Every morning I wake up, and I face myself in the mirror at my medicine cabinet. Behind that mirror are three medications I take daily: one antidepressant, one antipsychotic, and a benzodiazepine.
I wake up, look in that mirror, and often ask myself who I am?
Not out loud, but it murmurs in the background. I say a positive affirmation out loud and tell that face in the mirror; I love you.
And then I take three brain-altering drugs.
There are several ways a person ends up taking psychiatric drugs.
Physician
Psychiatrist
Therapist
Emergency Room
Community Clinics
How a person ends up at the physician's office or ER depends on several factors. We can identify when we are down, we are well versed in the warning signs for depression, we know where to get help, and we trust that help.
A person can take themselves to the ER, and so can the police. A person can "voluntarily" admit themselves, or they can be "involuntarily" admitted. These distinctions are in quotes because they have different implications for the admitted, both in personal and legal ramifications. The experiences of people of color and others without resources tend to fall into a confrontation with police that ends unsatisfactorily for the person needing help.
Another use for antidepressants is off-label. For example, Elavil is an antidepressant used for managing pain. And benzodiazepines are prescribed to manage Parkinson's symptoms.
And Then There are Women Like Me
In 1991, I had my first baby and experienced acute anxiety postpartum. It's been thirty years as of this writing when I saw my ob-gyn about my symptoms. He referred me to a psychiatrist who diagnosed me with Postpartum Anxiety.
I had experienced anxiety before a few times in my life for understandable and identifiable reasons.
For example, after my parents divorced when I was 13, I became a bit of a handful, as you might imagine. So for my sake and my mother's, my parents sent me to sleep away camp, a place I'd never been. I left behind good friends for the summer, and I felt like I was being sent away, not being given a fun experience. Situational anxiety is not uncommon.
I also recall experiencing anxiety starting my first year in junior high school. I wasn't a great student, and I wasn't great at making friends. Again, this is what I call normal anxiety for the situation.
Heck, I had anxiety leading up to my wedding day. We call those wedding day jitters. All normal.
The anxiety I experienced after my firstborn was acute and included panic, usually in the middle of the night. The psychiatrist started by prescribing Klonopin, a benzodiazepine. It took the edge off the anxiety during the day and ended the panic attacks. I would check in with him monthly in his office.
Around two months postpartum, I started to feel better. I went with my son to Baby and Mommy classes at the local Y. I made friends with a great group of women, all with new babies. We socialized as moms and couples and shared our trials and joys. And with my sister and her babies nearby, life couldn't have been better.
A Good Cry
I was a full-time teacher, and I returned to work happily. I honestly don't remember what had happened at work the day I went to see my psychiatrist for my monthly visit. But, I had a good cry in the office about it. And at the end of the session, my doctor asked me to consider a different medication type to address the broader symptoms he "suddenly" saw.
A woman in his office, crying about a difficult day at work, still breastfeeding and full of postpartum hormonal and emotional stresses of a new baby, recently returned to work for the first time since having her first newborn. That is the holistic picture, but psychiatrists are not trained to look beyond identifying disorder to circumstance, culture, or environment.
Disordered bodies are their bread and butter, and, dare I say, jam!
I grew up during a period of extreme trust in medical professionals. I could put my finger on my discomfort. I didn't want to be like my mother, who had a lifetime prescription for Valium and then Klonopin, but I had no idea how not to, though.
When you go to a specialist, you expect them to look for red flags in your health that is backed by science and medicine . . .
Not backed by the pharmaceutical company's educational and marketing materials for prescribers. Doctors are repeating tropes to their patients taught to them through the pharmaceutical companies. Worldwide, patients share on support forums they were told to consider antidepressants like insulin for diabetes and expect to need them for life. Being a lifelong user is an easy way to avoid withdrawal, which is getting negative attention now.
My psychiatrist found a problem with my mental health because of my emotional reaction to a work situation. He said a neurochemical imbalance caused my symptoms-- crying at work and in session afterward was apparently too much emotion.
But I wasn't depressed; I was emotional. And this is the problem with psychiatry. Someone else is the judge of your emotional health, and they have a BIG BOOK of DISORDERS. Known as the Diagnostic and Statistical Manual of Mental Disorders, it provides a tidy label and prescription to go with it.
In this scenario, it is easy to lose self-agency unless you are balanced and grounded in your life. And who goes to a psychiatrist feeling balanced and grounded? I never thought to ask how we went from postpartum anxiety to a depressive disorder. My PPA diagnosis was never discussed and, my adult life had become entrenched in this "disorder for everyone" biomedical model.
Tomorrow, I will wake up and face myself in the mirror at my medicine cabinet. I will take one antidepressant, one antipsychotic, and a benzodiazepine.
I look forward to the day when psychiatrists, at minimum, provide informed consent.
No one should ever be given psychiatric drugs without knowing the dangerous and life-altering side effects and horrific withdrawal possible when following doctors and pharmaceutical company guidelines. Patients should be told the drugs are difficult to stop, and providers should offer a safe strategy like tapering strips for safe reduction. (Tapering strip | Responsibly reducing your medicine intake)