You Can Rely on Meds

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.