Mental Health Meds: When to Take, When to Hold Off

There’s a pill for every­thing these days. I even saw one that can make your poo glit­tery. Because who doesn’t need glit­tery poo? When it comes to men­tal health, med­ica­tion has become a stan­dard treat­ment option for many peo­ple. Research shows that for emo­tion­al symp­toms, includ­ing depres­sion, anx­i­ety, and ADHD, a com­bi­na­tion of med­ica­tion and ther­a­py is often the best form of treat­ment. But when should you or your child try med­ica­tion? Are there oth­er things you should try first? How does any­one even make that deci­sion? Is there a pill for that?

The fol­low­ing is a list of fac­tors to keep in mind as you nav­i­gate this poten­tial­ly over­whelm­ing decision.

When is med­ica­tion a good idea?

• If your symp­toms are inter­fer­ing with your abil­i­ty to func­tion (i.e. go to work, raise kids, be suc­cess­ful in school, etc.)
• When ther­a­py and appro­pri­ate self-care (ade­quate nutri­tion, qual­i­ty sleep, reg­u­lar exer­cise, etc.) aren’t working
• If your doc­tor rec­om­mends medication
• When symp­toms are long-last­ing or con­tin­u­ing to wors­en despite oth­er efforts
• If your symp­toms are side effects of oth­er med­ica­tions or med­ical con­di­tions that are unlike­ly to get bet­ter with­out help
• If you are fac­ing a very dif­fi­cult and chron­ic life stres­sor that is prob­a­bly not going to improve in the fore­see­able future
• If symp­toms or behav­iors are result­ing in safe­ty issues, low self-esteem, or sig­nif­i­cant social problems

When should you hold off or avoid meds?

• If you’ve just start­ed med­ica­tion for anoth­er con­di­tion because it will be dif­fi­cult to deter­mine which med­ica­tion is caus­ing what impact
• If behaviors/​symptoms are only expe­ri­enced in one set­ting (home, work, school) and not in oth­ers as this would sug­gest a prob­lem in that set­ting needs to be addressed first
• If your symp­toms are relat­ed to a spe­cif­ic sit­u­a­tion, it is wise to first try to address that as no med­ica­tion can change your circumstances
• Imme­di­ate­ly fol­low­ing a major stres­sor or change

(Note: You are sup­posed to feel bad when bad things hap­pen – I know, I don’t like it either – and tak­ing med­ica­tion as a first response can impair your abil­i­ty to cope with and process what hap­pened. That’s not to say that med­ica­tion wouldn’t be help­ful but try oth­er things first or talk with your doc­tor about the pros and cons)

What to expect when start­ing a med­ica­tion for behav­ior or mood?

• Most med­ica­tions don’t start work­ing right away and depend­ing on your pre­scrip­tion and dose, you might not expe­ri­ence the intend­ed ben­e­fits for a month or more
• Med­ica­tions should not elim­i­nate all feel­ings; feel­ing ​“numb” is not the goal
• Fol­low your doctor’s rec­om­men­da­tion but it’s gen­er­al­ly wise to start with low dos­es and one med­ica­tion at a time so that you can bet­ter mon­i­tor the impact of that medication
• Some med­ica­tions are to be tak­en as need­ed but most need to be tak­en dai­ly, often at the same time each day; read your labels

What are the risks of tak­ing psy­chotrop­ic medications?

• Even though the goal is to make you feel bet­ter, some psy­chotrop­ic med­ica­tions can make symp­toms worse or cause new ones to develop
• Incon­sis­tent­ly tak­en med­ica­tion can cause an increase in symp­toms or new symptoms
• Do not sud­den­ly stop tak­ing your med­ica­tion as this can be dan­ger­ous with some med­ica­tions; if you wish to stop tak­ing a med­ica­tion, con­tact your doc­tor for assistance
• Some med­ica­tions can cause vivid or scary dreams and/​or changes in your sleep cycle; check with your doc­tor if you notice trou­bling changes in your sleep
• Many psy­chotrop­ic med­ica­tions do not mix well with alco­hol and can enhance the effect of alco­hol and/​or cause seri­ous health issues; read your labels closely
• Chil­dren and teens face a high­er risk of sui­ci­dal ideation and wors­en­ing depres­sion on some med­ica­tions; be sure to dis­cuss these risks with your child’s doc­tor and report any changes or concerns

Con­tact your doc­tor right away if:

• You (or your child) start to have new or wors­en­ing sui­ci­dal thoughts or aggression
• You do not expe­ri­ence any pos­i­tive ben­e­fits after an appro­pri­ate amount of time
• You expe­ri­ence severe side effects that inter­fere with your abil­i­ty to function
• You have trou­ble remem­ber­ing to tak­ing your med­ica­tion on a reg­u­lar basis
• You are think­ing about dis­con­tin­u­ing your medication

Meds aren’t always an easy fix, but in com­bi­na­tion with ther­a­py and/​or appro­pri­ate self-care, they can be an effec­tive tool to help you man­age and reduce men­tal health symptoms.

Remem­ber, it’s okay to strug­gle. Life is sup­posed to be hard some­times. A lot of the time, actu­al­ly. But it’s also okay to ask for help, what­ev­er that might look like for you.

Thanks for reading!

Nik­ki