Magazines 2021 Jan - Feb Mental health medications and stigma

Mental health medications and stigma

29 January 2021 By Rebecca Hicks, RN

How would you respond if a doctor told you they are going to prescribe something to help you cope with your emotions or your racing or depressive thoughts?

Adapted with permission from a post at AgoraNetworkMinistries.com.

Either you’ve experienced it yourself or know someone who has – the moment where a doctor tells you they are going to prescribe something to help you

  • cope with your emotions
  • cope with your racing or depressive thoughts
  • cope with your past
  • regulate your sleep
  • stop the voices, or
  • take the “edge off.”

Some people will easily take whatever a doctor prescribes. Others say, “No thank you, I can fix this myself.” But there is a lot to consider when taking medications, and unfortunately a stigma that comes with taking medications for mental health reasons.

Let’s take a moment to explore the stigma and why it exists, when to use medications and how to advocate for yourself or others (if you are a caregiver or support person). Let me be absolutely clear, the information here is from my experience as a registered nurse and is not to be taken as medical advice. Please always consult with your health care professional before making any changes to medications.

There are many reasons why people have stigmas, attitudes, beliefs or judgement towards psychotropic medications. Many people who struggle with mental distress (of any kind) are often ashamed or embarrassed of their symptoms. They often feel

  • fearful of what others will think if they are taking medications to treat depression, anxiety, addiction, trauma, bipolar disorder, schizophrenia, insomnia, etc.
  • fearful that medications won’t work, or that medications will make them feel nothing at all
  • fearful about side effects
  • taking medications might be a sign of weakness; they should be able to cope with how they are feeling on their own.
  • fearful that other believers will cast judgement on them, accusing them of lacking faith or saying they should get better by just trusting in God
  • in denial that there is an issue. They don’t want their close family members and friends to see that they are struggling. They feel they need to handle it on their own
  • fearful that if they start on a medication, they will be stuck on it for the rest of their life.
  • they must have done something to bring on the symptoms
  • something has happened in their past that they don’t want others to know about.

These are just some of the reasons why there is so much judgment and hesitation in taking medications to treat mental illness.   

Despite these fears, medications can be a great tool in helping people cope with their thoughts, emotions and behaviours. I use the word “tool” because just like a carpenter has many tools to build a house, medications are one tool that when used with other tools can help rebuild someone’s life. 

What I mean by this is that you can’t expect medication to fix all of your problems. There just isn’t a pill for that. But medications can be a tool to help get your brain in the right sequence so that you can do other things that you enjoy. And it will help align your mind and body to work the way they’re intended to work.

Medications work best in conjunction with a healthy lifestyle. It’s important to exercise, have a nutritious diet, get enough sleep, refrain from using substances (I’m soon going to write an entire article over at www.agoranetworkministries.com/blog related to this topic) and find meaningful activities that give you purpose and a sense of accomplishment. 

A question I’m often asked is, “When should medications be considered?” Some of the most common reasons are

  • when your regular (healthy) ways of coping with stress aren’t working
  • when your sleep is affected
  • when your quality of life is affected
  • when you struggle to function in your regular activities
  • if you are feeling hopeless and/or having suicidal thoughts
  • (I would strongly suggest getting help before suicidal ideation occurs but it’s not too late if suicidal thoughts occur before medication is started).

When to consider medication is one thing. Where to get them is another. Family doctors, psychiatrists and nurse practitioners can all prescribe psychotropic medications. Medications can also be prescribed at a hospital (usually either in the emergency department or on an acute psychiatric unit) but follow up will be needed afterwards.

How to use medications is also important. Keep in mind the first medication you are introduced to may not work. You may need to try a few different kinds with your health professional.

Also, most medications do not work instantly. It usually takes weeks and in many cases months to see the full effect of the medication (this can be very frustrating for people when they are struggling).

It can be helpful to let your practitioner know what medications worked well for you in the past and which medications did not work well. It can also be helpful to know what medications your family members are taking for mental health (if you have a close family member on medications) as it is known that sometimes what works well for one family member will work well for another (genetics come into play). 

Advocate for yourself, or have someone you trust go with you to your appointment and help advocate for you. Don’t be afraid to take notes (it’s helpful to keep a timeline of your emotions, sleep patterns, etc.) and tell your practitioner exactly how you are feeling. Ask about side effects. If you are having too many unwanted side effects, ask your practitioner if it is possible to titrate the medication slowly, meaning start at a low dose and increase it slowly over a longer period of time. Everybody is different, so what works for one person may not work for another.

For some people multiple medications need to be used.

But again, don’t be afraid to speak up for yourself and tell your practitioner what is working and what is not working. Often people will give up after one short trial because it didn’t seem to work. Give it a chance, and work with your practitioner in finding a medication that helps you.

If you had a broken arm you’d go to the hospital to have it reset. If you had high blood pressure and wasn’t able to manage it with exercise and diet you’d take an antihypertensive medication. It’s no different for our mental health – except that our brain controls the entire body and our emotions, and if it’s not doing well, how can we expect to be doing well?

Rant over. Now let’s change the stigma. Here are seven ways we can reduce stigma as outlined by the Centre for Addiction and Mental Health:

  1. Know the facts. Educate yourself about mental illness including substance use disorders.
  2. Be aware of your attitudes and behaviour. Examine your own judgmental thinking, reinforced by upbringing and society.
  3. Choose your words carefully. The way we speak can affect the attitudes of others.
  4. Educate others. Pass on facts and positive attitudes; challenge myths and stereotypes.
  5. Focus on the positive. Mental illness, including addictions, are only part of anyone’s larger picture.
  6. Support people. Treat everyone with dignity and respect; offer support and encouragement.
  7. Include everyone. It’s against the law to deny jobs or services to anyone with these health issues.

Let me encourage you with Matthew 5:1-10.

One day as he saw the crowds gathering, Jesus went up on the mountainside and sat down.  His disciples gathered around him, and he began to teach them. “God blesses those who are poor and realize their need for him, for the Kingdom of Heaven is theirs. God blesses those who mourn, for they will be comforted. God blesses those who are humble, for they will inherit the whole earth. God blesses those who hunger and thirst for justice, for they will be satisfied. God blesses those who are merciful, for they will be shown mercy. God blesses those whose hearts are pure, for they will see God. God blesses those who work for peace, for they will be called the children of God. God blesses those who are persecuted for doing right, for the Kingdom of Heaven is theirs.”

This post by Rebecca Hicks is adapted with permission from a post by Agora Network Ministries.