Just a spoonful of sugar makes the medicine go down.

I’ve been thinking a lot about medication lately. (Also working overtime to buffer my family financially for my upcoming maternity leave, hence the sparse postings.) (Further parenthetically, I am not, to be clear, a prescriber of such, nor do I believe that psychotropic medications work for all people in all mental health situations.)

I’ve noticed that the people I see in treatment tend to fall into several camps. The first group believe that medication is the most important part of mental health treatment, and if they don’t feel “normal” yet, then they just haven’t found the right pill at the right dose. These folks tend to get frustrated the minute I mention the word “process” in relationship to their wellness, or suggest that the choices they’re making or the beliefs they have might be contributing to feelings of being less than well. Obviously, I’m biased towards thinking that my professional output leads to effective outcomes, but these folks and I don’t tend to do very well together.

The second group of people I see are highly medication resistant, either because being diagnosed and prescribed a medication feels stigmatizing, or out of fear that the medication will in some way fundamentally and/or irreparably alter their personality or state of being. While resistance to therapy is not a problem here, I have found that people in this camp hit impasses as well because their symptoms interfere with their ability to act on insight and new learning sufficiently to make serious headway.

Historically, I have not found myself to be particularly effective in convincing folks in either of these groups to budge towards the middle path, but, in an interesting twist of fate, my pregnancy has provided me with some rather powerful talking points.

The story goes like this: up until my late husband’s suicide, no one in my circle of wellness helper types had ever recommended medication to me, which is a mystery I’ll leave for another time, but that probably has its roots in my particular cultural location. Regardless, things got sufficiently squirrelly in the aftermath of his death that I ended up with a referral to a psychiatrist. We tried me on a few different medications over the course of a year or so, all of which I “felt” in various ways in terms of both their impact on my mood and various physical symptoms, until both the psychiatrist and I agreed that we’d landed on an antidepressant and a take-as-needed for supremely anxious moments combination that was the most helpful with the fewest annoying side effects.

And then I got pregnant, and had to drop it all so the baby didn’t get a cleft palette and a heart defect, which was a sacrifice I was (hopefully obviously) willing to make.

But now, I have my symptoms back, and it’s giving me a very useful perspective on what medication does, what it does not do, and why I probably would have been a lot easier to live with, both as myself and in relationship to others, if I had gone on medication about a decade and a half sooner.

When I went on the medication, I had a basic hunch as to what was different, but mostly I just knew that I felt better, and that better was good. Now that I’m off, I have been able to pinpoint exactly what has come back: there are a set of experiences, the most salient being this state I get into for about 24-72 hours at a time in which I’m tense, irritable, sad, afraid and just super negative, that immediately reemerged off the medication. It didn’t change who I am, or how I think, or my beliefs. It just eliminated that particular mood experience from my life.

What’s further interesting is that I can now look back on my life and identify when it was that this particular state started coming over me, either sporadically, or for months at a time, and say AH HA! That was a brain state, the kind that medication can shift. That wasn’t “me”, which is what I used to think. On medication, no cloud of icky. Off medication, clouds of icky are in the forecast every few weeks.

In defense of my non-pill-prescribing-profession, I’ve been using mindfulness, a variety of coping skills including talking with my partner about how this is a transient state, cleaning random things, and baking a lot of whole grain muffins (the most recent batch were banana chocolate chip), to get through since I don’t have the medication tool at my disposal these days, but I never thought I’d say that I was looking forward to getting back on medication (in, like, two years when daughter has been born and is finished breast-feeding).

And I am.

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