For those of us who need meds, getting on them is almost as difficult--sometimes more--than finding a good therapist. For one thing, medication culture has made it harder to find a good prescribing doc. For another, meds take time to work and are fraught with possible side effects.
Let's start with finding a prescribing doc, since, obviously, meds can't happen without one of those. The safest way, I've found, to find a psychiatrist, is to ask your therapist for recommendations. She will usually know of someone safe and good.
What makes a prescribing doc safe and good?
1. One who listens to you. Appointments are generally fifteen minutes long. About five to ten of those should be spent talking about how you're feeling.
And--this--is a really important note: you HAVE to be honest with your prescribing doc. If you're just feeling "not suicidal" but you tell her you're "fine," she doesn't know any better. She can't read your mind.
But if you DO say "fine" and she doesn't press, doesn't ask questions about, say, sleep patterns and enjoyment of regular activities? Find another doc. Depressives are taught by society not to express themselves. Any doctor should know that's a self-protective measure.
2. One who explains things. You're NOT a doctor. You don't know what one drug does as opposed to the next. It's your doctor's responsibility to explain that to you, and to make sure your questions are answered.
3. One who gives you choices. You're the person who has to go on these meds. If you're doc is telling you something is imperative, i.e., "this is the only med that will work for you," something is hinky. Instead you're doctor should say, "there are a couple of routes we can go, here are the pros and cons of each," and leave the final decision up to you. It's rare that there's only one treatment option, this is not an exact science.
Let's assume you've found a doctor who fulfills all those prerequisites, now what?
Well, first of all, it's going to take about six weeks for the meds to kick in if this is your first go around. Do not freak out if nothing happens--that just means you need to try something else. Alternatively, also do not freak out if what happens is you stop sleeping and/or start gaining crazy amounts of weight, or some other serious side effect. Again, this probably just means you need to try something else.
TALK to your doctor about all these things. Tell her what's bothering you about it, what's working about it. Meds can be tweaked time and again--and need to be. I've had to change meds seven to eight times in the last seven years due either to them ceasing to be effective, or having counter-indications, or just side-effects that I couldn't stand. For instance, when I first when on Prozac, I stopped sleeping. Like, at all.
Sometimes, it takes a combo. I'm currently on a cocktail of Welbutrin, Lexapro, AND Abilify. There are side effects. There are going to be side effects with almost any of these drugs. It's a matter of whether you can handle them, or if they are worth the trade-off of not being suicidal and never wanting to get out of bed. For me, Lexapro and Abilify cause weight gain, something that is hard, because I have body dysmorphia. It's another reason why I exercise so much. But I make myself handle it in order to enjoy daily things like writing and spending time with my pets.
Medication is NOT for everyone, but if you've spent significant chunks of your life feeling hopeless and wanting to just close your eyes and sleep forever? It's definitely worth a shot.
I was amazed to find, when I first got on meds that worked for me, that there was someone underneath all that pressing, obliterating hopelessness, someone I actually found pretty interesting and diverse. There might be someone inside of you who you want to meet. It really is worth a shot.
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