by Rebecca Hicks, RN
Either you’ve experienced it yourself or know someone who has… The moment where the doctor tells you that they are going to prescribe something for you to help you cope with your emotions, to cope with your racing or depressive thoughts, to help you cope with your past, to regulate your sleep, or to stop the voices. Something to take the “edge off”. For some people, they’ll easily take whatever the doctor prescribes, for others they say “no thank you, I can fix this myself.” But there is a lot to consider when taking medications and unfortunately a stigma that comes with taking medications for mental health reasons.
Today’s blog will explore the stigma and why it exists. I’ll also touch on when to use medications and some tips for advocating for yourself or others (if you are a caregiver or support person). The information shared today is from my experience as a registered nurse and is not to be taken as medical advice. As with previous blogs I have written for AGORA, please consult with your health care professional before making any changes to medications.
In my experience, there are many reasons why people have stigmas, attitudes, beliefs, or judgement towards psychotropic medications. Many people who struggle with mental distress (of any kind) are often ashamed or embarrassed of their symptoms. They often feel that they must have done something to bring on the symptoms or something has happened in their past that they don’t want others to know about. They may be fearful of what others will think if they are taking medications to treat depression, anxiety, addiction, trauma, bipolar disorder, schizophrenia, insomnia, etc. There may be fears that medications won’t work, or that medications will make them feel nothing at all. There are often (real) fears about side effects. For some people they feel that taking medications is a sign of weakness; that they should be able to cope with how they are feeling on their own. Unfortunately, some Christian’s also live in fear that other believers will find out they are taking medications and cast judgement on them stating that they lack faith or should get better by just trusting in God. For other’s they may be in denial that there is an issue; their close family members and friends may see that they are struggling but they feel that they can “handle it on their own”. Another fear that many people have is if they start on a medication, that they will be “stuck on it” for the rest of their life. These are just some of the reasons why there is so much judgement and hesitation in taking medications to treat mental illness.
Despite the fears that we explored above, medications can be a great tool in helping people cope with their thoughts, emotions, and behaviours. I use the word “tool” because just like a carpenter has many tools to build a house, medications are one tool that when used with other tools can help rebuild someone’s life. What I mean by this is that you can’t expect medication to fix all of your problems. There just isn’t a pill for that. But medications can be a tool to help get your brain in the right sequence so that you can do other things that you enjoy and it will help align your mind and body to work the way it’s intended to work. Medications work best in conjunction with a healthy lifestyle. It is important to exercise, have a nutritious diet, get enough sleep, refrain from using substances (there will be an entire blog related to this topic- stay tuned!), and to find meaningful activities that give you purpose and a sense of ac
com
plishment.
A question I am often asked is “when should medications be considered?” Some of the most common reasons are the following:
when your regular (healthy) ways of coping with stress aren’t working
when your sleep is affected
when your quality of life is affected
when you struggle to function in your regular activities
if you are feeling hopeless and/or having suicidal thoughts (I would strongly suggest getting help before suicidal ideation occurs but it’s not too late if suicidal thoughts occur before medication is started)
Now that we’ve explored when to use medications, I will provide some general tips on how medications should be used.
Perhaps this is an obvious point, but in case some readers aren’t sure where to get medications, family doctors, psychiatrists, and nurse practitioners can prescribe psychotropic medications. Medications can also be prescribed at a hospital (usually either in the emergency department or on an acute psychiatric unit) but follow up will be needed afterwards. It is important to keep in mind that the first medication you are introduced to may not work; it may take a few different trials of medications. Also, most medications do not work instantly. It usually takes weeks and in many cases months, to see the full effect of the medication (this can be very frustrating for people when they are struggling). It can be helpful to let your practitioner know what medications worked well for you in the past and which medications did not work well. It can also be helpful to know what medications your family members are taking for mental health (if you have a close family member on medications) as it is known that sometimes what works well for one family member will work well for another (genetics come into play).
Advocate for yourself, or have someone you trust go with you to your appointment and help advocate for you. Don’t be afraid to take notes (it’s helpful to keep a timeline of your emotions, sleep patterns, etc.) and tell your practitioner exactly how you are feeling. Ask about side effects. If you are having too many unwanted side effects, ask your practitioner if it is possible to titrate the medication slowly; meaning start at a low dose and increase it slowly over a longer period of time.
Everybody is different, so what works for one person may not work for another. For some people multiple medications need to be used. But again, don’t be afraid to speak up for yourself and tell your practitioner what is working and what is not working. Often time’s people will give up after one short trial of medications because it didn’t seem to work. Give it a chance, and work with your practitioner in finding a medication that helps you.
If you had a broken arm you’d go to the hospital to have it reset. If you had high blood pressure and wasn’t able to manage it with exercise and diet you’d take an antihypertensive medication. It’s no different for our mental health (except that our brain controls the entire body and our emotions and if it’s not doing well, how can we expect to be doing well?) Rant over.
Now let’s change the stigma!
Here are seven ways we can reduce stigma as outline by the Centre of Addiction and Mental Health:
Know the facts. Educate yourself about mental illness including substance use disorders.
Be aware of your attitudes and behaviour. Examine your own judgmental thinking, reinforced by upbringing and society.
Choose your words carefully. The way we speak can affect the attitudes of others.
Educate others. Pass on facts and positive attitudes; challenge myths and stereotypes.
Focus on the positive. Mental illness, including addictions, are only part of anyone's larger picture.
Support people. Treat everyone with dignity and respect; offer support and encouragement.
Include everyone. It's against the law to deny jobs or services to anyone with these health issues.
I’ll conclude by sharing these verses found in Matthew 5;1-10. I hope these words Jesus shared 2000+ years ago encourage you today.
1One day as he saw the crowds gathering, Jesus went up on the mountainside and sat down. His disciples gathered around him, 2and he began to teach them.
3“God blesses those who are poor and realize their need for him, for the Kingdom of Heaven is theirs.
4God blesses those who mourn, for they will be comforted.
5God blesses those who are humble, for they will inherit the whole e
arth.
6God blesses those who hunger and thirst for justice, for they will be satisfied.
7God blesses those who are merciful, for they will be shown mercy.
8God blesses those whose hearts are pure, for they will see God.
9God blesses those who work for peace, for they will be called the children of God.
10God blesses those who are persecuted for doing right, for the Kingdom of Heaven is theirs.”