I currently take eleven different medications – many of them for my mental health. I have been taking medication for my mental health since 1995 when I was first diagnosed with schizophrenia. I want to share some of my thoughts and experience around medication.
Medication is not a choice for me. If I stop taking my medication I get very unwell indeed – I know this because it has happened and I do not ever want to repeat the experience! My medication is for mood (lithium), anxiety (sertraline) and psychosis (clozapine and risperidone). One of my medications is a sort of last line of defence schizophrenia thing. Clozapine is only prescribed – and by law can only be prescribed – for treatment resistant schizophrenia. That basically means that I have tried a large number of other anti-psychotic medications and they have been ineffective. Clozapine is potentially dangerous and can affect the heart and the white blood cell count. When it first came out people would die from it but now monitoring means it is a lot safer. I have to have a regular blood test and an appointment with a clozapine nurse at the local mental health service. I actually like clozapine. It was offered to me dozens of times before I accepted that I needed it. I thought it would turn me into a drugged out zombie and it actually does make me sleep a lot but no more than other similar medications I have had. It makes a big difference to my experience of psychosis and psychotic symptoms. Many anti-psychotic medications cause weight gain which has been an issue for me. It means I have to be extremely careful around food and watch my weight all the time. I got up to 130kg but I am down to 91kg now after a very determined effort to manage my weight. I hate when people assume that those on anti-psychotic medication are lazy or have let themselves go. The side effects of these meds are often significant and can be debilitating.
Like many with a schizophrenia diagnosis I have struggled with taking the medication. If I am well I feel like I don’t need it. I also struggle with denial of my condition so I question the need to take the meds even now. One of my nurses once told me that schizophrenia meds are like insulin for people with diabetes. If they take the insulin then effectively they are ‘cured’ but if they stop taking it they will get unwell. I like that analogy but I do still struggle with denial and question the need for the meds. Mostly I take them because if I didn’t I would be put on a court order to take the meds. I have actually been on one of those beforehand it was humiliating. I know it seems silly for an intelligent person to think this way but I do. I think it may be a part of the illness.
Sometimes people ask me what medication I take, almost like asking for advice and recommendation. One thing I know about psychiatric medications is that they impact on individuals differently. If I recommended that people take what I do it would be irresponsible and unhelpful. What works for me may or may not work for others. Psychiatric meds are something of a ‘suck it and see’ thing. You will often need to try a few different ones before you get one that works and if you are like me and your condition is treatment resistant then you may never find one – or a combination of drugs – that work 100% effectively. My medications take the edge off my mood issues, anxiety and psychosis but they definitely don’t ‘fix’ my mental health issues.
One thing that I come across is people saying children shouldn’t be medicated. I understand this concern but for some autistic kids and other neurodivergent kids medication makes a huge and positive difference. I have one friend who is a parent and their daughter was put on medication for ADHD and the difference it made was immense. The kid’s anxiety decreased noticeably and the medication made a massive positive difference. A competent clinician will ensure children aren’t given damaging medication as well. I don’t think clinicians take the decision to medicate children lightly and even if the medication doesn’t help or causes issues then they can stop taking it.
It is important to note that medication can have harmful effects. I actually had a very dangerous medication issue myself. In 2019 my psychiatrist at the time diagnosed me with ADHD and prescribed Dex amphetamines. As a person with schizophrenia I was aware I probably shouldn’t take these meds as I knew they can cause psychosis in people with schizophrenia. However my doctor told me I should be fine. I wasn’t. Within a week of taking the medication I was acutely psychotic. I spent the next two years in and out of hospital and am still struggling with that episode of illness. I was quite angry with the psychiatrist for putting me in danger and doing something which resulted in so much suffering for me. I guess it illustrates that these medications have big risks associated with them.
For some people psychiatric medications can change their lives dramatically and enable them to live well. That being said they are not always effective. The decision to take psychiatric medications should not be taken lightly. I hope – if you take them – that your meds work well for you and if they don’t that you find something which does. I do know I need the medication in order to live the life I do. Without my medications I would be extremely depressed and psychotic so it is not an option not to take them. I would love a world where I didn’t need to take meds!