Psychopharmacology

How to Deal with Pressure to Take Psychiatric Medication

Consider these seven issues when making this very personal decision.

Posted Jul 06, 2020

Viacheslav Iakobchuk/Adobe Stock
Source: Viacheslav Iakobchuk/Adobe Stock

What should I do if someone I love is pushing me to try a psychiatric medication? I hear about this scenario fairly often in my clinical work. It’s a difficult position to be in, especially if you’re not interested in medication. To be honest, I found myself in that position when I was in a major depression and several friends gently urged me to try medication.

Maybe you’ve also struggled with low mood, and your sibling wants you to try a medication for depression. Maybe your partner wants you to get a prescription for sleeping pills. You might be having a hard time focusing and getting things done, and someone wants you to have an evaluation for a stimulant medication. Or perhaps anxiety has become overwhelming, and you’re being urged to seek a prescription for a tranquilizing medication like alprazolam (Xanax).

No matter what the condition and the potential drug, what we put in our bodies is a very personal decision—and even more so when it’s a substance that alters our brain chemistry. Many people are turned off by the thought of an external agent affecting their bodies, minds, and emotions. They may be interested in seeking treatment, but would prefer a non-chemical solution.

There’s also the issue of potential side effects. Benzodiazepines like alprazolam can cause drowsiness and problems with memory. Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) are known to cause sexual side effects like difficulty reaching orgasm, as well as headaches and nausea. Stimulant medications like amphetamine+dextroamphetamine (Adderall) and methylphenidate (Ritalin) can cause nervousness and problems with sleep.

Additionally, psychiatric meds may not be easy to discontinue. There is often a withdrawal period, which can include a rebound of the symptoms the drug was meant to treat. For example, discontinuing a medication like alprazolam often triggers a spike in anxiety. Accordingly, stopping a medication may be harder than starting it. 

This is not to suggest that no one should take these medications. Physicians and other prescribers are familiar with the potential adverse effects of the medications they prescribe, and generally take these effects into consideration in their cost-benefit analysis. If they write a prescription, they expect the benefits to outweigh the costs.

The decision to take medication ultimately comes down to the individual and the professional they’re working with. But it can be hard to resist the pressure from someone we care about. Here are some issues to consider when weighing one’s options.

1. Be as Open-Minded as Possible

It's worth considering your loved one’s suggestion as nondefensively as possible. We all have blind spots, and they may see things we haven’t, or haven’t wanted to. For example, maybe we haven’t wanted to admit just how depressed we are. So you can ask yourself what's behind their urging. What are their concerns? Do you share some of these concerns?

Whether or not you need medication, most likely there is an issue that needs attention. Maybe it’s something between the two of you, like difficulty communicating or frequent conflict. Maybe it’s something personal that you’re having a hard time working through. Whatever the case, people generally don’t push someone to take medication when everything is going well: “Honey, I’m so happy with our lives right now. You know what would make this even better? An antidepressant medication.

2. Is Psychotherapy an Option?

If there is an issue that requires professional attention, consider whether therapy may be an option. Many people assume that a psychiatric condition requires a medical intervention, often because of the now-discredited idea that a “chemical imbalance” causes conditions like anxiety and depression. In reality, many people find great relief from psychotherapy alone, which has the advantage of no medication side effects. Your loved one may not be aware that other effective treatments are available. Consider talking with them about different options.

3. Consider Where It’s Coming From

What’s the energy behind the pressure the person is putting on you? Does it seem to come from love and concern for your well-being? If so, they may think of medication as the best way to alleviate your suffering. Or does it feel like it’s coming from their frustration? Perhaps they’re annoyed at you for how your struggles affect them, and want you to “fix the problem.”

Their motivation doesn’t necessarily tell you whether medication is the right option for you. Medication could be the wrong idea even if they’re motivated by love, or the right idea even if they’re driven by irritation. Nevertheless, it may be important to understand where they’re coming from.

4. Maybe It’s Them, Not You

Sometimes the person in a family who is identified as “the patient” isn’t really the one with the problem. It could be, for example, that a difficult person blames all the conflict on their partner, and thinks medication could make their partner more agreeable. Or an overcontrolling parent might see medication as the solution to a child’s growing expressions of independence. Consider whether a similar dynamic could be at play in your own relationship.

5. Are You Being Gaslighted?

Along these same lines, telling someone to take psychiatric medication could be part of a broader pattern of emotional abuse and manipulation. The implicit (or explicit) message may be, “You are the one with a problem. Your sanity is questionable. You need professional help.”

Keep in mind that gaslighting involves a broad pattern of manipulation and trying to make you doubt your reality, with the intent of controlling you. Just because someone disagrees with you or questions your perspective doesn’t mean they’re gaslighting you. Assess their intent as best you can. Are they trying to be helpful? Or trying to maintain their dominance and control? For more on gaslighting, see Dr. Stephanie Sarkis’s seminal article, and this interview on the Think Act Be podcast.

6. How Likely Is Your Issue to Resolve on Its Own?

People often suggest medication for normal issues of adjustment, like bereavement or an acute response to overwhelming stress. They may not understand that painful emotional experiences and even difficulty functioning do not necessarily mean that medication is warranted. Some people do find that medication can be helpful when their symptoms are overwhelming or aren’t improving on their own. Or some may have a chronic psychiatric condition that requires management with medication. But for others, the key healing ingredients are time and the love and support of others.

7. Examine Your Feelings About Medication

Finally, take a look at your beliefs and assumptions about psychiatric medication. How do you feel about the idea of taking it? What do you believe it means about a person when they take meds? Some people think, for example, that taking medication implies a personal weakness—that we “couldn’t solve it on our own.” But in reality, it can take great strength to accept help, in any form. Or perhaps you're convinced that the issues you're going through require deep personal work, and that taking a drug could actually interfere with the process of growth. Explore these thoughts and feelings with someone you trust, and ideally someone who has no vested interest in your decision.

For more on medication vs. therapy for depression, see this post: 27 Facts About the Best Ways to Treat Depression.

If you’re interested in psychotherapy, you can search for a therapist through the Psychology Today online directory.