To Medicate or Not?

To Medicate or Not?


Note: This post should not be construed as advocating for or against a particular medication or for a person to go on meds or not. This decision resides within an individual and their specific care team. What follows is a reflection of one man's experience.

My Experience with Medication

For people with depression and anxiety and other mental health problems and who may or may not be in recovery from addictions this can be a difficult question. I’ve faced it myself. I was about fifteen years sober and seeing a therapist for my complex PTSD. Despite a lot of therapy and a committed recovery I couldn’t seem to shake my symptoms: sleep difficulties, easily anxious over relatively minor situations, irritability and vague but frequent sadness with no directly identifiable cause.

 I tensed up when my therapist suggested I go on antidepressants. Really, me? Is it necessary? I’m a therapist for God’s sake! I had been indoctrinated in Alcoholics Anonymous and Narcotics Anonymous in the mid-1980’s and both programs were at best cool to the idea of medication. My recovery meant everything to me. I didn’t want to do anything to jeopardize it.

 My therapist sensed my resistance. She said, “I think you could really be helped by a dose of an SSRI. They’re pretty clean medications these days and the side effects are minimal. You can give it a try for one month and if it doesn’t work or there are side effects you can’t manage then stop. It’s always your choice to stop.” This resonated. It’s my health and my recovery, I make the decisions about what’s best for them.

 I went to see a reputable psychiatrist and she prescribed 20MG of Lexapro after a thorough intake and then scheduled me for a follow-up in two weeks. I didn’t feel any difference for about ten days but then felt a tingly lightheadedness. It wasn’t horrible but it was mildly unpleasant. It lasted a day or two and then resolved, as if my body just needed to calibrate to the drug. At about the two week mark I felt more relaxed and a little more light-hearted.

 At my next appointment with the psychiatrist, she questioned me closely about how effective I felt the medication was in ameliorating my depression and anxiety. How was I sleeping? (Still not great) Was I eating well? (No problems with eating). Any side-effects? (None to speak of). I told her I felt my anxiety and depression were about fifty per-cent better. I thought that was pretty good. She said, “What if you felt ninety percent better?” Sounded great to me! She suggested a dose of Seroquel at 150MG. She said the Seroquel would have a “synergistic” effect with the Lexapro. In other words, the two drugs together would be more effective in diminishing my anxiety and depression than they might be alone. She also felt the medications would help me sleep.

 The first night I took the Seroquel, I felt quite tranquilized and fell deeply asleep on the couch. The next morning, I felt a bit groggy, a kind of hangover. Neither of these two side effects persisted however and I sleep solidly every night. Gone was the broken sleep I’d been experiencing for decades, post-trauma. I can’t stress enough how big a difference getting a solid seven or eight hours a night makes in my mood and physical health. I am less irritable, more energetic and happier. My anxiety and depression both lessened to the point where I could manage them better, yet I don’t feel artificially happy. I’m not overly tranquilized and I feel fully myself. I just have fewer episodes of depression and anxiety.

On a scale of one to ten, with ten being the worst case, my anxiety is usually a one or a two and the same for depression. I take my medications very consistently, usually around the same time at night. Being an addict in recovery I am conscientious in never exceeding my doses because of some emotional struggle I’m having. I don’t skip a dose because I feel okay. I view it the same way I view brushing my teeth and other self-care: I do it routinely because it’s good for me.

In Part Two I will make some practical recommendations about medications should you decide to go that route.