When I Learned How Dangerous Medication Stigma Is
Four years ago, I went to a medical office to undergo psychological testing. After a short wait, specialists came in and shepherded me to a room in the back — where they proceeded to explain what they had decided was wrong with me, and why.
“You light up an entire section of the DSM,” they said. “It was difficult to come to a decision, but this is our best guess.”
Based on this “best guess,” they then diagnosed me with four different disorders: Obsessive Compulsive Disorder (OCD), Attention Deficit/Hyperactivity Disorder (ADHD), Gender Dysphoria, and Schizotypal Personality Disorder.
And so it was that my complicated relationship with medication began.
Those who’ve lost themselves to mental illness sometimes refer to “losing their mind.” And when in the throes of something so terrifying, it can indeed feel like “losing” something; like your mind is “going” somewhere far away.
It’s a sensation for which many can imagine quick and easy solutions:
“Just exercise! It will give your life structure and make you feel wonderful!”
“Just eat healthier; it will give you energy and confidence!”
“Just spend time with your friends; people will help you if you let them!”
But illnesses of the mind aren’t simple enough to be treatable via self-help aphorisms repurposed as pithy, Pinterest-worthy prescriptions. Nor is there a one-size-fits-all checklist for avoiding a mental-health crisis.
The truth is, for many, medication is a necessary part of treatment — the only way to fully gain control of that which could be lost.
For a long time, I struggled to understand this . . . until it led me to make a very serious mistake.
This summer, I had a job at Walmart where everyone, coworkers and supervisors included, were not only supportive of my status as a trans woman, but never once displayed ignorance or lack of competence concerning accommodations for my preferred name, use of restrooms, or dress code. I’m sure there are other ways in which that store made life a lot easier for me in my first job as an out and presenting trans woman. It was the best of all possible scenarios for an employer.
And yet, still, I suffered from the panic attacks that have long plagued me. Three months in, I had to quit because the stress was overwhelming and causing psychotic symptoms to appear. During one episode, my boyfriend had to physically restrain me in order to prevent me from tearing at my hair and face. I became hysterical, then unable to speak.
This phenomenon is called alogia, and it makes it impossible for me to communicate verbally no matter how much I try. Up until then, it had happened only twice before: once when I was hospitalized for a similar mental breakdown that the doctors thought was meningitis, and once when I went out drinking and had too much.
But this latest occurrence was the most terrifying. I had never tried to physically harm myself before, and it scared me.
The most likely reason for this exacerbated incident? I had not taken my antipsychotic for at least a couple of weeks.
In part, this was because I had simply misjudged my problems. I thought that maybe the root of my bipolar and SPD — the two disorders my antipsychotic was primarily intended to treat at that time — was my gender dysphoria, and now that I was living as my true self and in a loving, supportive partnership with my boyfriend, I thought I had perhaps “gotten better.”
But the other reason is, in its own way, more insidious, simply because it’s so common: I didn’t want to be dependent on medication.
My hesitation was partly a product of a culture that props up stigma of mental health, and creates significant social and economic burdens for people who struggle with mental illness. I always worry that people will think of me differently after I tell them that I take medication, or after I reveal exactly how many different diagnoses I’ve been given over my lifetime.
Society’s stigmatization was compounded by my own personal history; growing up, my father enforced the expectation that how much work you accomplish determines your value in society. If I struggled to work without medication, did this make me less valuable? Were my actions less valid — more contrived — if they could only be accomplished with the help of pills?
My desire to be “better” — that is, able to function in the world sans medicine — has always been rooted in a deep yearning for agency. In my head, I thought that if one of my mental diseases went away, then perhaps I could become the kind of person who can work hard in any environment and just brush aside the panic as it rises like bile in my throat. This thought process came directly from my own internalized ableism, a result in large part of my father’s teachings.
This fear of being perceived as “crazy” often puts those with mental illness in a catch-22 situation: We won’t take the medicine that will make us mentally stable, because by taking it people might think we’re mentally unstable. It’s a difficult trap to extricate ourselves from.
In my own experience, I wanted so badly to be “better” that I ended up sacrificing my health — and, in turn, my job. I was lucky to have a boyfriend willing to support me financially, but I wonder what may have happened were I on my own with no one to help me. I have not yet had the strength to try working again, because this was, in fact, not the first time I had had to quit a job due to panic attacks. Panic attacks have cost me my job a total of four times now. As of this moment, it is difficult to justify trying again, when my history would seem to indicate that trying to work will always turn out poorly.
Every day, this constant fear leads to a mental spiral, where I blame myself for lacking some nebulous and ill-defined work ethic that might cure me of the laziness that is so obviously at the root of my career failures.
But in time, and especially after this latest incident, I’ve learned how I need to rethink this relationship to medication.
Even if I wanted to be someone who — for whatever reason — did not need medication, I’ve had to accept that, at this time, I am simply not that person. My brain needs the chemicals that my medication provides . . . and that’s okay. As I grapple with this, I’m finding refuge in new places; I know, for instance, that every time I sit down to write, I am defeating the voices that cry “Failure!” from the shadows of my mind.
To those who struggle like I do, I want to share this lesson I’ve learned: Whatever you may believe about who or what may or may not be behind this weird thing we call existence, your brain is entirely yours and there is no other one like it in the whole of human history. Treasure it, be nice to it, and don’t deny it the sustenance it needs to keep on being amazing — whether that means taking your medicine or going for a walk or watching Netflix.
You, and your brain, deserve to be happy and healthy. Maybe it’s time we reconfigured this notion of “getting better” to mean something so simple, it has the ability to help us all get better: Treat your brain with kindness — on its own, individual terms.