Many people respond to a psychiatric diagnosis and medication recommendations by saying that they are simply “not a pill person”. It seems that the idea of having to take a pill every day is a daunting thought to some and a sign of weakness to others.
In truth, there is no such thing as a “pill person”. Although many people seem to have a specific idea in mind of the kind of person likely to take pills, this doesn’t really exist. People are people – some experience medical problems that need to be treated, others may not. Most people would prefer not to have the medical problem or the need to be treated.
Some people have no problem with the idea that a person with a heart condition should take cholesterol-lowering drugs or that a person with diabetes needs to take daily insulin shots and yet object when the subject turns to psychiatric illnesses such as depression, anxiety disorders or bipolar disorder.
Society as a whole needs to understand and accept the validity of psychiatric illness as just that – illness that can and should be treated. The only difference is that in the case of psychiatric illness, it is the brain being affected rather than the heart or pancreas. Just like a heart condition or other serious chronic disease, mental illness often causes premature death and many other serious problems.
Taking medication for a mental health problem is not a sign of a weak character.
Medication for treatable conditions is a step forward just as immunization, chlorinated water and electricity were. These measures were all developed to improve our quality of life. We should be grateful for the advances made rather than feeling guilty for using them.
Some who say they are not “pill people” do so out of a belief that as a society we put too many people on drugs. For example, those opposed to the use of Ritalin in children with ADD/ADHD or to the widespread use of antidepressants often hold this view.
Sadly, this opposition is mostly the result of being uninformed about how the medications work to treat symptoms or how they are prescribed. These are not sedatives or ‘happy pills’, but specific medications that affect naturally occurring chemicals in the brain.
Also, medications are not handed out like candy to every rambunctious child or to every adult who has had a bad day. Specific diagnostic criteria must be met in each instance and medication use should be monitored closely by a physician. Far from being over-prescribed, most studies indicate that the vast majority of psychiatric disorders are under-diagnosed and even less commonly treated.
Sometimes it is a fear that chemicals are unhealthy that causes people to resist medication use. Most of us do not eschew chemicals as a whole. We drink chlorinated water and take vitamins. For those who oppose all chemical use, this is usually a religious or ideological objection and is, of course, a matter of personal choice.
What is a chemical? Serotonin, insulin, potassium, vitamins and iron are all chemicals. A molecule is a molecule or an atom an atom whether it is made inside the body or administered to the body from another source. Many medications use molecules that do occur naturally in our bodies, but that may be deficient or out of balance.
The important question is not whether a substance is a chemical, but whether it helps or hinders the body. Few would question the benefit of administering vitamin C for scurvy, but research was still necessary to determine whether extra, exogenous vitamin C had any adverse effects or dose limitations. The same holds true for other medications including most psychiatric ones.
Potential risks from medication use should be measured against the benefits of relieving symptoms of the disorder. There is also risk in doing nothing. There is no virtue in suffering needlessly if safe and effective treatment is available.
Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.
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