pill shaming

My first fifty milligrams…

wp-1603464946144.jpg

50 mgs of a drug,

A drug that i have been prescribing without a second thought or hesitation to so many of my patients since almost 6 years now…

50 mgs of a ssri ,a drug which i remember my father taking when i was a baby and getting back to his normal chirpy self,20 mgs of its brother drug which my mother has been taking since long.

50 mgs of an ssri aand here i am questioning my ability as a mental health professional,or is it a part of my illness?

i ponder i procrastinate,i suffer even after knowing that this might help

i delay,i think ,i judge myself,

50 mgs of an ssri for the first time and i feel low about it,it is a sinking feeling,most probably a symptom of my illness

june 2020 i take my first 50 mgs of ssri,and i feel ,empathise and understand all those peoples plight,who hesitate taking psychotropics ,who refrain from opening up about it ,and suffer for longer they could,this pill shaming runs deep,it is embedded deeply,difficult to overcome and uproot …

1066772-common-causes-of-depression-5ae727a7875db900375789d5-1

pill shaming can be defined as the negative reaction and responses that one receives when they are taking medications

it is usually seen with mental health issues or menstrual issues,i would restrict this blog to psychotropics…

so why is it there and why do we justify it?

  1. IGNORANCE: many of us including myself minimize our distress,invalidate our feelings of despair and say to ourselves ‘ah this happens to everybody”it will get better on its own’ ‘it is not severe enough ,that i need to take meds’ ‘my distress is not that bad that i warrant taking medicines’ well i know how it feels,especially when your judgement is clouded ,i fortunately had my mother and reliable seniors who helped me get over my procrastination and reservations related to being on medicines.
  2. within the mental health community,mental health professionals at times themselves engage into pill shaming, majorly psychologists and alternative therapists(not at all generalizing,i have my share of very good and aware psychologists) and they believe ,that since the medicines did not work very well for them,or some other modality worked better,it is not the right path for anyone else,on the other hand due to the stigma associated with mental illnesses ,people who have genuinely benefited with pharmacotherapy do not open up about it.
  3. Within the medical fraternity as well,people consider psychiatry to a non scientific or vague subject,even though recent advances and studies prove that apart from environmental and psychological factors,biological causes of mental illnesses are equally or even more important,

download (1)

  • for example like there is insulin resistance in diabetes,similarly in depression the neurotransmitter serotonin has deficient levels in the brain,and just like giving insulin injections,diabetes can be put under control ,giving antidepressants can help in treating the biological etiology of depression, like stress can aggravate diabetes ,it can affect the mental health as well,like exercising and dietary changes  help with mild insulin resistance,similarly they might help with mild depression and anxiety symptoms as well,when we are diagnosed with diabetes,we get conscious about everything and take our medicines regularly,because we are well informed about the ill effects of not taking the meds and the effects are clearly visible and evident,but for mental illnesses we take a different approach,just because it is not visible and we are not well informed about the adverse effects it can have on our quality of life
  • on our work and functional efficiency
  • Our physical health and immunity 
  • our relationships and social standing
  • it can led to life threatening events like suicide

effects of pill shaming:

  • the lag between the onset of distress and treatment is increased massively ,we delay seeking help,the solution to it is reaching out to people you trust,seeking professional help and letting the experts decide along with your agreement on what will be the correct line of treatment,ask questions whenever in doubt.we as mental health professional are already trying and will keep trying to reduce the stigma and burden of mental illnesses from our side.
  • once starting,we hurry to taper or adherence to medicines is poor,which can lead to frequent relapses,solution to this is again asking your doctor,till what time you will have to take the medicines and reminding them to taper it when they and you feel it is right.
  • people often have to struggle with negative beliefs about themselves,thinking they are ‘less than’ if they have a mental illness or if they need medications,these feelings feed shame,it makes people feel alone and isolated.
  • talking about side effects ,they can be a powerful deterrent if someone is already ambivalent about taking medicines,often side effects subside once our bodies acclimatize to the medication,some might even persist.Like any other treatment the pros need to outweigh the cons,that i why we advocate holistic approach towards treatment,where both the patient and the doctor have a role in deciding the treatment plan,no doctor will ever force you to take medicines(unless there is a lack of insight and your life is at stake”
  • DEP_info_meds

These believes are pervasive  and deep rooted in our culture as a whole, but is even found in some self-help books or mutual-help support groups .It is never helpful to shame individuals struggling with mental health issues and to discourage them from getting help in the same way that they would for any other medical condition.

take home message

Treatment for mental health conditions can help end symptoms, restore quality of life, and allow you to feel healthy once again.Having suffered myself and getting much better on treatment i can vouch for this even more confidently now.Talk to your doctor ,discuss about your concerns and clear your doubts.It requires efforts ,patience and adherence from both sides.

Mental illness is not a moral failing or a lack of motivation and it doesn’t only affect people who don’t try hard enough or who are weak,Instead, mental illness is a chemical imbalance in our brains, and in order for us to not experience symptoms or active illness, we need to seek out and receive ongoing treatment.

It is okay if you have been reluctant about your mental health,it is okay if you have been resistant and biased again taking medicines,it is okay if you have procrastinated and questioned your doctor about the decision,be sure about it,clear your doubts,information(from the right sources) is the greatest tool to reduce anxiety,and please reach out, you are never alone,it is not worth this much suffering…

https://youtu.be/joquQNgtuzk

Ps:SSRI: Selective serotonin reuptake inhibitor


Joy and Sorrow

Pass it on and do return 

@vickykaushal09 se prerit
@sirphira_ghumakkad ke dwara vilambit

People turn to God, and spirituality, when they experience suffering,I did too,turned to Bhagwad Geeta 
Vishada means sadness or sorrow, and yoga means the state.(my interpretation)
The first chapter of Geeta is about Arjuna’ sorrow,and doubt,he was taken upon by grief ,grief of what lay in front of him,doubt about what is right and what is not.
Why was Arjuna filled with sorrow in the battlefield? Arjuna the mightiest warrior of all times,the learned disciple of Lord Krishna was sad?Did that make him any less courageous?

It was primarily because he was emotionally attached to his relations and family members . Attachment is a human value.People experience fear and anxiety at the prospect of losing something,in the prospect of seperation

Being human, Arjuna felt the same. His state of mind also revealed that he had preferences and biases in life. We all have likes and dislikes and Arjuna was not different. He had attraction for life and aversion to death. He identified himself with his mind and body, which made him feel vulnerable. Even if you have trained well under a spiritual master for long, in moments of crisis you may act like a normal human being and experience stress. It happened to Arjuna, although he too was well-versed in the knowledge of the scriptures and possessed the knowledge of the Self.

Sorrow is a modification of the mind,  books in Psychiatry have also mentioned mania of extreme happiness to be a defence mechanism against sorrow.

Being sad and anxious to little extent in crisis situations like these are normal.You are not alone.

I am not alone.

Being Sad at times is normal, giving up at times is normal,we are not sages ,we are humans.We feel therefore we are human.
If you study life carefully, you will realize that sorrow opens our eyes to the truths of our existence. It makes us reflective and introspective.it gives depth, compassion and empathy.
Stop judging yourself for giving up. Be kind to yourself.

Learning important lessons from the difficulties and sorrows in your life makes you wiser.
Karma does the same. It chisels our thinking and behavior.Trust the almighty,times are tough ,but we are not alone,We are all connected in a collective consciousness,We are all a part of Him ,he is a part of all of us,Rekindle what you have always had, rekindle your spiritual being,sit with yourself meditate,help others,serve others .
Spread love and positivity.
we are in this together ♥️.