The Med Talk, Part One: In Defense of Meds

 

I am going to approach this post as though I were writing a letter to someone who is resistant to the idea of using psychopharmacological medications but could possibly benefit from them.  Rather than approaching it from the perspective of a therapist addressing a client, I will write as though I were addressing a friend or family member. 

Dear friend,

You recently shared with me that you have been struggling with symptoms of depression and anxiety and that you have recently started attending counseling sessions.  And I wanted to say again and in writing that I think that you are amazing and I love and admire you and am glad that you were able to recognize that the ways you have been thinking and feeling aren’t you.  I am glad that you are seeking out help.  I know that doing so can be scary, and I admire and respect you for exercising the courage to act.

antidepressants_1673710cAs I have thought back about that conversation, there has been something that you mentioned in our conversation that I didn’t comment on at the time, but want to share some thoughts on.  I hope that you don’t mind my unsolicited opinion.  You are welcome to disregard it if you feel so inclined.  The topic I wanted to share some thoughts about is medication.

You mentioned that you do not want to consider medication as an option.  You referenced friends who have had bad reactions, worries about becoming dependent on any kind of substance, and concerns that the side effects would be worse than the original problem.  And I respect and admire the way that you are thinking carefully and critically about the risks of taking medications.

Still, I do want to encourage that you also apply your careful and critical thinking towards a consideration of circumstances in which medication may be a helpful part of your support system.  That last sentence was a little bit vague.  Let me try to explain myself a little bit better.  First off, a disclaimer: I’m not saying that I think you should take medications.  But, I am advocating for considering the possibility.  And I’m not saying this based on what I know about you specifically.  This is advice I would give to anyone who says that they would never consider medication.  Because I know that there are many people who do benefit from medication, and that there are some who I would even say need it.  I’ll explain why I think and feel this way.

There are two scenarios in which I generally am in support of, and perhaps even an advocate of taking medication in the treatment of mental health.  I can best explain these through the use of two metaphors.  So, if you’ll humor me, allow me to explain why I believe medication can be helpful when it is used as a scaffolding or in a role similar to those of eyeglasses.

Scaffolding

A scaffolding is defined as “a temporary structure on the outside of a building, made usually of wooden planks and metal poles, used by workers while building, repairing, or cleaning the building.”  In an educational setting, the term scaffolding is used to refer to “a variety of instructional techniques used to move students progressively toward stronger understanding and, ultimately, greater independence in the learning process.”

supported-scaffoldingIn a lot of situations, individuals experience symptoms of depression or anxiety in response to stressful things going on in their lives, as a result of past traumas, or in reaction to negative thinking patterns and beliefs that have developed, often influenced by relationships and society.  These things, in turn, can elicit responses in the brain and body.

In these situations in which biological responses are the symptom rather than the root cause, enduring healing is most likely to be achieved by addressing that root cause.   BUT, that doesn’t mean that medication should never be part of the treatment plan.  In some cases, the symptoms have become so severe, that the individual is unable to function.  Or, they may be so limited by the symptoms of their depression or anxiety that it would be disruptive to engaging in therapeutic work.  In such cases, medication may be helpful as a scaffolding.

As the definitions above mention, a scaffolding is something that is temporary that facilitates building and growing, or, in the case of therapy, healing.  It gives someone the tools and the ability to do the work that needs to be done.

If symptoms are at a level of severity that it impedes general functioning, then something that gives a person enough reprieve from symptoms that they can engage in life and in therapy can ultimately be an investment in being able to do the work needed in order to not need medication anymore.

Corrective Lenses

As you have probably noticed, I am a glasses wearer.  I have been wearing corrective lenses since the first grade.  Without them, I would not be able to function well: I wouldn’t be able to drive, I wouldn’t be able to read signs, I wouldn’t be able to recognize people from a distance, and I’d likely accidently put myself into dangerous or embarrassing situations far more frequently than I do now.

538652I benefit from wearing glasses because I was born with deficiencies in my eyes.  I anticipate that this deficiency is largely genetic, as both of my parents wear glasses or contacts.  My vision isn’t something that can be improved through therapy.  But, by looking through corrective lenses, I can experience the world in a way that many people do naturally.  The lenses don’t change or fix my eyes, but they do change the way I perceive and am able to interact with the world.  They compensate for my deficiency.

Sometimes, medication can play a similar function to my glasses.  If the root of someone’s problem is biological, there is often a medication that can have a corrective effect that compensates for the deficiency.  It can help people see and interact with the world in a way that comes natural to many people, but that they feel removed from.  Mood disorders, for example, may have origins that are genetic, biochemical or hormonal.  In such situations, it may be helpful to use medication to compensate for deficiencies or disruptions in these processes.

Okay, so summary.  Are you still reading this super-long letter?  Thank you.  I know I can be verbose.  What I hope that you took away from this letter is this:

  1. I love you and admire you and am happy you are seeking help
  2. There are times when it may be appropriate to consider and talk witha professiona about the possibility of including medication as part of getting help:
    • When symptoms make it hard to function in life or therapy
    • If a problem seems biological at its root

Again, I don’t know enough about your individual situation to know if medication would be beneficial to you.  It might not be needed.  And there are always risks.  But I hope that you will allow yourself to entertain the option of medication as a potential part of treatment.  Think about it critically, possibly consult with a medical professional, and make the choice that you feel is best for you.  Thanks again for being tolerant of me in my unsolicited advice.  If anything I said has caused offense, please let me know and I will do my best to make things right.

Your friend,

Allison

The Med Talk: A Preface

As a therapist, I often interact with individuals whose functioning is significantly impaired by symptoms of depression, anxiety, bipolar disorder, or other disorders that can be heavily influenced (at least in part) by biochemical imbalances.  Accordingly, it is not uncommon to discuss the possibility of medication when co-creating a treatment plan with clients.  Many people presenting to my therapy office for help are in one of two camps as relates to medication.  And they make their views known without me ever bringing up the topic of medication.medicine-bottle2

Those in the first camp are eager (and sometimes overeager) to receive medications, confident in its ability to relieve their symptoms.  They see medication as a magic pill and they present to a primary care physician or psychiatrist so that they can have access to it and supposedly be done with it.

Those in the second camp are resistant to the idea of medication. They see it as a source of new and potentially worse symptoms.  They fear it will separate them from themselves.  Or they may fear that it will validate their diagnosis and confirm that there is a problem that they are still not willing to confront.  For any of a number of possible reasons, they don’t want to have to take a pill.

I wish to spend the next two blog posts inviting those in each camp to consider a few things.  To those who are overeager to use medication, and perhaps desire that medication be their only treatment, I wish to offer some warnings and invitations.  For those who are resistant to using medication, I wish to provide some context to consider so that the decision they make about treatment is an informed one.

And, before tackling this topic, I want to be transparent with my biases.  Here is where I stand: I have mixed feelings about the use of medications.  It depends on the person and the situation.  The following are a few beliefs I hold about medication (you’ll be able to read more about these thoughts and others in the following posts):

  • I believe that medications can be a helpful and important element of healing, but that it generally isn’t a standalone cure.
  • I believe that many can and do misuse and abuse prescribed medications in a way that is detrimental to physical and emotional health.
  • I believe that for some, medication can help manage symptoms, allowing them space to heal.
  • I believe that some people use medication in a way that disrupts or delays healing.
  • I believe that for some, medication is essential in allowing individuals access to themselves and to healthy functioning.

So, let’s talk about meds!  I will post Med Talk, Part One: In Defense of Meds this Thursday, and Med Talk, Part Two: A Word of Caution about Meds next Tuesday.  Feel free to join the discussion by posting questions, sharing experiences, or providing insights.  Thanks!