An honest conversation about psych drugs

Three years ago I went to visit my sister in London, for her wedding. 

(Remember when overseas trips were a thing?)

I stayed with her for a couple of weeks and, truth be told, I was not having a good time. 

It had nothing to do with the trip. I was simply at one of those points in life where it all gets to be too much.

The ‘oh shit I've ruined my life’ point

I call this the ‘oh shit I've ruined my life’ point. A period of profound despair that makes you seriously wonder how the hell you’re still here, putting one foot in front of the other.

So there I was, surrounded by family I love, spending delicious quality time with my niece and nephew (who live far too far away for my liking), celebrating a special occasion. 

And feeling absolutely blown apart the whole time.

When you can’t hide your feelings

I mostly kept my shit together, including for the wedding itself. But I couldn’t hide everything.

At one point, I broke down crying in front of my sisters.

This is something I have essentially spent my whole life trying not to do. That sounds a little dramatic, but what I mean is pretty simple. 

When you learn from a young age that you’re the sensitive type - that your emotional response to the world doesn’t always make sense to the people around you, even people who love and accept you - you learn to hide your feelings. Not all the time, but you hide them at least until you have some idea what the hell is going on.

Hiding your feelings is actually a useful skill, much of the time. But like any strength, it can also be a weakness if you rely on it too much.

Crying has never come easily to me, even when I'm alone. So for both me and my sisters, crying in front of them was extremely unusual. It was clearly time for a chat.

Bravery? Or something else?

My flight home was a couple days later, and my sister drove me to the airport. It was a long drive. Plenty of time for one of those big, connecty life chats. 

We talked about all sorts of things, not just my meltdown. Life, the universe and feelings. Just the kind of chat I needed.

And at one point, we happened to touch on a subject I don't remember us ever talking about before: psych drugs.

I remember my sister saying, ‘I think you’re so brave you know, for living life the way you do. Choosing not to take medications can’t be the easy path.’

A bit of context. The thing is, this wasn’t the first time I’d reached the ‘oh shit I’ve ruined my life’ point. This was number three (if we’re counting). But it was the first time I’d reached that point and didn't even try the medication route.

After years of trial and error in my teens and twenties, I had come to the conclusion that - even as hard as things had gotten again, and as desperately as I wanted some kind of relief - psych drugs probably just weren't going to help me feel any better.

So when my sister said she thought I was brave for taking the non-medicated path, I thought that was kind of funny. I laughed and said something like, ‘It ain't bravery sis! I tried every pill in the pharmacy. They just didn’t make me feel any better...’

The simple story of psych drugs

Looking back on that exchange now, what strikes me is this. The inside reality of the psych drug experience is so much messier than we're used to hearing about.

We're used to hearing the simple story of psych drugs. The simple story goes like this. ‘See your doctor, take your pills, feel better’.

Having worked in mental health for fifteen years, and having struggled with my own shit for much longer than that, I know that for many of us, this simple story doesn’t always ring true.

What if the drugs don't help you?

What if you try psych drugs, and they don’t help?

Or what if they do help, but it’s complicated? Because of side effects, or because of the diminishing returns over time that some of us experience.

Not to mention the other more philosophical questions. As one Big Feels Clubber put it to me recently, what if you just don't know how to feel about the whole idea of it, worrying that the pills are somehow changing who you are as a person, in slow, small, imperceptible ways?

These complications have all been part of my messy, not-so-simple experience of psych drugs. I have also had periods where meds have just been extremely damn helpful - but for me, that somehow only makes the whole thing even more complicated. 

When it comes to the public conversation on this topic, the messier, more complicated parts of the story are usually left out.

Even mental health professionals are not always very good at helping us navigate those murkier waters. And I don’t think that stems from a lack of skill or compassion on this subject. I think it’s about honesty.

Honesty makes people nervous

When it comes to the topic of psych drugs, I think there’s a nervousness about being too honest. 

I’m nervous even posting this newsletter, despite this being something I have considerable knowledge about - both the personal and professional kind. 

For me, the nervousness comes from knowing just how personal the topic of psych drugs can be, and how there’s usually guilt in the mix no matter what. Whether you’re taking psych drugs and finding them useful, or taking psych drugs and not finding them useful, or not taking psych drugs and feeling like shit... all these options can come with a healthy side-dose of guilt. It’s truly one of those ‘damned if you do, damned if you don’t’ things for many of us.

Yay. Love those!

That’s why it’s taken me three years of running the Big Feels Club to even broach the subject. I was scared anything I'd add to the mix would just end up poking everyone's soft spots (mine included).

An understandable fear

In the mental health system, the nervousness about being ‘too honest’ stems from a simpler fear. If we’re honest about the full spectrum of experience - the fact that, sometimes psych drugs help, and sometimes they really don’t - there’s a fear that people will stop taking their pills. 

From the perspective of mental health professionals, this is an understandable fear. 

But from the perspective of those of us taking the pills, the unwillingness to have honest conversations about psych drugs has its own set of consequences.

If the only story you’re told is that psych drugs ‘just work’ for most people, what happens when you find it much more complicated?

You can start to think you’re one of the unlucky few. Uniquely screwed. Beyond all help.

In fact, it’s a really common experience to find the drugs don’t always help, or don’t help in the way you hoped they would. So why don’t more of us know that?

I want us to have more honest conversations about psych drugs, with our doctors, with our friends and family - so it’s not such a lonely path trying to make sense of your own experiences with medication, whatever those experiences happen to be.

But... it’s hard to know where to start!

So I decided to push through my nervousness and have one such honest conversation myself. In public, with my frequent Big Feels Club collaborator and general feelings guru, Gareth Edwards. 

Gareth and I sat down for a good long chat on this very subject, and hit record. You can now listen to our chat, which we called (appropriately enough) ‘An Honest Conversation about Psych Drugs’.

It’s a gentle but real chat about the complexities of the psych drug experience, plus our thoughts on a few ways mental health clinicians could be more honest about it (without scaring everyone off).

Between us, Gareth and I have had almost the full range of experience, including finding the drugs really helpful, finding them really unhelpful, and even times when taking the drugs wasn’t a choice. We talk about it all.

Click this big pink button to listen in Apple Podcasts:

Or search ‘big feels club’ in most podcast players. You want episode #010 :)

(Our podcast is now on Spotify! Just ignore all those random playlists that come up when you search ‘big feels club’! For some reason a bunch of people have made Spotify music playlists using our name and artwork. I’m flattered I guess? But to be clear, if Honor and I made a music playlist for big feelings right now it would just be Phoebe Bridgers’ entire first two albums, in order...)

Not a podcast person? Click here to listen in your browser.

Hey, tell me your thoughts on this topic? 

I’d love to hear your thoughts on our conversation. Click here to tell me what you make of it all.