How can I support my soon-to-be-medicated beloved?

January 29, 2007 8:00 AM

My girlfriend is going on medication for anxiety. Help me be a good boyfriend.

She's just started graduate school and is having the normal first-year jitters. She's had problems with anger and anxiety in the past, but our stable relationship and her growing self-awareness and maturity were really getting her beyond this. Keep in mind, we're talking garden-variety outbursts of anger and frustration, not a crippling disability; the issue is enhancement of quality of life, not how to bring someone up to a functional level.

The problem is that I'm away from her this year on a post-doc. The separation is clearly contributing to her anxiety, though her grades are very good and she is stable. Before I left, we talked about strategies to help with her anxiety, one of which was getting into therapy. After a couple of sessions, her therapist has suggested she go on medication, high dosages of a drug like Prozac (an SSRI, I assume) and a tranquilizer to help with the potential side-effects of the main medication.

I am strongly opposed to taking these sorts of medications except in severe cases. I have a hard fought conviction that one should work through these sorts of problems on one's own, that learning how to regulate your emotions and stabilize your life is a central part of what it means to be human. And I feel strongly that the motivation behind the prevalence of these drugs, and people's lifelong dependency on them has more to do with the balance sheets of the big pharmacy companies than with a coherent and ethical anthropology.

But these are only my feelings. In our conversations on the subject, I've been nothing but supportive to her. She asked me for my opinion, I gave it once and only reluctantly. On the other side, she has several friends and her therapist who are pushing her to go on medication. I have made it clear that I will support her no matter what she decides and that my primary interest is in her health and happiness. Having said that, I don't know quite how to follow through.

So I've got several questions: what can I expect once she goes on the medication? Will her sparkling, quirky personality change radically? If it does, if she starts to look like a zombie or something, what are my responsibilities? Will our sex life, which has been fantastic, suffer? More generally, how can I support her despite her making a choice which goes so strongly against my own beliefs? I love this woman like I've never loved anyone in my life and I want to continue building our life together, even if it means holding my tongue while she makes a choice I cannot agree with. Finally, is it wrong of me to hope that, once this year is over and we're living together again, I can convince her to get off the medication and back to learning how to live a happy and satisfying life without drugs?

posted by anonymous to health & fitness (40 comments total)

Maybe you can simply respect HER choices.

Maybe the medication will help her. Maybe not. If not, believe me, she will be able to notice for herself. SSRIs don't make you into a zombie (I cannot speak for any additional meds they put her on.)

And another point: I am bipolar type two. When I was diagnosed there were people in my life who were flummoxed, and told me to my face I did not need meds, that I was fine. What they could not know was how incredibly hard I was working in order to APPEAR fine, and I just couldn't gut it out anymore. I mention this because it very well could be that your girlfriend has struggles that she either could not or would not show you. Better she get help now than she totally crash.

It is not your job to persuade her to get off meds, and really it is none of your business unless you are a doctor or therapist. You ARE entitled to an opinion, but that is all.

Sorry to be so harsh, but I had to deal with people like you when I was first getting help. Their attitudes made it that much harder for me to deal. I am incredibly thankful for the pill that enables me to lead a normal life instead of one where I am curled in a fetal position on some bathroom floor.
posted by konolia at 8:21 AM on January 29, 2007 [2 favorites]

>have a hard fought conviction that one should work through these sorts of problems on one's own

That's your conviction not hers. Your assumption of these drugs and methods as being 'lifelong' is factually incorrect. Most cases are a temporary use of medication to habitualize a non-anxious lifestyle then slide into the lifestyle without the medication. This takes time and effort and support.

No, she wont be a zombie unless she is getting severe side-effects from the medication. Most likely she will just feel more like herself.

Yes, it is wrong for you to hope that you can magically fix a serious disorder with your loving presence. Although it probably wont hurt unless you begin to guilt-trip her for finding relief from her symptoms, then you'll be the biggest problem in her life. Your anti-medication bias can be a huge problem for her unless you really watch yourself.
posted by damn dirty ape at 8:21 AM on January 29, 2007

You note that you believe one should "work through these problems on one's own". I'm in the same camp as you, but having dated a number of girls with emotional issues in the past, that's simply not a solution, sometimes. It's like asking someone without legs to work REALLY hard to become a marathon champion; They could work all day and all night for a decade and not get it.

Step one, then, is to accept that she is who she is: Someone with an anxiety problem who's only hope for functionality may lie in pharmaceuticals. Expecting her to have a sudden epiphany and become a charming woman outside of the pill will only end up pressuring her and setting yourself up for disappointment. You note that she has made a decision against YOUR beliefs. She's her own person. Remember that you are blessed with a balanced brain chemistry and a capability that allows you to live a life relatively unfettered by anxiety. Don't expect the same from her.

If she's been okay up to this point, I suspect it might be the stress of grad school that's doing her in. My advice in these situations is to keep in mind that you can't "fix" her. She has to do for herself. What you can do is to be supportive and helpful. It's my experience that many people kind of "dull" when on Prozac. Some don't mind the feeling, some hate it, but regard it as a necessary evil. It is not out of the question that once the year is over, she may no longer need the pills. However, don't set up that expectation. As above, so below, yadda yadda.

The rule of thumb here is just to remember that you're in a better place than she is and not to expect her to just buck up and soldier on. It's not an option for some people. Being a good boyfriend now is about being there when she needs you without allowing yourself to become her sole support.

Good luck!
posted by GilloD at 8:25 AM on January 29, 2007

This is a topic near and dear to my heart. I am in my third year of law school and recently decided to go on anti-anxiety medication and return to therapy. The symptoms you describe in your girlfriend are very similar to my own. I was extremely reluctant to go on anti-anxiety medication but decided that I could no longer continue to be so anxious, unhappy, and angry. The medication has been a amazing - that coupled with therapy.

You may not agree with your girlfriend's choice, but this is her journey and your support is integral. Her personality will not change, she will just feel more like her old self. This is an amazingly freeing feeling.

If you or she start to believe that you can be her answer you are setting yourselves and your relationship up for failure. She needs to find the help within herself.

It would be great if we could fix anxiety problems through hard work alone, but sometimes help is needed in the form of medication and therapy. If she was physically ill you would encourage her to take the medicine that would make her better. This is the same situation, she needs some medicine to help her get through this difficult time. She won't be on it forever and it will help.
posted by sara558 at 8:30 AM on January 29, 2007

I have a hard fought conviction that one should work through these sorts of problems on one's own, that learning how to regulate your emotions and stabilize your life is a central part of what it means to be human. And I feel strongly that the motivation behind the prevalence of these drugs, and people's lifelong dependency on them has more to do with the balance sheets of the big pharmacy companies than with a coherent and ethical anthropology.

I used to agree. Then I decided that the the alternatives to SSRI treatment of my anxiety disorder were much more severe than the potential effects of SSRI usage. Everyone needs to make that informed choice on their own.

So I've got several questions: what can I expect once she goes on the medication?

Mild side effects for the first month or so that decline over time. Benefits for me included dramatic reductions in stress headaches, fewer panic attacks, and a nice reduction in anxiety-related insomnia. Better productivity but a less aggressive approach to problems. It's not a panacea BTW.

Will her sparkling, quirky personality change radically?

Probably not.

If it does, if she starts to look like a zombie or something, what are my responsibilities?

Raise the issue with her in a supportive way.

Will our sex life, which has been fantastic, suffer?

Possibly. My sexuality took a major slip for a while, then mostly corrected its self. Personally, my anxiety disorder symptoms were severe enough that I was willing to make that compromise.

More generally, how can I support her despite her making a choice which goes so strongly against my own beliefs?

If you can't agree to respect her decisions regarding her own health, then perhaps this isn't a good relationship for either of you.

Finally, is it wrong of me to hope that, once this year is over and we're living together again, I can convince her to get off the medication and back to learning how to live a happy and satisfying life without drugs?

I don't think it's wrong to hope. But I do think that you need to be prepared that she might disagree as to the best long-term management.
posted by KirkJobSluder at 8:30 AM on January 29, 2007

OK, I know you've got some opinions that will be very difficult to change, but here's my recommendation:

Wait.

Wait to see how this medication makes her feel. You'll be pleasantly surprised to find out that she's still her sparkling self and not even close to a zombie. You'll see that she's happier and more relaxed. You'll see that after medication is better than before. And then you'll say "maybe I didn't need to be so afraid of the medication".

But until you've seen how medication can help your girlfriend you really, really need to reserve judgment. It'll save the both of you a lot of aggravation.
posted by stefanie at 8:35 AM on January 29, 2007

I understand where you're coming from but you are not in her shoes.
Also, some SSRIs do affect sexual function, however, many do not. Unfortunately you can't always tell straight off who will respond to which SSRI in a certain way.
If this becomes an issue the therapist will know to switch her meds to something else.
I recall about 2 years ago a Phychiatrist trainee friend of mine had a list of the more common side effects reported by patients with their SSRI and there was one that specifically mentioned an increase rather than a decrease in libido. I'm sure her therapist can advise, but if any Mefites can link to such a list it may help you both.
posted by Wilder at 8:42 AM on January 29, 2007

A lot of times, anxiety is environmental. A lot of times, it is a chemical imbalance. A lot of times, it's both. in those cases, even if she works through the environmental stuff (ie, relaxation, excercise, journaling, therapy, whatever...) That might only fix half the problem.

So, if your girlfriend had another chemical imbalance, say, diabetes, or a thyroid condition, would you be opposed to her taking medicine to correct them?

Didn't think so.
posted by Green Eyed Monster at 8:44 AM on January 29, 2007 [1 favorite]

Since you say you're in a post-doc I reckon you've gone through grad school and understand the stress it puts you through. It seems that a hideous first year is a fairly universal experience in grad school, regardless of discipline, degree, or institution. That said, it's very easy to forget just how hard that first year is once you've passed it, and especially once a few years beyond that have passed. It's also very easy to forget that it's often not just the stress of, 'how will I do in this class/on this paper?' that gets to people, but the soul-jarring fear that you're in over your head, that you aren't cut out for your field or program, that you're a failure, fraud, etc... you have no idea if you'll be able to pull it all off. Even the best of us need some hand holding when going through something like that. This may simply be her way of helping herself as she works through - particularly in light of the fact that you aren't around. As others have said, respect her decision and simply be supportive of her choice. It's likely not a permanent solution.

And that first year... hoooo boy.

On the other hand, it sounds to me like you are already being a very supportive and caring boyfriend, particularly to worry enough that you come to MeFites for help. She's a lucky woman.
posted by AthenaPolias at 8:51 AM on January 29, 2007

I recently went on medication for my anxiety disorder. For many years I wasted too much time thinking that I could change and control my issues without help. This isn't something you can just snap out of.
The only side effects I've had is that I felt extremely tired the first week, but that has worn off. I feel more relaxed, and much less stressed.
My doctor said I may not be on the medication forever, but it is a possibility and I can honestly say I haven't felt this good in a long time.
There is such a stigma at times about people not being able to control things themselves that people who truly need medication and help don't seek it because they don't want to be critiqued. The best thing you can do for your girlfriend is be supportive. More than likely, this will probably help your relationship.
posted by Elaisa at 9:09 AM on January 29, 2007

am strongly opposed to taking these sorts of medications except in severe cases. I have a hard fought conviction that one should work through these sorts of problems on one's own

Well hello Tom Cruise. Do you want to support her? Then respect her. Your fears about these medications represent a road block to her well being. From your comments it is clear you know little about them anyway.

They won't turn her into a zombie, or harm her sparkling personality. They will smooth out her emotional rough spots, and they will hopefully lessen her anxiety.

They will probably affect her sex drive, which frankly is going to be more painful for her than you. If she can deal with it than you can too, if you want to be supportive.
posted by caddis at 9:24 AM on January 29, 2007

I do not have an anxiety problem, but I do have a thyroid problem. When left untreated, thyroid problems sometimes manifest as anxiety or depression, constant illness and insomnia, etc. My thyroid is pretty out of control and was for a pretty long time. I cannot imagine not taking my medication to regulate this. As hard as I might try to will my thyroid into working, it just won't. As a note, I also went through this thyroid mess as a doc student.

The difference between those with something like anxiety and those like me is that the locus of chemical imbalance is different. The similarity is that we need a pharmaceutical to regulate our bodies. If anti-anxiety medicine is what she needs, then this is what she needs. She will find out for herself fairly quickly if it is helping her. She might be lucky and may be able to re-regulate, but if not, then she and I are in the same boat.

Please try on this new way of thought for a week and see if you can get used to it (just like a hat, I am serious). I think that it will be an immense help for both of you, as I can imagine your thoughts on the matter of medication and the fact that your girlfriend is on medication is causing you stress.
posted by oflinkey at 9:29 AM on January 29, 2007 [1 favorite]

I am in a very similar situation. As the girlfriend in the relationship, I made the decision to go on anti-anxiety medication. My boyfriend made it clear to me that he did not approve. I was deeply offended that he did not respect my choice. Although I realized that he did not and could not ever understand what it was like to suffer from anxiety like I did, it still hurt.

And of course the medication helped, along with therapy. There is no "snapping out of" these situations. After going on the medication my life changed drastically for the better. A heavy burden was lifted from my shoulders. I was in no way a zombie, in fact I was able to enjoy life even more.

My sex drive suffered just a little at first, but like the others above said, it evened out. I did gain a fair amount of weight, but to be honest, I didn't work very hard at keeping it off.

All in all, my advice to you would be to support her and respect her and keep your views to yourself, even if she asks. She is in a sensitive situation right now and will need you more than ever. You don't have to change your mind on these types of drugs, but once you see the effect they have on your girlfriend, maybe you will. I wish you both luck!
posted by bristolcat at 9:36 AM on January 29, 2007

It's amazing how often we get these "I'm a Christian Scientist and my girlfriend wants to have her inflamed appendix taken out" questions here.

The best possible thing you could do for your girlfriend is to really accept that the two of you experience life in different but equally valid ways. If you don't believe in modern medical care, that's fine: it's your issue. It has absolutely nothing to do with her.

As for the potential side effects, stefanie nails it. It's clear that you're anxious about what changes may be coming to your relationship, but in worrying about specifics you're just borrowing trouble. Hang out, relax, and continue to respect your girlfriend as the fully competent individual that she is.
posted by tkolar at 9:37 AM on January 29, 2007

I have a hard fought conviction that one should work through these sorts of problems on one's own, that learning how to regulate your emotions and stabilize your life is a central part of what it means to be human.

Speaking as someone who's been struggling with depression and anxiety for most of the past the past decade: Bullshit. Yes, SSRIs and similar medications do get overprescribed, and in many cases, people can just work through their problems. But real anxiety disorders & depression aren't something you can work through if you "just try harder." In my case, at first I wasn't willing to admit I had a problem... and then I ended up having to take a medical leave from my university before I flunked out. Took a lot of therapy & hard work to get back in, and made a lot of changes in my habits to try to prevent myself from falling apart again.

But you know what? None of that's enough. I'm actually considering trying medication for a while, despite the fact I'm pretty scared about mucking around with my neurochemistry. Hopefully, I'll be able to be more or less stable without medication eventually. But for now, no matter how hard I try, depression and anxiety are negatively affecting all aspects of my life: friendships, job prospects, creativity, everything. When a panic attack has me shaking in my room, unable to do anything else, or when a series of depressive episodes leave me ever more isolated from my erstwhile friends... Well, people with your kind of attitude just add to my burden. It redefines my illness as a character defect: a great thing to have to hear & take to heart when you're already struggling just to get by. I bring up my story because I want to give you an example to help you to understand that your beliefs are ungrounded, may not reflect the reality of her illness, and may be doing her harm.

Now, I'm not her therapist. I don't know how bad her problems with anxiety are, or whether your description is accurate. But, based on my experience, it's entirely possible she's figured out your attitude towards her problems & this possible solution, even though you think you've been "nothing but supportive to her." If that's the case, it's entirely possible she's stopped letting you know the full extent of her problems. You may think she's functional and just wants to "enhance her quality of life," while she may feel that she's struggling just to get by. If she understands your point of view, it's probably hard for her to draw much comfort from your "support," since she knows you think her problems are just evidence of a character defect.

So what can you do to support her? Read up on anti-depressants - given your assumption that people automatically take SSRIs for the rest of their lives, it doesn't sound like you know that much about how they're actually used. Talk to psychiatrists yourself, so that you can understand anxiety disorders, and how psychiatrists make the decision to use medication as a treatment. Talk to other people who have anxiety disorders, particularly ones who have decided to try medication, so that you can do a better job of understanding what it's like and why they might be willing to risk medication in the end. When she starts the medication, help her watch for side-effects. There are many anti-depressants, and the first one isn't always the best one for everyone. And throughout the process, listen to her. Do your best to listen without judgement. Keep your mouth shut, if that's what it takes. You're second-guessing your girlfriend and her doctor - would you do this for a physical illness? No? Then why do it now?

Regarding side-effects: Those will vary wildly, depending on her personal neurochemistry and on the drug. If she ends up on Wellbutrin, for example, sexual side-effects are fairly unlikely to be a problem. Will she end up a zombie? Almost certainly not. Antidepressants are very different from antipsychotics. If everything goes right, she should be herself - only with less anxiety and anger and unhappiness. If she does have personality-changing side-effects, she'll switch medications. Will she be able to go off the medication at some point? Quite possibly, but that's something for her and her therapist to decide. It is not your job to decide for her or convince her, however, and it is misguided to assume that your return will automatically solve her problems.
posted by ubersturm at 9:37 AM on January 29, 2007 [4 favorites]

You can see her as weak for taking medication, or you can be a supportive boyfriend, but you can't be both.

If you choose "supportive boyfriend," I'd recommend you read a book like The Anxiety and Phobia Workbook, which describes the effect of common medications, as well as suggesting a range of non-drug remedies for anxiety.

Anti-anxiety drugs are indeed like crutches. They help you get around until you heal and are able to walk on your own. Then you put them down.
posted by desjardins at 9:43 AM on January 29, 2007

Cut the guy a bit of a break. Yes, pharmaceuticals help drastically improve people's lives, but his fears aren't completely unfounded and irrational. I've personally known more than a few people who have had significant personality changes (including periods of zombie-like behavior) due to psychiatric drugs. Eventually the worse effects were worked out with dosing and the milder effects were probably worth the trade-off... but still, whatever the cartoon Zoloft character would have you believe, it's not accurate to portray these drugs as if they are perfectly shaped missing puzzle pieces.
posted by the jam at 10:03 AM on January 29, 2007 [3 favorites]

I have a hard fought conviction that one should work through these sorts of problems on one's own, that learning how to regulate your emotions and stabilize your life is a central part of what it means to be human. And I feel strongly that the motivation behind the prevalence of these drugs, and people's lifelong dependency on them has more to do with the balance sheets of the big pharmacy companies than with a coherent and ethical anthropology.

I'm going to give you the benefit of the doubt and assume that you've never encountered any sort of mental health issues, Anon, and that you therefore don't recognize the incredible hubris of that statement. You thus are not acquainted with disorders that sap you of the will to fight, of the will to do anything but curl up in a little ball and hope that it goes away, but that simultaneously compel you to invest every bit of energy you can summon to put on a front for the people around you, because you presume (quite rightly, judging from the tone of a few of the folks in here) that even people who care about you will think you less of a person for exhibiting weakness.

Tuck this bit of knowledge away for that day a few weeks from now when the two of you are talking about how things're going: when you question the need for her to seek pharmaceutical help for her condition, you explicitly question the validity of her ailment. This is functionally identical to scoffing at a cancer patient for seeking chemotherapy, but for some reason doesn't elicit the same sort of outrage from the population in general. This is a truly evil thing to do, and will cause irreparable harm to someone who is already not at her best. Don't. If you feel the need to wax Scientologist, bite your tongue, or you will cause needless damage to someone you profess to care for.

No, the drugs will not make her a zombie; SSRIs can wreak a bit of havoc when you're beginning or ending a course of them, but when they're operating normally, the effect is only the flatten the troughs and peaks, and raise the baseline of your mood. (ubersturm speaks rightly) You will probably notice some subtle changes, but it is a tiny, insignificant price to pay for someone to be free of the demons. It's even possible that in six months, she will have completely acclimated to the pressures of grad school, and can stop taking the medications. Leave the choice to her, and please god don't place your own opinions about Big Pharma above the mental health of this girl.
posted by Mayor West at 10:11 AM on January 29, 2007 [1 favorite]

the jam: Yes, "psychiatric drugs" can have side effects, although modern anti-depressants generally have side effects that are way less serious than almost any other sort of psychiatric drug [you're much more likely to see personality changes with anti-psychotics and older anti-depressants.] No one is saying that SSRIs and other antidepressants are magic, or that there will be no side effects. As I said, and as several other people have said, his girlfriend might end up trying multiple drugs to find one that works, or altering the dosage to find one that works. It's medication: it's not always easy or perfect, but the end result is generally an improvement.

But anonymous isn't saying "My girlfriend is going to start medication. I know the process of finding the right drug & dosage can be hard, and that the side effects can suck, so how can I help her deal with it?" He's condemning the very idea of her taking medication for her anxiety disorder, saying that he thinks she should just be trying harder, and then he asks how he can support her. It's that condemnation we're reacting to, since hearing that sort of condemnation from loved ones can be a significant burden for people dealing with mental illness. We're responding harshly because to be truly supportive to his girlfriend, he is going to have to educate himself and get over his supercilious views about mental illness and appropriate treatments thereof. I personally think that it's probably the single biggest thing that he can do to help her: it can make a huge difference to have someone you trust who honestly believes that you're brave to try to face up to mental illness and who thinks that you're trying to do the right thing. Supporting someone with mental illness is hard, since there's often not much that friends, family, and partners can do other than say "I'm here for you, I believe in you." If he can manage to actually believe in her without judging her, without assuming she's taking the coward's way out, well...
posted by ubersturm at 10:33 AM on January 29, 2007

the jam wrote...
I've personally known more than a few people who have had significant personality changes . . . due to psychiatric drugs.

Actually this is a fair point. SSRIs (and therapy) helped me out of a six year long depression, and the first thing I did when I was free of it was to get the hell out of a relationship with my pushy and judgemental SO.

So yes, in fact SSRIs can be major threats to relationships.
posted by tkolar at 10:33 AM on January 29, 2007

Well, I guess you're in the interesting position of having to just hope that you're wrong.
posted by koeselitz at 10:35 AM on January 29, 2007

the jam, the psychiatric drugs in question that made that 'zombie-like' behavior were probably anti-psychotics (which are notorious for their more harsh, emotion deadening side effects), and not anti-anxiety medication. One cannot lump all psychiatric medication into one whole genre! And no-one is going to turn into a 'zombie'; that kind of stereotype reminds me of how far we need to go in terms of education.

Look, nobody's saying that these drugs are 'the' perfect answer - they are part of a solution that includes therapy and a bunch of proactive things people can do (including exercise, proper nutrition, etc.). Yes, pharmaceutical companies make craploads of money; yes these drugs are probably over prescribed. Does that mean that she shouldn't take meds? No. Does that mean she should reach a certain point of suffering before trying meds? No. Does this mean she's somehow not capable of enjoying life just because she's on meds? NO.

Successful threatment of mental health illnesses means understanding that it's an illness - for some people, they cannot just 'work through' these problems or learn to 'regulate' emotions. I'm glad you're being supportive, but as others have said, it's her health, and her choice. She might not have to be on the medication for long - people do come off them, but again, it's not your job to convince her of anything other than to get help. If you can, go to a support group for people with anxiety or read up on it; you may find that it has nothing to do with choice, and much to do with coping and managing an illness. (on preview, what Mayor West said, and others).

Good luck, and please keep an open mind - it might be the best help in this situation.
posted by rmm at 10:36 AM on January 29, 2007

(Be prepared for that possibility.)
posted by koeselitz at 10:37 AM on January 29, 2007

And another point: I am bipolar type two. When I was diagnosed there were people in my life who were flummoxed, and told me to my face I did not need meds, that I was fine. What they could not know was how incredibly hard I was working in order to APPEAR fine, and I just couldn't gut it out anymore. I mention this because it very well could be that your girlfriend has struggles that she either could not or would not show you. Better she get help now than she totally crash.

This is incredibly common in medicine, and I've seen it in my own life as well. "Getting by" with any health issue - mental or physical - often means not showing how much it's affecting you. Sometimes, you even manage to fool yourself, only to discover later on that your quality of life could have been much better if you'd only done X, Y, or Z.

On the one hand, you have to do a certain amount of this "appearing fine when I'm not" thing in order to live a life that doesn't revolve around your issue. On the other hand, sometimes hiding it only makes it that much harder to get treatment.
posted by spaceman_spiff at 11:21 AM on January 29, 2007 [1 favorite]

In the people I know who've gone on anxiety medication, generally there have been changes. I wouldn't call them "personality changes," but perhaps behavioral changes. In discussing one person's going on pills with friends, we pretty much agreed "It's like she's high all the time now." This particular girl is still on the pills as far as I know, and while she doesn't act the same as before them, the effects have levelled out after a couple months. Another girl exhibited similar behavior and lost her boyfriend who she loved because on the pills she didn't have the good sense to not cheat on him. (That's her own admission; I wasn't there.) She got off the pills after 6-8 months, but the effects were there the whole time she was on them.

I don't know specifically what pills they were taking. Even with the consequences I've described, for these two particular instances the pills were better than the alternatives - a suicide attempt or severe self-harm, and being unable to swallow solid food.

I've never seen anyone act like a zombie, though. To expand on my descriptions above, they were a little "crazier" (in the "zany" sense), a little less inhibited, and a little hyper.

One thing you can do to help her - the doctor will tell her not to drink. If she wants to, don't let her. I know one guy who did and the doctor is right.
posted by TheOnlyCoolTim at 11:28 AM on January 29, 2007

There are a lot of potential side-effects to these types of medications, but there's no way to know in advance which ones will or will not show up in your girlfriend. If you notice a distinct change in her behavior, it might not even be from the meds; it could be from the new grad school program, or from being away from you. If you find yourself wanting to address a behavioral change, keep in mind these multiple possibilities; don't just blame the medication. Mention to her that lately she's seemed more quiet/loud/weepy/cheerful/whatever, and ask her if there's something bothering her and how can you help.

If you really care about her, you will want the best for her, and if these medications help her, then you should be happy for her. That's how you can be supportive. You seem to have a lot of strong feelings and opinions on this medication issue, but not a lot of experience or education about them. If this new treatment really helps her, maybe you'll change your mind about them.
Either way, it's her decision to make, and if you can't get over it, then you have some serious control issues.
posted by Sprout the Vulgarian at 11:41 AM on January 29, 2007

I am strongly opposed to taking these sorts of medications except in severe cases. I have a hard fought conviction that one should work through these sorts of problems on one's own, that learning how to regulate your emotions and stabilize your life is a central part of what it means to be human. And I feel strongly that the motivation behind the prevalence of these drugs, and people's lifelong dependency on them has more to do with the balance sheets of the big pharmacy companies than with a coherent and ethical anthropology.

Try this. Have someone electrically stimulate your pain center and then ignore it. Assuming that everyone is physically capable of "regulating their emotions and stabilizing their life" is much like looking at someone who has legs and assuming that they can walk. Just because the equipment is there does not mean it is fully functional.

Would you recomend to someone who needed dialysis should not take it because they will potentially be on it for the rest of their life? Would you tell to a person in a wheelchair that they need to get out of it at some point?

Your brain is an organ just like a heart, kidney or liver. If it does not work correctly, as some chemical imbalances indicate, then drug therapy may be the best option. It might be for the rest of their life, but that does not mean that it is the wrong course.
posted by slavlin at 12:00 PM on January 29, 2007 [1 favorite]

Lay off the poster for having the integrity to admit his true feelings about medication. It's normal. The fact that he came here and posted is all anyone should need to see that his feelings are in the right place. Using verbiage that set off some of the posters is unfortunate, but don't work out your frustrations for the real assholes that think medication is for the weak of heart/mind with this guy.

Good luck to you. As several have said already, give it time. Living with anxiety or depression is very analogous to hypertension or diabetes. A diabetic that needs medication despite exercise and diet is no different than someone with anxiety that is more optimally assisted with medication despite the same attention to good choices, i.e. exercise, good social commitments, education, counseling, etc.
posted by docpops at 12:10 PM on January 29, 2007 [2 favorites]

Hi, I am another person that was in a similar situation and am throwing my 2c in. I was the girlfriend, and actually did not go on medication partially because I was afraid of losing my ex-boyfriend's respect. (Turns out, there are easier ways of doing that!)

Eventually I came around to what my doctors were trying to tell me, which is that every person's brain produces different chemicals at different levels. If she is anything like I was, I was feeling constant anxiety with absolutely no relief or peace. I wasn't able to begin the process of soul searching, learning to control my emotions, and deal with the stress of graduate school that you describe until my brain chemistry was dealt with. She probably genuinely wants to deal with this on her own (who doesn't?) but can't right now.

Anyways, if she is on the right medication (this might take a few tries) she shouldn't seem like a zombie, and you shouldn't notice any drastic personality changes. If you do, make sure to bring it up so she goes to her doctor to get her drugs adjusted. And be prepared to help her on her soul searching process once she gets used to the drugs and is ready for it.
posted by lastyearsfad at 12:24 PM on January 29, 2007

When you have a headache, you don't need to free yourself from the illusion of the body, or pray to bring yourself closer to Christ, or appreciate that the corporate-militarist agenda is causing your stress and pain; you need to take a goddamn Excederin.

I have spoken in the past 2 weeks with at least 2 friends in a simliar position to your galpal (and we can up that to 4 in the past month). All say that the medication has made their lives immeasurably better. The "zombie" stereotype is really not something that actually happens to all that many real people.
posted by ibmcginty at 12:45 PM on January 29, 2007

OK, now I'm over being pissy, and can make an effort at being helpful and answering your question.

The first couple days of trying a new medication can be tough. They can increase negative emotions, make you tingly, or just feel "on edge." Or they can do nothing of the sort; just be mentally prepared for the eventuality.

For the most part, though, just remember that she's still the some old chick.

One drug-taker told me, "it was like all the background noise that I'd been so distracted by was tuned down." Another said, "I felt more like myself than I had in 3 years. I had been prone to feel like I could have a panic attack over totally nonsensical things, and now I don't."

She's not all of a sudden broken or subhuman or possessed, she's just trying to do better day to day. So, continue to be caring and supportive.

Your sex life may be affected, especially short term. As to how to "support her despite her making a choice which goes so strongly against" your own beliefs, I would urge you to (1) reconsider those beliefs; (2) realize that you can date and love someone without sharing 100% of the same opinions; and (3) consider having this discussion with her-- in a highly supportive and non-judgmental fashion-- in, say, six months. Be ready at that time to not win the argument, and to have alternative means of dealing with anxiety at the ready-- ie, therapy. "Drugs are bad, m'kay?" is really not a convincing line of argument to people who have found them helpful.
posted by ibmcginty at 1:07 PM on January 29, 2007

Lay off the poster for having the integrity to admit his true feelings about medication.

No more than I would lay off a racist for admitting his true feelings about black people.

But I'm a bit militant that way.
posted by tkolar at 1:26 PM on January 29, 2007

I think you've been properly chastized about the no medication attitude enough that you know you need to put your feelings away about that in order to be supportive. That's enough of that...I think some were being a bit too harsh, though their points were well founded.

I DO need to respond in that many here have stated meds won't change your girlfriend. I wish to say they might.

The 3 major groups of medications for depression, anxiety, etc. can and do have many side effects, and will manifest none, some, or all of them in varying degrees for each individual. Some feel no side effects and the meds work. Some the meds work with minor side effects. Some have such bad side effects it matters not if the meds are working...you see where I'm going. She won't know where she falls in the spectrum until she's been on them at least 2 weeks at theraputic dose. The one thing that is true is they won't change who she already is, because they just don't do that....which I'm taking as being your main concern.

My best to you and your girlfriend...may you both work through this well!
posted by mattfn at 1:45 PM on January 29, 2007

Lay off the poster for having the integrity to admit his true feelings about medication.

No more than I would lay off a racist for admitting his true feelings about black people.

But I'm a bit militant that way.

Medication for anxiety and depression is overprescribed, tkolar. And most people view it through a lens similar to the poster. Equating it with racism, is, well, idiotic. Why stop there? Holocaust denial seems fair game, too.
posted by docpops at 1:54 PM on January 29, 2007 [1 favorite]

One thing to keep in mind: not all SSRI's are the same. Some work better than others for some people, some have different side effects, etc. If the one she goes on has significantly disruptive side effects, she should talk to her doctor about trying another.

Also, I personally think the "no drinking" thing is way overly cautious. There's apparently some evidence that alcohol can reduce the effectiveness (and some anecdotal evidence that certain SSRI's making drinking more fun), but in my experience, moderate, sane drinking is fine.

Finally, if she's going on a significant amount, she should take care not to miss a dose (actually, one dose should be ok, but not more than one) and she should never just stop and go cold turkey. Suddenly stopping can cause some really intense and nasty side effects.
posted by treepour at 2:14 PM on January 29, 2007

Medication for anxiety and depression is overprescribed, tkolar.

No argument there.

And most people view it through a lens similar to the poster

The lens in question is, and I quote: "that one should work through these sorts of problems on one's own [without medication].", and I have no doubt that lots of people believe that too. Also, that a reasonable number of the people who believe that are walking around with full-blown biological depressions which are left untreated -- or far more commonly, medicated with drugs and alcohol that are much less subtle (and a lot more damaging) than the SSRIs.

The common waning-but-still-potent belief that all or even most depressions can just be wished away by clicking one's heels together is a hateful, hateful thing. It is at this very moment causing people to endure absolutely horrid day to day lives.

For the OP to present it as some sort of a moral stance that he wants to inflict on other people, instead of the personal and sad neurosis that it is ... well, I find that offensive.
posted by tkolar at 3:04 PM on January 29, 2007 [1 favorite]

I'm surprised at how hard people have come down on what seemed like a concerned and conscientious poster who emphasized that he is going to support his partner's decision whatever it may end up being.

I am not currently taking, and have never taken, antidepressants or anti-anxiety medication. However, I've known plenty of people who have, anonymous, and my advice to you is for the case that your partner does end up taking some such medication. Encourage her to be her own judge of their effectiveness. When drugs are being given to affect the mind, except in some pretty extreme cases, the person taking the drug should be the one deciding whether the cure is better or worse than the disease. In particular, SSRIs and related drugs can themselves play with your emotions and thoughts, and it's important to be clearheaded about this so that an overzealous doctor doesn't tell your SO that side effects from one of the drugs she's taking are in fact a sign of yet another "mental illness". It can be hard to stand up to authority in this sort of way (i.e., telling your doctor that they're wrong about what's going on inside your head -- they are the doctor, after all), but I think it makes a big difference if she stays in control every step of the way.
posted by louigi at 3:22 PM on January 29, 2007

>>Lay off the poster for having the integrity to admit his true feelings about medication.

No more than I would lay off a racist for admitting his true feelings about black people.

But I'm a bit militant that way.

And a bit ridiculous too. Anon seems to be getting slammed by people who themselves take medications for mental illness and don't like it to be suggested that, in fact, some (note, some) people take them unnecessarily. Equating the OP's position with either some crazy Scientology bullshit or racism is absurd in the extreme.

I think a concern that the OP's girlfriend is not in fact suffering from mental illness but rather is suffering from stress that we all do and is resorting to medication to deal with it is a valid concern. He even notes that he is not opposed to medication to deal with severe issues. The question is whether his girlfriend's stress rises to the level of severity that requires medication. The American medical system is renowned for over-prescribing meds since so many people gain monetarily from it. His fears are justified. This may not be popular with the (seemingly endless) stream of people on meds on AskMe, but there you go...

To the OP: if you truly love your gf and you think she will benefit from the meds, then you should support her through the process regardless of how hard it is. If you genuinely think she doesn't need meds and you think she is weak for going on them, then just get out (I'm not saying she is, before the deluge against me begins). I see this if you have any sort of contempt for her, then the relationship is over. At that point it doesn't really matter if you are right or wrong in your stance on meds.
posted by modernnomad at 4:33 PM on January 29, 2007

Modernnomad, altho I too think meds are overprescribed, it isn't up to the poster to decide that-he doesn't have the training. And the reason so many of us have such a chip on our shoulder is we have run into so many like him -people who assume they can tell what we do or do not need without benefit of an MD degree.

Walk a mile in our shoes. You might be surprised just how militant you get.
posted by konolia at 6:27 PM on January 29, 2007 [1 favorite]

I know this isn't of practical help, but the very fact that you're asking how to be a good boyfriend tells me you're a decent guy and you're likely to be naturally good support system for her. Trust your instincts; try to put yourself in her shoes.
posted by gb77 at 4:42 AM on January 30, 2007