M is for Medication

Like so many things in this life, how to treat your anxiety is not a black and white issue. There are no easy answers as anxiety exists on so many levels. It exists in the brain and body, as I’ve mentioned over and over, it exists in our belief systems, and I believe it exists on the level of spirit as well. For some people, it is mild and doesn’t interfere much with their daily lives. For others it is severe to the point that their life revolves around it.  If you have very bad anxiety, attacking it from many directions will give you a better result than if you just sit around wishing it would go away. That never works, I can tell you. You need a large bag of tools to deal with pervasive anxiety.

One of my favorite photos from last summer. You’d never know that later that day I’d be having a panic meltdown. Medication? Yes, please. Thanks.

I went on medication to treat mine, and, of course, I do continuous work on myself and my belief systems. It was a relief when I finally realized that I needed medication to help my brain calm down. It works beautifully for me, and for that I am grateful. I’m fairly certain that after about a year I’ll be able to go off of it and be fine like I always was before.  I probably should have made the decision sooner.

So let’s talk for a minute about medications because there is so much fear and apprehension about this stuff. People really get confused and have strong opinions, sometimes without having much information to back them up. Please realize I am not a doctor and I don’t play one on TV. I am a psychotherapist with 27 years of experience doing assessment and treatment, and referring people to medical providers who can prescribe medication for mental health issues. These opinions are my own, based on my professional experience.

There are two kinds of medications that are commonly prescribed for anxiety. One is the anti-anxiety medications, tranquilizers actually, like Xanax. I’m not going to focus much on Xanax and other Benzodiazipines except to say that they are excellent in the short term for acute cases, but are highly addictive. They are central nervous system depressants and using them with alcohol is dangerous. If you want more information about how they work, here’s a  good article. These medications are not a good solution for long term treatment of anxiety.

Mike is using a lead line to check depth because I thought the water was too shallow. Turns out, this time I was right.

The other is the SSRI (Selective Serotonin Reuptake Inhibitor) anti-depressant category, which also treats anxiety. Depression and anxiety are best friends and frequently walk around together holding hands and sharing the same neurotransmitters. Many, if not most, people who have chronic anxiety also have depression. It’s only a matter of which problem rears its ugly head the most.

After so many years in the mental health business, I am disheartened that we continue to have a serious problem in our country with a belief system about mental health. People continue to be ashamed to say they are on an anti-depressants, as though that means there is something immoral or unethical about them, as though they suffer from bad character development of some kind. It’s okay to say you’re on high blood pressure medications, or antibiotics, or that you take something for pain. We’re not ashamed of taking those things. But suddenly, if it’s mental health medication, there’s an issue.

I can’t tell you how discouraged I get as a clinician when a client who is clearly suffering from a profound anxiety disorder, suffering every moment of every day, tells me that they “don’t believe in medication.”.   It’s disheartening because I know that they are going to suffer for a much longer time than necessary, it’s going to be next to impossible for them to follow through with any of the things I’m going to suggest to them, and that they are going to get discouraged that therapy isn’t the magic bullet they thought it would be.   If you are someone who ‘doesn’t believe’ in medication for anxiety and depression, then please consider your belief system carefully. Why, exactly,  don’t you ‘believe’ in it?

Take a careful look past the aft deck. That’s VERY shallow water covering mud right there. We were just that close to touching bottom. Thanks, Amy.

In my experience the answer to that is usually twofold. First and foremost, the person thinks they should be able to handle it themselves. This is fine for mild cases. Certainly changes in diet, such as how much caffeine you drink, and changes in exercise habits can do wonders for mild anxiety. Even supplements, which I may talk about later, would be a good choice if you want a natural approach. I’ve recommended certain coping skills in this series of posts. And by all means please get a physical exam that includes blood work for thyroid functions, adrenal functions, and other hormone levels.

However, for people who have severe anxiety that truly interferes with their daily functioning, and that is not caused by another medical condition, medication is a good solution and can make the difference between being able to cope and learn new tools and making little progress. In those cases, the combination of psychotherapy and medication is the best bet for creating lasting changes.

Recent research has revealed that the amygdala in anxious people actually has less plasticity than in people who do not suffer from anxiety. This means that once it records an emotional event, it is less likely to be able to differentiate in the future between a neutral event and one that triggers the emotional event. This is a measurable thing using actual science that I am not making up. I think it is important to remember that we are dealing with a physical organ here; one that shows differences in structure between people with anxiety and those without.

Best fun ever. I want to feel like this all the time. At the Owlery in Scotland.

The second reason is lack of education and information. Somehow many people continue to associate anti-depressants with illicit ‘drugs’. I mean, like ‘uppers and downers’. They continue to call medicines like Prozac and Zoloft ‘happy pills’.  And this could not be further from the truth. These medications do not ‘make you feel happy’. When they work correctly, they make depressed and anxious people feel normal. There’s a big difference.  People aren’t out there getting high on Prozac and Zoloft.

I have a little educational talk, complete with bad drawings that I do on the fly, that I give people who really do need medication but don’t understand how it works and are at least open to information.  Instead of giving you that talk, I’ve found a video that does a better job.

A final point I’d like to make is that many of the folks I’ve talked to who won’t entertain the idea of using medicine to treat their disorder actually are self-medicating at an alarming rate with alcohol, or pot in the wrong form. (Actually, pot in the right form can be a very good anti-anxiety medication for some people.) So, what they are telling me, really, is that using alcohol all the time or smoking pot every day is more acceptable to them than taking a pill. Unfortunately, in the long run, self-medicating with alcohol can make anxiety worse. And it definitely makes depression worse.

I hope that if you are a fellow anxiety sufferer this post gives you food for thought about using medication as one of your tools for treatment. I’m not going to sit here and tell you that medication is going to completely ‘fix it’.  It’s not likely to be the only tool you will need.  Does it help everyone? No.  Does it come with risks? Almost certainly, but so does continuing to have high anxiety. Might you have side effects? Of course you might, but you might not.  Do you still have to do your own personal work in conjunction with medication? Well, it does work better that way. Will you have to take it for the rest of your life? I don’t know. That depends on your history and on your particular set of circumstances. Like any other kind of medication or treatment, there is a cost/benefit analysis that must take place in the decision making process.


Just joined us in this A to Z Blog Challenge on Anxiety? Want to read from the beginning? Go here.


7 thoughts on “M is for Medication

  1. Cool image of you with the owl.

    Was going to suggest trying medical mary jane but looks like you already covered that in your post.

    It has been said that depression can be suppressed anger. Perhaps there is something in your life that is truly making you really angry? …IDK just a thought.

    • Well, I’m not depressed but sometimes yes, that’s true about depression for some people. Medical marijuana is a great medication for many people with anxiety when used appropriately. In WAshington state, marijuana is legal now so you can buy all sorts of forms of that substance.

  2. I’m so glad you mentioned caffeine. We ban coffee on days where we suspect we may have a difficult passage to make, mostly to avoid sea sickness, but I noticed that my overall stress levels were significantly lower on green tea days. On coffee days, I’d sometimes have to stop and ask myself “why are you getting so worked up over this?” and the answer was almost always too much coffee. It just makes me feel like all my nerve endings are hanging out raw, waiting to magnify everything. Green tea days are SOOOO much nicer, like the clouds have lifted and like there’s a Bob Marley soundtrack playing softly in the background (every little ting gonna be all right…). I wish I could completely ban coffee all the time, but I love it too much, so I schedule regular “cures” around sail time.

    • Ah, green tea. High in caffeine, but also has Theanine in it, which is one of the supplements I would recommend to people with a chronic low level anxiety. Yes, for many coffee is simply too much. I, too, cannot seem to give it up completely. I experimented with all kinds of ‘giving up this and that’ before I finally just admitted to myself that medication might be the way to go for awhile. Sometimes it works to reset us, then we can go without it. I know that’s how it’s going to go with me.

  3. It was interesting to read your thoughts on coffee and Sailing Mareda’s comment above. I hadn’t known that it can impact on anxiety.

    I think it’s great that you’ve shared your view on meds, how they can help and the fact that you’re on them too. I think there is less of a stigma these days about talking about anxiety, depression etc., but we still have a long way to go to make people feel as comfortable discussing these issues. Jenny Lawson comes to mind as someone who is helping generate a conversation about these things.

    Cheers – Ellen | http://thecynicalsailor.blogspot.com/2016/04/n-is-for-nautical-miles-nancy-drew.html

    • Yes, caffeine, that ubiquitous substance, does actually increase anxiety when taken too much. For some people who are particularly sensitive, even a cup a day is too much. I’ll have to find Jenny Lawson’s site. Normalizing these things would certainly make more people seek help.

  4. Pingback: 10 Longish Ways to Not Be a Virus Zombie | Little Cunning Plan

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