A Girl’s Guide to Mental Health Medication

Disclaimer: I am not a doctor. My information comes from research and my experiences as a patient. Be sure to talk to your doctor about any medications you’re considering for your mental health!

I was eighteen when I started taking Lexapro for my anxiety. I still take Lexapro today, plus two more medications for my mental health. Clearly, I’m not someone who balks at the idea of medication for mental illness.

But depending on where you live or who you hang out with, you may have heard otherwise. Some people believe needing medication makes you “weak” (it doesn’t), that mental health medications aren’t safe (they are) or that taking medication will change your personality (it won’t).

While everyone is entitled to their opinion, it’s my opinion that my mental health medications saved my life and gave me the boost I needed to start working on my mental health. That’s why I support movements like #WearYourMeds — and why I’m writing this post to educate you all about mental health medication. (Remember: I’m not a doctor, and you should never start a new med without talking to your doc first!)

Why People Take Medication

People take medication for mental illness for a variety of reasons. When it comes to anxiety, many people say that meds “take the edge” off just enough to allow them to use their therapy skills to calm themselves down (this was the case for me when I started Lexapro). Or, someone with depression might find that medication gives them more energy, allowing them to take part in more positive activities throughout the week (this is also the case for me and my two other medications).

Medication is often associated with severe cases of mental illness, but you don’t have to be hospitalized or incapacitated to need or want psychiatric medication. So, when should a person start to consider taking medication for their mental health? There’s no simple quiz you can take to determine if you need medication, but here are some situations where medication might be necessary:

  • To stabilize acute symptoms (i.e. while in the hospital, while suicidal or when having a panic attack)
  • To treat conditions that are resistant to other types of treatment, like talk therapy
  • To treat conditions where medication is the first line of treatment, such as schizophrenia
  • To treat patients who feel they need additional help beyond therapy
  • To counteract the side effects of other psychiatric medications (for example, Wellbutrin is sometimes prescribed to counteract sexual side effects of SSRIs)

Even if you have a therapist, a doctor (as in, an MD or a DO) is the only person who can prescribe medication, whether they are a psychiatrist or your primary care physician. Make a doctor’s appointment to chat if you’re curious about starting psychiatric medication — I’ll offer tips on talking to your doctor about psych meds later in this post!

Types of Psychiatric Medication

When you decide to talk to your doc about starting psychiatric medication, there are a host of different types of medications they might mention during your conversation. I recommend researching them in advance, so you’re at least aware of what the different medications are for your condition. To get you started, I talk about some of the most common types of mental health medication below:

Selective serotonin reuptake inhibitors (SSRIs) work by inhibiting, or stopping, the reuptake of serotonin by neurons, so more serotonin is available in the brain to make you feel happier and healthier. SSRIs include Lexapro (escitalopram), Prozac (fluoxetine) and Zoloft (sertraline). They’re frequently prescribed to treat depression and anxiety.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) work the way SSRIs do, but they block the reuptake of another chemical called norepinephrine in addition to serotonin. SNRIs include Effexor (venlafaxine), Cymbalta (duloxetine) and Pristiq (desvenlafaxine). They’re frequently used to treat depression and anxiety.

Antipsychotics are prescribed to treat psychotic symptoms, yes — but they’re also prescribed for a host of other reasons. For example, antipsychotics are also prescribed to treat bipolar disorder, and as a supportive therapy for depression alongside traditional antidepressants (that’s why I take one!). Antipsychotics include Abilify (aripiprazole), Seroquel (quetiapine) and Risperdal (risperadone).

Other drugs used to treat mental illness include atypical antidepressants (like Wellbutrin/bupropion), BuSpar/buspirone (used to treat anxiety) and Lithobid/lithium (used to treat bipolar disorder).

Talking to Your Doctor About Medication

If you’re contemplating starting medication for a mental health concern, your first step is to make an appointment with your primary care physician or a psychiatrist. They do not have to be a specialist: as long as the clinician has a medical degree, they can prescribe psychiatric medication.

But talking to your doctor about something as sensitive as mental health medication can be scary — which is why I’ve compiled a list of tips to help you talk to your doctor about medication:

  1. Write down what you want to say. If you’re anything like me, you might rehearse what you want to say for an hour, only to forget it the minute you get to the doctor’s office. Write down what you want to say, and especially any questions you want to ask, to prevent this effect.
  2. Explain why you think medication is a good idea. Remain calm and rational (or as calm and rational as possible), and get specific. Explain yourself in clear, concise terms. For example, you could try saying “I’m ready to try medication for my mental illness” or “I want to know if mental health medication is an option for me.”
  3. Communicate with your doctor. Your doctor will likely have their own opinions about what is best for you and your mental illness. Listen to them, but don’t be afraid to communicate with your doctor. If you’re confused or not feeling heard, say so. If they want to put you on a medication you don’t want to be on, say so. When we don’t communicate, we prevent ourselves from getting what we want without even giving others the chance to help. So, make sure you are open and honest with your doctor about what you want. This is YOUR health — be an active participant in it!

How to Advocate for Yourself at the Doctor’s Office

Earlier today, I experienced the scenario that those of us with chronic health conditions have nightmares about: my doctor didn’t believe me.

The doctor-patient relationship is one of the most vulnerable relationships you’ll ever have, especially if you have a chronic health condition that requires long-term care. So, when you bare your soul to your doctor, it can be incredibly painful when they don’t understand, validate or truly hear what you’re saying.

In the past year, I’ve seen 5+ doctors, including multiple specialists (both GI and OB/GYN), for my IBS. That doesn’t even include my mental health issues, which have warranted visits to the doctor, psychiatrist and multiple therapists. Still, it never fails to shock and hurt me when my doctor isn’t on my side.

Unfortunately, as someone with an emotional support animal (not to mention invisible health conditions), I know all too well what it feels like to be dismissed by your doctor. With so many people abusing the ESA designation these days, it’s become harder and harder to find a provider who is willing to advocate for you in this sphere of treatment.

If anything good came out of this journey, however, it’s that I learned how to advocate for myself in the medical system. I had to fight to get my ESA dog, Chandler — and it’s been one of the most meaningful and rewarding experiences of my life.

As Amy Kurtz writes in her book Kicking Sick, you are the only person responsible for your health — and you must become your own best advocate. Here’s how to do just that, based on my personal experiences with chronic illness.

Do your research.

As someone who’s done her time at the doctor’s office, it still surprises me how many docs don’t know the latest research.

I don’t say this to sound pretentious, but rather to point out that your doctor is human. Too many people make the assumption that their doctor knows more than they do — but just because you don’t have a medical degree doesn’t mean you can’t conduct your own research.

The key to successful medical research is knowing how to distinguish a credible source from a lousy one. Thankfully, I learned a lot about research as a Political Science minor, so I have plenty of tips and tricks to share! For starters….

  • Not all websites are created equal. Sites like Healthline and Web MD are infamous for a reason. Sites like these will leave you thinking you’ve got fatal cancer after reading two paragraphs, when all you’ve got is a head cold. Instead, opt for sites that end in .edu, or ones affiliated with a major hospital. Mayo Clinic and Harvard Medical School both have great blogs that provide credible medical information. On the other hand, avoid Wiki sites like the plague: anyone can edit these sites, meaning not all the information on them can be trusted (no matter how authoritative they may seem).
  • Learn to read scientific studies. If you’re not a doctor or don’t have an advanced degree, most journal articles simply aren’t written with you in mind — but that doesn’t mean you can’t garner useful information from them. Once you learn to look past all the medical jargon and decimal points, scientific studies can be one of your most valuable sources of information as a patient. Check out this step-by-step guide from Huffington Post for a detailed explanation for the non-scientifically minded.
  • Check yourself before you wreck yourself. Before putting too much stock in the latest study, double-check two things: first, what was the sample size of the study? A sample size (represented by the variable ‘n’) tells you how many participants were involved in the study. Needless to say, a study of 10 patients yields less credible results than a study of 10,000 patients. Second, were the results statistically significant? This is the reason scientists include a column of ‘p-values’ in their reports. A minimum value of p<0.1 is required before a study’s results are considered statistically significant (which is basically a fancy way of saying that they’re legit), so keep an eye out for this value before you bet your life’s savings on the latest miracle cure.

Come armed with questions.

If you’ve ever been diagnosed with a chronic condition, you know how questions can crowd your head like a school of fish, leaving you laying awake at night tossing and turning. Yet when you visit the doctor’s office, your mind goes completely blank! How does this happen?

When you’re not prepared, you might forget to advocate for yourself, despite the best intentions. That’s why I always suggest writing down the most important questions as you think of them. I keep a little notebook in my purse to jot down questions for my doctor whenever they pop into my mind. Saving a note in your phone works, too!

Just remember the golden rule: there are no stupid questions, especially when it comes to your health. Chances are, your doctor has heard them all before, so you should never feel ashamed to ask. If you do, that might be your first sign that your doctor may not be the best fit for you and your needs as a patient!

Still stuck? Questions you might want to ask your doctor about your condition include:

  • What is my diagnosis?
  • What are my treatment options?
  • Why do I need this treatment?
  • How do I understand my test results?
  • What are the side effects of my treatment?
  • What lifestyle changes should I make to support recovery?
  • Are there alternatives to my current treatment method?
  • How many times have you done this procedure?
  • Will this medication interact with my current treatment?

To build your own list of questions for your doctor, the Agency for Healthcare Research and Quality has a helpful Question Builder that will compile a list of questions for you to print and bring to your appointment. It even includes lines for notes beneath each question on the page so you can write down your doctor’s answers!

Suggest tests.

When I first suspected I had a gastrointestinal health condition, my mind immediately flew to the million-dollar question: IBS or IBD? There’s a huge difference between the two, since one impacts your colon cancer risk and one doesn’t (among other notable distinctions).

That’s why I pushed my doctors to rule out IBD as definitively as possible. The first time I went to the doctor’s for potential IBS, I pushed for a C-reactive protein blood test used to diagnose IBD. When I saw my first GI doc in Boston, I asked about getting my fecal calprotectin checked. And when my GI doctor in Cleveland suggested an optional colonoscopy, I went for it.

Long story short, my doctor was able to rule out IBD and diagnose me definitively with IBS — in no small part due to all the tests I’d pushed to have done. To some, these tests may seem excessive, but as someone with a family history of Crohn’s disease, it was especially important to me to rule out IBD as completely as possible before settling on a diagnosis of IBS.

More than once, I’ve worried about appearing “pushy” to doctors, or seeming like a “difficult” patient. But at the end of the day, what’s most important is your health — so, do your research and don’t be afraid to push for a test if you think you really need it.

At the very least, ask questions. If you’re curious about a test you read about online, bring it up casually at the doctor’s office and feel out their opinion on it. Should you find that your doctor is opposed to a test you think you really need, that might be a sign that your doctor isn’t the best fit for you and your chronic health condition after all.

Get a second opinion.

Doctors aren’t like partners. You aren’t “cheating” on your doctor if you decide to get a second opinion!

When you suffer from a chronic health condition, the doctor-patient relationship is important — but what’s most important is making sure you have the most comprehensive healthcare possible. If you find that your current doctor isn’t working for you, or says something about your condition that just doesn’t sit right, there’s no harm in getting a second opinion. Any doctor who is threatened by the idea of a second opinion probably shouldn’t be a doctor in the first place.

And look, I get it. Getting a second opinion can feel “dirty,” especially if you have a good relationship with your current doc. But think of it this way: the best case scenario is that you find the perfect doctor for you and switch to your new doc with zero regrets. The worst case scenario is they confirm exactly what your previous doctor said, and you have to choose whether to continue with either of them or get a third opinion instead.

The way I see it, this is an ideal worst case scenario — after all, no one gets hurt, and you won’t be jeopardizing your health either way! But if there’s anything I’ve learned in my journey through the healthcare system, it’s that you should always follow your instincts.

If you sense something is wrong with your health and your doctor won’t listen, you owe it to yourself to take your health into your own hands. In the doctor-patient relationship, YOU are the employer — so, hire and fire accordingly. You wouldn’t stay with a shitty boyfriend, so why stay with a shitty doctor?

Want to get a second opinion, but aren’t sure where to begin? Check out The American Cancer Society’s guide to getting a second opinion for helpful tips and conversation starters on when and how to get a second opinion.