If I take anti-depressant medication, am I a failure, weak or crazy?

I can’t tell you how many clients who have come to see me, started out believing that if they “had to” go on anti-depressant medication, it meant that they were weak-willed, crazy or had failed in some way. I consider this to be tragic. It is hellish enough to experience the depths of despair without having to add to it guilt about using medication as one means of coping. One of my colleagues commented that when her clients felt like they were the only people in the world who ever had to take anti-depressant medication or anxiolytics (i.e., anti-anxiety medication), she would point out that the pharmaceutical companies were not getting rich due to a lack of business; and that they probably would be shocked to learn how many people they knew who were on medication but simply not broadcasting it!

As a psychologist, my work is to help people to better cope with their problems. I am pretty conservative when it comes to medication. If a client is still able to get out of bed in the morning and is not at risk of harming themselves, harming someone else, losing their job or neglecting their children, my first line of attack is usually to work with them in order to see whether therapy (and lifestyle changes such as nutrition, exercise and good sleep hygiene) can improve their functioning. However, experience has taught me (and I am so glad that I was not rigid about this) that even when people are able to muster enough strength to get through their day, this does not mean that they are living with any quality of life. People can suffer brutally inside without anybody knowing. Sometimes, not even a parent or spouse know how much of a nightmare every day is for them.

There are young people and old people alike whom I have worked with who after going on medication were far better able to make use of psychological assistance. They had more energy; they could think more clearly and medication took the edge off their symptoms just enough to enable them to better access their already existent resources. This is when medication truly is a critical part of effective treatment and an excellent complement to therapy. Medication though highly used is still very much stigmatized. Few have a problem taking medication for diabetes or high blood pressure and yet, when it comes to psychological problems, many of us believe that we should be able to handle these problems ourselves or we must be weak-willed in some way. In general, I believe that people need to be a little bit more humble and a lot less judgmental of themselves and others about using medication to address psychological problems.

I have met few people who want to be on medication. It is always a weighing of the scales. Do the benefits outweigh the drawbacks? The research is clear though. If your depressive or anxiety symptoms are severe enough to warrant medication, those who go on medication and also do therapy show better long-term gains than those who use medication alone. The choice to go on medication rather than being viewed as weakness can be understood as an act of self awareness. The person has come to understand that one of the several routes to wellness is psycho-pharmacological. There is no shame in making this choice. In fact, it can be experienced as a act of empowerment and strength to know if and when it makes sense to take this step. As long as people are also working hard to develop better coping skills, make lifestyle changes and decipher what has caused their distress in the first place, taking medication to treat depression or anxiety most definitely falls under the category of sound judgement and good coping!

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