When folks struggle with ongoing depression or anxiety, serious action is required. Mood disorders are no joke and can suck the joy out of a well-built life. While medications are hardly the first order of business, they are a key effort in our arsenal, and one that too many reject.
Experiences of depression and anxiety are a normative feature of regular living. Sometimes consuming hours, sometimes days, sometimes even weeks, most of us will experience times when we are burdened with an overarching mood that makes it hard for us to function well. We find ourselves preoccupied and unable to “snap out of” an unpleasant disposition. This is usually in direct response to something going on in our lives, externally or internally, identifiable or a temporary mystery, but an actual something that can eventually be identified. While unpleasant, it is hardly a life crisis and can usually be surmounted by some basic self-care rituals and a community of friends and family. The problem is when this mood goes on for months or, worse, years.
Once depression or anxiety is a prominent feature of several months, much less years, we are no longer talking about a mood that is a natural response to a life situation or crisis. It may have started that way or not, it may be something we have always identified with as part of our personality, it may be something that crept up on us, and we can hardly remember when it started. But once significant symptoms have gone on for months, it is a mood disorder.
One of the burdens of mood disorders is that every person who has ever felt anxious or depressed and remembers how they got out of it thinks we should be able to get out of our situation the same way. But of course, a mood and a mood disorder ultimately have little in common.
The first order of business for both is all those great things people recommend, like exercise, healthy eating, fresh air, seeing friends, meditation, etc. They go a long way, at least with moods. With mood disorders, however, they barely make a dent. And that is assuming we can even find enough decent energy to pull them off.
The second order of business, for both moods or mood disorders is a doctor’s visit. Sometimes medical issues, like thyroid conditions, allergies, Lyme disease, anemia, etc., can impact our energy in notable ways. Good news, bad news, they might even prescribe you with medication for your anxiety or depression. This isn’t great, because it really isn’t the next step yet. The only time medication is called for before a stint of psychotherapy is if you are too anxious or depressed to do the work of therapy, or if you are actively suicidal. Otherwise psychotherapy is the third step.
Psychotherapy is a brilliant tool. You don’t need to be anxious, depressed, or in a bad place of any kind to make therapy a key component of a well-lived life. If the issue is a mood, therapy is sure to unpack the causes and identify some paths out. If the issue is a mood disorder, a therapist will help you identify it and begin the long road of untangling the disorder from your self-identity. Plus, once they help you identify the disorder, it is time to talk about medication.
Top 5 Reasons People Don’t Want to Take Medications, but Should Anyway:
1. We want to do it “on our own.”
The problem is, this is a fallacy. There is no such thing as on our own. People who function well in this world have good genetics and chemistry, solid enough childhoods, have avoided any major life traumas, and had sufficient opportunities to access fulfilled life options. All that came from people and resources that helped. I don’t even see “on my own”; I wear glasses. And no one judges me for needing help to see.
2. We think we should try more “lifestyle” techniques first.
It is true that healthy, happy people eat well, gets lots of movement, know ways to relax and play. The problem is, that is really hard to pull off if you are anxious or depressed. Plus, if the issue is a mood disorder, “lifestyle” techniques won’t make a dent. The good news is that if you take medication and thereby manage some of your depression or anxiety, then you will have the where-with-all to start exercising, doing yoga, and blending chia seed and wheat grass smoothies all the live-long day.
3. We don’t want to put unnatural things into our body.
This is totally legitimate, at least for people who are serious about that thing and are eating all organic, don’t take any other medications, don’t drink alcohol or take other drugs for pleasure. But if we are eating Doritos and chasing them down with beer, then we might be using this as an excuse. Even if you are super healthy, medications may be the exception you want to make. Depression and anxiety can be debilitating. A life free of these crippling disorders, a freedom you can likely not even imagine, might well counter-balance the downside of medications.
4. We don’t want our mood improving unnaturally.
Not to be too snarky, but this is usually pot-heads. The thing is, if medications work, nothing about it will feel unnatural. You will feel like yourself. In the same way that if your body doesn’t make sufficient insulin, and you take some medically, you will feel well, instead of your previously hard-to-define unwell state.
5. Taking medication means acknowledging a shaming disorder.
Mental/emotional/psychological distress gets a bad rap. It is so unfair. It has the same types of etiology as physical issues; some are genetic, some environmental, some can worsen or improve based on behaviors, but little can be reduced to “fault.” Even the elements of our physical or mental illnesses that we play a role in, why do we have so little compassion about how hard it is to live a good life. Sure, it would be great if we could all take fabulous care of all of the aspects of our lives that impact our well-being. In fact, it would be great if we had no issues at all. We wouldn’t be human, but it would be great. The other option would be to have some compassion for ourselves and others as we try to traverse the terrain of this complicated realm we call life.
Re-reading this, it sounds like I am pro-meds. That isn’t quite it. I am pro-contentment. I think life is hard enough that I believe in eliminating unnecessary barriers. I believe this may be our one and only life, and I think we should be allowed to make the best of it for ourselves. So live fully—even if you need the help of medications to do it!
Smith is the founder/director of Full Living: A Psychotherapy Practice, which offers clinical services with seasoned, culturally competent clinicians throughout Philadelphia and the surrounding areas.