Medication or Therapy ? The Mental Health Conundrum.

When I was 18, I went to the GP with low mood. Within three minutes, I left clutching a prescription for fluoxetine, more commonly known as Prozac. This was in 2004, when mental health was not as widely talked about. It was still a little taboo, judged by the ignorant and dismissed by the resilient.

I was just a teenage girl hoping this pill would solve my problems. Little did I know that it was only the beginning; the beginning of my problems, and the beginning of my long relationship with mental health medication.

In 2009, I was prescribed duloxetine because the Prozac clearly was not cutting it. I was cutting myself often, so my psychiatrist at the time switched me to this newer medication. Duloxetine is used to treat major depressive disorder, generalised anxiety disorder, fibromyalgia, and diabetic peripheral neuropathy. I am not sure how long I stayed on it but, by 2011, according to my NHS records, I was back on Prozac. You may remember from my first post that I struggled through this haze to get a degree in Forensic Science, but understanding the effects of medication on the body is different to the effect they have on the brain.

Low Level Depression and Anxiety But No Therapy. The Medication or Therapy Conundrum.

Prozac is used for low-level depression and anxiety, OCD, and eating disorders. So by then, I was seven years into medication, and still no one had offered therapy to help me understand why I needed it in the first place.

As the years went on, I was then tried on lamotrigine, used for bipolar disorder and epilepsy, and later on sertraline for a year or two. These medications gave me awful restless legs and insomnia. As I mentioned in my first blog, the medication needed medication for its side effects. I was taking promethazine, an antihistamine, although a drowsy one, with the hope that it would help me sleep.

It did not.

The Medication Guinea Pig

Even with the sleepy antihistamine, I still could not sleep because my legs were as restless as hell. If you have ever experienced restless legs, you have my deepest empathy. My psychiatrist decided I needed procyclidine, a medication used for Parkinson’s symptoms, or, in scientific terms, an antispasmodic drug for Parkinsonism.

But the antihistamine was not enough, so I was prescribed zopiclone. During the day, I was restless and, if I am honest, a little manic. Then came lorazepam, but that was not strong enough either, so I ended up taking clonazepam. That was meant to help with my restless legs too, as well as the twitch I had developed in my face, known as tardive dyskinesia.

Even writing that is exhausting.

Around this time, I was admitted to a psychiatric ward for the first time. Let us pause there: nearly a decade of medication, and then I ended up on a psych ward.

No therapy had happened. It felt as though I had spent years going around a Monopoly board of medication, only to pass Go and collect more medication for my side effects instead of £200.

Clopixol " The nastiest drug I have ever been on"

During that admission, I was put on Clopixol, and it was my first experience of an antipsychotic. Clopixol is the nastiest drug I have ever been on. I genuinely believe the hospital psychiatrist must have had shares in it, because he seemed to put every single patient on it. The entire male and female ward were on Clopixol.

It is mainly used for schizophrenia, but it can also help with disturbances in thinking and behaviour in people with manic depressive illness. All I know is that I slept a lot. The whole ward did. We were like dopey zombies, and it soon became obvious why so many of us were on it; the ward was quiet.

Since then, I have had five psychiatric inpatient stays, and I am now finally on a regime of venlafaxine and aripiprazole; an antidepressant that also helps with anxiety, and an antipsychotic that treats the more severe side of my depression. It works well.

The downsides of medication are not just the side effects

I have gained a lot of weight from the antipsychotic medication, and I find it hard to lose. That, I think, is one of the worst side effects. But I also believe it works well only because, four years ago, I dedicated two years of my life to therapy.

Therapy at last and an awakening for me.

The Complex Needs Service was a therapy service offered to people diagnosed with BPD/EUP, a personality disorder involving emotional outbursts, self-harming behaviour, unstable relationships, and a whole range of other symptoms described in the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM-5.which in effect is a tick box diagnostic tool.

I say that with a little tongue in cheek, because in my opinion no one with a mental disorder should be reduced to a tick-box diagnosis. There are common themes, yes, but no two people with the same diagnosis will present in exactly the same way. Psychiatrists do not know enough about the brain to make those tick boxes, and if they were honest with themselves, they could probably apply a few to their own lives.

Anyway, back to CNS. The format included both group therapy and individual therapy, and we were encouraged to do our own personal development too. I read some excellent books during that time, including The Body Keeps the Score, a book about trauma healing, and When the Body Says No: The Cost of Hidden Stress. I would recommend both.

Group therapy gave us the chance to learn from one another’s experiences and to develop a deeper understanding of ourselves. We were taught about the importance of “wise mind” rather than “emotional mind,” and how acting from emotional mind can lead to negative outcomes.

This was a pivotal moment for me. I realised that for most of my twenties, and well into my thirties, I had no idea why I did the things I did.

All those years of medication had not changed that. I had resigned myself to the idea that this was just my life, that this was who I was, and that I would be miserable forever, flirting with death by misadventure more times than I could count.

Through therapy, I eventually realised that there is always a choice. No matter how depressed I was, I chose to pick up a blade and cut myself. I chose to overdose. I chose to drink heavily and make bad decisions. I chose to be selfish. I chose the darkness. At the time, I did not understand that, because I had never been taught to see it that way. I was simply given medication after medication and told it would help.

And now I understand that it does help — but only when I make better choices, and when the medication gives me the clarity to do that.

I should caveat that, apart from once, I have always had the capacity to make choices and was fully aware of what I was doing. I am not suggesting that people without capacity, or those in a full-blown manic episode, know the right choice. This is simply my experience.

More recently, there have been movements such as “Post Your Pill,” an Instagram campaign by former Love Island star and A&E doctor Alex George, who encourages people to share a photo of their daily mental health medication to help remove the stigma around taking it. I really like Dr George, and he has done a lot for the mental health community, but I also think it is important to place equal emphasis on therapy.

In my opinion, medication can mask the deeper issues behind why we need it in the first place. It is not a miracle cure, and it does not fix everything. It helps, but we need to talk more and medicate less.

I have been reading about logotherapy recently, which is a type of psychotherapy developed by Viktor Frankl, an Austrian psychiatrist and Holocaust survivor. It is based on the idea that a central human need is the search for meaning: meaning after trauma, loss, illness, or despair. It also suggests that while we cannot choose what happens to us, we can choose our response to some extent. I would love to write a full blog on logotherapy, because I find it fascinating.

If you are reading this and feel nervous about therapy because of the vulnerability it brings, I understand completely. But from someone who lost over a decade of their life simply popping pills and ignoring the deeper reasons behind my feelings, I would say: take the jump. It could save you time, and more importantly, your life.

Think of it this way:

The Mind refers to your inner mental world. It includes thoughts, emotions, memories, beliefs, imagination, attention, self-awareness, decision making and perception of yourself and others.

Medication affects all of those faculties.

Meaning refers to the sense that life,experiences, relationships, work, suffering, all matter in some way. People cope better when they feel there is a reason to keep going. It's what gives life purpose.

Stay hopeful,

Rachel

Please note

“This is a personal blog sharing my own experiences. It is not counselling, therapy, medical, or psychological advice.”