How to think about taking meds for mental health
November 15, 2021 9:34 PM   Subscribe

I've recently started taking medication for my anxiety. I don't really want to specify what or why as I'm not looking for answers about alternatives to meds, or which medication I should be on. My question is this: how do I think about taking meds for mental health that doesn't put me in a place of "I'm broken"?

Prior to the meds I've been getting through by ACT strategies of accepting myself and remembering that what Im feeling is transitory, that I can still find joy in small moments. Mindfulness, meditation, and making an effort to connect with other people. Exercise, pilates. Eating well.
The side effects of the meds (I'm just over 2 weeks in) have knocked me sideways and it's been really difficult to maintain my routine. Anything that takes an effort to do has been dropped, even things I used to find a lot of joy in. Which is not like me, even at my worst times before meds.
The side effects do seem to be abating. But I'm really struggling with how to think about myself in this process. I think there's a part of me that feels guilty for struggling like this, feels like I should be able to manage better.
I'm seeing a therapist, but while she hasn't said anything, I get the feeling that she doesn't approve of the meds. That's quite possibly projection from me and not based on reality, but it means I'm reluctant to bring up my meds based issues with her.
In the past, spending time with other people has helped me a lot. But most of my usual opportunities for social connection are not available right now for various reasons. My husband is not well, and I don't want to lean on him too much.
At the moment my main strategy is doing only the minimum of work that I have to do, and watching a lot of Critical Role videos and funny, cute videos on Reddit. Also trying to at least get a little bit of writing done on my novel every day, doing soothing domestic things like gardening and laundry. Going for a walk every day. I used to go for long cycles but that kind of exercise seems to be beyond me right now.
Maybe I'm asking the wrong question here, and there's no way to think myself into a better place? I just have to accept that I've committed to this process and see it through at least till I've been on the meds long enough to judge if they are working for me? Maybe I'm once again trying to control something that is beyond my control?
At the moment my main problem is feeling guilty about letting go so many activities that made me feel useful, competent, etc before. I can only watch so many videos before I feel like I'm wasting time.
posted by Zumbador to Health & Fitness (26 answers total) 4 users marked this as a favorite
 
It is never wasting time to take care of yourself. With your mental illness better addressed, you will be able to do more of the things that are important to you with more enjoyment and satisfaction.

The transition onto meds can be difficult, but the experience is often...transitory. If you find that the side effects persist for a long time, you can always switch to a different medication in the same class. Just take it day by day for now.
posted by praemunire at 9:38 PM on November 15, 2021 [6 favorites]


Response by poster: Sorry I meant to add - what about support groups? I am reluctant to join one as my experience with (unmoderated) groups in the past hasn't been great. But maybe that's an option?
posted by Zumbador at 9:38 PM on November 15, 2021


I just have to accept that I've committed to this process and see it through at least till I've been on the meds long enough to judge if they are working for me?

IME, yes, exactly. I had to try three different ones until I found something that worked for me, took that one for a few years, now I’m not on anything.

….now, mind, I’m someone who never saw themselves as anything other than a collection of electrochemical reactions so the idea that a drug could affect “me” was never challenging or surprising in the least. Chemicals react, that’s what they do. Doesn’t make it wrong, or right, broken or flawless.

Guilt? What’s the moral status of gravity?

It doesn’t have one, it just is.

Day at a time, until it’s been long enough to know if it’s gonna work for you (this is largely a question of homeostasis and chemical half-life), then try something else with a different profile.
posted by aramaic at 10:18 PM on November 15, 2021 [10 favorites]


I have Rheumatoid Arthritis. I got it about 5 years ago or so. It's a funny disease, and there's LOTS of stuff online about "oh just eat anti-inflammatory foods" and "exercise in this specific way" and it's not so bad. The medicines for it can be pretty scary -- rare but life-threatening side effects, and some of the more hardcore medicines actually are painful to get administered.

I can survive without the meds. If I micromanage my movement and my food and everything else it hurts badly but not debilitating.

You know what I do? I take the meds every day. It just... Helps. It's not perfect, the pain isn't gone, I still tweak my meds and go to the rheumatologist fairly regularly, but the quality of life on the meds is better than the quality of life without it.

I also have anxiety. I've taken anti-anxiety meds even longer than I've taken the RA meds. And I could have written the paragraphs above with really very few edits and had it been about my anxiety instead of my RA.

The drugs don't change who I am. They don't fix everything. But they vastly improve my quality of life every day. And that's all it is.
posted by brainmouse at 10:52 PM on November 15, 2021 [34 favorites]


I'll share my experience and you can decide if any of it answers your first question.

First, give the meds time. If the side effects are concerns do share them with your doc(s). They are best suited to assess whether those are expected or cause for concern. But they take time. In my experience, some have been most hard at the beginning, and later I'm surprised that the initial side effects were even there, esp after the dosage was increased and the side effects did not.

Medication is a tool. That's all. It's one of many. Others need other tools you may not. This is one that maybe you need. A couple therapists described to younger versions of me : 'It's just something to help you get to the place where you're able to actually do the work you need to do, and get something out of it.' They meant '..in therapy' , and in my experience this has been true. It's hard to figure out some important things when you're just trying to stay alive, or function at the most basic level. The medication can get you up to a different level, so that you can do more of the things (in therapy, but elsewhere too) that will help you get better.

I take medication for a mental health disorder. I have taken medication for the majority of the past 30 years. For a lot of those years I didn't participate in the process as fully or honestly or consistently as I should have, which just delayed getting to the right place. Fortunately the last year has seen a new doctor, new re-diagnosis and vastly improved treatment. It is clear now that because my condition is unmanageable (and makes me unmanageable) at best , and carries a risk of death, I'll be on medication for the rest of my life.

You know when I was broken? Before I started taking medication.

It's been hard fought (I almost didn't make it, TBH) and by NO means do I suggest that the medication did all of it, or that the medication makes me more of 'who' I am. But because I am medicated, I'm here. I can now struggle and have the struggle get me somewhere (most of the time). I can participate not just in my life but the lives of others. I can be a better friend. A better partner. A kinder person to strangers. Hold a job and perform at a level that meets my lifestyle wants and financial obligations. I'm better for my dog.

Most importantly, I can be a good and present parent. I'm still a crap parent from time to time (more frequently if you ask my tween) but I can be here *with them* ; I have the energy and mindset and presence that I did. Not. Have. before I was medicated. (Or, at least, have it often enough as the commitment of a parent requires). My kid lost out on a lot of their dad for a few years there. Depression is a thief. Anxiety is a thief. If 'Better Living Through Chemistry' is something that'll allow you to kick at the knees of that thief, do it. If it doesn't seem to work, say so. Tell your doc. Reach out. Ask friends for recommendations for another doc. Whatever. Just keep kicking. Sometimes you'll want to rest and watch Reddit videos. That's fine too.

Truly the vast majority of people I've met - including the people I admire - could be considered as having been 'broken' at some point and by some measure. That's the damned truth. My current therapist and at least two before him have said, essentially, 'Everyone is broken in one way or another'.

What matters is not whether we are broken. What matters is what we do in spite of it.

There are so many who've said such far better. Start with Jung. Or listen to almost any music. Especially, but not limited to, Country.

Zumbador, you know how I know that being potentially broken doesn't matter? Because you wrote this askMe.

You can be broken, and still live your life.
You can be broken, and live in others' lives.
You can be broken, and you can love others.
You can be broken and still be loved.
You can be so, so "broken" and still live a life that is so, so worth living.
posted by armoir from antproof case at 11:42 PM on November 15, 2021 [23 favorites]


I have an assortment of anxiety-related diagnoses for which I take an assortment of medications and expect to for the rest of my life, so first I'll +1 what brainmouse and armoir from antproof case said.

Beyond that: The first few weeks of any new psych med are weird. I generally feel like death for a week, off for another, and then start actually noticing a difference around week 4-6. Please give this transition time, and please don't assume that if this med at this doesn't isn't right, meds in general aren't.

Also, this really stood out to me: I think there's a part of me that feels guilty for struggling like this, feels like I should be able to manage better. This keeps coming in my therapy sessions, so I'll share it: This feeling is the anxiety talking! Ooh it is whispering in your ear because it doesn't want you to get better.

So much of anxiety is about fear of what we can't control. We hate that, so we start trying to control it. We think if we can gather up enough stuff and manage off it it perfectly, if we keep an eye on every variable and not slip and handle all our messes and deal with all our shit (and probably a few other people's shit too) everything will be fine. We'll never be shocked or scared if we can just control! all! the! things! This is of course impossible, so then we get to feel guilty for failing to meet impossible standard we set for ourselves. We want to protect ourselves so bad, we end up feeling worse and worse. For me, there's a even tiny little corner that doesn't actually want my meds and therapy to work because I'm scared that without all my anxiety to protect me, the world will be even harder.

That is all of it my anxiety talking. You don't have to "manage better" or be perfect, never slack and keep yourself under perfect control, you just have to care for yourself. The first change I noticed when I finally started trying to wrangle my anxiety was the realization that my anxiety and I aren't the same thing. My anxiety was like a drawing on layer of tracing paper following my outline so perfectly, I didn't know it wasn't my skin. These days, I'm able to scoot that paper over and get some space between me and the the anxiety I have. I didn't lose me in the process, I uncovered myself.
posted by mostlymartha at 12:02 AM on November 16, 2021 [7 favorites]


1. Don’t worry about your therapist. Mine’s awesome and she’s the same about meds. It’s just a thing with some therapists. It’s their approach, and they’re not right about everything.
2. Re medication: I think when we think we should always be able to handle mental health problems without chemical intervention we are forgetting that the brain is not just this emotional/spiritual place between ours ears. It’s an organ. Would you judge yourself if your malfunctioning lungs or kidneys couldn’t just will themselves into functioning? Probably not, and people would think you’re a dumbass for even trying.
If you can operate healthily and happy without medication that is wonderful. But if you have a chemical issue and need it, you can lose months, years or decades of your life suffering needlessly. I’ve seen it, and experienced it.
Just try it out and see how you go. Try to give yourself permission to go for 6 months or a year without worrying about the should I/shouldn’t I of it, and then revisit the subject then.
posted by cultureclash82 at 1:15 AM on November 16, 2021 [8 favorites]


Can you change therapists? It is so clear when someone is against meds in an unspoken way and it is important for you to be able to talk through these feelings. I hope you find some peace.
posted by ellieBOA at 1:30 AM on November 16, 2021 [2 favorites]


My question is this: how do I think about taking meds for mental health that doesn't put me in a place of "I'm broken"?
One mindset that might help is to see the meds as a tool that will allow you to break the cycle of unwanted feelings and thus allow you to build your own coping mechanisms. So, rather than feeling that you are passively having your brain fixed, you are being supported in your personal journey to rebuild your life as a new and better person.

Mental health problems often feed on themselves (anxious about anxiety, depressed about depression etc.) so you are benefiting from something that jams that mechanism and gives you the space to focus on your ACT strategies and experience life without that endless internal voice of anxiety.

So you're not 'broken' in the sense of a machine that won't operate. You have a problem that you are using the most appropriate tools at hand to fix.
posted by Busy Old Fool at 2:24 AM on November 16, 2021 [5 favorites]


Mental health is not your fault, but it is your responsibility. You are taking responsibility for treating yourself well, and that’s a good thing.
posted by glaucon at 4:51 AM on November 16, 2021 [4 favorites]


"Broken" assumes a state of being "whole" that is singular and perfect. That's not only now how it works, it is a (common) way of looking at the world that erases the diversity of experience that exists across the species. Everyone - every single person - is a slightly different collection of genes, experiences, chemicals, and situation. Everyone has some things in that mix that are maladaptive or unpleasant, and everyone lives with or mitigates them as best they can. There is no "whole". There is just "human".
posted by restless_nomad at 5:02 AM on November 16, 2021 [12 favorites]


My question is this: how do I think about taking meds for mental health that doesn't put me in a place of "I'm broken"?

What if it was okay to be a little bit 'broken'? Is that something you could imagine coming to believe?
By which I mean, a thing can be 'broken' - imperfect, a bit battered or chipped or the handle needs jiggling in a special way to make it work - and still be good and worth having.
Maybe your brain needs jiggling in a special way to make it work the way you want it to. Maybe that includes meds. Maybe that could be okay? Maybe you're still good and worth having even if you don't work exactly the way you'd like to, and part of that is giving yourself the treatment you need to function best.

On preview, like restless_nomad says!
posted by BlueNorther at 5:13 AM on November 16, 2021 [4 favorites]


I have never felt so dreadful in my life as the few weeks I was adjusting to taking an SSRI. Much worse than the reasons I took it in the first place! But sticking out was very worth it. I feel like the drugs soothed the brain/re-calibrated the brain chemistry enough that my thought patterns were able to heal and re-wire. I stopped taking the SSRI after 2 years and I do believe that that in combination with therapy and meditation made it so that now I can manage my mental illness ok day-to-day and season-to-season, and my bad days are no longer as bad as they were pre-medication. Maybe this anecdotal evidence can help you stick it out and see it as a long-term investment in being healthier.
posted by Balthamos at 5:22 AM on November 16, 2021 [3 favorites]


what about support groups? I am reluctant to join one as my experience with (unmoderated) groups in the past hasn't been great. But maybe that's an option?

Try finding a local group through NAMI. Their groups are moderated and (IME) very well-run and inclusive.
posted by Thorzdad at 5:30 AM on November 16, 2021 [1 favorite]


You've already got some good answers, but you may still get something from Chris Gethard's special, "Career Suicide." As the title indicates, he talks frankly about suicide, his own mental health struggles, his own trajectory to getting on medication. Basically, he's been through it, and is thoughtful about it.
posted by coffeecat at 5:50 AM on November 16, 2021 [2 favorites]


I got cancer at 38. I absolutely felt broken, like my body had betrayed me. I felt weak and inferior and, somehow, humiliated. But I took my medicine and now that was almost seven years ago and I'm still here. When I first found out, a coworker of mine said dismissively, "Oh, everybody's got something," and I was offended and irritated, but over time I have come to see that he meant it as a kindness. And he was also right. We all have something about us that makes us less than perfect. In my case and in yours, it's a thing that can be treated effectively with medication. We're so lucky to live in the modern world with effective treatments that can save our lives. You wouldn't tell someone not to take medication for cancer, right? That someone could think themselves out of it? I know it doesn't feel like this to you, but they are the same. Medication can help you get better.

I will also say: mental health medication pulled my husband back from active suicidal ideation 17 years ago. He was very very close to leaving this world, and now he's okay. He still takes meds and he knows he always will.
posted by something something at 5:55 AM on November 16, 2021 [9 favorites]


I think there’s two issues here:

1. Problems with the side effects of the specific medication. You might talk to your prescriber or maybe the pharmacist about the effects and how likely they are to abate over time. if they don’t, or the side effects are very bothersome, you can explore other medications.

2. That worry about being broken. Others have challenged the idea; I’ll say “so what if you are?” I have a bad knee; I use a brace when I’m going to stress it. I have poor eyesight; I wear glasses. My brain is damaged, which causes seizures; I take medication to control them. So, basically, I am broken in a variety of ways, and I take steps to compensate. Clinging to the imaginary perfect wholeness is a guaranteed source of suffering every time you bump into reality.
posted by GenjiandProust at 6:08 AM on November 16, 2021 [7 favorites]


Someone I'm close to is about six weeks into psych meds. We talk about it a lot. The thing that I try to say a lot is that it's such a huge deal that they wanted help, got it, and are sticking to it.

You're doing this too - you are making active moves toward better mental health. Even if it feels like you're doing less, you're actually doing a huge amount of work while your brain adjusts to a new chemical balance. It might feel passive but you chose it and continue to choose it every day when you take the meds. I can see this from the outside in them, and the people who love you can see it in you, even if they can't articulate it.

Take my words instead. Sending you good thoughts.
posted by wellred at 6:45 AM on November 16, 2021 [4 favorites]


Hi hello I am medicated for anxiety and resisted it for years.

Here to say medicated is so much better. One thing I repeat to myself over and over again is that if your brain doesn't make the right chemicals, store bought is fine. I'm not obligated to make cupcakes for every occasion and my brain cannot make certain correct chemicals for every occasion, and that is okay. Not everyone can make from-scratch pie crust, Thanksgiving is still great.

Of all the things you said, the one about your partner not being someone you want to lean on right now stood out to me. I think this is something to be careful with. Your partner may not be well but be open and honest with them about how you're doing and allow them the space to support you as they are able. Knowing you have even a little bit of backstop may be more helpful than you think.

Adjusting to being medicated is a whole process. When I was first getting acclimated, I could not take my meds other than right before bed because they wiped me the FUCK out. I'm used to them now so I can take them kind of any time, but I'm still pretty careful to take them before bed just in case I'm extra sensitive for some reason. I think the meds I am on take 1 month to six weeks IIRC to reach full efficacy. So this is a process. It's okay to take this time to adjust to your new meds and gradually get a feel for what you want to do, as well as what you are able to do.
posted by Medieval Maven at 7:04 AM on November 16, 2021 [10 favorites]


At the moment my main strategy is doing only the minimum of work that I have to do, and watching a lot of Critical Role videos and funny, cute videos on Reddit. Also trying to at least get a little bit of writing done on my novel every day, doing soothing domestic things like gardening and laundry. Going for a walk every day.

Here to say that it sounds to me like you are doing a great job at doing a whole boatload of things. Please don't feel guilty for not doing more than you already are.

I personally can't imagine doing all of the things you listed in one day. No one I interact with on the daily does all of those things every day. I will do some (very minor) housework today and cook soup for dinner. That is more than enough for me with my limitations right now. You are doing more than enough.

As far as not wanting to lean on people and feeling as if you should be able to manage better: People are okay with you being a beautiful mess (link is to an article from this thread on the Blue). No one is in control all the time, no one has all of their shit together, and we all know it.

You leaning on people when you feel broken is just you being real with people. Many people wouldn't have had the guts to post this Ask for fear of revealing their guts. You are admirable.
posted by RobinofFrocksley at 8:09 AM on November 16, 2021 [5 favorites]


I just started meds after some years of inaction when I really should have made the call. Now, I don't have any particular self-esteem issues about it: many many many people I love dearly are here because medication is bridging the neurochemical gap between what they need and what they can produce/retain on their own. I love me and I am now in the same boat; there was a time when I could power through but age and particularly the hormonal ravages of age mean I require a tugboat these days.

Just like Medieval Maven says, I routinely cheerfully say to myself, "If you can't retain your own serotonin, store-bought is fine!"

I have had to mess around a lot with what time I take mine, as my biggest side effects are drowsiness when I cannot be drowsy and also kinda thin, shitty sleep at night. Right now dinnertime is what seems to work best, but whenever I take it I always think, "Oh, I get to take my medicine now!" It's a boon. It's a privilege.

But you're not wrong that the first few weeks don't feel so great and may even magnify the worst of the feelings. It helped me that I decided even before I finally made the call for meds that I would need to strip my life down to bare bones for a month or two because I was already so short on spoons. The house is a fucking pit and we are eating a lot of assembly meals but it has been immensely helpful to reduce my essential requirements down to work, basic hygiene, take care of the dogs, food/water for self but really easy versions, and rest. I've been trying in the past year or so to treat rest as a more sacred practice: it is necessary to body, brain, spirit and it is a form of protest against capitalism. It really sounds like what you're doing right now is mostly same thing I am, except you're beating yourself up for it and I am treating it like treatment - like staying off a broken leg for a few weeks, or avoiding screens for so many days after a concussion, this is what my body requires at the moment.

Nobody makes it out of this life unbroken. Everyone you love or like is walking around with some kind of damage - right at the moment for one person it might just be bad eyesight and a creaky knee, but for another it might be cancer. You know people who have maybe literally unspeakable trauma in their past. Lots of people you care about need (and may or may not be getting) neurochemical assistance to feel okay. People you know have autoimmune diseases, deadly allergies, diabetes, asthma, heart disease. None of this lessens their value as humans, it doesn't lessen your value as a human, and I'm absolutely certain you would not tell a single one of them they they shouldn't treat whatever it is that isn't working as it should. I imagine you would drive them to the doctor or the pharmacy if they needed your help.

You deserve the same grace and encouragement. You have not failed a test. You will not go to a different heaven because you took some medication. You have a health condition with the nasty side effect that it will whisper insults in your ear and declare your unworthiness, but if you can just roll your eyes at it a little bit longer you will get on top of it and your perspective will feel very different.
posted by Lyn Never at 8:24 AM on November 16, 2021 [11 favorites]


You sound like you are working so hard at getting and feeling better. Good on you, seriously. Taking charge of your mental health is really difficult and you should feel immensely proud of yourself.

I felt the same way when I finally, with tears in my eyes and a tremor in my voice, asked my doctor for a prescription; it felt like admitting the ultimate defeat that I was not able to think/coach/exercise/etc. my way out of my anxiety and depression (I laugh at that very idea now) or that I was less strong than my med-taking peers somehow for needing it (even though I had watched their successes on it!). You bet I felt broken. And now, almost two years into the process, I do feel "fixed." Not even just fixed but like an enhanced, optimized version of myself. I take my meds joyfully every morning, feeling beyond grateful that they allow me to function as well as I do, that anxiety no longer has such a stranglehold on my life and my happiness. By now they have taken on the same significance as any other pill I swallow throughout the day that helps keep me upright and taking in nourishment: vitamin D for seasonal depression, fish oil for creaky joints, a multi-vitamin for general wellness, ibuprofen when I have a headache, Pepto-Bismol for when my stomach acts up, and so on. They feel no different, honestly.

Joking about it helped for me too. Better living through chemistry. All hail our great god Wellbutrin. Worshipping daily at the altar of Lexapro. You will be amazed how many people will be like OMG SAME if you openly and straightforwardly mention your experiences of being on medication for mental health and little by little, it will begin to normalize for you.

Lastly, I read a book recently where the author talked about how whenever we're dragging ourselves hard because whatever is happening does not match our mental image of how things "should" be, that moment is "a beautiful opportunity to be kind." I think about that phrase all the time whenever I am not giving myself enough grace or have some misaligned expectations for myself that I should be coping better than I am.
posted by anderjen at 9:23 AM on November 16, 2021 [5 favorites]


Your comment flagged as fantastic, armoir from antproof case. I take all my meds, including for anxiety, and just take it one day at time. Unless they are new meds, when I sometimes have to take it an hour at a time. But eventually they work or get swapped out for something else. Good luck!
posted by Bella Donna at 10:45 AM on November 16, 2021 [1 favorite]


I was hesitant at first and resisted for a long time. But with a trusted therapist and psychiatrist — ans wurie frankly some desperation on my part — I took a chance and it was really, really life changing. Since then I’ve been on and off as needed; transitioning between has been surprisingly easy for me. When I stop, I feel a bit better and more self-aware every time. Meds work differently for everyone and it’s true there are some horror stories or just flops but there are many more stories that are positive (or neutral) that are just not told as loudly.
posted by smorgasbord at 2:29 PM on November 16, 2021 [3 favorites]


First, when I began to take medication and the symptoms of my mental illness began to clear up (I can get up in the morning! I am able to accomplish the goals I set! I can maintain a job!) it did wonders for my self-confidence. You mean I'm not just a bad and lazy person who will always fail at life but really am suffering from a treatable illness? Though I still engage in a good deal of negative self-talk the degree of improvement from medication that occurred separate from therapy has helped me understand that the years of struggle were not the result of immutable personality defects. YMMV, as this is entirely dependent on whether you've gone through life internalizing your struggles as evidence that you are not good enough.

Second, life improved so much with medication that one day I stopped agonizing over the "proof" of my broken brain and said fuck it, things are better now, who cares how it got there?
posted by socks_for_all at 4:23 PM on November 16, 2021 [4 favorites]


Response by poster: Wow wow wow. Thank you all so much. This is incredibly helpful.So many beautiful, wise answers.
I'm sitting in bed now, and it's raining gently outside, and everything has that "it's just started raining" scent. I can feel my anxiety prodding at me ("something might be wrong somewhere!") but I can ignore it right now.
posted by Zumbador at 9:28 PM on November 16, 2021 [9 favorites]


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