Gary McClain, PhD, is a therapist, patient advocate, and writer who specializes in helping clients—as well as their family members and professional caregivers—deal with the emotional impact of chronic and life-threatening illnesses.
So, how are you feeling?
I’m talking about how you’re feeling emotionally. Are you having days when you just don’t feel like you have the resources to cope with what it takes to live with your diagnosis? Feeling a little depressed, or a lot depressed? Anxious? Or have you had days like this in the past?
Somewhere along the way, you may have thought about medication to help you to cope emotionally. Or your doctor has brought up that possibility with you. Especially if those feelings have been persisting over time.
Medications that help you with your emotions are called psychiatric or psychotropic medications. They are developed to treat a wide range of psychiatric diagnoses, including feelings of depression and/or anxiety.
I hit a rough spot: Will medication help me get through it?
Many of my clients are currently being treated with psychiatric medications.
I have had clients tell me that their physician recommended a medication for anxiety or depression at the same time they were given the news that they were being diagnosed with a chronic condition, such as diabetes or cancer. Their physician was concerned about their emotional reaction and wanted to give them a medication to help them cope.
Others reached out to a physician and reported how they were feeling and were prescribed a medication. The stress of events in their lives, or the stress of living with a chronic condition, had them feeling like their emotional resources were drained.
And of course, I often have conversations with clients who are considering medication and want help in making the decision. Often, they have mixed feelings about the value of these medications and are unsure of whether they want to take that step.
I will be honest with you. I see both sides to the psychiatric medication question, based on my experiences with my clients.
I have seen clients really benefit from medication. It helped pull them out of their overwhelming feelings of depression or anxiety. In turn, they were able to function better, to focus more on their self-care, to learn new ways to cope with stressful situations. They achieved more quality of life.
I have also had clients who didn’t have success with their initial regimen. Their dosages were changed, or their medication was changed, or another medication was introduced. It was a process, sometimes requiring repeated changes.
And I have had clients who didn’t seem to benefit much from medication. Or the side effects they experienced made them decide the trade-offs weren’t worth any benefit they received.
Any way you look at it, making the medication decision is a big decision. It can be costly, with copays that can run high as well as periodic doctor visits. Psychiatric medications can cause various side effects, so there are trade-offs. And they may interact with other medications you may be taking.
Considering medication for depression or anxiety? Here are some of the questions I hear most often from clients, and some things to think about as you make your decision:
How do psychiatric medications work?
Psychiatric medications essentially reduce the symptoms of mental illness by blocking certain receptors in your brain. For example, they can stabilize your mood if you are depressed, or help you to cope with anxiety. They don’t make your problems go away. But by helping you to not be so overwhelmed by the symptoms, medication may help you to be better able to cope. If your physician does recommend a medication, then do your own research on it. Be aware of potential side effects. Ask questions!
How do I know if it’s time?
There is no definite answer to this question. Generally, a client who has experienced symptoms over a period of time – and is still having difficulty coping – may be a candidate for medication. Medication can be beneficial when the depression or anxiety is the result of a biochemical imbalance. Someone who is experiencing a difficult life event, like a loss, or a stressful situation, might also benefit. What I emphasize to my clients is that this question is one that you and your mental health provider or physician will answer as a team.
What about therapy?
Therapy can be helpful in a variety of ways. A therapist or counselor can be an objective listening ear who can provide ongoing support, and can help you to sort your feelings and get some perspective on what’s going on in your life. A therapist can work with you to help you cope better with your symptoms. And a therapist can teach you some skills to manage your life better. Some clients choose to work with a therapist and want to avoid medication. However, therapy can work with medication as a one-two punch against the symptoms of mental illness. It’s not necessarily a question of one versus the other. In fact, some physicians insist that patients being prescribed medication also participate in regular therapy sessions.
Who should prescribe my medication?
Many internists and family practitioners are comfortable prescribing medications for mental health issues, and they do this on a regular basis. However, physicians who are not psychiatrists most likely have a handful of go-to medications that they prescribe for depression or anxiety. One of these medications may work fine for you. However, if you are not getting results, it is advisable to consult with a psychiatrist. In fact, your internist may make a referral. Because treating mental illness is his/her specialty, a psychiatrist will most likely be familiar with a greater number of medications, and combinations of medications, and will be better able to provide the help you need.
How do I know how I’ll feel on medication?
Your physician can give you a general idea regarding what it will be like to adjust to the medication and how you might expect to feel. However, each person has their own unique experience with medication. It depends on so many factors that it is impossible to predict the results you will have. It’s a combination of your own individual body chemistry, the medication and dosage, your specific symptoms, any other medications you may be taking, your age, your gender, your past medical history, your expectations … and other factors. It’s really important to work closely with your prescribing physician as you are adjusting to a new medication, to communicate how you’re feeling, to ask questions, and to stay compliant with his/her recommendations going forward.
Is medication forever?
If your symptoms of depression or anxiety are related to a life event, including being diagnosed, and you are feeling better, then you and your physician or therapist may have a talk about going off the medication. If the need for medication is due to a biochemical imbalance, you may need to remain on medication indefinitely. This is something for you and your doctor to decide.
If I don’t like being on medications, can I stop taking them?
It is not recommended to abruptly stop taking a psychiatric medication. The effects of suddenly withdrawing medication result in a biochemical imbalance that can cause a number of mental and physical symptoms. So the same advice as when you first begin a medication applies here too: Work closely with your physician. Most likely, your doctor will recommend that you taper off slowly, and will want to monitor this process. Don’t go it alone.
Antidepressants, anti-anxiety medication, and you. It’s a big decision. Get informed. Ask questions. Team up with your doctor.