Medication for mental illnesses is a controversial and complicated subject. While not a psychiatrist, or any kind of doctor for that matter, I believe that after being on some form of psychiatric medication for the last 20 years I have a good idea of all the different reasons to take and not take them. I have argued with myself, my doctor and other people about them many times. I have seen the amazing effects of them and suffered the awful side-effects from them. It’s important to note that what I say below is only my experience of medication and the medication that I have been on. There are hundreds of various types of medications and hundreds of more generics of those same medications. Some work the same, some work differently, some are used for different aspects and sometimes you have to use more than one on the same aspect.
I have been on so many different types of medications, first for depression, then borderline personality disorder, then bipolar and sometimes for anxiety. I have tried and tested over 30 different medications since I was 19 years old. Some worked, some didn’t, some worked and then didn’t, some didn’t and then did and some still work. As I said, it’s a complicated mess and that’s why we pay psychiatrists the big bucks to prescribe them. They need to know which medications are better for different symptoms, how they work together with each other and any other type of medication you might be on as well as how you might negatively be affected.
So here are the various categories that I know of: anti-depressants, anti-psychotics, anti-anxiety, mood stabilizers, and stimulants. Anti-depressants are most commonly used to treat depression but can also be used for anxiety and insomnia. They are normally divided into 2 categories – selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Anti-psychotics are used to relieve symptoms of psychosis (often occurring in bipolar 1 and schizophrenia) but can also be used to help with PTSD, ADD, eating disorders and depression. Anti-anxiety medication is obviously used to reduce anxiety, fear, and worry. Mood stabilizers help keep moods more stable for people who have bipolar or some personality disorders. It has been found that anticonvulsants (medication for seizure-related disorders) in varying doses work very well as mood stabilizers. Lastly is stimulants, these are mostly used to increase alertness and attention. Commonly used for ADHD but also for narcolepsy, and occasionally depression. For precise information on the breakdown of various psychiatric medication check out this article.
So now to the good, the bad and the ugly of medication. And all of these sides co-exist, medication is not just good or just bad. Sometimes it’s amazing and other times it’s downright horrendous. I took anti-depressants for years with only slight alleviation, then I landed up in a psychiatric clinic had all my medication changed and put on 30 kilograms in just over a year. The new meds worked though and I felt better, I didn’t even notice the weight gain until later. Unfortunately, after about a year on the medication, it stopped working and I slipped into a bad depression again and had to go back to the hospital. For the next 5 years, I was in and out of the hospital with my medication changing every 12-18 months. Then we figured out the mix that worked for me and things settled down, only I slowly continued to pick up weight. Some medications made my joints sore, some left me with a dry mouth and some made me itch. Mentally though I was moving forward, I was learning to manage my mental health and my moods started to stabilize.
One of the hardest things about any type of illness where you have to be on medication for long periods of time is the feeling that you don’t control your own life. That the medication is controlling you, that you cannot just go out and live your life. Every morning or every evening, sometimes 3-4 times a day you have to stop what you are doing and take your medication. You have to always remember it when you go away or sleep out. More often than not you can’t take them without eating first. And you have to acknowledge that you can’t live without them, they control us. Sometimes you are forced to get a certain amount of sleep or you always have to be home by a certain time to take them, sometimes you can’t drive afterward and sometimes you can’t just wake up when you feel like it because you have to wake up with enough time to take them and let them take effect before you can leave the house. I often feel like they are controlling my life and it frustrates me but I know I need them and that frustrates me even more.
The other thing about so many of these medications is the awful side-effects you often get. Like I mentioned earlier I put on a lot of weight. This was mostly from the anti-psychotics and some of the anti-depressants that I was on. I’ve never been super thin but I have always been athletic and after putting on so much weight I was no longer comfortable in my own skin, I wasn’t comfortable walking around let alone running around. I wasn’t comfortable showering and everything became harder to do. I became tired and sore all the time. Some medications make me drowsy after I have taken them in the morning but have no effect in the evening. I have fallen asleep at my desk, in busses and sometimes before I could even get to work. People don’t understand this, they think it’s my fault for not sleeping enough and don’t believe me when I say that I have. I literally could not keep my eyes open which was particularly hard when I was traveling through Lesotho for work and holding workshops every morning. Some people completely lose their appetites, others yawn continuously and others still struggle to sleep. I often get exceptionally restless when the dosages of some medication increase too dramatically. My legs move so much it stops me from falling asleep at night. Basically, the side-effects are so varied and plentiful you really can’t be sure if you will be affected or not. More often than not you just have to stick it out for the first 3-6 weeks and then they slow down but sometimes not.
So why then, through all of this, do I continue to take my medication? Because even in the ‘uncomfortability’ and frustration I am very much aware of how much worse it could be if I wasn’t taking any of these medications. Being on medication for my mental illness, along with some hard therapy work, has changed my life. It has allowed me to live, if not a ‘normal’ life, then at least a manageable life. A life where I do not lie in bed all day every day for months on end, or spend thousands of rands on useless things. Because, no matter how hard I worked, pulled my socks up, decided to be happy, I wouldn’t be able to do it by myself. I need to be on my medication to function daily, to successfully hold down a job, friendships and be productive. Even though I go through moments of arguing with myself, of wanting to give up I know that being on medication makes my life better in the end. So, knowing this, I am then happy to go through different medications, the awful side effects and the frustrations it brings. I am happy to follow my doctor’s instructions explicitly because, at the end of the day, when you find the right combination, medication works for the most part.
So, there it is, the good, the bad and the ugly according to my thoughts about medication. It’s hard at times and it’s frustrating but I wake up in the morning with the motivation to get out of bed and I feel grateful. Sometimes I am sore and tired but other times I find great joy in being able to go out with my friends and just be. I hate the fact that I have to be on medication, probably for the rest of my life, but I am happy to keep pushing through because the benefits far outweigh the effects. Each person has their own experience and this is the only mine.
Twikst 