What you should know about medication Part 2

 Part 2: What You Should Know About Starting Medication.

The darkness that comes with a lack of direction is something the worst part of getting help. The not knowing what’s wrong. The not knowing if there is a way out. The not knowing if you are willing to take on this journey. Sometimes all of this not-knowing is worse than the pain itself. Awareness, advocacy and actionable steps forward are transformative agents in gaining control, rescuing your relationships from the abyss and experiencing joy again.

Are you considering if medication will be part of your path forward? Years ago, I made the choice for myself. Through trial and error of a variety of holistic and pharmaceutic tools I found that a combination of EMDR trauma therapy and medication was the best fit for me. These tools gave me the head-space to make better decisions for my lifestyle and I was able to eventually remove the medication and graduate from counseling.

In ​Part 2: What You Should Know About Starting Medication​ we’ll take the next step forward by outlining the steps that will empower you with the necessary knowledge,tools and mindset to make the most of whatever decision you make. Medication is not for everyone. But if you are considering it, you deserve a clear path forward. Let’s take that first step.

1. Medication is not a “fix.” Plan for a lifestyle adjustment. ​Medication is not a quick fix by any means. First, while some medication might be quick acting it can still be a few weeks before you feel the full helpful effects. Second, other medication might be “take as needed” (you might feel relief within minutes) but it’s not going to solve anything for you in the bigger picture. Third, you might still need to adjust your lifestyle or engage in therapy to address a larger issue such as a trauma or patterns of thinking and behaving that have made your life difficult or painful.

Now is the time to tune into how you practice self-care and be radically honest with yourself about your needs. If you don’t have a therapist, now is a good time to begin looking for someone that is skilled in your area of need:anxiety, depression, trauma, etc. Identifying people who will be supportive of you now and making plans to talk on the phone, have coffee or go for a walk. Depression is a leading cause of disability worldwide (​World Health Organization,2020​)​ and ​anxiety disorders are the most common mental illness in the US, affecting 40 million adults in the United States (Anxiety and Depression Association of America). ​You are not alone in this journey. Finding a therapist, support system or friend can significantly aid your healing journey.

2. Your genetics matter. ​Your doctor can now rule-in or rule-out certain medications based on a simple cheek swab, often called a ​CYP450 test. ​This painless little test can identify what medications are most likely to work for you,which might but might not and which probably aren’t worth even trying. The Mayo Clinic explains, “​Drug-gene testing — also called pharmacogenomics or pharmacogenetics… look for changes or variations in [your] genes that determine whether a medication could be an effective treatment for you or whether you could have side effects from a specific medication (Mayo Clinic).” If you decide to try a genetic test you can expect it to be a relatively simple event. During the test a sample of your DNA is taken, using one of these methods:
–  Cheek swab.​ A cotton swab is rubbed inside your cheek to get a cell sample.
–  Saliva collection.​ You spit saliva into a collection tube.
–  Blood test.​ Blood is drawn from a vein in your arm.
Depending on the method, this may take just a few minutes to accomplish. Then your results will be sent to a lab. The results will be returned to your doctor within a matter of weeks. Know that completing this test does not guarantee a medication will work for you but it will provide clues. Tests are available for only certain medications and it can’t predict how a medication will affect your body.The test will provide some direction and it’s a wonderful tool. Ultimately, the doctor will consider this test and then make a recommendation based on your medical history and symptoms.

3. You may have to try more than one medication. ​Medication is highly personal.What worked for your friend might not work for you. Oftentimes clients get on the first medication and it’s a great fit – end of story. Other people have to try two or three medications or one medication at different doses. You have every reason to be hopeful. Be patient and be honest with your doctor about how you feel on your medication. If you don’t tell them that it’s not working great or that you are experiencing side effects they won’t be able to help you. And remember, feeling like a zombie is an unacceptable side effect. Use your voice and be unafraid to advocate for yourself.

4. You can change your care provider whenever you like. ​After all this, if you don’t feel like your doctor is listening to you, taking you seriously or that you aren’t on the same page about a course of action – leave. Don’t go back. Find a new doctor. It doesn’t matter if you’ve seen this doctor since you were 9 years old. It doesn’t matter if they are your “family doctor”, delivered your babies or cured cancer. They are not the right doctor for you. Ask your therapist for a referral, talk to friends or search on the internet for someone who you can feel good about.

5. Keep going to counseling. ​Research shows that for certain emotional issues counseling has been found to be more effective than medication. Other results show that for certain emotional issues counseling in addition to medication is more powerful than either modality alone. It all depends on your pain, your journey and your hopes for the future. This path is highly personal. Counseling can support you in advocating for yourself if you decide to explore medication. It can provide you with assessments to take to your doctor’s appointment. You may also learn skills and achieve healing so that you can be on a lower dose or reduce how long you stay on your prescription. Keep your therapist informed and know that there are many methods to increase your wellness.

Congratulations on completing this two part series! If you have gotten this far, now is a good time to make that first appointment. Whether it is an appointment for counseling or to speak with your doctor it’s better to act sooner rather than later. Keep in mind it can take more than a week at some doctor’s offices to book an appointment so don’t delay in scheduling. If nothing else, lean into the insight and confidence you’ve gained thus far. You have the ability to change the exhaustion and the anxiety. You can gain control of your moods and energy so that relationships feel safe again. If you’d like more assistance in deciding if counseling is part of your journey I hope you’ll reach out. A 15 minute consultation will provide us a chance to talk about your pain, explore if and how counseling can help and outline your next step forward.

Anxiety and Depression Association of America. ​Facts & Statistics.

Mayo Clinic. (n.d.). ​Cytochrome P450 (CYP450) Tests​.

World Health Organization. (n.d.) (30 January 2020). ​Depression​.


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