?
There was a time when we had to struggle alone and medication was simply not an option. Now that we have the gifts of using therapy, lifestyle, spirituality, a healthy diet, and also medication; maybe this is something we can rather be grateful for.
Will it really make a difference? It feels like nothing else works.
As a medical community, we continue to see studies that reinforce that these medications are safe, effective and actually make a difference! The most common cause of disability worldwide is major depressive disorder. The average delay between onset of symptoms and actual treatment is 11 years! This is a staggering number, especially considering that between 80% to 90% of people who are treated benefit from treatment.
With that possibility being within reach, I would encourage you to get your questions answered. It is natural to have hesitations or even fear about taking medication. You may be surprised that many of the things you are wondering have reassuring answers.
Our suffering may not always be avoidable, but in this particular case, some of the suffering you are experiencing may just be one decision away.
Mena Mirhom, MD, is an assistant professor of psychiatry at Columbia University and teaches writing to public psychiatry fellows. He is a board-certified psychiatrist and a consultant for the National Basketball Players Association, treating NBA players and staff. Connect with him on Twitter , Instagram , or at Drmirhom.com .
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