To come off medication or not?

Is stigma driving your decision?

Dear readers, I have been sick as a pup this week with Bronchitis and everytime I try to write, I can’t. So, I’m hoping you’ll forgive me for surrendering to the sickness and lazily sharing an archive column of mine that was originally published in Life Magazine with The Sunday Independent. It’s as relevant now as when I first wrote it, and my recent podcast chat with Millie Mackintosh - where we discuss the shame and stigma that still sadly lingers around what can literally save people’s lives - made me think of it.

Recently my husband asked me if I’ve given any thought to coming off my anxiety medication. (Up to date edit: And my GP just made the same suggestion the other day when renewing my prescription) I’m in two minds about it (hence thrashing it out here in a national paper, of course). On one hand, I’m curious to see how I’d fare; maybe I don’t need it anymore. I’ve come such a long way since my days were punctuated with panic attacks. On the other hand, I worry that despite my best efforts to address my anxiety in a most holistic manner, I might only be as good as I am because of the meds. What if I come off them and find myself engulfed by the anxiety again? Mostly though, I’m hesitant to come off them because I don’t think I’d be doing it for me. I’d be doing it so as to feel more socially acceptable.

I’ve been on my medication since 2014. At the time, I was in a black pit of anxious despair - a pit that was getting deeper and darker by the month - and try as I might, no amount of positive thinking or meditating or downward dogging was helping to lift me out of it. I needed the help of medication to get myself back on an even keel and only then would I benefit from all of the other things we turn to when we’re not feeling our best. Looking back, I wish I had done it sooner but at the time it was a very difficult decision to make.

I feared what people would think of me, and given how little we spoke about mental health difficulties at the time, and how they were portrayed on screen - the reserve of fictional characters who were truly falling apart or certifiably unhinged - that fear was valid. I still remember the look of disappointment on the face of the doctor who prescribed them for me; the doctor! The one person I thought would understand. I was almost asking her permission to suffer just a little bit less. I worried that a person dependent on happy pills was not at all what my boyfriend had signed up for (he’s now my husband so that was one worry I needn’t have grappled with). I worried that I’d bring shame on my family or that needing medication would somehow make me unemployable. I worried I would now be considered the ‘crazy’ friend or the ‘mental’ one. I worried that people would think I didn’t try hard enough to overcome it. I wasn’t ‘strong’ enough. I wonder, is it a human tendency or an Irish one to apply this badge of honour to our suffering? Why, if there is something that makes our lives easier, less painful or more manageable, are we so reluctant to reach for the life-raft? This martyrdom of mental health, the ‘just get on with it’ attitude, and the social implication of going on medication given the stigma that prevailed at the time, was a layer of additional anxiety I could really have done without.

Though it felt a lot like admitting weakness, I know now that confronting my reality head on and deciding that medication was exactly what I needed at that time was one of the strongest moments of my life. It might have looked like I was giving myself a free pass when really what I was giving myself was a chance. The first medication I tried made no difference whatsoever. The second - the one on which I stayed - made me feel even worse for the first while (this is common) but then, about six weeks into it, things started to feel a bit lighter. The permanent panic swirling in my stomach got smaller. The aches in my body softened. The physical symptoms lessened. It wasn’t a fix all by any means but with the help of medication, a light emerged at the end of the tunnel. From there, I was then able to do the work. And there was a lot of work to be done, all of which was then chronicled in my books and podcasts (and now this Substack too). Once my body had regulated to some degree, I immersed myself in understanding how and why this anxiety came about in the first place. I made lifestyle changes, I went to therapy - cognitive behavioural therapy in particular. I switched from high intensity exercise - which drove my heartrate up making me feel more anxious - to resistance training which worked better with my nervous system (it’s different for everyone but anything that activates the parasympathetic nervous system is always a green flag in my book). Through trial and error, I learned what helped and what didn’t. Like spokes on a wheel - one spoke being the medication - I put myself back together and eventually I crawled my way out of that hole. And now I’m okay. I’m really okay (up to date edit: minus the small matter of being consumed by worry for my son but I myself am okay now.)

While the stigma has lifted somewhat, it’s still there. I can see it in the DMs I get on Instagram from those who think they might benefit from medication but are stopped in their tracks by the fear of what other people would think, their words weighed down with embarrassment and shame. But in fearing what others think, and letting that guide our behaviour, we serve only to stigmatise ourselves. We focus on what our anxiety says about us, when we should be more concerned with what our anxiety is saying to us. Of all the learnings and changes, the hardest thing for me has been swapping out this outward concern for inward support. Swapping that shame and self criticism for self-compassion. I wasn’t weak, I was brave. I didn’t cop out, I took action. I can come off my medication if I’m curious or I can stick with it. I can also come off it and go back on it if I feel the need. Whatever I do, I just want to make sure it’s an inward and not an outward decision. It’s not what it says about me, it’s what it does for me.

How do you feel about medication. If you take it, are you quiet about it? Why is that? If you don’t take it, how do you perceive those who do? Do you feel pressure to only be on it for a short while and then be ‘fixed’? I’d love to chat in the comments.