“Uh oh. Someone’s off their meds.”
It’s a common joke, usually in reference to someone doing or saying something that to the joke-teller is ridiculous. Maybe they’re way into conspiracy theories (all hail our lizard overlords) or perhaps the person is merely expressing an idea in a way that’s passionate or emotionally charged. Regardless, the sentiment is the same, “She’s crazy.”
I’ve worked hard to be open about my mental health. There’s a double stigma with mental illness – there’s the stigma to having mental illness and then there’s the stigma for taking something for mental illness. The truth is, I can’t win. Either I’m weak because I need medication or I’m crazy and I need my meds.
In both cases, I’m invalidated as a person.
Mental health medication is rough. Unlike many medications, there isn’t really an easy way to know what medication a person needs. We can’t crack open a skull and see what’s going on. The best psychiatrists (and I love mine) have experience and humility. The pretty good ones have experience. Even so, it’s hard. I literally tried 20+ medications plus a round of ECT (never again) before ketamine.
It’s hard to explain to people who haven’t experienced it, but in the year or two leading up to the ketamine, I had intense anxiety around new medications. I would cry because I had no idea how it would affect me. I finally got to the point where I just refused to try anything new.
I share this because at some point, you’ve met or heard of someone who has a mental illness who “was off their meds” so to speak. To the outsider, to those who at least accept that medication has a very important place in mental health care, it seems bewildering. Why would you stop taking a medication that keeps you level? It seems… crazy.
The thing is, these are mind-altering drugs. Not mind-altering in an LSD sort of way, but they have an affect on the brain which is really the whole point. Unfortunately, they come with side effects. Sometimes those side effects are bearable but sometimes they get to be too much even if one is used to them. It’s a trade off and there are days or weeks when it seems like that trade off might not be worth it.
In my own life, I have ketamine. It makes me loopy for a couple hours and then just leaves me tired. I can’t drive and my thinking is a bit sluggish. This happens every four days. I have two kids, I homeschool, and I have a household to manage. Being exhausted and unable to drive can put me in a bind. I struggle with feeling like I’m inconveniencing my family and friends. I even struggle with stigma in talking about it because antidepressants are hard enough for people to wrap their minds around, but ketamine? It’s new and being prescribed to me off-label through a compounding pharmacy. I sometimes even pick up on skepticism when I’m talking to medial professionals and I want to scream, “This is the only thing that has ever touched my depression!!!!” As though I have to justify myself for taking it even though I have the support of two psychiatrists and a clinical psychologist.
This is me who we’re talking about. Me, who is open about my struggles, who fights stigma, who will brazenly talk about her depression in front of a group of people and will tell haters where to stuff it — I feel these things. Now take what I’m feeling, remove my support system, add to it side effects that are worse (weight gain, dizziness, nausea, etc) plus people who are constantly belittling you for taking meds or needing meds and a society that does a poor job of supporting those with mental illness and is it really any mystery why someone with a mental illness might “go off their meds” sometimes? I have it a lot better than most people which is why I’m talking about it.
My point is this, those of us who require medication are grappling with a struggle inside of ourselves. Many of us have been invalidated in our experiences. Many of us have been given unhelpful or even harmful advice. While I’m not advocating that a person needs to censor themselves, I would say to consider your words.
It’s hard enough to take medication that comes with its own package of risk and benefit. Consider that the person taking it needs it, most likely, and love them when they struggle with the drawbacks. Don’t invalidate their struggle when they are wrestling with whether or not to take the next dose. Instead, hear them and help them carry the burden. Do a load of laundry. Cook them something easy on the stomach. Offer to schedule an appointment. Hold them if they cry.
And when you don’t know what to do, just listen. Sometimes that’s all we need.