More support and understanding needed for people wanting to try a no meds approach

pills_medicationI’m concerned about the medicalisation of life; over-prescribing and how sometimes normal difficult emotions are (mis)diagnosed as an illness requiring medication. I expressed this view on twitter and said how I think Dr Joanna Moncrieff does make some valid points. Immediately I was accused of pill shaming, lack of empathy and insulting people who suffer from real deep depression.

Here is the article in the Telegraph which triggered the twitter responses to me after the psychiatrist Dr Alex Langford had put up a link to a similar article – his blog about this topic is here. The media is often insensitive in its choice of language. I can see why ‘happy pills’ would annoy some people. This wasn’t my choice of words so I won’t try to defend a phrase I don’t use. ‘Happy Pills’ or ‘antidepressants? Call them what you will. They didn’t make me happy and they increased my depression. But adopting a critical approach to psychiatric medication does not automatically amount to criticising those who take pills. Isn’t the valid point being made in the Telegraph articles that there is over-prescribing, and sometimes the (mis)diagnosing of human experience for a ‘depressive illness’? The increase in prescriptions for depression gives rise to genuine concern and I think Joanna Moncrieff is right to point this out. I struggle to see how expressing my agreement with this makes me a pill shamer.

So what does pill shaming mean? ‘Pill shamers’, I am told, don’t understand what ‘real’ depression is and think it’s just a sad mood that can easily lift. But I do know, only too well, that suffering and despair is very real. It can be a devastating, gut-wrenching experience whether it’s a normal reaction (as in the normal grief process, to use just one example) or goes beyond our perception of what is ‘normal’. Pill shaming, I am told, means demeaning people who seek help and take pills for depression. Shaming and demeaning anyone for taking pills is something I would never do. (After all, I took pills, for depression and heaven knows what else, for five years). Maybe meds helps some people and not others. There is no shame in taking them or in not taking them (though hopefully both through informed decisions). But let’s not forget, too, that people choosing to come off pills are often told they’re ‘ill’ and have long been made to feel they are doing something wrong, dangerous or shameful in making that choice. More support and understanding is needed for people who do want to try a no meds approach.

I would have liked to engage in constructive debate about this important topic but found I couldn’t get beyond trying to defend my views against the strongly felt accusations of pill shaming. This has happened to others before, and often it silences people and hinders much needed discussion, as expressed in this blog here. I’m aware that speaking out against the use of medication and the medical model in psychiatry upsets and angers a lot of people, not only some psychiatrists but people undergoing psychiatric treatment. It is the latter group with whom I empathise and I hope I do always remain sensitive to their feelings in the ways in which I express my views. But I MUST speak out. People have been, and are being, harmed by the medicalisation of their problems. A rigid application of the medical model almost destroyed me. I’m not antipsychiatry, I’m anti-bullshit – and psychiatry did throw a lot of that at me.

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54 thoughts on “More support and understanding needed for people wanting to try a no meds approach

  1. Jean this is an excellent piece and I am with you all the way. I cannot agree more. I was medicated at an early age by a white coated doctor in a child guidance clinic and really it wasn’t medication I needed, but to be listened to, and understood and to have my emotional needs met. In later life I became psychotic because of my earlier dysfunctional and abusive upbringing, and a cocktail of anti psychotic and anti depressant medication combined with Electro Convulsive therapy, reduced me to a zombie like state and caused distressing side effects like cataracts in both my eyes. There is too much emphasis on medication and a compulsion to prescribe as if this is the only option. It is not the only option and if I could have my time again, an option I would not consider. Thanks for this post.

  2. My issues with psych drugs are…

    – Misdescribed, for example, “anti-psychotic” thus giving the impression they correct a ‘chemical imbalance’. This is unproven. Major tranquilliser would describe them better.

    – Over prescribed – too much emphasis and over reliance by psychiatry in prescribing psych drugs.

    – Prescribed as first response rather than last resort.

    – No or inadequate informed consent – people are not given the true facts about the effects of drugs (toxicity, brain shrinkage, diabetes etc).

    – No or little accountability on the part of prescriber in how drug effects are monitored and reviewed.

    – Prescribed for long periods, rather than viewed as a short term measure.

    – Polypharmacy – too many drugs prescribed at the same time.

    • Thank you, Nick, for listing these very important points of concern about psych drugs. I’m not saying it’s the same for everyone, but these issues relate to what happened to me years ago, and I’m sure many people can attest to it being the same now for them.

    • It’s good that many people have been helped by meds used with talking therapy. My meds made me feel much too dim-witted and drowsy for talking therapy had it been offered. People have different experiences of meds, which are all worth listening to and sharing.

    • In treating children, during my training, my supervisor talked about treatment being a 4 legged stool (therapy, parent education, coordination with schools, and medication). If they are all not even and in agreement, the child sitting on the stool will fall off. Medication needs to be part of a conversation and a good assessment and on-going collaboration will always tease out the need for medication.

  3. Whilst i agree with this i also think there should be less anti meds propagandising directed at those who are content to take meds. Respect for people’s choices is the key..

  4. You are absolutely right Jean to speak out about this. Please do not let the naysayers deter you. It is going to take time for us to move towards a more enlightened approach towards health and mental health care.

    For a long time, our approach has been too narrow (biological). Industries have grown around this view and we have all been brainwashed to believe that this is the right and only way. Many have a vested financial and professional interest in promoting and maintaining this worldview. However, it is not “the truth”.

    The balance is shifting and people are starting to wake up. It is important that those of us with lived experience raise our voices and speak our truth, in order to fight for justice and the wellbeing of others in the future. I have seen so many people harmed by the drugs and coming off them can be very difficult (they are designed that way).

    Those who believe in / have been told to believe in the drugs, feel they are helping and that they cannot function without them, should be encouraged to think more critically. The reason they feel worse when they try to come off them does not mean that the drugs are working, rather that the process of withdrawal is very difficult. Yes we should not be pill-shamers, but we should definitely be pill enlighteners.

    These two links are worth looking at:

    Lives ‘left in ruin’ by rising tide of depressive drugs:

    http://www.telegraph.co.uk/news/features/10789916/Lives-left-in-ruin-by-rising-tide-of-depression-drugs.html

    Doctors tell Sinead O’Connor: ‘You’re not bipolar’ – Sinead talks about the effects of drugs here:

    http://www.irishmirror.ie/showbiz/irish-showbiz/doctors-tell-sinead-oconnor-youre-2344863

    Keep up the good work and keep exposing the truth!

  5. Thank you, Helen, for your comments and the links. I appreciate your support. Yes, it’s so important that those of us who have learnt bitter lessons from lived experience remain steadfast in our fight for truth and justice.

  6. Excellent post, and I wish more people would speak out as you have. My son was on various meds for severe OCD. They only harmed him, and it wasn’t until he was off all meds that he was able to recover, with proper cognitive therapy. Thank you for speaking your mind and I hope you continue to do so.

  7. Great article. I wish I had not been put on medicine 15 years ago. The side effects of the meds, labeling me and blaming me was hurtful. I needed to be taught how to feel, that it is OK to feel, that what I feel is right and my right. And that I have a voice and can have boundaries to keep me safe. I hope people read this that are wavering on whether to try medication or not. I too advise to try therapy first. Do not settle on any therapist, find the one that helps you. The skills I have learned from my therapist now are priceless. I tried eight therapists before I found this one that is able to reach me and help me. I am now on the lowest dose of one medication currently. Be kind to yourself. Do not give up, you deserve to be heard.

    • Hello, Cindy, and thank you for sharing your experience. I’m pleased to hear you did eventually find the help that is right for you. Yes, we all need to be kind to ourselves. Warmest wishes.

  8. NOTICE ABOUT ADS: May I apologise if anyone is seeing ads on my site, and especially if the adds are inappropriate. The reason that WordPress.com show ads is because I haven’t paid for the ‘No Ads’ upgrade. WordPress runs ads to cover the cost of operating these free sites. The reason I haven’t yet paid for the ‘No Adds’ upgrade is because I’ve frequently in the past had problems where the site has become inaccessible. This hasn’t happened for a while, so I may reconsider and pay for removal of ads. I just wanted to explain this in case you see ads and are puzzled by them. Jean.

  9. Is the dichotomy really as simple as pill-shaming and anti-shaming? Isn’t it possible to occupy the position that medication and medicine can be used to help people if applied in the right way, at the right time, for the right amount of time? Orthodox psychiatry gets a lot of schitck for being reductionist…but if our critiques throw out the entire medico-pharmacologic register then we risk reductionism as well. The point isn’t to refuse models, to reject strategies, but to sift, dredge, and reassemble from those we find around us. And to do so in a tactical manner: that is, for as long as it works.

    For disclosure, I’ve never been medicated- although I’ve taken some meds to feel their effects- and I work as a mental health nurse.

    • If I’ve given the impression that I think the entire medico-pharmacologic register should be thrown out and that drugs shouldn’t be used in any way under any circumstances, I’m puzzled as to what I said to give that impression.

      No, the dichotomy is definitely not as simple as pill-shaming and anti-shaming. In accusing me of pill shaming and such like, I feel I’m being attacked for an opinion I don’t hold. If I, and others in this position, try to explain that we’re not pill-shaming but the accusations persist, then I fear that debates on important issues surrounding medication are being shut down. The discussion gets polarised into a battle between those who are ‘for’ or ‘against’ and this gets us all nowhere when the whole issue is more complex than that.

      I’m interested in your views as a mental health nurse. Thank you for commenting on my blog and I hope you will visit again.

    • I don’t think most critics of psychiatry, and the general pharmacological approach, are suggesting throwing out the medical model, but I do think most are against cover-ups of negative side effects, and the sanitization of the (often very severe) ill effects which a lot of people unfortunately experience…

      • Some people, rightly or wrongly, feel that understanding their problems in terms of a diagnosis and receiving drug treatment helps them, which makes me hesitant to go so far as to say the medical model should be abolished altogether. But I do question the underlying assumptions of the medical model, and I know that many people framed within it are being harmed, as I once was. It has to be challenged.
        And, yes, we most certainly need to fight to expose cover ups of negative side effects and all the lies and injustice that unfortunately abounds.

      • I don’t know if the medical model could actually be abolished, so I presume that you must mean “abandoned altogether”.
        Also, whether people “feel” that any particular viewpoint or model or justification for drug (or any other) treatment helps them, might be less relevant than objective results, e.g.: are they working or on the public dole? Are they in trouble with the law? Are their families reasonably provided for? It’s a social result which counts more than a psychological one.
        I cannot be very sure what somebody thinks or feels, so I can’t control that or be responsible for it. But what they do in my neighborhood is visible, and I may choose to watch, thank or stop them.

  10. Yes, I meant ‘abandoned’, though I would like to see a move away from the medical model to psychosocial and holistic approaches.

    I agree that hearing from people who ‘feel’ that a particular model or treatment helps them doesn’t tell us enough about its efficacy without relevant observable factual results. But if someone feels that they need psychiatric drugs to enable them to function, I have to respect their right to hold that view. Maybe they wouldn’t think or feel that way if they’d been given adequate and honest information (about drugs for instance) or if they’d had different experiences, were in a different situation or had been immersed in different ideologies. I suppose we are all biased in one way or another depending on our background and circumstances.

    I have to take responsibility for myself and do what is right for me, but I would be on shaky ground if I started telling others what they should think, feel or do. This gets back to my blog post. Although I have a heartfelt connection with people who want to refuse psychiatry and drugs, I am not shaming or demeaning others who choose to take antidepressants or other psychiatric drugs, or those who believe they have really no choice. (Objectively they do have no choice if on coerced treatment, but that’s another issue and something else that needs to change).

    I will continue to express concern about the harm that the medical model approach has done to many of us, with its diagnostic categorising, drugging and other physical treatments. Like many others, I have learnt a lot about this from lived experience on the receiving end.

    • In my view the critical/anti perspectives of psych drugs need to develop their argument when one is wildly ‘psychotic’. That is a bottom line which I don’t feel is addressed by components to psych drugs. Im not saying that everyone who has gone mad should be medicated but what do you suggest in terms of assistance in acute situations?. Many things can be helpful beyond crisis but Im talking about real situations where someone has completely lost their mind?….

      • A good point, Nick, and one which I have pondered over a lot. The only honest answer I can give you to this is I don’t have the answer: I simply don’t know. I lack the expertise and knowledge to say otherwise. Thinking of extreme crisis situations like this is one reason why I say (as I did in one of my replies above), ‘I don’t think that drugs shouldn’t be used in any way under any circumstances.’
        If anyone reading my blog takes an anti-medication stance and believes drugs needn’t be used, even temporarily, in extreme crisis situations, I would be interested to hear your views.

      • It seems to me that in such circumstances, drugs are justified. The critical point, however, is that the drugs absolutely are not honest “help” for the individual who is psychotic. Not in any sense of medicine. The drugs are a control device, justified even as a policeman’s baton would be, or a bullet for that matter. If you’ve ever seen a “patient” held down by six security therapy aides, screaming while a needle is forced into her body, this was probably pretty clear.

        Obviously, the general agreement is that people who become violent or too actively obnoxious due to a psychotic episode should be dealt with in the most merciful and least forceful way which can still be effective. But just presuming that it’s a “medical matter” because that means some expert has to deal with it out of public view is irresponsible, social cowardice.

        In fact forced psychiatry is torture under United Nations human rights conventions. We must not blur the line between protection of the community and help for the mentally ill. The drugs are one or the other, and the telltale is true informed consent.

        This is actually even more important than what works therapeutically, because without honest collaboration there’s no therapy, only domination or escape.

  11. Pingback: Depression vs. Normal Unhappiness

  12. Very well put, Jean. If anyone is qualified to debate this topic it’s you, and it’s a shame you’ve had to spend time defending your views x

    • When we make assertions publicly about psych drugs, we are going to come under scrutiny from others. This is to be expected and reasonable, and I don’t feel its some kind of waste of time being required to substantiate held views.

    • Thanks Karen. Yes, when called upon to keep defending my views against things I never even said, discussion about serious issues surrounding psych drugs can get diverted and shut down. I’ve never been shaming or demeaning the people who choose to take pills, so those twitter accusations were a straw man argument. As I said in my post, this also happens to others, often silencing them. Realising this has made me more determined than ever to keep speaking out.

  13. I take both a neuroleptic and antidepressant. I feel benefits from both, but believe, I am addicted to the ‘antipsychotic’. I don’t take the criticism of psych drugs too personally, “pill shamed”, but it can unsettle me. For example, regular messages of how toxic these drugs are, and how damaging they are to physical health. Thats quite a downer to be honest, and its only human to feel concerned about it!.

    Id like to see radical changes in how psych drugs are promoted and prescribed, as outlined in a previous post. I do feel they have a place too, and all the therapy, exercise, and healthy eating in the world may not be enough for some of us. I find the ‘if only you exercised more’ kinda advice patronising and wholly inadequate.

    • Nick, I don’t think we’re disagreeing with each other, though we’ve obviously had different experiences. You find psych drugs beneficial. I was bombarded with neuroleptics, antidepressants (and ECT) in my teens/twenties and I found these physical treatments harmful to me. I was eventually fortunate enough to get off them (many years ago) and have been fine without them. But what worked for me doesn’t work for everyone. Comments such as yours keep me reflecting, and I think this is where open discussion and sharing different experiences is good.

      I like your list of concerns about drug-prescribing that you gave in one of your comments above which, if adhered to, would at least lessen the risk of being harmed by drugs.

  14. This is such an excellent post Jean. Of course you must speak out and are right and entitled to do so, even more so because of your deep knowledge of this subject. It’s getting so difficult at times to speak out – due to bullying and intolerance – and I think you are very brave. I completely agree about the over medicalisation of mental health issues – case in point, it is now no longer possible to be ‘just shy,’ this now has a mental health tag. I think your article was balanced and thought provoking. Sorry I am late to it!

    • Thanks, Ruth. Good point about shyness. People being given a mental health tag for being ‘just shy’ is also an issue close to my heart. Shyness caused me great unhappiness in the past and held me back in so many ways. But shyness is not an illness and to see it and treat it as such can lead to greater suffering.

      • It’s not only a matter of harm caused to individuals who get “diagnosed”. Shyness, sadness, inattention, exhilaration, stray thoughts, “voices”, imagination, anger… have all been translated into excuses for, and little roadsigns directing us to, a totalistic Psychiatric Imperium. Such a scheme must fail, and will, but only if people actively resist its logic and relentlessly challenge its pretenses. I desperately hope that everyone who has commented here will continue to communicate and actively oppose attempts to turn us all into “patients” to be “treated” whether we like it or not! Thank you all for your good work!

  15. Since we know each other Jean I know we are in agreement about this topic. Those who decide to remain on prescribed medication despite their reservations about long term side effects, those who are ‘happy’ to take them long term, and those who choose not to all deserve equal support and understanding. Well done for finding strength to withstand the misunderstandings re your stance. Hope they take time to read more about your experience. Sue

  16. I guess it’s a case of what works for you. That may or may not mean it will work for someone else. For some people that doesn’t matter, which is self centred. Ideology as war. What is an acceptable level of casualties? Who will win and who lose from the new policies and ideologies?

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