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Note: Always consult with your doctor when making decisions about your options for medication and the severity of your symptoms.

People experience mental health symptoms on a scale, which is to say that the severity of their symptoms vary widely amongst individuals.  For example, most people have a bandwidth of happiness in which they exist regardless of their circumstances.  Think about happiness as being a scale from 1-10, in which 10 is the most happy, joyful, and blissful mood you can experience, and 1 is being so depressed that you are suicidal.  Some people never get to that feeling of 1.  Even when things are really bad, such as experiencing the pain of grief, or significant financial hardships, or experiencing a severe trauma or assault, they still never get to the point at which they are suicidal.  Maybe that person stays within a bandwidth of 5-9, so that when things are really, really, bad, they would rate their happiness around a level 5, and when things are going really, really well, they get pretty close to that 10 on the happiness scale.  There are other people, though, who never ever get to that feeling of 10.  They tend more towards depression, and when things are really, really going well, they experience their happiness around perhaps a 7, but when they are really struggling with things going on in their life, or something pretty bad happens, they can become suicidal and really struggle to cope with their circumstances.

 

All this means is that some individuals may need more interventions depending on where they fall on an overall bandwidth of their symptoms.  The same analogy above can be considered when you are thinking about symptoms of anxiety as well.  Some people tend to have more of an anxious nature, while others may be very laid back in how they handle life’s curveballs, and many of us land somewhere in between.  You can use this analogy to help you determine how severe your symptoms are and whether or not your symptoms are likely to improve with non-medical interventions such as traditional talk therapy, utilizing your coping skills, and reaching out for support from family and friends, or whether you need to seek out medical interventions.

 

I have found in my clinical practice that many people do not want to take medication for depression, anxiety, bipolar disorder, or other diagnoses or symptoms.  This is understandable, because no one wants to feel like they have to have a crutch to help them cope with life.  However, there is no shame in using a medical intervention when needed to help you better manage your mental health.  We use medication all the time to address our physical health needs.  Just as we preserve our physical health by using non-medical interventions such as diet, exercise, and lifestyle changes when necessary, we can use our coping skills, support systems, and lifestyle changes to preserve and promote our mental health.  However, just as we sometimes need an antibiotic or another medication to manage a temporary or chronic physical condition, we may need to use a mental health medication to manage a temporary or chronic mental health condition.

 

If you are wondering whether medication is right for your mental health, consider the following in order to help you make a decision about whether a temporary or long-term mental health medication is something you should discuss with a therapist or doctor.

 

  1. You have been diagnosed with a mental health condition that includes symptoms of psychosis or other features that necessitate medication management.
  • If you have a mental health diagnosis that includes symptoms such as hearing voices, dissociative states, or severe mood swings, medication may be something that needs to be included in your long-term treatment plan. While some diagnoses may be temporary in nature, other conditions such as schizophrenia, dissociative identity disorder, or bipolar disorder require long term treatment and medication is frequently a part of the treatment recommendations.  Understandably, there are many people who resist being on medication long term.  People with these conditions often do benefit from their medication protocols, but they can be susceptible to lapses in medication compliance because they begin to feel better and mistakenly believe that they no longer need the medication.  This can result in a harmful cycle of symptom escalation, which could be avoided with regular compliance with their medication protocols.  If you have a more severe clinical diagnosis, it is important to recognize that medication can be an important part of maintaining a good quality of life, with your symptoms being closely monitored by your treatment team and your medications managed by a doctor you trust.
  1. Your symptoms have been ongoing for a month or longer.
  • We all experience temporary struggles in life that can affect our mood and can increase symptoms of depression or anxiety. However, sometimes those feelings become overwhelming and our regular coping skills aren’t cutting it when it comes to managing our mental health.  For example, you may experience a significant loss in your life and grief becomes overwhelming.  Or, you might be going through an extremely stressful life change, and your anxiety starts to escalate to the point at which you begin to experience panic attacks.  While some stress, depression, or anxiety is normal when you experience these major life changes, if you are experiencing significant distress for a month or longer, please consider consulting your doctor or a psychiatrist to help you learn what medical options may help you experience some relief.
  1. You have begun to experience physical manifestations of your mental health symptoms.
  • When your body starts to show physical signs of your mental health stress, it is probably time to consult with a doctor about your symptoms. For example, some anxiety under periods of stress is normal, but when you start to experience panic attacks, tightness in your chest, or hyperventilation, you have crossed a threshold at which medication management may be another tool that you can benefit from to get relief from the distress.  This applies to depression, too.  Many people experience bouts of depression during difficult times in their lives, but when your depression is causing extreme fatigue, disrupted sleep, changes in weight, body aches and pains, or other physical manifestations, you may benefit from trying an anti-depressant under the supervision of a qualified doctor.
  1. You have tried utilizing your coping skills and support system but your symptoms have not improved.
  • I am a big advocate of utilizing non-medical interventions for mental health treatment and building the right skills to help manage symptoms on your own. However, this doesn’t mean that medication can’t be an appropriate tool to use when your other skills are not helping you to feel better.  We all need to develop and use our own coping skills and reach out to our positive support systems when we are distressed.  Yet if you have tried these interventions and you are still suffering, there is no shame in seeking out more help when needed.  This doesn’t mean you have to be on medication forever, but medication can help your brain chemistry a little bit, and help you get back to feeling normal (whatever that is for you) again.
  1. You have had thoughts of wanting to harm yourself or other people, or you have engaged in self-harm behaviors such as cutting to relieve or manage your symptoms.
  • Self-harm behaviors or suicidal ideations are significant indicators that you may need some help with medication management. No one deserves to feel like they need to harm themselves to experience relief from anxiety or depression, and no one deserves to feel like their life is not valuable enough to fight for.  If you have engaged in self-harm behaviors (including disordered eating behaviors like restriction, binging, and purging) or you have thoughts of wanting to harm yourself, you need to talk to a professional about getting your symptoms under control so that you can stop harming yourself and start working towards recovery.  Your life and your mental health are worth fighting for and you should not feel ashamed about seeking medical help.  If you have significant anger issues that result in you having thoughts of wanting to act out in violence or harm others, you also may need to seek medication in addition to traditional therapy in order to prevent an escalation of these impulses.
  1. You are engaging in other forms of self-medication such as overuse of alcohol, marijuana or other substances to get relief from your symptoms.
  • If you find that you are using alcohol or other substances on a regular basis to experience relief from symptoms of depression or anxiety, your efforts may backfire on you. Alcohol is a depressant, and thus it may temporarily make you feel more relaxed or less anxious, but it can ultimately exacerbate your symptoms.  Alcohol also interferes with your sleep, and the lack of quality sleep can also exacerbate your symptoms (hint: passing out is NOT quality sleep!).
  • Substance use functions as a form of escapism for many people, but your problems are still there when you wake up in the morning. If you really want to get a handle on symptoms of depression, anxiety, or other mental health conditions, think about your use of substances and whether it is really helping you improve your life, or if it is just serving as a form of self-medication or causing you to avoid seeking professional help.
  • Alcohol and other substances can interfere with many medications. If you have consulted with your doctor and decided that medication is right for you, be sure to let your doctor know about your drinking or other habits so that they can ensure you are informed about potential interactions or side effects when taking your medication.

 

So, what if you have been on medication for mental health symptoms, but now you are feeling better and you don’t want to be on medication any longer?  First, recognize that if you are feeling better- this means the medication is working as intended.  Some people want to get off medication as soon as they start to feel better, but understand that you may need to stay on the medication for a while longer, especially if you are getting good results.  Sometimes people stay on an anxiety medication or an anti-depressant for a year or longer.  However, if you have done the work of developing stronger coping skills, or you have had success with traditional therapy and feel as though you are ready to wean off of a medication that you have been utilizing to address your symptoms, you can seek guidance from your providers about your options for the next steps.  A good provider will be honest and frank with you about your progress and the risks and benefits of changing your medication protocol.  However, if you have decided to go off of your medication, make sure that you do so under the guidance of your doctor.  Many medications build up in your body in order to reach a therapeutic level (the dosage at which they are most effective).  It is very important not to wean yourself off of a medication without consulting your doctor, because your doctor may be able to help you get off the medication slowly so that you do not experience harsh side effects or a dramatic return of your symptoms.  You do not have to feel ashamed about pursuing medication when it is right for you.  Think of it as just another tool in your toolbox of coping skills.  Deciding to take a medication doesn’t mean you have to stay on it forever, and it doesn’t mean you don’t still have to do the work of going through therapy or otherwise building your other methods of coping and obtaining support.  Just understand that medication is a tool, not a panacea to resolve your problems.  A medication is not going to magically make your problems go away, but it may just help you get the relief you need to keep moving forward with your life in a healthier and happier way, and there is no shame in that.

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