I realise my new perspective on all things mental health related, and in particular on medication, may be more than a bit disconcerting for some of you. It’s so hard to explain in just one post, but let me try:

This page has always been about me sharing my experience, and my experience now is that my view on everything mental health related is changing quite dramatically. This includes treatment options, and yes, medication.

That said, I’m not specifically anti-medication or anti-psychiatry, it runs much deeper than that. I’m painfully aware that medication is the only option for an awful lot of people. My issue is not with the people who are taking medication (which I still do by the way!), but rather with the fact that this is currently the standard means and first port of call in treating mental health difficulties. I’m coming to a much greater understanding of where problems come from, and how they may potentially be treated. Part of that is the realisation that medication my not be as central to it all as I thought. As I learn more, I’ll share more.

We really are in a horrible catch 22 at the moment – there’s so much new thinking on how to successfully treat mental health problems, but to make those means accessible to everyone? I don’t even know where to begin.

I’m genuinely sorry if any of the views I’ve been sharing recently have been upsetting for any of you in any way. But like I said at the beginning, and as I’ve always said – this is my experience, and my opinion. I’m not an expert, I don’t have all the answers. All I have is how things have played out for me. I’m neither right nor wrong, I’m just finding my way through as best I can, like everyone else!

This article has 7 Comments

  1. I’m disappointed with the anti-medication articles that you’ve been posting. Obviously, you can post whatever you want however I prefer info that’s factual, evidence-based…not just based on anecdotes which is a weak form of evidence.

    BPD isn’t a mood disorder so medication is only mildly helpful in treating it. Long-term therapy is typically needed to treat BPD from the sources I’ve read. However, medication is very helpful in treating mood disorders like depression, bipolar disorder, schizophrenia. I strongly believe it’s important to make this distinction.

    Medication and therapy combined is more effective at treating depression than medication alone. So yes, access to evidence-based therapies needs to be increased. I understand that you were unable to access DBT through the HSE and that was probably a hugely frustrating experience to go through. That being said, characterising medication as bad or malevolent is just not helpful for other service users who need to take medication to function in their everyday lives.

    I suspect that you may be thinking of this in all-or-nothing manner..that it’s either medication or therapy but the fact is that both have a place in mental health care.

    1. Hi S, first off, apologies if anything I’ve been posting has been upsetting for you, that was far from my intention. I may not have made myself clear in my this post, but sincerely, I’m not anti-medication when it’s prescribed under the right circumstances. I’m just frustrated that there are so few alternative options out there for people, or at least, that the alternatives are beyond the reach of the majority for financial reasons.

      I’m not for one second trying to imply that I have all the answers, because I know I don’t. All I have to go on is my own experience over the last few years, and in particular, the last few months, so yes, anecdotal is the best I can give. But, I know what’s working for me. I know there’s a very real difference in my outlook and state of mind in comparison to this time last year, which can be attributed to two things – intensive, focused therapy, and a reduction in sedating medication which allowed the therapy to happen in the first place.

      The whole area of mental health and its treatment is a minefield. I’m not sure there actually is a definitive right answer, because there’s just so much science can’t see yet. Right now, I’m putting my faith in what’s working for me, but I genuinely do appreciate that this opinion is only mine, and that everyone else is entitled to their own.

      I’ve really appreciated your support over the years, and that you were able to be honest with me about this. I hope you’ll keep reading, even if just to continue to disagree!! Without this kind of debate we’ll never be able to move forward.

      1. You didn’t upset me. I’ve just had people make horrible remarks to me when I’ve been on anti-depressants in the past.. implying that I “should” be able to cope without it. But the thing was, I needed the medication to balance my mood out, to be able to get anything out of therapy and to function in my everyday life.

        I’ve had issues accessing evidence-based therapy and that’s been a real bugbear for me. In my experience, psychologists in private practice don’t seem to be trained in the latest therapies unless you go to a private hospital like St Pats or get a psychologist who’s trained in the UK. I think Simon Harris is talking about regulating the therapy sector more and that’s good however I think psychologists need more training opportunities to keep updated on new developments in psychology and that would require government investment. Therapists in the UK seem to be able to train with the NHS and we just don’t have anything similar and I think that’s an issue. I don’t think its the psychologists’ fault..it’s due to the lack of investment, lack of infrastructure within the system. Obviously, psychologists are doing their best and no doubt, they’re under huge amounts of pressure.

        I totally agree that access to therapy needs to be expanded. There is research that says how lower socio-economic areas tend to only get medication for depression whereas more affluent areas get meds *and* therapy. I think that’s what you’re trying to address-that classism, that divide between public and private healthcare in this country, that social injustice. It’s something that badly needs to be addressed.

        I’ve had to read a ton of psychological self-help books to help myself and I just think “why is it this hard? Why are all these barriers being placed in my way when I just want to recover?”

        I don’t know if you read The Guardian or look at Channel 4 news but they have a lot of mental health coverage from a leftwing perspective. Mental healthcare is supposed to be based on a biopsychosocial model and I think the social part has been forgotten i.e. access to services, affordable housing etc. In the UK, Alastair Campbell was saying how Theresa May’s government feel that anti-stigma campaigns can effectively replace treatment and I suspect that our own government have a similar mentality. If the funding is not there to provide social or psychological services, then the biological part of the model i.e. meds is all that remains. It’s deliberate neoliberal policy.

        Treatment seems to be prescriptive i.e. take this med, go to therapy (basically instructions) as opposed to patient-centred i.e. focused on the patient’s needs and what they want to get out of treatment, meeting the person where they are as opposed to where they want to be, praising even small changes not just big changes. I don’t have all the answers but I have a lot of ideas on what could help improve things. Motivational Interviewing is all about motivating people to achieve positive change by recognising that people don’t like being told what to do..that positive reinforcement works better than criticism. I think that compassionate type of approach could be utilised more to great effect.

  2. I am 6 years being treated for depression/bpd symptoms through the HSE. Treatment has been medication, talking therapy and I am also currently in a group therapy, called Mentalisation Based Therapy (MBT). I’ve always been grateful that I am one of the lucky ones to receive such intensive care and support. Im well aware there are many suffering, hopelessly stuck on long waiting lists. Fiona, I found your blog only a year ago and have read in amazement at times, as our two personal paths have so many similarities. It’s like looking into a mirror at times. I feel the need to “come out” of the background to validate what you have been experiencing and writing about recently. Its only since I took full responsibility for my own health and happiness, that Ive made real progress. A combination of mindfulness & meditation has enabled me to reach deep into my self and my history, to my younger self, and help me recognize and soothe the experiences & traumas that have riddled my life with ongoing drama, anxiety and self hate. I am still on medication too and will continue to be, until the time is right. Longterm medication is certainly necessary for conditions that are caused by genuine chemical imbalances. Its my personal belief that most patients with mental illness though, are not suffering chemical imbalances. And medication in these instances, acts only as a bandage, a support. It can help alleviate some of the horrible symptoms but to get to the root cause of the problem, I’ve needed to accept, I had a personal journey to make, into my past, to help the little girl I once was, feel her pain, nurture and love her. // I realise some people will roll their eyes to heaven at some, maybe even all, of the aforementioned and that’s ok. I would have too in the past. Its taken time, curiousity, a hell of a lot of perseverance, so many books, articles, retreats, meditation classes, pills, alcohol, pyschiatric appts, tears, tantrums, fear and pure despair. It could have gone either way at times. I’ve said enough. Thank you for your blog and your courage.

    1. Thank you so much T, for all of that. It’s huge, and I can see just how similar our paths have been. Even down to ‘I realise some people will roll their eyes to heaven at some, maybe even all, of the aforementioned’. I’m conscious of that every time I write these days, but I’m going to keep writing anyway. If it makes sense to you, then it has to make sense to someone else as well. Really appreciate you reading and taking the time to comment

  3. I was first admitted to hospital in 1997. Was diagnosed with Bi Polar Disorder. Spent 6 months in Hospital. The Max VHI paid for then . Anyway I came home and found it hard to adjust. Had a good couple of years, still on meds. Then I had another very severe spell of very very low mood. ECT suggested. Had it. After many weeks I felt good again.
    3 years of up and down I again had ECT. This time it really helped and I am well since. I take some melds but I don’t mind.

  4. Everyone’s journey is different, just as each illness is different. I have two kids, each with a different illness, but both prescribed meds. My daughter is always caught in the cracks insurance wise, so meds are hard for her to buy. But she can manage if she uses her coping skills. My son could never go without. I am not saying ever again, but not for quite a while. It is just what works for you.

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