3 Rites of Passage When Starting Psychiatric Medication

I’ve been taking psychotropic medication for the majority of the past two decades. While receiving psychiatric treatment — and seeing several of my loved ones start their courses of treatment — I’ve identified several “rites of passage” we psych patients go through as we navigate our relationships with prescription medication:

1. The “How dare you suggest medication, Doctor?!” or “I don’t need medication!” fallacy

This one can be summed up with five words: discriminatory society and internalized ableism.

First and foremost, you’re not “broken” or “wrong” or “weak” for going on psychiatric medication — or taking medication of any kind for any condition. I don’t care that your cousin’s hairdresser’s great aunt’s neighbor Millicent thinks you can “cure” depression by eating homegrown St. John’s Wort and drinking unpasteurized milk. Taking prescription psychiatric medication is still heavily stigmatized and that stigma can be a huge deterrent for folks considering medication as part of their treatment plan. While it’s true that medication isn’t — nor does it have to be — part of everyone’s treatment plan, I hope that’s an informed decision people make for themselves with a trusted health care provider, rather than avoid the option altogether out of external or internal shame.

The first time I was diagnosed with bipolar II disorder, I refused to accept the diagnosis and only took the prescribed mood stabilizer for a month or so before I decided that it was unnecessary. I was embarrassed by my diagnosis — though I didn’t realize it at the time — and ignored what the psychiatrist observed and identified as bipolar symptoms. You can probably guess what happened: I stopped the mood stabilizer cold turkey, experienced several years of damaging hypomanic and depressive episodes, and was diagnosed with bipolar II disorder for a second time. Thankfully, I had enough support (and self-awareness) to face the diagnosis and follow through with the appropriate treatment this time.

2. The “I feel better, so I don’t need to take meds anymore!” trap

Ask anyone who knows me and they’ll tell you I’m super duper extra not into a “tough love” approach to anything. I think it does more harm than good in pretty much every situation. That being said, I’m going to get a bit tough right now:

You’re feeling better because your meds are working.

When you finally find a treatment that works for you in your current situation, don’t suddenly stop it! If it works and you’re not annoyed by side effects, then it works.

I’ve fallen into this trap, my loved ones have fallen into this trap, everyone I’ve ever done group therapy with has fallen into this trap — you get the idea. It can feel liberating when one day you realize that the weight of depression isn’t as heavy as it was a couple of months ago, or you’re having less difficulty sleeping through the night compared to a few weeks prior. If that’s the case, please stay the course with your treatment plan! Just when things get good is not the time to stop all the work you have been putting into your mental health journey. Trust me, quitting your medications because you decide that you’re magically “healed” makes the relapse of your symptoms — which will hit you before you think it will — even harder.

3. The “I’m not myself,” conundrum, aka the “My meds make me someone I’m not” paradox

I’ve been through this one more times than I can count. As a kid, especially when I hit those middle and early high school years, I strongly believed that I couldn’t discover the “real” me while taking psychiatric medication. None of my friends who were also going through puberty and trying to find themselves were on medication, which made me feel even further removed from myself and my peers. I remember frequently lamenting to my dad, “Who would I be without medication? How do I know who I actually am if I’ve been medicated since third grade?”

Once I hit 20 or so, similar thoughts crept up. Your 20s are supposed to be a period of self-discovery and chaos, right? That’s what I kept telling myself. Add to those feelings a college wellness center doctor who was misogynistic, ableist, and couldn’t give less of a darn about student mental health, and you have a recipe for disaster. With barely any supervision, I tried to taper off a medication I had been on for six years at that point. It did not go well, and I returned to my usual dose fairly soon after this “experiment.”

This last rite of passage is tricky to work through. It requires levels of patience and self-reflection that take a lot of time to develop — as well as trying to unlearn some more internalized ableism. On the better days, when things feel too good to be true or I feel a teeny tiny bit self-actualized, I wonder if it’s really me and the work I’ve put in on top of my psychiatric medication, or if it’s all just thanks to those pills I take each day (or if I’m about to enter a hypomanic episode). This uncertainty can be hard, but I challenge all of you — and myself! — to keep these words from the wise Glennon Doyle in mind: “Take your meds… and go about your business, which is to suffer less so you can live more.”

The truth is that when you find a medication or medications that work for you, they help you be your true self, not someone constantly bombarded with painful symptoms. This aspect of treatment can help with all the others as you go through your healing journey and become better able to let yourself shine.

A final note: Please, please, please speak to your doctor before stopping or starting any medications. I’m not 100% certain of many things in this world, but I know without a doubt that withdrawal symptoms and wonky dosages are not fun.