If I start taking a medication . . .

by Valueris Provider Bethany Carter MN, PMHNP-BC

If I start taking a medication for my mental health issues, will I need to take it forever?

First and foremost, medication is a choice made by the patient.  Only under very extreme circumstances in the hospital or inpatient psychiatric facility will one be given medication against their will.  Self-determination in providing consent for any kind of treatment is a tenant in mental health care.  A licensed medication provider will work with you to make a treatment plan and alter that plan according to your needs.

As far as what your mental health care provider will recommend about remaining on a medication, like so many other important questions, the answer is: it depends.  Medication for mental health is used to treat symptoms that cause distress or dysfunction.  If one person has low energy and motivation, but it doesn’t concern them or cause problems in their life, they don’t require medication.  For another person, these may be issues that prevent them from achieving their full potential in their career or cause problems in a relationship, and they feel the need for medication to augment their mental health. 

Of course there are other ways of achieving augmentation.  Therapy, using many different styles and forms of interaction with a trained or informal therapist, is frequently used to improve one’s mental health.  Lifestyle changes implementing exercise, mindfulness, nutrition, social connections, and restorative sleep are crucial for meaningful improvement.  For some people, medication can be a crutch that helps them get through a rough patch in life while they work on their mental health from several different angles to achieve lasting changes.

“Medication is a choice that can be part of a healthy lifestyle for as long as the individual feels that it is in their best interest to take it.”

For other people, the issues affecting their mental health are not primarily life circumstances like a trauma, divorce, or a history of child abuse.  Some people suffer with organic brain disfunction that will be a life-long condition.  Those with diagnoses of obsessive-compulsive disorder, ADHD, bipolar disorder, schizophrenia, or schizoaffective disorder have conditions that have a distinct biological basis that can be remediated with medications that alter brain chemistry to restore functionality.  While therapy and lifestyle changes are also invaluable to optimize their mental health, the chemical imbalance caused by their conditions will not be significantly altered by them. 

Many people with these disorders find that, to lead a stable and fully productive life, they depend on medication.  Within a month or two of discontinuing their medications, people with these diagnoses frequently find themselves back in the same situation that caused them to seek medication in the first place: inability to focus and organize tasks to complete them in a timely manner, manic or compulsive symptoms causing problematic behaviors, a psychotic break with reality requiring hospitalization.  Similarly, some people with life-long histories of recurrent episodes of depression make the choice to remain on medication rather than repeatedly cycling through episodes of depression, medication, balanced mood, tapering medication, and then again experiencing another episode of depression. 

The stigma of mental health issues in our culture dictates that individuals should not have to rely on medication.  Our society seems to brand those on psychiatric medications as “weak.”  A strong person is perceived as someone able to pull themselves up by their bootstraps and stoically persevere through any challenge.  But who would apply this logic to any other health condition in the body?  Does anyone tell someone with diabetes that they would be better off without needing their insulin?  Or congratulate the person with Hashimoto’s disease for going off of their thyroid medication?  Rather, we should honor anyone who is willing to thoughtfully advocate for their mental and physical health to be the best they can be.  Medication is a choice that can be part of a healthy lifestyle for as long as the individual feels that it is in their best interest to take it.