Treating Anxiety With Medicine, And The Common Myths Around It
Ali Madeeh Hashmi in this article debunks most of the common myths about psychiatric medicines. ‘The idea is so fraught with misconceptions in our society that most people have a visceral negative reaction to the idea. Let’s take a look at some of the most common fallacies that surround the use of psychiatric medicines’.
A young woman just walked out of my office with a prescription for an antidepressant. She had been referred by her therapist, a very well trained, competent young psychologist with whom I collaborate closely. Her psychologist felt that despite several months of psychotherapy, this young woman’s symptoms were not improving and perhaps medication would provide the boost that was needed.
What can you do if your therapist or perhaps a doctor recommends that you take medicines for an emotional illness? The idea of psychiatric medicines is so fraught with misconceptions in our society that most people have a visceral negative reaction to the idea. Let’s take a look at some of the most common fallacies that surround the use of psychiatric medicines.
Myths about psychiatric medicines
- All psychiatric medicines are ‘addictive’.
Absolutely untrue. Psychiatric medicines, if used under appropriate medical supervision by a properly qualified psychiatrist, are nothing like alcohol, cocaine or heroin, the substances commonly associated with addiction. If used appropriately, they are safe and effective.
- Psychiatric medicines have to be taken life-long.
Another fallacy that refuses to die. While it is true that many psychiatric illnesses are chronic longstanding conditions that often have to be treated over a period of months or years, it is absolutely untrue that in every case, a person will have to take medicines indefinitely. Between 30 to 50 percent of the people that I treat are eventually able to wean off most or all of their medicines over time with the rest usually able to take lower doses or fewer medicines overall.
A certain proportion of patients do need to take medicines long term, akin to treating diabetes or high blood pressure but even those people, with the right lifestyle changes and non-medication interventions can successfully lower their doses over time.
- Psychiatric medicines make you sleep all day and/or make you feel like a ‘zombie’.
Another myth that refuses to do albeit one that is reinforced on a regular basis by incorrect and over-prescribing of psychiatric medicines including by psychiatrists. If medicine is prescribed by an ethical, well-trained, properly qualified psychiatrist (admittedly hard to find in Pakistan), they should make you feel better. If you are anxious, they should help reduce your anxiety; if you are depressed, they should lift your mood; if you cannot sleep, they should help you get a good night’s sleep (and wake up refreshed). If your medicines are making it hard for you to function, go back to your doctor and explain. If you cannot find satisfaction, find another doctor.
- Psychiatric illnesses never get better.
Wrong. Like most chronic illnesses, it may take some time and patience to overcome your problems, but it can be done. Ignoring them in the hope that they will go away usually does not help.
- Psychiatric medicines will ‘change my personality’.
I ran into this one recently when I treated a brilliant young woman, a medical student who had suffered from depression for many years. After being on medicines for a few weeks, her mood improved dramatically. Her parents told me that she was much more sociable, didn’t sit in her room all day crying like she used to and was generally much easier to be around. Her main complaint: she didn’t feel like ‘herself’. It took some convincing from me to help her understand that her former ‘self’ was deeply flawed, saw the world in a persistently dark and negative light and like all changes, getting used to a new point of view would take time. Her last message to me just a few days ago: “I’m feeling better. I don’t cry all the time now and I’m getting used to being happy again”.
- Psychiatric medicines all have horrible side effects.
Incorrect again. While all medicines can potentially have side effects, including psychiatric medicines, if used judiciously by a competent psychiatrist, any side effects are usually minimal.
There are other myths but these are the most common and most pernicious ones. So, you have been referred to a psychiatrist for medicines for symptoms of anxiety. What specific medicines can you expect might be suggested? In the next, last part of our series, we will look at some commonly used medicines for anxiety and what to expect if you take them.
The writer is a psychiatrist practicing in Lahore. He taught and practiced Psychiatry in the United States for 16 years. He tweets @Ali_Madeeh