Modern medicine has made many impressive advancements in the treatment of physical health conditions such as cancer, diabetes, and heart disease. Similar progress has been made in the mental health field, where there are now various effective treatment options for different mental health conditions. However, social acceptance and openness to the latter are quite disappointing. Psychiatric drugs are stigmatized in a way that if somebody chooses to take medication, people usually consider it unnatural, unnecessary, or as a sign of weakness or giving up. This is commonly referred to as “pill shaming.”
Even though the developments of psychiatric drugs have allowed many people to have a better quality of life as well as increased functionality, societal stigma regarding such drugs has a major negative influence. In fact, according to research, self-stigma, which is defined as the negative attitudes individuals with mental disorders have against themselves, as well as perceived stigma, which is one’s perception of others’ negative views are of the most common reasons individuals do not adhere to treatment. Consequently, individuals who need such drugs do not obtain their prescriptions or take their medications as prescribed.
Since there are so many rumors and misconceptions regarding psychiatric drugs, we thought we could clear some of them up by addressing the most common questions and concerns:
Why would I need psychiatric medication?
The biopsychosocial approach is one of the most popular approaches in psychology that explains disease and health. It provides a model that explains disease and health as the result of interactions that occur between physiological, psychological, and sociocultural factors. To elaborate, the cause, progression, expression, and prognosis (an educated guess regarding the likely outcome of a health condition) of a mental illness are affected by all three aspects: psychological, social, and biological. The use of psychiatric medications falls under the physiological or biological aspect of this model and is not considered a cure, but rather a part of the treatment plan, which could be essential to recovery in some cases.
How do psychiatric medications work?
To explain the biological/chemical processes that occur, we would have to be introduced to three biological terms, which are:
Neuron: brain cell
Synapse: the space between two brain cells (neurons)
Neurotransmitter: Chemical messenger that transmits a signal or a message from one brain cell (neuron) to another.
The type and quantity of neurotransmitters available affect the way messages/signals are sent and received. This influences how a person thinks, feels, and behaves. Consequently, most psychiatric drugs work, initially, at the synapse of a neuron to adjust the amount of naturally occurring neurotransmitters.
Aren’t psychiatric drugs addictive?
Most psychiatric drugs – with the exception of benzodiazepines (a prescription sedative that’s prescribed for anxiety or insomnia) – are not addictive. Addiction is characterized by intense cravings, urges, obsessions, and compulsive behavior to satisfy the addiction. It also involves loss of control over the amount of substance consumed as well as continued use despite harmful consequences. These aspects are absent with psychiatric drugs.
However, it is common for individuals to experience withdrawal symptoms (also called discontinuation syndrome) that are temporary when they stop taking specific medications at first. This could involve nausea, dizziness, insomnia, among other things. They tend to begin first when one stops the medication abruptly or with a significant reduction in the dose. They generally disappear after a week. Nevertheless, this temporary response does not indicate that an addiction has developed.
As for benzodiazepines, addiction can be avoided by following the psychiatrist’s prescription correctly and never taking it without a prescription. For most people, they are extremely safe and result in a positive therapeutic outcome. Medical health professionals mostly prescribe anxiolytics as a short-term treatment. However, a small percentage of people can benefit from more long-term treatment, but they should usually be a part of a medically supervised treatment program.
Why do I need to try different medications until one finally works for me?
Each person is different and until now, there is no simple test to determine the specific chemical difficulty one has, which would indicate which medication will bring out the best outcome. Individuals can have different neurotransmitter compositions even if they have the same diagnosis. This might explain why a friend’s medication with the same diagnosis might not work for you. So, the psychiatrist chooses the medication based on various factors such as the client’s symptoms, treatment history, family history, ethnicity, side effects, and other health conditions (if present).
What about the horrifying side effects?
As with the effect of a medication on symptom relief, side effects can also vary among different individuals. It is fairly common to experience some side effects in the short-term such as sleepiness or nausea when first starting or increasing the dosage of a medication. However, they usually subside after about two weeks while your body gets accustomed to the new drug in its system. Moreover, if the side effects persist, they can be reduced or prevented by adjusting the dosage of the medication or changing the medication to another one. Furthermore, like any treatment for physical health conditions, it is a cost-benefit analysis. The psychiatrist, together with the client, assesses the cost, which is the side effects or the money spent on the medications, and weigh it against the benefits, which is the symptom relief and possibly saving the client’s life (in cases of suicidality or self-injury).
Mental health professionals encourage the client to always communicate with them if the side effects are too severe or are significantly affecting their quality of life. Further, if the client has specific concerns, they should discuss them with their mental health professional before beginning treatment. Also, if the client wishes to stop the medication completely, they are highly advised not to stop it completely on their own as it could have adverse effects on their physical and mental well-being. Rather, they should follow the guidance of a mental health professional so as to stop it gradually and safely.
Lastly, for those who are hesitant and are affected by the stigma: you are not weak for taking psychiatric medication. It is incredibly brave of you to choose to get better, seek help, and keep taking that step each day.
To know more, check out our video on psychiatric medications (when are they necessary and the possibility of addiction) by Dr. Huda Gamal:
- Busting myths about psychiatric medication. (2019). Retrieved from https://www.sane.org/information-stories/the-sane-blog/mythbusters/busting-myths-about-psychiatric-medication
- Miles E. (2013) Biopsychosocial Model. In: Gellman M.D., Turner J.R. (eds) Encyclopedia of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1005-9_1095
- NAMIAustinTX. (2018). Retrieved September 08, 2021, from https://www.youtube.com/watch?v=hwuiE6-17AA
- NAMI Illinois. (2021, August 20). Retrieved from https://namiillinois.org/how-pill-shaming-hurts-those-who-take-medications-for-mental-health/
- National Institute on Drug Abuse. (2021, February 03). Benzodiazepines and Opioids. Retrieved from https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids
- Salzman, C. (1998). Addiction to Benzodiazepines. Retrieved from https://link.springer.com/article/10.1023/A:1022125929946#citeas
- Stein-Shvachman, I., Karpas, D. S., & Werner, P. (2013, September 20). Depression Treatment Non-adherence and its Psychosocial Predictors: Differences between Young and Older Adults? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843650/
- Signs & Symptoms of Addiction. (2021, March 05). Retrieved from https://www.marrinc.org/signs-and-symptoms/
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Hussein Haj Ahmad
Nour Abdel Baki
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