Say Yes to Medication And No To Drugs

Please don’t call them drugs.

Image via Wikipedia

Today I spent eight hours in the company of many neuroscientists.  Smart folk.  People I look up to, want to emulate and learn from.  It was an honor.  We covered different stimulating topics about serving our patients, diagnosing better and the development of our field of practice.  We connected collegially, ate too much chocolate, exchanged cards and talked about each other’s families.  I hope to meet them again soon at future related conferences and continue learning from their experiences and study.

The one thing I do not like about any of these meetings however, is hearing people who know better (if they thought about it) naming our good medications “drugs.”

Drugs.  Yuck.  What do you think of when you hear that word?  I think of stigma, addiction, substance abuse, ruined families, fathers who do not come home, needle marks or powder on mirrors, low-living, illegal behavior, dealers, hepatitis and so much more – very little of which is good.  Drugs.  I cannot number how many patients I have spent oodles amount of time on talking them away from the stigma attached to medications because they thought of them as “drugs.”  Blah.  It is not anyone’s fault but we can start over when ever we want to, so let us.  It is time.

Who thinks of anything that actually improves us when thinking of drugs?  Who thinks of life-saving remedies, disease cures, hope, ability to feel pleasure again, forgotten shame, ability to hold a job, restful sleep, speaking well in public, desire to live restored or a mother who no longer wants to drown her baby?  Do you think of that when you hear drugs?

Let’s get together on this and forget the word that carries so much loaded negative meaning.  It is a disservice to ourselves – physician, scientist, grocer, student, surviving family of a suicide victim, newborn baby, patient and all of us who have any connection whatsoever to disease and treatment.

Drugs.  I think of First Lady Nancy Reagan‘s famous campaign in the 80’s, “Just Say No!”  That is not what we want to say or hear when we write or receive a prescription to treat and to heal what can be healed from a debilitating disease.  Just say yes, please.

Medication.  Not drugs.  A word does matter.  A word carries emotion on it like the smell of cookies baking in the oven or the toilet that was not flushed.  A word can start a war or inspire forgiveness.  Words matter.  Words can be part of what helps us be better friends to ourselves.  Why not use them to our advantage?  Let us change our culture and decrease stigma with this simple word – “medication.”

Maybe when I am able to get together with my colleagues again, maybe next year even, we will be using the word “medication.”  Maybe it will be because of the shift in culture people like you and I can start now.

Self-Care Tip:  Please forget about the misunderstood word, “drugs,” and say yes to medication.  Be a friend to yourself.

Questions:  What do you think of when you hear “drug?”  vs. “medication?”  Is there a difference to you?  To you think it would matter to culture and your “Me” if we used “medication” to refer to prescription therapies?  If so, how?  Please tell me your story.

Related Articles:

Fears of Addiction To Medications For Brain Illness

 

Demanding Freedom and Other Oxymorons That Empower Our Self-Care

Désirée Nick at "Oxymoron" in Berlin...

Désirée Nick at "Oxymoron" in Berlin, 1999

I read today on bipoblogger’s blog,

I am trying so hard to keep my head wrapped around keeping a hold on this broken heart/life balance/bipolar thing.  It’s been complicated by stupid migraine headaches.  It’s hard to make sense of things and to pay attention.

Today while I was waiting for my laundry to dry, I began writing some deep thoughts, deep like I didn’t want to deal with them. I basically wrote a page of self-help advice.  I appreciate my stubbornness.

My answer:

This sounds like a woman of courage doing it, taking accountability for where she is at, afraid maybe but pressing on to start over any time she chooses, demanding her freedom to self-care.   Demanding freedom seems like an oxymoron but this is what is called for when we feel trapped.

I will add to this “answer” that self-care often seems like an oxymoron.  Such as using the brain (the same organ that is diseased) to figure out what it’s behaviors and emotions mean or everything starts and ends with Me (when we know that there was a beginning before Me) – we see the weaknesses and the conflict and we say yes.  I am an oxymoron.  I am good and bad.  I am healthy and ill.  I am growing and dying.  I am flawed but perfect.  I’m sure you have more.

Demanding freedom is a basic tenet of self-care.  We say that despite the limitations in our lives, in our decision-making, in our suffering or pleasures – despite all, I am free to do self-care.

Questions:  How have you managed to demand your freedom to self-care?  What oxymorons in your life are empowering you in your self-care?  Please tell us your story.

Our Embrace With Our Powerlessness Stabilizes More Than Our Power

In our growing familiarity with our fears about medication therapies, we are getting to know about control and identity.  Separate those in hopes that will help us bring them together later.

            I don’t want to lose control of my choices to the control of medication.

sugar_frosted

Image by sillydog via Flickr

Jane had pocks on her face from childhood acne.  Kids had bullied her.  She learned to fight.  Jane’s mother had a boyfriend who victimized Jane.  She fought harder.  Not against her mom or her mother’s boyfriend, but against kids.  Jane left her mother’s home when she was fourteen and lived between friend’s houses.  Her story continued to develop.  Jane learned to really fight.  She bloodied herself to get control and she still had her teeth.

Jane had sold marijuana for five years when I saw her.  She had used one to two bowls a day since she was twelve.  It was one of the first things that had given her a sense of control.  Emotions sparking, nerves peeled back and exposed, dilated eyes, afraid and shaking; Marijuana took the peaks and filled in the valleys.

And what brought Jane in to my clinic?  This scraping, scratching survivor?  Weeping, Jane’s pocks folded as her face scrunched up.  Thirty-one years old and she was not in control.  Jane was suspicious of everyone who crossed her path, she couldn’t concentrate and just suffered an at fault motor-vehicle accident when she was ticketed for carrying marijuana.  Jane awaited her trial.

Reader, you see the push-me pull-me in the room.  Was Jane ever in control?  Are any of us?  Our embrace with our powerlessness stabilizes us more than our power.  This was the time in Jane’s life where she was available for help.  This was one of the best times of her life, even if she didn’t know it.  It is the surrender of all that we are, controlled and uncontrolled, to our Higher Power that stabilizes us.  Control comes from the outside in.

But being a friend to ourself isn’t about control.  It is about putting ourselves immediately and ultimately in the care of Love.   What does Love want for us?  To be good to ourselves.

We offer medication therapy (and sobriety) not to put us in control or to take away control.  Assuredly some of our goals will happen.  But still, we offer medication therapy when the benefits outweigh the risks to “Me.”  When it is friendly.  Not to erode us.  See blog-post, Self-Care Works You, Pushes You, Tires You Out Until You Are Happily Spent On Your Friend – You.

Over the past two days, we have asked a lot of questions and gotten insightful, perceptive, inspired and intuitive answers with power to connect us and point toward healing.  We will continue to explore these questions and these answers, as they will continue to influence our relationship with and ability to befriend “Me.”  For today, however, I will bank these Q & A pages and pause Jane’s story.  I send you into blog-post, Are Your Meds Safe?

 

Other Fears of Medication For Brain Illness

Yesterday we talked about fears of addiction to medication therapy.  There are other fears that influence our choice to use or not use medication therapy for brain illness.

In clinic, we hear about people’s preference not to take medication, as if it were like ordering mushrooms or no mushrooms on pizza.

I am not someone who likes to take pills.

veggie pizza

Image by mccun934 via Flickr

Again, I think most of us agree entirely.  Who of us set out in life thinking, “I hope my life depends upon medication therapy?  I just want to have a reason to medicate.”

So tell me about this.  Questions:

  1. Are nonprescription substances safer for us?
    1. If so, why?
    2. If not, why?
  2. What are other risks you fear of taking medication for brain illness as compared the risk of brain illness remaining and likely progressing untreated?

Fears can provoke us to grow stigma and biases.  However they can also be used a tool for getting friendly with ourselves.  We can use our fears.  We can use them to gain clarity to know better why we are making our choices – stigma? Or friendship to Me?

Nothing is all right or all wrong.  But we should know our motives if we can because of it’s potential usefulness.  It is a friendly thing to do.

Self-Care Tip #285 – Know your fears so you know why you are making your choices.

Fears of Addiction To Medications for Brain Illness

I don’t want to get addicted!

We agree.  Who does set out to get addicted?  Is that really a starting motive for anyone?  “Ok.  I’m going to take this pill crossing my fingers that I get addicted.”  Even those of us who have suffered from addictions of illicit substances such as cocaine didn’t get into it hoping it would hook us real good.

pills galore

Image by "Boots McKenzie" via Flickr

So here are some questions for you:

  1. Do you have this concern about psychotropic (i.e. for the brain) medication?
  2. How do you see prescription medications for brain illness in comparison to illicit drugs?
  • Are they related?
  • And if so, how?
  1. Is there a difference in addictive qualities between one medication for the brain and another?
    • Is there a difference in addictive qualities between a medication for the brain and a medication for the rest of the body?
  2. Does the amount of time we stay on medication affect our risk of addiction?
    • I.e., more time, more addiction?
  3. What are other fears re: the risk of addiction with psychotropic medication that you have or think others may have?

Fears can be anxiety provoking filling us with dread and avoidance, including fears of medication addiction.  However, they can also promote a more deliberate course.  We can use our fears to get friendly with ourselves.  We can use our fears.  Fears can be a the energy we needed to do the work, to gain clarity about what we need to consider fair warning and what should be thrown out.

Self-Care Tip #284 – Use your fears as a tool to clarify what precautions are worth keeping and cleanse your stigmas otherwise.

Stop! Don’t Stop! – Affecting Our Practice Of Medicine and Other Agendas

Self-Care Tip #281 – Be aware of how your “Stop!  Don’t stop!” behavior is interfacing with your agenda.

One of the challenges in practicing medicine is the inevitable “Stop!  Don’t stop!” petitions.

stop & go

Image by Joseph Robertson via Flickr

It’s similar in a few ways to being a shoe cobbler who receives clients that don’t want her to use leather.  Ms. Cobbler spends 40-60% of her time with clients persuading them of her capacity to use leather, the objective and subjective evidence behind the use of leather and empowering her clients to wear their leather shoes despite public opinion.

This sounds silly and is not meant to be disrespectful to patients, including myself as a patient of physicians and my own difficulties being a patient.  It is only to describe the forces we are all working with when we work together in medical care – physician and patient.

Quenn came in reminding me of this.  Quenn was a 32 year-old married mother of three, who complained of trouble swallowing, sleeping and ability to feel pleasure over the past two months.  She had struggled with this after her mother died nine years ago, but the problems went away over the following year.  However nine years-ago, Quenn was not a mother.  Nine years-ago, Quenn could shake, stay in the house with the shades down, silent or crying loudly, not eating lying in bed for days and if she wanted, nine years-ago no one would know.  This time however, Quenn told me she was desperate.

I have to get better!  This time, I’ll do anything!  But please start with something natural.  I don’t want to get addicted!  I’m someone who never does meds.”

Quenn, why are you seeing me?  

This is challenging for everyone.  Together, the physician and the patient work with this influence on their agendas.

My brothers and I used to play a game on each other when we were kids.  Maybe you did this too.

Stop!  No don’t!  Stop!  No don’t! Stop!  Don’t!  Stop! Don’t! Stop! Don’t stop! Stop! Don’t!  Don’t Stop!  Don’t Stop!

And for some reason that was hilarious to us.  I like to remember this when I’m in the office and smile despite being played by the “Stop!  Don’t stop!” behaviors and emotions.

Questions:  How about you?  How are the “Stop!  Don’t stop!” behaviors and emotions playing on your agendas?  Please tell me your story.

Mental Illness Relapses When Medications Are Stopped

Free face of a child with eyes closed meditati...

Image by Pink Sherbet Photography via Flickr

Self-Care Tip #246 – Collaborate with your physician to change your medications.

It keeps happening.  People are stopping their medications and then getting more sick.  Recently it was Olivia.  I can always tell when she’s off medications – she personalizes things way more and she acts like a victim to many many random things.  She is irritable.

Olivia, did you stop your meds?

Olivia on medication was not a super easy-going person but she dropped much of the edge, her thoughts were clearer and she was able to see other people around her.  Today Olivia felt like her bullets were in place and about to fire.  She answered my question obliquely.

There are sooo many reasons I am better without those in me!   I used to not be able to feel God.  When I prayed, I didn’t sense His Spirit.  Besides, I’m doing fine.  There’s nothing wrong with me.  I’m happy!

The biggest bummer about getting into the scene after the medications were stopped verses before, when stopping them was just a consideration – is that the patient doesn’t see themselves clearly.  They don’t see how bad it’s gotten.  They can’t be objective largely because they are using the same organ that is ill to describe itself.  If I could have discussed it with her before she stopped her medication, she would have been in a healthier state and more able to weigh her risks and benefits of medication verses no medication.

Sometimes we do agree together, patient and physician, to stop medications and sometimes we don’t.  Doing it together is the key though.

Questions:  How do you work with someone who wants to come off their medication?  How about yourself?  Has this ever been a problem for you and if so, how did you deal with it?  Please tell me your story.