Tasha Fierce blogs about race, feminism, body politics and disability daily at Red Vinyl Shoes. She also contributes to the pop culture blog I Fry Mine in Butter. You can add her on Twitter @redvinylshoes.
Among those who are diagnosed with mental illness, there is a continuing debate over whether or not taking medication is acceptable. For groups such as The Icarus Project, mental illness is something not to medicate but to celebrate, a “mad gift” we should cherish and cultivate. For many others, however, mental illness is far from something to get excited about — it’s something that is out of their control, and can only be managed using psychiatric medications.
In no way do I wish to posit mentally ill people who can manage without medication as “not disabled enough”. But at the same time I wish to dispel the notion that those who take medication are weak and buying into the overmedication advocated by some in the psychiatric establishment. There should be no shame in how you decide to manage your mental illness. Some can get by with talk therapy and vigilant self-care, others survive on occasional medication when symptoms get out of control, and still others may be on medication for the majority of their lives. We should not assign a stigma above and beyond the stigma of being mentally ill to those who are unable to manage their illness without meds.
We need to acknowledge that there is privilege in being able to afford not only just medication but medication that actually works. Newer psychiatric medications are extremely costly and although some drug companies do offer discounts for those without means, they can still be prohibitively expensive. If you’re lucky enough to have health insurance, you can get meds for a low price, but in many cases in the US the insurance company has a say over whether or not you can take a certain med. Some insurance plans require you to take less effective older medication because it’s cheaper for them. Those without insurance may be able to get public assistance, but again, the medications you’re allowed to take may not be the newest, best medications you can get. Then of course there’s the stigma of being on public assistance.
If you are on medication, don’t let those who can go without cause you to feel ashamed or less than. If you’re not on medication, don’t shame those who desperately need it. And in general, don’t judge those who manage things differently than you. Everyone should have agency over their own bodies, their own minds.
For full disclosure, I take medications and have for 16 years. I do experience side effects but they have pretty much become part of my life now. I’ve tried many different combinations of medication to find some that work for me. And I’m okay about being on meds for so long because every time I tried to go off them I relapsed. But I do still one day hope to be able to manage without them. I think medication is a useful tool, but one that should be used sparingly and for as limited a time as possible. However, there are many like myself who must remain on them for decades. I’m a strong person. There is no “I’m not strong enough to manage without meds” because I know that it has nothing to do with strength. I am not less strong than someone who doesn’t take meds. At the same time, I’m not trying to say my disability is greater than someone’s who goes without medication because I haven’t walked in their shoes. That’s really what it boils down to: you don’t know what someone else needs unless you have been in their exact same place and you can pretty much guarantee that you haven’t because everyone’s disability is experienced in different ways.
Lived experiences should not be lost in the great medication debate. Most neurotypical folks don’t much care if you’re on or off meds, all they hear is “crazy”. We can’t work to erase the stigma of mental illness if some of those affected are doubly stigmatized.
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Thanks for this post. I don’t know how many times I have been shamed one way or the other by someone about my medication, and it has always been by someone who hasn’t had to deal either with the types of medication that I deal with and their side effects or the conditions and stigmas for which I would or would not be medicated for (and their effects of my life).
I hope your guest posting here is positive!
Thank you for this great post! I’d like to add to your statement that it is wrong to say that people who manage their psychiatric conditions without meds are not disabled enough. You are right of course; and on top of that, there is not necessarily a correlation between severity of illness and the best course of management. It is possible to have a fairly severe form of depression, for example, which does not respond well to meds, while someone with mild depression might respond better, for whatever reason. The person with the milder form of depression, in this example, would probably be more likely to take meds than the person with the severer form, even though one with the milder form could be considered “less disabled.” And so forth.
I am a legally blind individual. My condition is neurological– I have polyopia. It has been most accurately compared with visual echoes– I see many objects where there is just one, many worlds where there is just one, and all of it is angled variously.
I have been offered the experimental treatment consisting of taking small doses of anti-seizurals. I have refused it.
It’s not that I feel I have the gift of multiplicity, it’s just that I am a swimmer and I value having my consciousness uninterrupted as much as possible. I have learned to live with this condition for more than 47 years. I do not feel like making a neurological experiment of my life.
I have also found that many of these experts are curiously unempathetic and uncaring about quality of life as something determined by the individual living.
They want to determine and define what it is for us all, it seems. The most caring and the sharpest can be part of the same set.
But more often, those who are sharp happen to be curiously uncaring.
“With an emotional I.Q. of 10,” my friend has commented.
Thank you for this. It needs to be repeated frequently.
I spent over two decades unmedicated for consistent dysthymia since early childhood with periods of major depressive disorder, as well as untreated likely PTSD, because of the family attitude that one should just be able to handle it with strength. If I had a stronger will, I could overcome it, etc. It took way too long for me to accept that I needed the meds at 30, but I’m glad that I finally did. I no longer have suicidal thoughts, I can function on a regular basis, and even the depressive periods are much easier handled. It was totally freeing for me. I finally figured out that I am NOT my disorders, that they aren’t an inherent part of who I am.
On the other hand, I still get harassed frequently by well-meaning people who think that meds are horribly bad, that they will only make the situation worse, etc. All I can tell them is that being on Wellbutrin has saved my life, more than once, and helped me cope with levels of stress that I can’t even imagine surviving in my previous state. That one little pill twice a day is the difference between coping and despairing for me. However, I know that it’s not that way for everyone.
I think that everyone should have the right to make their own decisions about their own care without all of the freaking out about doing it the “wrong way”. The right way is different for everyone.
When I was diagnosed with depression, I was reluctant about taking medication. Personally, I would prefer to manage it with therapy if possible. But at the time, I was pretty much non-functional, and I wanted to get back to functional ASAP (plus, being at college, I knew I wouldn’t be able to start seeing someone long term at that point). So I started on medication.
While my eventual goal would still be to get off the medication, I can’t deny that it has been a godsend for me. The biggest difference I noticed is that PMS no longer sends me into a state of near-mental breakdown. Therapy could not have created that effect in nearly as quick a time. Using medication isn’t what I consider ideal, but I can’t deny that it works. It’s helped me, and I do not regret taking it one bit.
@Ouyang Dan thanks for the well wishes!
@Rebecca That’s true, often milder disorders are treated well with meds whereas treatment resistant disorders may require other means. Thanks for pointing that out.
@goethechosemercy I agree, you definitely have the right to choose not to take the meds due to the side effects. Quality of life is important. I have had to try a lot of medication to find some that have a low side effect profile for me and enable me to have a decent quality of life.
@Liss I’m glad your medication has helped so much. Definitely don’t listen to the haters!
@Jayn I’d like to be able to at least take a lower dose of some of my meds, but I worry about relapsing, which would be devastating. I think I might be stable enough to try lowering a few of them.
Well I’ve got to get to work so I won’t be able to respond to comments until tonight.
Thanks for posting this! I’m in the middle of dealing with a really bad anxiety/depressive phase right now, and am feeling incredibly ambivalent about the meds I’m on. I’m also struggling with what it means to be taking an anti-anxiety med while my younger sister continues her lifelong anti-convulsant treatment; for me, there’s a real need to be strong because I perceive my body to be less atypical than hers, and I’m not sure I’ve given myself enough credit for being strong ever since starting this prescription. Reading this post has given me a lot to think about, and made me feel less ashamed.
Thanks for this post. I have to second what Rebecca said about being off medication and severity of illness. I was “med-free” for two years, and people in the institution I live in, even my psychiatrist, used to compliment me on that. That is while I wish I’d known the psychiatrist was open to medication for autistic irritability (some psychiatrists don’t think medication works for anything to do with autism), since if I’d known, I may’ve asked about meds a lot sooner than when I actually decided to go on them, which was by my psychologist’s andpsychiatrist’s suggestion when my irritability went through the roof. I now take medication with some good success and actually function better than I did before I went on meds. Although I must say, meds should of course never be an excuse for poorer services, and that is an attitude I’ve also encountered during a previous experience with medication.
thank you so much for this post! i try to keep in mind that we’re all just doing what we can, whether that’s medication, therapy, prayer, or whatever, and nobody’s necessarily any stronger than anybody else for what methods they use. how i deal with my mental illness is between me and whoever i choose to share it with, and the same goes for everyone else: it’s not my business unless they want it to be.
I’ve found the more stress I’m under, the more I need the meds.
I first started on them when I was a freshman in college. I took Psychology 101 and read the description of bipolarism and went ‘Oh my god, that’s ME!!!!’ My shrink and my doctor agreed that it seemed like a good fit, and I went on my first medication for the depression side of things. My official diagnosis was Bipolar II, which means I didn’t have ‘true’ mania, I had hypomania that manifested as being extremely goal oriented, going a little short on sleep, being rather excitable, and occasionally forgetting to eat – no big deal, really.
The difference was astonishing.
When I first started on them, yeah, I was pretty dedicated to only being on them when I HAD to be, and at as low a dose as possible. I’d take them when I was depressed, and as soon as my mood stabilized, I’d be off them again. I treated my bipolar that way for years.
Then I got into a more stressful situation, and suddenly I was having trouble with ‘true’ mania, streaks where I had near uncontrollable anger, paranoia, urges to do foolish things. Over the next few years, I went through a handful of meds, some of which made things worse, some of which provided temporary relief. I finally found a new med that worked.
For me, the quality of life with the right medication is so, SO much better than without. I get to be a person who does things. It even seems to help make my panic attacks less frequent.
I certainly don’t think of my madness as a gift. It’s inconvenient, and I very much prefer it managed so that it doesn’t get in the way of what I want to do. I’m very grateful that my medication works and my insurance pays for it. If I didn’t have good insurance, I’d be hard pressed to pay for my name-brand, no-generic-available medication. Scratch that, I wouldn’t be able to afford it.. And I’m lucky that my side effects are minimal – I’m more likely to sleep through the night (talk about a positive side effect) and I have episodes of dry mouth. That’s nothing compared to the way bipolarism affected my ability to be the person I want to be and do the things I want to do.
Of course, having said that I have better living through chemistry doesn’t mean that everyone does. I think everyone should have the option of good medical treatment, but that there should be no obligation. We are the people best able to figure out what methods of coping work best for us, and what improves our quality of life the most. If that’s medication for me, yoga for you, talk therapy for that other person, and nothing at all for someone else, well, we all ought to have access to the thing that makes us feel best.
~Kali
I liked this post.
I can’t use medication. Mentally, I just can’t. People I know are bothered by that fact, and all I can say is “I’m just not that strong.” I’m just not, and I have no other way to put it. I have nothing but respect for those of you who can take medication.
My lived experience is that that is treated as a choice and I get shamed for it. My friends tell me they would be ANGRY if I died of something easily treatable. There are several more sides to this issue.
I’d like to add to your statement: “Most neurotypical folks don’t much care if you’re on or off meds, all they hear is “crazy”. ”
I’ve come across a certain subset of people on the internet who probably think they’re being open-minded by “accepting” people with mental illnesses who “have it under control” – which invariably means people with mental illnesses are ok by them as long as they’re taking their medication. No consideration of how people could use other forms of therapy, no consideration of whether the medication works or whether it has side effects that aren’t worth it, or that it might be difficult to even get medication, or any of the other issues discussed here. People on the internet shouldn’t be so fearful of the unknown, as it’s so easy to find information and anecdotes to dispel it!
Tasha, thank you so much for this post. I really appreciated it and I think it highlights something that doesn’t get talked about enough without lots of shaming being slung around every which way.
I am pretty sure that without meds I would not have survived college. Or grad school, for that matter. When I first talked to my dad about possibly going on antidepressants, his reply was: “Have you tried exercise?” REAL HELPFUL, DAD.
I love my meds very very much. For most of last year, I was a complete mess, suffering from undiagnosed depression, and going on anti-depressants, in combination with seeing a counsellor, has been amazing for me — although I still experience shorter depressive episodes, most of the time, I have MYSELF back.
Fortunately, I haven’t experienced any direct negativity in relation to my medication; everyone that I’ve told about it has been very supportive, but of course I still hear people talking about how anti-depressants stop you from dealing with the REAL problems, that medication for mental illness somehow makes you into a zombie*. Well, I say BAH TO THAT. Since I’ve been on anti-depressants, not only have I been more productive on my thesis than I had been in well over a year, I’ve also been way more creative than I’ve been in years. Now, I realise that correlation doesn’t equal causation; I’m not saying that my creative burst was caused by my meds (although my creativity was certainly suppressed by my depression), but it certainly hasn’t been harmed by them!
*I’m not, of course, trying to diminish the experiences of people who haven’t reacted well with meds for any reason.
Everyone should have agency over their own bodies, their own minds.
This should be handed out to everyone who thinks they know better.
I’ve been on medication for over a decade, and I’ve also noticed the “Well, why aren’t you cured then?” crowd. I explain that I take medication for my thyroid, my PCOS and my depression, and all three of those are conditions that, for me, aren’t cured. They’re managed. It turns out that medication for my brain must be different and special, though, even to people who take regular medication themselves.
(And yes, I know I’m privileged to live in a country where my treatment is not dictated by an insurance company, and my medication is heavily subsidised. I remember that every time I read about an American having to take the wrong medication because the right one is hundreds of dollars; every time I read about Nigerians taking medications they know are counterfeit because there’s a chance it’s got some actual medicine in it.)
I have such an ambiguous relationship to my meds. Most people I have met with similar conditions have had either wholly positive or wholly negative reactions, so I feel a bit like an anomaly.
The best way I can describe it: Meds keep me alive, and they also make my life miserable. (Due to side effects). What I hate hearing is “but you’re on the wrong kind/you should try this one/sometimes you need to combine them/are you sure you are taking them correctly?” etc. As if I haven’t thought it through myself!
i suffer from dissociative identity disorder. When i was 19, i tried medicated therapy to control it, and keep my life in check. It worked until two weeks ago, and now they’re out of the box.
Now, i’m trying to talk to them, make peace offerings, and organise us to share time in the body so that we don’t have to fight for control. my mood has improved somewhat, and i’m starting to get used to living with a 10 year old in my head at all times… hell, i prefer it this way. Medication can be a useful tool, but for us we’d rather be at peace with each other
awesome post tasha! i said some stuff on the topic over at my blog and here it is http://icedteaandlemoncake.wordpress.com/2010/05/12/pills-who-needs-them-people-with-medical-conditions/
I’ve been on meds and off meds. Currently, I’m off, though I have considered asking for an anti-anxiety med.
My problem with meds is that insurance companies sometimes act like a med=problem solved, no need for therapy. My experience is just the opposite- meds made it possible for me to get the most out of the therapy. They brought my anxiety down and my mood up so I could work on my issues with my therapist. I also struggle with the way society pours research dollars into medication research at the expense of research into effective therapy and making societal changes that would enable PWDs to participate fully in society. Then the pills are sold for a profit, when much of the research was government funded.
Meds are not bad. They aren’t good either. They are value-neutral aids to help people live happier lives. My problem lies with ways that research monies are allocated and the way insurance companies support meds at the expense of therapy, which, in my mind, is of equal or greater importance to a person with mental illness.
Thank you so much for posting this! I’m pretty involved in the disability rights movement these days, and I’m really uncomfortable with the fact that in some circles it seems almost mandatory to be anti-psychiatry. I’m a better activist when I’m not super depressed, thank you very much.
KJ – I’m very happy I’m seeing a therapist through my school (and it’s available to anyone, on a sliding scale – after the family emergency, I asked if my sister could come in for help this summer – she’d probably pay two dollars more than me) and the meds are through someone else.
At the psych ward, we didn’t get much one-on-one time with “our” shrinks. And the 2 week check-up was a joke. (And because of insurance, I had to see somebody different.)
I made a blog post about this too
http://ohmonkeytrumpets.blogspot.com/2010/04/medication-for-bipolar-disorder-and-tv.html
I got one comment agreeing with me and another disagreeing.
My main issue is with TV. Ads are horrible, of course, but I had Law & Order: SVU in mind. Victims/suspects with “tv BPD/schizophrenia” are shown as silly for not wanting to take their meds, but all the people on medication on the show talk about how horrible it is.
So we should be drugged against our will (worst case scenario) and just be miserable?
I think many people judge those who do take meds because they were forced to take them. And those of us who do take them judge those who don’t because we’ve been in situations where we were told to tough it out, you don’t need meds.
Having been misdiagnosed – therefore incorrectly treated – for a sundry of mental illness conditions, I fully co-sign what Tasha has written here. My experience was tedious for nearly 24 years of reductive or ineffective treatments.
Finally figured out my visual impairment – Keratoconus – neurological “oddity” – synesthesia – and ADD were the source of my inability not to freak the heck out on a regular basis. And having access to proper medication has definitely provided reduction of acute symptoms in a way that enables my life to be manageable. Living in Vermont means there is a lot of pressure and conversation around “overmedicating” and how we all ought “holistic” healing, which might work for some people, but it’s not accessible in terms of class and often comes with some pretty problematic ableist framing.
Thank you so much for writing this, Tasha.
You’re welcome, Angie!
Thanks to all of you for your kind words. I’m glad the post resonated with y’all. I hope this helps keep a dialogue open about the benefits and downsides of taking medication. And no judging!
hi!
thanks for your post. after years of therapy, bodywork, herbs and self-care, i decided to experiment with how meds could help me manage my post traumatic anxiety and depression. i like to call my anti-depressants my “happy pills” and taking them has helped me significantly. personally, i only pursued psych meds after about ten years of working on trauma recovery, because i wanted to be sure that i wasn’t covering up any material from my past. i’m happy with my choices.
i also want to mention that i am a member of the seattle branch of icarus, and while we celebrate madness and creativity, there is no judgement about the level of engagement members have with the mental health industry. for most of us, meds and hospitalizations have been a part of our lives, both by consent and by force. something i like about being part of icarus is that we create a safety net for each other that can supplement or replace being dependent on a system that is often abusive and controlling. i also enjoy the creative work we do together.
take care,
billie
If you’re lucky enough to have health insurance, you can get meds for a low price,
Not even then, sometimes. Sometimes a drug is so expensive that it still costs a lot even with insurance, and someone for whom $40 a month is a terrible hardship — and I have been there and may soon be there again — is pretty much fucked. Also, my insurance recently decided that it is going to regularly raise what I have to pay for the drugs I take most often, so I am now paying full price for one of my prescriptions. It’s the cheap one, but the price on the expensive one is going up, too. There will come a day when affording it is difficult for me.
Moving on. Thank you for this. I have written about this on my own journal more than once. I resisted meds for years, and I did okay for many of those years, but there was also a long time where I was suffering hideously for basically no reason at all. I am in no hurry to go off my drugs. Other folks I know don’t take them, don’t want to, often because they are scared of side effects, to which I say “Goddamn right, it IS scary as hell!” and I don’t blame those folks AT ALL for that. They have my love and support, and I hope that if they do try it, they find what works for them quicker than I did, but I will not look down on someone who avoids drugs to treat their health issues and uses whatever other means are helpful to them.
I also have folks I know who are on drugs who only take them until they feel “better” and then they quit, and the whole thing starts over again. The nature of my illness being what it is, I am never going off my drugs, at least not until after menopause, which might cause the worst of my symptoms to remit, as it did in my mother.
It’s not a strength thing on either side of the fence. I have an underactive thyroid. I need to take drugs for that or I will slowly die. It’s not a lack of strength! No different is the dopamine deficiency causing the worst of my mental health issues. I take drugs for that, too, because if I don’t, I will probably also die — suicide. Why some people perceive a difference in the two is something I do not understand.