Is Psychiatric Medication the Right Choice?

A lived experience opinion

Photo by Towfiqu barbhuiya on Unsplash

On Wednesday I put out that I was open to hear what you readers wanted me to write about, and

Blake Long

brought up an excellent question:

There are a few reasons I’m hesitant to answer this question. The first is that I don’t want to give medical advice. So I’m not. Here’s your warning: the following is not to be taken as medical advice. I’m going to share my opinion based on lived experience. Take it or leave it. You are the advocate for your health.

The short answer to your question is: talk to your doctor. But there’s a problem with that advice. The problem is even when you talk to your doctor you still have to weigh the information and make a decision whether or not to pursue taking medication. In my experience, if you want to take antidepressants, you can honestly talk most doctors into giving them to you. But are they good for you? Is it right to take them? Is it moral? Will it lead toward recovery? Those are the questions that matter.

Let me begin by addressing the last part of Blake’s question: What’s stemming from mental health and what’s not? Unfortunately, we don’t always get to know the answer to that question. For someone with clinical depression who suffers the loss of a favorite pet, how much of their current depression is contingent upon normal life experiences (loss) and how much of it is due to a mental health condition? It’s immeasurable. For me with OCD, how much of the anxiety I carry around is related to my condition and how much is due to the natural stressors of life? Who knows! However, what I do know is that I have a mental health condition that has been diagnosed by numerous mental health professionals. And I do know (through research) that statistically many people with OCD respond positively to medication.

But I think behind this question is a more important question: is psychiatric medication cheating in some way? Could these medications be crutches that prevent me from actually dealing with my problems? I think these kinds of questions haunt a certain kind of conscientious person. What compounds this question is the explosion of the myth that antidepressants correct a “chemical imbalance.” When you could believe that medications were simply fixing a discrete biological problem, it was easier to trust that it was moral to take them. But now that we’ve learned (as I understand it) that the most we really know antidepressants is that some of them work well for some people for some reason, things are less comforting.

In my experience, I would say that a crutch is actually a good metaphor for psychiatric medication. It’s a tool that enables us to function somewhat normally while we are healing. I don’t, however, think of it as cheating. I know many people on medication for OCD (I’m not interested in sharing my own medication “journey” here. That’s too personal) and they would say that while it helps take the edge off the worst of the intrusive thoughts or make them quieter, the daily work of resisting compulsions remains the same. I suspect, but cannot say, that something similar is true for those who struggle with general anxiety disorders or depression; there’s some level of relief, but there is no magic bullet. It’s a crutch. And when that crutch is paired with a good therapist who is locked-in on a recovery program for you, the crutch can be invaluable.

This does raise the question about how long you remain on the medication. Ideally, everyone would be able to be on medication while they need it to recover and then taper off, but some mental health challenges don’t go away. And for some people, a maintenance dose keeps their life functional and full. There’s no shame in that. Mental health challenges are a result of the Fall and medication can help some people deal with those challenges so they can be more fully who they were created to be. That’s a wonderful gift from God! I do think that everyone with a mental health challenge should be their own advocate for recovery, and that means never giving up on the possibility of further healing. There are always new treatments and new therapists to try. In my own journey which I’m not going to talk about, that has been key.

Let me say a word here about faith and medication. When I first considered taking medication, I was overwhelmed with guilt. This was because of my time in a John MacArthur-influenced church which frowned on all use of medication, which I have written about before. I had to get counsel from a godly college pastor who eased my anxiety and helped me see that medication can be used by God to heal. But I was still nervous. Shaming Christians for using medications is itself shameful. Medications have saved people’s lives.

Now, as to the question to when and how to decide to take them, my recommendation is to talk to a psychiatrist in addition to a general physician. And a good first question would be, “When is medication the right choice?” Probably what they are going to tell you is that when the benefits outweigh the side-effects and risks, which can be substantial or negligible. Specifically, you have to consider how much of a burden your mental challenges are on your life currently. How many hours of a day are they taking up? How are they disrupting your life? How are they affecting your quality of life? How are they preventing you from pursuing therapy fully? These are good questions to wrestle with as you consider medication. If a mental health condition is significantly disrupting your life and a medication would help you reclaim your life while you work toward recovery, it seems prudent to me to try medication, assuming that the side-effects are not onerous. But ultimately, this is a decision you have to make in consultation with a doctor.

A word about online research: you’ll find whatever you want to find. If you go looking for evidence that a specific drug will produce a side effect, you will find a Reddit thread with someone sharing that experience. Or some european study that finds that it’s possible. If you want to believe that a drug will magically cure you, you will find that, too. I think your best bet is to talk to a psychiatrist and ask them, “What are the risks and side-effects?” and “How effective has this drug been proven to be?” Let them filter that information. Are they unbiased? No, regrettably, not. But in my experience, I would rather people err on the side of trusting psychiatrists than trusting randos on Reddit—which isn’t saying very much. I’m not saying that you shouldn’t do any research online. But if you do, be judicious with your sources. It’s possible to get sucked into personal experiences and lose yourself in worst case scenarios or false hope.

Is it possible that antidepressants are being overprescribed? Sure. But that doesn’t mean that any one person’s mental health challenges wouldn’t be legitimately helped by antidepressants. While on a societal level we should be concerned about the rates of psychiatric medication use and what it says about our society, on the individual level one must make a prudent decision about what is best for their health.

In the end, the choice to use medication to help treat your mental health challenge is something you can enter into prayerfully with the help of a trusted doctor. I do think they are ethical to use and can be game-changers in the recovery process for many people who are struggling to enter into therapy. Some people have terrible experiences on medications, some people have wonderful experiences, some people find psychiatric medications to be like taking sugar pills. Your mileage may vary. But what I think we shouldn’t do is shame or guilt individuals who have thoughtfully made the medical decision to use psychiatric medication to pursue a life of recovery and fullness. They aren’t magic-happy pills. They aren’t easy-life pills. They are aids to live well.