The lovely Danny (who you’ll remember as my fantastic second blogger on recovery language) has written a very interesting piece around medication which i’d like to share with you. Psychiatric medication is often a controversial subject as side effects are common and difficult to manage and the NHS currently has a predominantly pro medication stance; This can make a dialogue around medication with professionals tricky. Common side effects are weight gain and sedation which i certainly found very difficult to manage as well as a kooky few like lactation (whaaat!?). Having been on a variety of medications that made me feel awful i am very lucky to now be on medication that has no side effects at all which makes the question of whether to stay on medication pretty simple. I have also been lucky to have a very positive dialogue with my Psychiatrist and CPN (community psychiatric nurse) around medication and in fact was given three different Psychiatrists in order to find someone with more specialist knowledge after i poo pooed all the standard treatments. I am therefore pro medication that makes you feel better and against medication that has intolerable side effects, i am also pro the NHS introducing/placing more emphasis on non medication treatment plans and removing the concept of someone being ‘non compliant’ when they disagree with their treatment plan.
Conversations on medication are important but often discouraged to prevent people from suddenly stopping medication which can be damaging physically and mentally. If you are interested in coming off your medication please speak to your Doctor first; You can also check out this fab page at the Mind website on medication, treatment plans and how to decide whether coming off medication is the right decision for you. You can find this here.
The Un-medicated Life
As a child, my mum encouraged me to take vitamin tablets every morning. I had no diagnosed vitamin deficiency and so it’s reasonably safe to say that my body was receiving and producing the requisite levels of vitamins, yet she believed the vitamins would provide some boost to my health. Perhaps she was drawn in by the advertised health benefits, “blinded by science” so to speak. Whatever the reason, my morning vitamins were well meaning, yet it could be argued completely unnecessary and somewhat fanciful.
Aged 22 my GP prescribed me an anti-depressant. Psychiatrists would later prescribe me various anti-depressant, anti-psychotic and anti-anxiety medications. As with mum’s vitamins I trusted my prescriber, I trusted that they knew what was best for me and were providing me with the best information and support available. Again, I have no doubt they were well meaning but here opinions diverge.
My relationship with psychiatric medication lasted for almost 4 years. From that first anti-depressant through to the last medications I would take I went on a significant journey with medication. I moved through medications looking for “the right combination” that could support my wellbeing. Whilst I never felt that medication made any positive difference to my mental wellbeing what I did experience was a grand tour of the adverse effects that these medications can have. Obviously, each medication interacts with everyone’s biology differently and that is why I feel no benefit to mention any of them by name (or brand name) however the challenging side-effects I experienced were varied and often unpleasant but at the time I believed that these were necessary evils in the pursuit of wellness. Medication is often the very first step in receiving support for your mental health, in my experience there was no conversation around medication being an option, only the very real belief that medication was a necessity and those deemed as “non-compliant” with medication are considered less likely to improve their mental health.
So-called ‘non-compliance’ in my perspective, is actually the expression of choice and freedom, a bold streak of resilience beaming through at and that’s what I chose to do. While the reasons I stopped taking medication are not the same as the reasons I would never take medication again, I had a well thought out argument against my medication. Firstly, as I was in the last few months of my time receiving support I wanted to assure myself that my wellness was much more than the right cocktail of medication, but was in fact because of the development and strengthening of my knowledge and skill around how I keep myself well and if this was true then I wouldn’t need medication. I was aware of the stigma (certainly self-stigma) around psychiatric medication and I wanted to ensure that my choices and behaviour could always be justified to, and by myself, as being authentic and true and nothing to do with taking medication which leads to the most crucial element of my decision, responsibility. I wanted to feel fully responsible for keeping myself well. This allows me to be fully aware of whether I am keeping myself well, am I doing the things I need to do to stay well or do I need to revisit what works for me? Instead of having to consider whether my medication is “working” or needs adjustment I know that it is up to me to keep myself well because the challenges of life are not medical challenges. The last element was being able to monitor my physical health, knowing that my health is impacted only by my lifestyle choices and not by the adverse effects of medication.
Around the time I began training as a Peer Support Worker (a year on from the end of my support from mental health services and over a year after last taking medication) someone asked me whether I would ever take medication again. I paused on the question for a moment; I hadn’t really considered the possibility but what if? At the time, I replied that I would if it was felt to be crucial but would prefer not to however it had got me to thinking about medication in mental health and I began to delve further into the subject.
What I found shocked me and informed my opinion on medication from then on. Science, as with mum’s vitamins had no valid support for psychiatric medication. I was aware when taking anti-depressant medication that these medications worked by essentially trapping serotonin as it occurred naturally in the brain and that this was because my low mood was somehow associated with a deficiency of serotonin. However, extensive research exists that highlights that there is currently no supporting evidence that experiencing low mood is linked to serotonin levels (Lacasse.JR, Leo.J 2005) and then a pattern began to emerge. The heavy-duty anti-psychotic medications I had taken were claimed to work by blocking the neurotransmitter dopamine in the brain, yet again there is no medical evidence to suggest any such overload of dopamine in people hearing voices and seeing things that others don’t. Why then had I spent almost 4 years of my life taking medication that had no basis in medicine? When I had been told that these medicines would stabilise my mood and reduce the intensity of my experiences with hearing voices and seeing things that others don’t, the question I should have asked was how? If the chemical imbalance model has been quashed then why was I prescribed medication that’s primary function is to readdress a chemical imbalance? The following quotes illustrate the point.
‘Many neuroscientists no longer consider a chemical imbalance theory of depression and anxiety to be valid.’ (Dr David D. Burns, Professor of Psychiatry, Stanford University)*
‘The results of decades of neurotransmitter-depletion studies point to one inescapable conclusion, low levels or serotonin, norepinephrine or dopamine do not cause depression.’
(Professor Irving Kirsch, Harvard Medical School)*
‘Patients have been diagnosed with chemical imbalances, despite that no test exists to support such a claim, and that there is no real conception of what a correct chemical balance would look like.’ (Dr David Kaiser Psychiatric Times)*
‘As a scientific venture, the theory that low serotonin causes depression appears to be on the verge of collapse. This is as it should be; the nature of science is ultimately to be self-correcting. Ideas must yield before evidence.’ (Dr Jonathan Rottenberg, Psychology Today)*
Beyond a possible placebo effect there was very little I could find in support of medication that was rooted in genuine tangible science, apart from the usual clinical trials that as always showed nothing but efficacy and success. In ‘Cracked’, Davies (2013) elaborates further about the sheer manipulation of results used in clinical trials and how with almost all medication associated with mental health the placebo sugar pill is roughly as effective. I struggled to find any evidence as to how these medications were meant to impact positively on my wellbeing.
In a way, my relationship with psychiatric medication is ongoing as I begin to understand its true implication through my continued exploration. I bought the dream of a miracle cure and when that was spent, I then bought into the faint hope that medication was in some small way supporting me on my recovery journey. Now as I leave psychiatric medication behind, I look with renewed and indefatigable belief to the truth that bolsters me in my own wellbeing and when supporting others with theirs, that hope and the resilience are all the medicine I need to live the life that I want. A life of ambition beyond what I thought possible when confronted with the stigma and disconnection of a mental health diagnosis. A life of success, constant, repeated success, in keeping me well and happy, both personally and professionally. A life of triumph not only for myself but all for mental health system survivors over the old ways of dictated treatment and for a mutual, empathetic approach that triumphs not by force but by compassion. I choose the life of inner-peace; it’s the un-medicated life for me.
If you are reading this and are thinking about changing or coming off mediation then please seek advice from your medical professional.
* Quoted in Davies J. (2013) ‘Cracked: Why Psychiatry is Doing More Harm Than Good’ London:Icon Books Ltd
If you are interested in exploring further any of the themes mentioned above around medication, diagnosis and mental health services generally there are various books I can strongly recommend.
I would encourage you to start where I did with as offers a detailed and thorough overview of the argument against contemporary psychiatry.
Davies, J. (2013) ‘Cracked: Why Psychiatry is Doing More Harm Than Good’ London:Icon Books Ltd
I can also strongly recommend:
Whitaker, R. (2011) ‘Anatomy of an Epidemic’ New York:Crown Publishing Group
Kirsch, I. (2009) The Emperor’s New Drugs: Exploding the Antidepressant Myth’ London:Bodley Head
Kinderman, P. (2014) ‘A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing’ London:Palgrave Macmillan
Lacasse, JR. Leo, J (2005) [online article] Accessible at: <http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020392>
[Accessed 10th January 2016]