medication

Drugs, crutches, and other tools

Psychiatric medication is highly stigmatized, and so is physical disability. One way that this comes out is that people say pejoratively, “medication is a crutch.”

Why is “crutch” an insult? What do people think is so terrible about using crutches?

I think that it’s a kind of ableism where people don’t understand that disability actually exists. They believe that anyone can do anything, if they put their mind to it and work hard. When people with disabilities can’t do something others can, they assume that we are just being lazy. They assume that about moving, they assume that about moving, and they assume that about thinking.

They believe that if they push us to try harder, then we will learn to stop being disabled. They think that if we stay disabled; it’s because someone’s giving us permission to be lazy. They’re constantly on guard against the possibility of a disabled person getting away with something.

They are aggressively hostile towards any visible adaptive strategy. When they see crutches or medications or whatever, they are terrified that we are getting permission to be lazy.

Sometimes, they think it’s ok for us to use these things, but only if we fall into a very narrow category of people think think have real disabilities. For instance, they might think wheelchairs are ok for paralyzed people, but have no respect for wheelchair users who can walk. Or they might think it’s ok to use medication if you’re trying to stop, but have contempt for people who need medication long-term and have no plans to stop taking it. Or whatever other combination of things. People have a lot of really weird ideas about disability, and just about any prejudice you can imagine exists.

Crutches are a tool. There are other mobility tools. Medications are several different tools. There are other mental health tools. They all have advantages and disadvantages, and everyone has to figure out what works best for them. Every strategy is stigmatized, because ableists expect us to think our way out of being disabled. But crutches aren’t actually bad things, whether they’re literal or figurative. We all find the ones we need.

tl;dr People with disabilities need adaptive strategies to work around disability-related limitations. Ableists think that we’re just being lazy when we use adaptations such as mobility aids or psychiatric medication. They often pejoratively say “you’re just using that as a crutch,” as though using adaptive equipment is the worst thing you could possibly do. But actually, there’s nothing wrong with crutches. We all find the ones we need, and that’s a good thing.

“You’re just looking for a quick fix”

If you use medication to make your life easier or better in any way, some people might object, and say “you’re just looking for a quick fix!”.

This is a mean and unhelpful thing to say.

Medication isn’t the right answer for everyone who has cognitive or mental health problems or pain or other reasons people take medication, but it can be game changing for some people. If you try medication and find that it makes your life easier, that’s a good thing, and it’s ok to be happy about it.

It’s ok to want your life to be easier. It’s ok if it turns out that there’s something that works quickly that makes things better. Using an effective strategy to make your life better isn’t being lazy; it’s being efficient.

"You're just looking for a quick fix"

squidids:

realsocialskills:

confide—nemini:

realsocialskills:

bluebirdofgrumpiness:

realsocialskills:

If you use medication to make your life easier or better in any way, some people might object, and say “you’re just looking for a quick fix!”.

This is a mean and unhelpful thing to say.

Medication isn’t the right answer for everyone who has cognitive or mental health problems or pain or other reasons people take medication, but it can be game changing for some people. If you try medication and find that it makes your life easier, that’s a good thing, and it’s ok to be happy about it.

It’s ok to want your life to be easier. It’s ok if it turns out that there’s something that works quickly that makes things better. Using an effective strategy to make your life better isn’t being lazy; it’s being efficient.

bluebirdofgrumpiness said:

Setting aside the fact that working out the correct medication and dosage is often anything but quick, it irks me when people condemn the desire for mental illness to be treated as quickly and painlessly as possible as some kind of moral failing. 

If you have pneumonia or a broken leg, do you request the slowest, most character building treatment available? No? I didn’t fucking think so.

realsocialskills said:

Actually, this happens to people with chronic illnesses a lot too, particularly if they are also fat and in pain.

People often pressure them into treating everything with diet and exercise, even if that’s not an effective treatment. And people who want actually effective treatments for physical conditions are often told that they’re just looking for quick fixes.

It doesn’t happen so much when people without disabilities or chronic conditions need treatment for an acute issue, because those people are socially valued and not blamed for their conditions.

confide—nemini said:

I don’t shame anyone for taking medication and I do believe that it is right in many circumstances. But, as someone who suffered from massive health problems from taking medication and as someone who knows about all the corruption between doctors and the pharmaceutical industry, I have some massive reservations. Just watch John Oliver’s “Last Week Tonight” episode on drug reps. One of the medications I was on is featured during the segment.

One medication made me lose 50 lbs and I was NOT overweight to begin with. I was skin and bones until I stopped taking it. Other medications made me sleep at least 12 hours everyday, making classwork and attendance almost impossible. I did not have this problem after I stopped.

I know fuckyeahlimerence suffered from similar problems though our views on the subject aren’t exactly the same. 

Message me if you want to know more.

realsocialskills said:

I am not familiar with that episode, so I can’t comment on that specifically.

I agree with you that there is a massive issue with lack of regard for the physical risks of psychiatric medications, particularly neuroleptics. (Especially when they are prescribed to control aggression or psychosis.)

Doctors often do not inform people of physical risks in any meaningful way, and often are dismissive of people who want help deciding whether or not the risks are worth the benefits. Further, when people who take psychiatric medications express concerns about side effects they’re experiencing, this is often treated as a symptom of mental illness to be addressed through counseling or a higher dose, rather than a physical symptom needing physical attention.

And it’s not at all uncommon for people to be prescribed medication that is flat-out inappropriate for their actual circumstances. (Eg: It’s fairly common for women to be misdiagnosed as depressed and prescribed SSRIs; it’s fairly common for autistic people who are aggressive during puberty to be prescribed neuroleptics to control their behavior.)

All of that is a huge problem. Medication is important for a lot of people, and so is avoiding inappropriate or harmful medication. Generally speaking, access to respectful, consensual and medically responsible mental health care needs to be far, far more widespread than it is. Far too many people only have access to needlessly dangerous care, often against their will. That’s as much of a problem for people who should take medication as it is for people who shouldn’t take medication.

I don’t want to be dismissive of any of that. Stigma is by no means the only important problem facing people who take psychiatric medications. 

squidids said:

The thing is, every single thing that has effects, has side effects. Literally every kind of thing, not just medication but also herbal stuff, and yes, even diet and exercise changes. Even meditation. If it is capable of doing a real thing to your body, then it is highly likely that it will also do other things to your body. I’d also even argue that lifestyle effects - such as cost, loss of time to do other things, or whatever - can also be just as side-effect-y as other physical effects like dry mouth or weight gain/loss.

It’s good to be aware of the side effects and to know one’s alternative options. And yes, when doctors have perverse incentives, then sometimes that can be hard. 

realsocialskills said:

Yes, exactly. Everything that has effects also has side effects. Those side effects matter. Sometimes they’re dealbreaking; sometimes they’re not, but they always matter.

It can be particularly hard to make good decisions when you’re surrounded by people who have some rigid ideology or other about medication. It’s hard when you’re surrounded by people who try to convince you that medication is bad and that no side effects are worth it at all, ever. It’s also bad when you’re surrounded by people who try to convince you that any medication a psychiatrist might want to prescribe is just like insulin for a diabetic and that there can be no valid question about whether it’s a good idea to take it. 

Decisions about psychiatric medication are complicated and personal. (That’s generally true for physical health treatments as well.) It’s important to acknowledge that reality in both directions.

I’m going through a breakup and am dealing with pretty crippling anxiety and depression despite the fact that my ex and I didn’t end on bad terms. I am a very socially awkward normally and my ADHD sometimes causes me to act impulsively. I have three questions: 1.) How/when/who is it appropriate for me to discuss my problems with (Like when people ask how I’m doing I normally lie but I think that may not be good for me.) 2.)How long should I wait before spending time with my ex, seeing him is like tearing off a band-aid and 3.) What is a good way for me to cope with my loneliness when my social anxiety prevents me from being able to be around most people?
Realsocialskills answered:
A few thoughts:
First and foremost, there is no one solution to this problem. You’re going to have to slowly find ways of making your life better. You’ll probably feel better if you think of it that way.
I get the sense that you might be thinking of the problem as “How do I get over my ex, stop being so impulsive, not be depressed, not be anxious, and not be so isolated, so that everything will be ok?” That’s a really overwhelming problem, but it’s not actually the problem you have to solve. The problem you have to solve is “What things can I do to start making my life better?”
And there are a lot of things that might be worth trying, and other things worth avoiding. I’ll start with the things I think you should avoid:
Don’t rely on your ex for emotional support:
  • It’s not good for either of you
  • Part of what being broken up means is that you need to separate emotionally and regain your own space
  • Relying on your ex for emotional support makes it damn near impossible to do this
  • Especially if you don’t have much else in the way of support
  • It is not your ex’s responsibility to make your life ok post-breakup
  • It’s probably not a good idea to spend time with your ex until you’re past the point of the breakup feeling like an excruciating loss when you see them

Respect other people’s boundaries:

  • Someone asking you how you are isn’t necessarily an invitation to share
  • “How are you” is usually a fairly meaningless socially greeting.
  • Sometimes people ask because they are concerned and really want to know. These are usually people you are already close to, or people you’re related to.
  • If you’re not sure whether they really want to know or if it’s just social noise, you can say “It’s kind of hard right now” or something similar, and see if they ask follow up questions
  • If they ask follow up questions, it’s usually ok to tell them what’s going on
  • But keep in mind that it’s ok for people to decide they don’t want to be your support system
  • And it’s important to respect that
Meetup.com
  • Meetup.com can bee a good way to meet new people in an unthreatening way
  • It’s easier to talk to new people when you know that you share an interest and are gathering to talk about it or do something
  • It’s also often ok to go and listen to other people talk
  • And it’s ok to leave if you need to

Interacting with people on the internet

  • A lot of people who can’t interact easily in person get a lot of social interactions from Tumblr
  • This counts as social interaction. Don’t devalue it
  • It also might help to seek out some other type of forum, like a message board about your interest/fandom/whatever
  • Email lists can be good too, especially if they’re the kind that don’t have archives that can be googled
  • Even with people you know, it might be easier to interact on chat or Facebook or some other internet based way

Religion

  • If you have a faith tradition, it might help you to go to church/temple/synagogue/mosque/place of worship.
  • If you have a bad experience with the place of worship you grew up with, you might be able to find one that works better for you
  • Most communities have a number of places of worship. Some of them probably have nice people
  • Unitarian Universalist churches work for some people who don’t feel comfortable in the organized forms of the religion they grew up with, but don’t want to reject it either
  • Going to a place of worship can be a way to meet people
  • It can also be a way to be around people without having to interact too much directly
  • For some people, being near people without having much conversation can be a way to feel less lonely without anxiety-inducing pressure
  • There also might be things you can volunteer to help with that aren’t too socially intense
  • There also might be study groups that work for you, because you can talk about the topic or just listen
  • Prayer can also help some people. Talking to God can help, even if you can’t talk to people.
  • Organized religion is not right for everyone, but it can be really good for some people

Reading fiction or watching TV

  • For some people, stories are a good way to cope with loneliness
  • Reading or watching stories is sort of like vicarious social interaction
  • It can also help you to learn a bit more about people and relationships
  • There’s a reason why lonely isolated kids coping with growing up by reading novels is such a pervasive trope
  • This isn’t helpful for everyone. Fiction can be really misleading and not everyone can understand it. But for some people, it can be good.

Therapy is helpful for some people

  • Some people find it helpful to talk to a therapist
  • Sometimes therapists can help people manage social anxiety and depression better
  • Or figure out executive functioning strategies
  • Or learn appropriate boundaries that make friendship easier
  • Therapy is not a good idea for everyone.
  • For some people, it isn’t helpful.
  • For some people, it’s a matter of finding the right therapist
  • For others, it’s actively anti-helpful and damaging.
  • For some people, it’s sort of helpful but not worth the costs
  • Therapy is something that can help some people to get support that helps them to figure out how to improve their life incrementally
  • Only you know whether therapy is a good idea for you (and it’s ok to decide to stop going to therapy if you decide that would be better)
  • In any case, therapy isn’t magic and it’s not a cure. There isn’t actually such a thing as “getting help” and that fixing your life. There’s just trying things and seeing what works.

Medication can be helpful for some people

  • Anxiety, depression, and ADHD are all conditions that some people find easier to manage with medication
  • For some people, medication is useful in the short term even if it’s not good in the long term
  • Some people don’t benefit from being on medications regularly, but do benefit from having medication available for occasional use to control anxiety or panic attacks
  • Medication is not right for everyone.
  • For some people it doesn’t work
  • For some people, it works, but has intolerable side effects
  • For some people, it works, but it takes a lot of experimentation to find the right medications and doses
  • Only you can decide if medication is right for you
  • Medication is not a cure or a way to become a different kind of person. It’s a strategy for managing things that works well for some people
  • If medication doesn’t work for you, that doesn’t imply that you don’t really have depression/ADHD/anxiety.
  • It also doesn’t imply that your condition is mild
  • Or that you’re not serious about making your life better
  • All it means is that medication is not a good strategy for you