I’ve talked about medication for OCD before; how I spent months trying to avoid it, how I tried to taper off after my first SSRI kicked me into a hypomanic episode, how I eventually came to terms with the fact that I’m one of those people for whom exposure therapy is not enough on its own.
That’s not true for everyone. Some people can beat OCD with exposure alone. Others have no luck with exposure, but medication helps immensely. And some of us are helped a tiny bit by exposure and response prevention, but we need a little help.
For me, the combination of ERP, mindfulness meditation, and other coping skills was enough to help me deal when my obsessions and fears worked me into a fever pitch of panic. They weren’t enough, however, to keep me from floating through each day in a haze of anxiety about completely unlikely scenarios. Because I insist on using the lowest dose of medication I can get by with, though, I still need those other tools for when I have “breakthrough” symptoms.
That’s just how it is for me. For a long time, I resisted medication because I was ashamed about using it. When I added lithium carbonate for a mood disorder to the mix, and learned that I will most likely be on it for the rest of my life, I was upset and embarrassed and guilty. Why couldn’t I just suck it up and get past this on my own?
I had seen so many news articles and op-ed pieces claiming the U.S. is over-medicated. And they were always, always talking about mental illness and other neurodivergences such as autism spectrum disorders. It’s so easy to buy into that, especially when there’s such a stigma around medication and mental illness.
Elisa May recently wrote a column for the Guardian about deciding to stop her OCD medication in order to have a child, even though the medication she takes has no known associated risks for pregnancy. She didn’t want to take any risks, and felt it was the correct thing to do to be a good mother. OCD quickly took hold and destroyed her ability to live a happy, healthy life. She reluctantly began taking her medication again.
I know that taking medication is the right thing for me, and will help me to be an amazing mum. If I don’t, I choose to take the real, evidence-based risk that OCD will take hold and prevent me and my family from living a full life.
This is what happens to me whenever I stop taking my medication with or without a doctor’s guidance. (Important note: Don’t be like me. Never stop taking your medication, psychiatric or otherwise, without a doctor’s guidance. Not unless you want to end up a sobbing, brain-zapped mess. Not staying you have to stay on meds, just wean off of them slowly and with help instead of deciding going cold turkey without telling your doctor is a great idea.)
The last time I wrote about this, I said I was coming to terms with the idea that I need medication. Back then, that meant that I accepted it with stubborn grumbles and embarrassment over the fact that I couldn’t think my way out of a pair of illnesses that are “all in my head.”
But that’s how all illnesses work. Very few people would choose to be ill. If people could walk off a broken leg or arthritis of the knee, they would. If they could suck it up to clear up strep throat or a sinus infection, they would. And if they could think their way out of migraines or multiple sclerosis, they would.
Those are all conditions that need medical treatment. Mental illnesses do, too, and sometimes that treatment requires medication.
Go on a message board for any chronic or major illness, and you’ll see people discussing the merits of different medications. What works for one person may not work for another. You’ll see people who had one massive flare of their illness and only the occasional small symptom ever since; you’ll see others who never had a major flare, but whose illness has progressively gotten worse for years. Some need surgery. Some don’t. Some find help from certain diets or exercise routines or icing and heating pad regimens. Others don’t.
Mental illness is no less complex. For example, I’ve had much better luck with Luvox than Zoloft. It works better at a lower dose, and does not cause the same mood issues Zoloft does. They’re both SSRIs; many people with OCD have excellent experiences with Zoloft. There’s nothing wrong with me or them, we’re just different people.
Just because not everyone needs medication doesn’t mean those of us who do are weak or lazy or over-medicated. It doesn’t mean our brains are better or worse than people who don’t need meds. All it means is that mental illness is different for everyone who has it.
Focus on finding the treatment that works best for you and gives you the best quality of life, instead of listening to what others say should cure you. Even if they have experience with your illness, they don’t have YOUR experience with your illness.