I’m angry. Honestly, deeply, really angry. And worse than that, I’m angry about something that I wanted to like and support.
The New York Times is currently running a series in their Opinionator column about one women’s experiences choosing to go off her meds (with the help and support of her doctor). The first few pieces of the series I enjoyed a great deal. I understood her reasons for going off meds (they had some side effects she wasn’t too happy with, and she felt that her mood was stable enough without them), but in the most recent piece she doesn’t really describe the process of going off meds, what she describes is just having depression. Seriously, full on episode, cannot leave the house for days at a time depression.
Now don’t get me wrong, I am in support of pieces that describe what it’s like to live with depression. Too often the disease is misunderstood or swept under the table and I want to cheer when people openly speak about what it means to be depressed. But where this piece makes me angry is that the point of it is to talk about what it’s like to be at a stage of recovery that you feel you can go without meds. Now the author is describing what appears to be a relapse, and based on the information available to the reader, no one is helping her, she is not seeing a therapist or her doctor again, and she is not considering bumping her dose up a small amount until she has better skills available to her.
New York Times, that is irresponsible. In the first article, the author says that she isn’t in therapy and doesn’t want to go to therapy. That means that all the improvement she was seeing was at the hands of her meds. I cannot believe that the New York Times thought it was appropriate to watch one of their authors make this incredibly personal choice with little to no support from either a family and friends network or a therapist, and asked her to write about it. I can’t believe that no one has jumped in to say that if you don’t have the skills and techniques to handle serious anxiety and depression, then maybe you still need your meds. And I especially can’t believe that no one, anywhere, has said that it’s ok if you need to stay on meds for the rest of your life.
I don’t want to condemn this individual for making a choice based on what was important to them in their life. Everyone has the right to choose to either take or not take meds, go to therapy or not go to therapy. Meds have all kinds of side effects and can seriously impact your life (in good and bad ways), although I would also throw out that meds for many chronic illnesses have side effects but if it keeps you alive and functioning it’s still considered a good choice to take them indefinitely.
What I do want to question is the narratives that get published, especially in places that are respected and widely read like the New York Times. Because more often than not, those narratives include medication as a temporary measure, with no consideration of the fact that it is entirely ok and for some people great to rely on meds for life, as well as little recognition of the importance of an integrated approach to treatment that includes therapy, meds, and sometimes even a primary care physician checking out any physical health issues that might be contributing. What I want to question is the inevitability of going off meds, the necessity of going off meds, and the requirement that one go all the way off meds if the withdrawal process is going poorly.
That is literally the exact reason why you shouldn’t go off your meds without the supervision of a doctor, because sometimes it has unexpected side effects and it’s a really good idea to have someone around who can coach you through whether or not you might need to plateau or try a different drug instead or get in to see a therapist. It’s also a really, really good idea not to take away the main thing that you’re relying on to cope with a mental illness without adding anything else to replace it.
Certainly the articles aren’t painting a rosy picture. In the first article, the author says “But at this point, I care less about my anxiety and depression worsening, and more about getting back to being me,” finishing up with “I’ve got this, my body is telling me lately. Let me show you I’ve got this.” For an individual person, these are choices that you get to make without criticism. But to publish these as insights in a major newspaper sends the message that what’s important isn’t dealing with a horrific illness, it’s being true to yourself. And that plays right into all the stereotypes about the evils of medications and how depression and anxiety aren’t that big of a deal.
That makes me angry. It makes me angry that a newspaper is publishing this woman’s real time descent into a depressive episode. It makes me angry that no one has said “stop, this isn’t healthy for you, please go talk to your doctor/therapist/anyone again.” It’s ok to need medication. It’s ok to be a different person when you’re treating your mental illness than you are when you’re not. It’s ok to never go off your medication or leave your therapist. Depression and anxiety are chronic diseases, and they need to be treated like it. They don’t need to be portrayed as little experiments in a kind of sadness porn that makes the NYT a lot of money off of one woman’s pain.
We Got So Far To Go 
Soo…as a member of the Icarus Project, I have firsthand heard so so many stories of being told by doctors “you’ll be on meds all your life and can never go off them or horrible things will happen and we can’t help you at all, meds or nothing.”
I do agree that especially depression is framed as a temporary medication measure. But other things like bipolar and schizophrenia are very often framed as permanent medication. And neither of these things are true.
I also don’t think it is irresponsible to give someone room and agency to make their own choices (including what we might see as mistakes). Nor do I think we can know if her colleagues have been bugging her to return to medication (which honestly sounds very invalidating and unlikely to be helpful) or ‘get help.’
I see what you’re saying, I do. I agree that we need a larger narrative that medication is not weakness, can be life-long or temporary, shouldn’t carry stigma or pressure. And there’s certainly room for dialogue about whether this series is decreasing or reinforcing stigma/stereotypes (or both, for different aspects).
Where I disagree is you seem to be advocating for an intervention and saying the lack of one is irresponsible. That scares me.
Hmm, that’s interesting that we’ve had completely different experiences of the messages from doctors. I’ve really only had docs and therapists, and especially family and friends etc. say that meds are a temporary measure. Not sure how that happens.
I also agree that I don’t think there should be some sort of major intervention, but it does seem irresponsible to me to ignore someone who’s in a bad place. I did say that I can only know what’s presented in the series, so it’s possible friends/colleagues/family are already having a dialogue with her, but I just don’t see how it’s possible to witness someone in such a bad place and not say “are you ok?” or “do you need some help?” or “is there something I can do?” or “have you talked to your doc about it at all? They might have some insight.”
Again, I do think everyone gets to make their own choices, but I also think we should be able to reach out to people who are in a bad place. It actually seems incredibly important to me that it’s considered normal to ask someone who’s struggling with a mental illness if they need some help.
The NYT framing/opening context paragraph was all kinds of wrong and definitely adds to the stigma surrounding meds.
As for the woman concerned, ugh, it’s heartbreaking to read as she really does sound like she’s getting worse rather than coping better. It also reads like she might have some very disordered eating habits which have not been addressed by her medical practitioners. I would think using disordered eating behaviours to cope with severe anxiety and depression is a really bad idea.
😦