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Should I Take Medication for my Anxiety, Depression, or OCD?

There are many factors to consider when answering this question.  Some clients are adamant that they don’t want to take medication.  Others are open to medication but have various concerns.  They may know someone who has experienced a negative response to medication or they themselves may have experienced a negative response.  They may voice the following specific thoughts or concerns: My symptoms might get worse. I don’t want to be on medication for the rest of my life. I don’t like taking any medicine.  Medication is a crutch. I don’t want to deal with the possible side effects of medication.  I’ve tried medicine before and it didn’t work.  Or, I might become addicted to the medicine. These are all very valid concerns.  So, how do you decide?

Research has shown that treating anxiety, depression, and OCD with medication only is not as effective as the combination of medication and therapy.   The symptoms of mental health issues alert us to the fact that our body, brain, and mind are out of balance and significant changes need to be made.  Treating our emotional difficulties with medication alone fails to address the wide-ranging complexity of what is happening and can be short sighted.  But, how do we know when we need more than therapy?  How do we know when taking medication is the best decision?  The decision is one that needs to be informed and made on an individual basis!

 

Questions to Ask

While none of these questions provide a definitive answer, they can help us make an informed decision.

How am I functioning on a daily basis? 

Am I eating and sleeping well?   Can I get out of bed in the morning and get to work or school?  Can I complete daily hygiene tasks?  Can I care for myself and my children and generally fulfill my basic life responsibilities?   Or, do all of these things feel overwhelming and exhausting?

What are my specific concerns related to my wellbeing?  What are other’s concerns about my wellbeing?  And, how do I address these? 

You may want to ask those closest to you if they have noticed changes in you?  If so, what are those changes?  Are your family and friends concerned about your wellbeing?  Have they noticed changes that you haven’t?   You may want to solicit their feedback.  Sometimes the very nature of emotional struggle is that those closest to us notice changes before we do.

Should I Consult with My Doctor and Therapist?

Whether you are for medication, against medication, or don’t really know, you may want to consult with your counselor and physician.  These professionals can give you more information and address your concerns so you can make the best decision.  Ask questions!  You should have all of your concerns addressed. If you aren’t comfortable with a professional’s opinions or suggestions, if you don’t understand the reasoning behind their suggestions, please ask questions and make sure you get answers.  Get the information you need and then make your own choice based on the advice and information that you have been given.  Consulting with a professional does not mean that you are required to be on medication.  I am not advocating going against medical advice.  There are certainly times and situations when we must be on medication and not taking the medication can be dangerous and even life threatening.  However, I am advocating that we make informed choices about our mental health.

When did the symptoms start and how has my condition improved or worsened over time?

Depression can be like a snowball rolling downhill.  If it gets too big and too out of control, it can be more difficult to treat.  Anxiety is the same.  If anxiety levels are high enough, individuals can experience paranoia, have difficulty driving in traffic or on the highway, have difficulty completing daily tasks, experience panic attacks, and even agoraphobia which can result in a fear of leaving home.  For individuals who struggle with OCD, they can have difficulties working or going to school due to their symptoms.  They may spend hours obsessing or acting out compulsions and that can be personally, academically, and occupationally detrimental.

Can I do the things I need to get better without starting medication?

Can I do things that my therapist recommends such as improving my sleep, getting more exercise, spending time with others, addressing negative thoughts?  Do I have a support system in place?  Are there people who will encourage me to do the things that are good for me and not allow me to isolate?  Are there people who will notice if my symptoms worsen?  Do I believe I can benefit from therapy without medication?

Do I have a family history of mental/emotional problems? 

If you answer yes, it does not mean that you should automatically be on medication.  However, we do know that having a family member with mental or emotional problems causes us to be at greater risk in terms of both nature and nurture.  We are at a greater risk genetically but we are also at risk due to because of our environment and living with those struggling with mental illness, emotional problems, addictions, etc.

What If I Try Medication and It Doesn’t Help?

Many people see their primary care physician when struggling with mental health issues.  This often results in the individual getting the results that they want with the medication prescribed.  However, there are others who don’t get the help that they need.  Too often, these individuals give up on medication when the first one doesn’t work.  There are many different classes of medication and sometimes your doctor finds the right one through trial and error.  Just because one medicine doesn’t work or has undesirable side effects, doesn’t mean that another medication will be the same.  Yes, there are side effects with some of the medications used to treat anxiety, depression, or OCD.  However, if those are experienced, they often resolve as you adjust to the medication.  If side effects do persist, those must be carefully weighed to evaluate the benefits in relation to the difficulties.  It can be helpful to visit a psychiatrist, especially when there are prolonged difficulties in finding an effective medication, or when an individual is struggling with multiple problems or diagnoses. There are times when a medication needs to be changed but there are also times when the medication dosage simply needs to be adjusted, or the medication may need to be taken with food, or at a different time of day.  This can be incredibly frustrating when you are dealing with debilitating issues such as OCD, anxiety, or depression and you just want to feel better but healing does take time.  Solicit encouragement from your family and friends, and your therapist and appreciate the steps you are taking to feel better.

Inspiration

Where do you find inspiration? Part of being emotionally healthy is feeding your mind and spirit with encouraging music, books, and information. As far as inspiration, Janine Shepherd’s TED talk is as good as it gets. A summary of Janine’s talk, taken from the TED website, (www.ted.com) is listed below. No matter what our circumstances, we have the power to overcome!

Janine Shepherd
Cross-country skier Janine Shepherd hoped for an Olympic medal — until she was hit by a truck during a training bike ride. She shares a powerful story about the human potential for recovery. Her message: you are not your body, and giving up old dreams can allow new ones to soar.

Music in Therapy

Canst thou not minister to a mind diseased.

Pluck from memory a rooted sorrow.
Raze out the written troubles of the brain,
And with some sweet oblivious antidote,
Cleanse the full bosom of that perilous stuff
Which weights upon the hearts . . .

—William Shakespeare in Macbeth

These words, quoted in the book entitled The Mozart Effect by Don Campbell, seem a fitting description for the manner in which music conveys what clients most often cannot put into words. Music is an incredible tool that I commonly use with adolescents and sometimes adults in therapy. Music speaks deeply to our hearts and often puts words to our experiences in a way that nothing else can.

The Power of Music

I often ask clients for the name of their favorite song. When we watch the music video I ask why it’s their favorite. Clients often tell me they like the music or the beat but very rarely tell me that they identify with the words. The ironic thing is that most often clients aren’t even aware that their story is being told. The power of music is that it allows clients to tell their story in a manner that is not threatening or shaming like the actual verbalization of their experiences might be.

Music Tells a Story

Like some of my clients, after I hear a song that I like, I will often listen to it over and over. I listen so many times that I eventually tire of it. Telling our story in therapy is much like sifting flour and we keep sifting over and over until everything is smooth. We tell and often retell the story until it makes sense. We do the same thing as we replay a song again and again. We experience the stories of songs until they make sense. Music allows us to tell a story that we long to share.

Music Puts Words to Emotions and Experiences

Emeli Sandé, in the song Clown, wrote her own story about her experiences in the music industry. This particular song is incredibly touching because of the emotion that it evokes. I hear the depths of oppression and the struggle against the total and complete loss of self. I see the power differential and the struggle in the music video. Emeli Sande wrote the song about the music industry. But music, like poetry, art, and scripture speaks to us all in different ways. No matter how it speaks or what it says, it is moving and powerful. It puts words to emotions and experiences that are too deep to communicate.

When I ask clients for their favorite song the reply is often the same. They say, “I don’t really have one favorite. I like a lot of music.” I ask them to simply pick one. Most always, I hear lyrics placed on a melody which tells their exact narrative. An artist has given life to words and melodies that dance on the page and in their hearts.

I guess it’s funnier from where you’re standing

‘Cause from over here I miss the joke
Clear the way for my crash landing
I’ve done it again
Another number for your notes

I’d be smiling if I wasn’t so desperate

I’d be patient if I had the time
I could stop and answer all of your questions
As soon as I find out
How I can move from the back of a lie

I’ll be your clown

Behind the glass
Go ‘head and laugh
‘Cause it’s funny
I would too if I saw me
I’ll be your clown
On your favorite channel
My life’s a circus, circus
Round in circus
I’m selling out tonight

I’d be less angry if it was my decision

And the money was just rolling in
If I had more than my ambition
I’ll have time for please
I’ll have time for thank you
As soon as I win

I’ll be your clown

Behind the glass
Go ‘head and laugh
‘Cause it’s funny
I would too if I saw me
I’ll be your clown
On your favorite channel
My life’s a circus, circus
Round in circus
I’m selling out tonight

From a distance my choice is simple

From a distance I can entertain
So you can see me
I put makeup on my face
But there’s no way you can feel it
From so far away

I’ll be your clown

Behind the glass
Go ‘head and laugh
‘Cause it’s funny
I would too if I saw me
I’ll be your clown
On your favorite channel
My life’s a circus, circus
Round in circus
I’m selling out tonight

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