[NOTE: I am not a psychiatrist, psychiatric nurse, nor doctor, and am not qualified to prescribe or advise anyone on issues of medication. This post summarizes what I’ve learned from some of my personal and clinical experiences with psychoactive medication For specific advice or assistance with medication, please see a medical professional.]
What is psychoactive medication?
A psychoactive medication or psychotropic substance is a chemical substance that acts primarily upon the central nervous system where it alters brain function, resulting in temporary changes in perception, mood, consciousness and behavior. Common examples are antidepressants, pain medications (analgesics), anti-anxiety medications, stimulants (used to treat ADD/ADHD), antipsychotics, and sedatives. There are many more. Research shows that about one in six Americans (around 17%) have a prescription for one. This doesn’t count what is available over-the-counter. Many people take several.
Many people have been tremendously helped by various psychoactive medications. This started with the miracles of pain-killers and anesthetics in the 19th Century which enabled humane surgery. It continued through the SSRI’s and antipsychotics developed in the last 50 years. When psychoactive drugs are appropriately used, they can be extremely beneficial. There are hundreds of psychoactive drugs available and they’re used to treat a wide variety of conditions. Psychoactive drugs can restore (or almost restore) normal functioning in many cases. This is the upside, and it’s a big upside. It sometimes can seem that soon we will have a pill for any mental health difficulty.
The role of therapy
One reason this won’t ever be the case, in my view, is that many problems aren’t the result of problems in the brain, and medication won’t solve them. If someone close has died, you’ve been traumatized, if you’re dealing with a toxic work situation or dysfunctional family relationships–medication won’t change these. Even though the medication might help you (and it can), you need tools and skills for dealing with some of the overwhelming challenges of life. And sometimes you need the committed, unconditional support of another human being. That doesn’t come from a bottle.
But even when medication is helpful, there are things to watch for.
Challenges and cautions with psychoactive medication
There are a number of bumps and potholes on the road to recovery using psychoactive meds, and some of them are very big.
All medications have side effects, and so there is always the need to determine if one can live with them. The person affected has to make this decision. Early on I decided to educate myself. I don’t put drugs in my mouth that I haven’t looked up on the web and read about. I discuss with my doctor what I should expect from the drug, and what to watch out for.
It’s never possible to know exactly how someone will respond to a drug. It may seem weird for your doctor to say “let’s try this and see what happens”, but looking carefully at exactly how your system responds is just what both of you should be doing (my opinion, based on my experience only). There’s not a single medication that’s perfect for everyone who has a condition, it seems. But there may be one (or a combination) that’s right for you. I’ve (fortunately) never had a doctor who isn’t careful about monitoring what’s going on with me. The brain is incredibly complex and what we know about it is still very limited.
Telling the truth
I always encourage my clients to make full disclosure to their doctors. This includes everything they are taking, as well as all of the symptoms they are experiencing. Everything you hide from your doctor could turn out to be important in her/his decision-making process. The same thing goes with your therapist, by the way–if I don’t know what’s really going on, how can I know how to help? This might seem obvious, and it is, but you’d be surprised how many people keep things from health professionals. Or maybe you wouldn’t. 🙂
Dependence or addiction
One of the dirty little secrets of our day and age is how many people get dependent on or even addicted to prescription medications. And I’m not just talking about narcotics, although that problem is huge. Many medications are habit forming, or even addictive. I want to know how difficult it will be to get off the medication, if I no longer need it. Also, will I develop tolerance and need more over time? How high is the risk that my use of it can become abuse? These are important practical questions for a patient to ask.
Who is prescribing?
I want to be careful here–any doctor is legally permitted to prescribe psychoactive medication. But you wouldn’t ask your family doctor to administer chemotherapy or take out your gall bladder, would you? That’s why there are specialists. For my mental health care, I want to see a psychiatrist (a doctor who specializes in mental health) or a psychiatric nurse practitioner. You might even want to find one who specializes in your particular problem. There are hundreds of psychoactive medications. I feel it’s not fair to expect my family doctor to keep up with the latest research on mental health treatment. When I go for help, I want someone who specializes in mental health to evaluate my situation and treat it.
How can I tell if my medication is “right” for me?
Well, how do you feel? The “right” psychoactive medication for me is one that brings me to more normal balance and normal functioning. Here’s a question: When you’re on it, do you feel “more like yourself?” Or do you feel odd, unbalanced, less controlled? You could keep a journal of your symptoms day-by-day, and take it to your next appointment. Getting your partner or friends to carefully observe and note any changes in your behavior also might help you answer the questions. Bottom line is this: It’s your life. You have to be the judge of what’s happening. Take all this information to your medical professional, educate yourself, and get better.
[More information on any prescription drug can be found at drugs.com