Messy Psychiatric Medication

1. Psychiatric medication helps many* people who take it.

2. Psychiatric medication has side effects.

3. Many of these side effects are unpleasant-feeling enough to cause people to decide that they would rather not take medication, or to make it prohibitively hard to take medication on bad days.

3b. I mean, really frustrating side effects. Like “this medication dulls all my emotions” or “this medication makes me totally disinterested in sex and is screwing with my ability to maintain a relationship” or “this medication is supposed to help me interact better with society, except that it gives me involuntary movements and people can be jerks about that.”

4. This means that some people don’t take their medication consistently. For instance, people with schizophrenia have some of the lowest rates of medication adherence. (How much nonadherence, exactly, is debated, with a range you could drive a truck, two Hummers, and a party bus through. 20% to 89%? Really?)

5. Tachyphylaxis, that thing where your medication abruptly stops doing anything for you at all, is deeply unpleasant.

6. It’s easy enough to tell if, for instance, you’re experiencing fewer panic attacks, or if the hallucinations are milder. It’s not particularly easy to tell if, say, your depression is lifting. Only around half of the people I’ve known who went on antidepressants noticed an immediate change in their mood—even as friends and family did. Meanwhile, the side effects were hard to miss.

*Disclaimer for everyone (including me) who flinched at this. It helps many, but not all.


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