Struggling with anxiety or depression? Maybe you’ve already tried talk therapy, lifestyle changes, and support from your relationships and you seem to still struggle overcome what people say is “all in your head.” Maybe you have met with a psychiatrist and they have suggested medication, but you were not ready. Or you have been intimidated to meet with a psychiatrist and do not really understand how they are different from a therapist.
It can be very difficult to make the step to start taking medication. Some people feel like they are giving up. Others have internalized the stigma that comes with having a mental illness.
Taking medication does not mean you will need it forever. Many people only utilize medication and see a psychiatrist only for periods in their life to help their brain chemistry adjust to the stressors they currently have and reduce the symptoms they experience.
Here is an exercise to explore your feelings about being on medication, using the different levels of scripts from Narrative therapy. Once you tease out the scripts that you have learned about seeing a psychiatrist and using medication you can identify where your barriers are and what you need to work through in order to give yourself permission to take medication. Take out a sheet of paper or open a word document to write out the positives and negatives (Pros and Cons) from each level of script.
Intrapsychic script
This is the level that is directly affected by medication. Your personality and brain chemistry is a mix of genetics and environment. Finding the right medication can help you manage your moods better. Explore how you personally feel about medication being an option for you. What feelings come up for you? What about medication could be helpful? What are you scared of? It is important for everyone to have a sense of agency or active control in their treatment decisions and not just start taking a medication because someone else told them to. The first step of giving yourself permission is sorting this out intrapsychically.
Interrelational Script
This script includes the one on one relationship dynamics you have with people in your life. Think about your closest relationships. Maybe you have a partner in a significant relationship, your best friend, or parents. Think about what they would say about your decision to take medication. Are you close with anyone who has made the decision for themselves? Write out how taking medication for mood management might improve your closest relationships. How might it damage them? Begin the conversation about your curiosity for medication use with these people. Write out their reactions and the conversations you had. What came up for you? How do you feel now? Who is supportive of medication? Who has reservations? What do you need from these supports in your life to help you make your decision? Try to let them know what you want their support to look like. If you have already met with a psychiatrist, evaluate your relationship with them. Do you trust them and feel they can help you? If you do not yet have a psychiatrist, what would you want from your psychiatrist?
Socio-Cultural Script
This is the level where you have received a lot of messages about taking medication from society and cultural influences. Medication may go against your cultural or religious beliefs. Or you may feel like the medical field/psychiatry is so quick to prescribe medication that you want to make sure that it is the right decision for you. Some have believed it is a crutch or a sign of weakness. What messages come up for you? Write every message that comes to your mind. Look through the list of messages you have heard about medication use for psychological problems. What is your understanding about the field of psychiatry? Do you know enough about the psychiatry discipline's mission? Think back to where each message came from and who said it. Circle what messages are true to who you are or what you want. Cross out each message that does not fit for you right now.
Once you have written out positives and negatives from the different levels of scripts that affect your life, review your lists for consistency and inconsistency across levels. It is common for people to believe they feel a certain way about medication, but through the exercise they realize it is the bigger messages from others that influence how they feel about taking medication rather than a personal decision. Everyone has the right to do what is best for themselves. Find what level of script the conflict is in. You can begin to rewrite a more useful story for yourself about what medication means to you and how you can take control of your mental health by making the best informed decision for you.
After you have identified and began resolving some of the barriers to going on medication, give yourself permission to only have an initial appointment with the psychiatrist to see what they believe might be able to help you given the issues you currently face. If they suggest medication, give yourself the permission to fully research the medication’s benefits and possible side effects then fill in your research into the intrapsychic level befre making the decision. Talk with your loved ones from your relational level about the dilemma you are facing regarding whether or not to take medication. Finally, seek out socio-cultural examples of medication helping people through similar things you are going through to counteract the stigma and internalized messages that going on medication is bad. Once all three levels of your scripts are consistent, you have given yourself permission to take medication. If you find this decision still difficult and want to explore other options other than medication, a therapist can help you explore your issues further.
