Mental health stigma goes hand in hand with medication adherence. Just as depression is often looked at as a weak, taking pills to stabilize is looked at as “a moral failing”. As if we human’s don’t have enough of our own critical inner voice to listen to, we have to listen to other’s criticisms too.
Pill shaming can create dysfunction and difficulty in those who need stabilization.
It takes courage to reach out and ask for help. Taking psychiatric medications and experiencing regular therapy with a helpful therapist is what keeps a lot of people stable and living their best lives.
There is tons of misinformation out there about psychiatric medication and it can be just as controversial as vaccines. Just because psychiatric illnesses aren’t visible doesn’t mean it makes it less of an illness.
Where I stand on Pills
In today’s world it’s easy to be polarized. Whether you’re a “raving republican” or a “push over democrat”. This is how I feel about our psychiatric and health care in general. Pill shaming is not okay, just as thinking you’re “too good” for medications is not okay. When people need it, they need it. They can be happy, healthy, and on medications. They could eat clean, exercise well, and still need medication. Every single person is different, and their needs are different.
I believe in the power of nutrition, the strength of a healthy lifestyle, and medications. We need more balance in our lives as we all deserve the best of both worlds.
Medication Adherence
There was a study completed that showed only about 50% of people with schizophrenia took their medication as prescribed and followed their treatment regimen. Another study showed that only about 10-60% took their antidepressant medication as prescribed.
There were multiple reasons for these low statistics such as forgetfulness, financial reasons, side effects, and/or inconsistencies. Treatment adherence is one of the most difficult challenges I face as a psychiatric nurse practitioner with my patients.
There are multiple reasons for issues with treatment adherence.
1. “I don’t have a problem”
Denial is common. A lot of people have lived with their illness for so long they aren’t sure what life could be like “stabilized”. The dysfunction in their lives can seem normal after so much time.
Some feel like once they start taking medications it’s a sign of failure and/or weakness.
These thoughts when it comes to diabetes or high blood pressure are very different. Physical ailments are less “stigmatized” because it’s often objective. You can see the abnormalities on a screen or cuff.
Mental health stigmatization leads to cycles of shame and can leave people feeling isolated and alone.
2. “I feel better, the medication fixed it”
Severe mental illness often needs continued management especially in illnesses like schizophrenia and bipolar disorder. Medication compliance is difficult if someone is “feeling better”. This leads to cycles of feeling better and then destabilizing.
For instance, when hallucinations stop, some feel like they are cured. These are lifelong illnesses that need constant supervision and maintained. Symptom free doesn’t mean “cured”.
3. “I don’t have the money”
Some insurance companies provide mental health coverage, and some don’t. Those without insurance often can’t afford the care they need. Some feel like having a diagnosed mental illness could jeopardize their job.
These are horrible and true realities of those who struggle with mental illness.
4. “The side effects are worse than the symptoms”
Common side effects include tiredness, dizziness, drowsiness, a decrease in libido, insomnia and there can be more/different ones depending on the medication.
These can deter those who are already unsure if they should be on medications. It takes time for the medication to work and it can cause terrible side effects if stopped abruptly.
But this is why having a good prescriber that you can be open and honest with is essential.
5. “Feeling ashamed”
Mental illness is looked upon as a weakness while mental illness is often viewed as “not someone’s fault”. There are so many misconceptions that if you take medication for psychiatric reasons you’re “crazy”. This is not the case.
Pill shaming HAS TO STOP.
Pill shaming has caused so many people to destabilize and not live their best lives. It’s unfair to assume weakness. There is nothing wrong with working to rebalance your brains chemistry.
What is Pill Shaming?
The people who say “change your diet”, “You’re not trying hard enough”, “Pills are for the weak”. My favorite is “my spouse told me I need to meditate more”.
While many coping skills, eating well, exercising, and tons of other things that could help with symptomology can help, it often can’t fully “cure” mental illness.
Shaming someone by expressing negative opinions about being on medications is shameful and unnecessary. Those who need it, need it because they aren’t functioning well.
Psychotropic medications are fixing chemical imbalances and helping neural circuits communicate more clearly. Those who pill shame often don’t understand what the diagnoses mean for those living with mental illness. They don’t understand the science and it’s not okay to shame someone for something that is not understood.
The Nut Shell
Treatment can help end symptoms, restore quality of life, and allow you to feel healthy again. It requires multiple levels of healing sometimes including mental health medication.
Mental illness is not a moral failing and it doesn’t only affect the “weak”.
So those who need medications should be allowed to live as they wish, be supported for facing their illness, and feels as healthy as they possibly can, despite the comments from the narrow minded.
Here are some things to remember:
- You are not weak for reaching out for help.
- You don’t need to justify what you and your doctors have decided is a path to keep you stable.
- Don’t listen to your own critical inner voice or anyone else’s.
- Pill Shaming is not okay.
- While there is a lot of distrust of pharmaceutical companies, they are there for a reason. So work closely with your doctor to find the best fit.
- You deserve to have your anxiety, depression, schizophrenia, mania, etc. managed. You’re not alone.
- Educate yourself and talk to those who have had an educational background in mental health.
- Don’t be afraid to reach out. Your life matters, every single aspect of it.
Talk soon,
Sarah
Here’s an article on mental health stigma if you’re interested! Click here!
