Taking Medication is Just the Beginning

By Choo Kah Ying

Medication, counseling, and in serious cases, ECT – this is the conventional treatment protocol prescribed for mood disorders in psychiatry. Unfortunately, for sufferers who are resistant to taking medication, there is nothing more disempowering than thinking that your mind – the sanctum of your being – rests in the pills you hold in the palm of your hand.

However, through my experiences, I have found that this perspective is a grossly limited conception of the role of medication for the treatment of mental illnesses.
In reality, taking medication is just the beginning – your courageous admission that you need external assistance to help you get back on your feet. For those of you suffering from depression, or manic depression, medication can stabilise your moods sufficiently for you to think and feel well enough to get your life back in order. It provides a critical foundation for you to build on your treatment and recovery.

At the same time, it is important for you to adopt a realistic conception of the role of medication. In my consultation work and at my talks, many sufferers will lament about their lives on medication. For them, taking medication has not transformed their lives, nor has it helped them to resolve their problems and challenges. In their minds, these sufferers believe that popping their pills should transform their perceptions of themselves, others, the environment and the world into a bed of roses. Steeped in their struggles with their vacillating moods, they cultivate an idealised notion of normalcy that does not in any way resemble the lives of typical human beings. Then when they open their eyes and see that their fantasy has not come true, they declare with self-righteousness that medications do not work.

In my opinion, sufferers will most likely benefit from taking medications only when they let go of their fantasised notions about medication and its role in the treatment process. Medication does not make your life problems vanish into thin air. But what it can do is to enable you to see life with a realistic perspective. And it is likely that you would not like what you see; the picture of your life is probably fraught with challenges, paved with regrets and lost opportunities, and overshadowed by shattered relationships. But, this time, instead of letting your past drag you down, or trying to escape from it, embrace your fresh start and learn how to live.

For many of us who have spent most of our adulthood buffeted by the ups and downs of our moods, we would have to re-learn how to live life. However, armed with our new-found sanity, we can now properly survey the landscape of our life and reflect on the areas for change and improvement. Through our own initiative and assistance from friends, family and professionals, we can begin to:

 

Throughout the “reconstruction” of the new edifice of our life, we will get to know ourselves like a long-lost friend. We will identify our strengths and weaknesses, discover our passions and dislikes, and gradually move towards a life that is most true to our being.

As you can see, you are in charge of your treatment and your recovery. Your fate and your life do not lie in the pills, but in yourself. There is no magic pill that will enable you to manage your emotions, pursue a healthy and responsible lifestyle, or cope with life’s challenges without running away. You have to summon the courage to face your life head-on and fix it. Your effort is the story of your life and your journey will transform you into the best person that you can be.

Moreover, the long-term work that you do on yourself will not only optimise the effectiveness of the medication you are taking, but also put you on the road to an enhanced quality of life (with or without medication). Considering the side-effects of medication, thriving on a lower dosage or with a decreased number of medications can bolster your physical and mental health in the long term.

This is why I find the focus of psychiatrists on medication somewhat limiting and disempowering. In his article, “Mind Over Meds” (The New York Times, April 19, 2009), Dr. Daniel Carlat, a psychiatrist, acknowledges that contemporary psychiatrists’ preoccupation with treating mental illnesses with medication often comes at the expense of getting to know the patients and addressing their emotional distress. Apart from prescribing medication, psychiatrists should be empowering their patients by highlighting the many things that the latter can do to get their life back on track.

In public forums on mental illnesses in Singapore, which I have attended, I have also found that strategies to empower sufferers such as the pursuit of a healthy lifestyle and the acquisition of cognitive techniques are not sufficiently discussed. Instead, the forums are centred on highlighting the stigmatisation and suffering of the sufferers and their caregivers, with the reminder to seek professional help. Important as it is to highlight such issues, I feel that a proactive approach should also be presented and given an equal emphasis.  

As a former sufferer of manic depression, I have been on-medication and off-medication. Back in 1996, when I went on medication responsibly after five tumultuous years, I began to experience the semblance of a “normal” life that was not buffeted by dramatic mood swings. What motivated me to stay on medication were the products of my stable life – raising my autistic son, holding down a job and keeping a roof over our head. At the same time, I also established a health regimen of regular exercise and relaxation. After almost a decade of being a model patient on medication, I was able to wean myself off it. Nonetheless, I remain grateful for the medication that initiated me on the path towards my medication-free life today, which I have enjoyed for the last five years.

But I did not stop there. Once I was no longer distracted by my mood cycles, I looked further at my relationships and my life goals. None of the changes happened overnight; in fact, it took me several years to construct a new life filled with a sense of purpose, as well as nurturing and supportive individuals. Since my divorce that ended a ten-year marriage in 2007, I have managed to pursue a challenging life of homeschooling my son (my life purpose) and cultivating my passion for writing and educating, while making a living with editing work. Throughout all these life changes, I have persisted in adhering to an ever-evolving manageable lifestyle of physical exercise and mental relaxation. At the same time, I have continued my quest to identify healing methods and cognitive strategies to manage my moods.

My life is not perfect; nobody’s is. I view myself and my life as an ongoing work-in-progress. Like many others, I have my good days and my bad days. I have come to understand, and more importantly, accept that all the imperfections – when things do not go according to plan or my sense of justice – are part and parcel of life and humanity. It does me no good to disintegrate into hysterical outbursts and worse still, indulge in unhappiness.

Along the way, even as I shed my tears of disappointment and shake my fists at the heavens, I do not dwell on the bad things in life. I know that I cannot afford to let the bad days destroy my faith in the belief that good days still lie ahead. So on those bad days, I pick up the pieces of my disappointment, frustration and sadness; reflect on the lessons that I need to learn; forgive myself for mistakes made; and challenge myself to do better the next time. Thus, I am able to trudge on in my life, even in the face of devastating losses that knock me to my knees, the maddening days of battling with Sebastien, my autistic son, in his throes of puberty, and the constant juggling of doing what I love and making ends meet. With each passing day, I am living a life that is inching closer to my true self and learning to manage my life.  

So if you genuinely want to get better, adopt a realistic attitude towards medication. Medication does not make you feel wonderful every single day and transform the world into a perfect place. But it will give you that boost you need to take charge of your life and figure out what you are meant to do.

You are in control. The pills and the professionals won’t take that away from you, unless you choose to let it happen.

Are you ready to take on the responsibility for your life?