Many people ask me if they should consider medication to help with symptoms of mental illness, such as anxiety, depression, or difficulties with sleep. Others let me know that they do not want to ever be on medication, because they don’t like the idea, or because they were once on medication and didn’t like how it made them feel. Some people have concerns about medication being overprescribed and being promoted by the pharmaceutical industry to make us believe that we are sick and dependent on them.

Medication can be a polarizing issue. Sometimes people feel that if they take medication they’ve somehow failed in life. Other’s have concerns about side effects or ‘being on it forever.’ Many people believe that medication is the first thing you should go to if you are having any symptoms of mental illness.

Here are 5 times that I might recommend individuals talk to their doctors to see if medication might be appropriate for them:

1. When the symptoms of mental illness are putting an individual at risk of harming themselves or others. 

If someone is suicidal, and is at risk of ending their own life, or having thoughts to harm others, medication may be warranted. If that person is you, you and you contact your doctor or go to a hospital, you will likely receive a mental health assessment. If you are offered medication, you may need to consider what is at risk if you take it versus if you don’t. Also, remember that taking medication does not necessarily mean that you will be on it forever. 

NOTE: If you are with someone you believe to be at risk of harming themselves or others, call 911, or if the person is willing to talk to someone contact the suicide crisis line (in Manitoba the Suicide Line is toll free 1-877-435-7170).

2. When an individual is using other substances to manage symptoms of anxiety, depression, or other mental health symptoms, and these substances are causing problems in life. 

If you are using alcohol, cocaine, crystal meth, or any other street drugs to manage anxiety, depression or hallucinations, you may be inadvertently causing other physiological, emotional or relationship issues. In these cases, if medication is recommended to you and you are unsure about it, you might consider the fact that by taking street drugs, you are already self medicating, but without the research to back up effectiveness (anecdotal evidence does not count as research). You are also doing this without being monitored medically and are using un-regulated substances which may have ingredients and effects that you are unaware of. 

However, your doctor may recommend that you not take any medication until you have been completely free of alcohol or substances for a time, in order to assess which of your symptoms are attributed to these substances. To get help with addictions to alcohol or substances check out the Addictions Foundation of Manitoba. 

If you are using street drugs, a lot of alcohol, or prescriptions which are not prescribed to you, be honest with your doctor about what you are using, the amounts and frequency of use. You will put yourself at risk if your doctor is unaware of this before prescribing you medications. 

3. When an individual does not have the skills to manage their symptoms and cannot access the resources (such as counseling or other treatment) that would be helpful.

Sometimes, life circumstances means that you are stuck, for the time being, in an environment that is not supportive of your mental health needs.

I strongly encourage you make choices that help you to get what you need for the sake of your own health. Here are some are online resources that can help, when you can’t afford counseling or can’t get out to a group or to an appointments. 

(See Mood Disorders of Manitoba, Anxiety Disorders of Manitoba, Manitoba Crisis Services, Manitoba Schizophrenia society for a few resources).

4. When an individual has the skills to manage their symptoms, but is unable to use them because the symptoms are too strong. 

Sometimes this happens due to a crisis, a change in physiology, or some other unknown reason. At these times, medication might be helpful to lesson the symptoms enough so that you can re-activate your coping skills. 

5. When an individual is using their skills, but they are no longer effective in managing their symptoms.

Perhaps you have support, information, and a counselor working with you to manage your symptoms and nothing seems to be helping. Medication may be helpful to get symptoms back under control. 

 

Here are some times when I might not suggest looking to medication right away:

1. When someone has been avoiding the tools, exercises or skills recommended to help them to manage their symptoms. 

Pay attention to the severity and changes in symptoms and communicate to your doctor and/or counselor about what you are experiencing. Also let them know what you have and have not tried to manage these symptoms. Sometimes you might need to consider using tools, exercises or skills that you might have avoided using for some reason. For example, if you have panic attacks related to driving and have been avoiding working on the steps to reduce these triggers, taking medication will not resolve the issues in the long term. Medication may be necessary for you to be able to function, until you are ready to risk trying the activities or exercises recommended, but see if you can bring yourself to take a step towards doing the tasks that may help you.

2. When experiencing symptoms which are developmentally normal, or considered a non-pathological response to a major event, trauma or crisis. 

If you are not in a hostile environment and are not at risk of harming yourself or others, medication may not be necessary. If you are experiencing symptoms that are ‘normal’ considering the event, then, learning to process, get support, and support yourself through this time can build your resilience and enable you to becoming healthier.

3. When you have not yet acquired information or support needed to manage your symptoms.

Start by talking to a counselor and/or trying some of the online resources listed previously. If your symptoms are not causing major disruptions in life, you might try these other things first before asking your doctor about medication. If you are unsure, of course you can always ask your doctor for recommendations and let them know that you are willing to try counselor or other things first, or in addition to any medication they might recommend.

4. When your symptoms are exasperated or caused by the situation you are in.

For example, if you are in an abusive relationship, workplace or school situation, don’t hesitate to reach out for support in getting out and/or addressing the situation. (For domestic violence situations in Manitoba, you can contact Stop the Violence). Taking medication will not change your situation, however, if your symptoms are preventing you from being able to make the changes needed to improve your mental health, talk to you doctor about your situation.

 

If someone is taking medication for mental health issues, such as anxiety or depression, it is always recommended to get counseling to learn skills to manage symptoms such as panic attacks, low mood, overthinking, etc. If you are not taking medication, and your symptoms are feeling unmanageable, counseling is also recommended. 

Medication has its limits. It will not provide a healthy environment, social support, the tools to manage difficult situations, or to heal from major crisis or traumatic events and should not be solely relied on for these things. 

Whatever you choose to do about the medication question, keep doing the things that you know will help.

• Get outside.
• Connect with those you love.
• Take time to be creative.
• Re-evaluate your stressful schedule.
• Check if you are living your values.
• Learn conflict resolution and communication skills.
• Take deep breathes.
• Increase your repertoire of coping mechanism, get more information about how to manage your symptoms, and any diagnosis you’ve received.
• Take care of the things you’ve been avoiding.

For more on caring for your mental health check out:

What do You Really Need? – A 6 Step Complete Self-Care Assessment Guide and

Depression Vs Grief – When You’re Down

Also check out A Good Time to Panic

And ‘Chronic’ – 5 ways to Increase Coping Skills for Chronic pain and/or illness