Deciding to take medications is a big step. You want to be an informed consumer. With the help of a qualified prescriber, it’s essential to learn about the pros and cons of medications, side effects, and how and when to take medicines. You should consider which medication is most likely to meet your needs in the safest and most effective way.
You probably have plenty of questions, as well as a fair share of stories you’ve heard (good and bad), beliefs, fears and hopes about this kind of treatment. Here are some of the most common questions I hear from my patients:
- Is this really going to help me? Will I actually feel better?
- Am I going to feel drugged? Will I feel “out of it?”
- What happens if there are side effects? I have looked on the Internet—drugs seem very dangerous to me.
- What if it doesn’t work?
- How long do I have to take a pill? Will I become addicted?
- What are other people going to think, like my employer or my family?
- I don’t want to become dependent on medicine. If I take pills, does it mean that I just can’t handle my own problems, that I am weak, that I should just “buck up” and push through?
Remember, you’re not alone in feeling some uncertainty, anxiety and resistance. The most important thing is to take the time to get your questions answered by a mental health professional with significant experience prescribing and monitoring use of these medications. Before beginning any prescription, you should feel as comfortably knowledgeable as possible about the decision process, the options, the reason for your ultimate choice, the expected benefit and timeframe for experiencing those benefits.
What happens when I start taking medication?
More uncertainties may arise after you’ve begun taking the medication:
- When should I start feeling something?
- What if I don’t feel anything? What if I can’t tell if anything is different?
- What if I feel worse?
- How will I know if it is working?
- What should I say to my friends and family about this? I might feel awkward about it or humiliated or criticized for my choice.
- What if people tell me I am making a mistake to trust any kind of medication?
- Who do I go to when I feel doubts or despair over trying to get help?
Actually, the first thing most people feel is—not much (for most, but not all medications). In fact, for many medications, you might feel no perceptible difference for several days. During the initiation period, your body begins to process this new substance, usually prescribed at a low dose, and adjusts to this slightly altered environment. Little to no change is in fact a good thing because it means that you are tolerating this addition without unbalancing your system and experiencing side effects.
Despite best intentions and knowledge of your body’s responses, however, sometimes you may note some unwanted effects. These can be barely perceptible differences, a slight sense of queasiness, a bit of fatigue, perhaps some shifts in your digestive routine. Most of the time these sensations fade over time.
Fortunately, intense symptoms and reactions are rare; however, they can appear within a day or two and be more disturbing and uncomfortable. These range from headaches, sleepiness or sleeplessness, gastrointestinal symptoms, skin symptoms like a rash or itchiness, and a variety of others. Should you experience any of these symptoms, stop the medication and call your prescriber immediately. In almost every instance, these more severe symptoms disappear within a day or two after discontinuation.
Having an adverse reaction is not common, but when it happens it is important to note and understand as much as possible about the occurrence. Those lessons will help guide subsequent treatment decisions.
Telling others about your treatment is a personal decision, and many, if not most, people keep this information private or limited to a very few number of trusted individuals. There is no need to go into detail if you choose to keep your private life private. Your decision should be respected by others. Your physician is obligated to maintain your privacy and to be open to receiving whatever you say, think, feel or do.
So I’m taking this pill, now what? When am I going to feel better?
Generally, depending on the medication and the indication for treatment, many patients start to feel some of the intended beneficial effect within a week or two. Nevertheless, with many drugs, the full effect of a particular dose might not be fully apparent until it has been taken for six or even eight weeks. This variability is normal and anticipated.
To monitor the initial responses, it is best to meet with your prescriber frequently during the first weeks of treatment. There is no reason to be stuck with uncomfortable feelings or uncertainty. Addressing your concerns early will enable you to work through and resolve questions, equip you with more information, alleviate your anxiety and allow you to attend to the processes going on in your body and mind. Ultimately, your goal in partnership with your prescriber is to preserve the hope and positive response associated with expectations for this treatment.
In my years of practice, I have found that most patients have good experiences with the commencement of treatment. Follow-ups should include relating your general feelings and experiences currently, and discussion about the finer point and subtle changes that are taking place. Here are some common experiences as medication begins to have a positive affect:
- I cleaned up my room for the first time in two years.
- I answered the phone without feeling like I was going to vomit or break out in sweat.
- My spouse and I were able to talk about hard things we have never been able to talk about before.
- I am not screaming at everyone all the time; in fact, I kind of enjoy things more now.
- Those temptations that have drawn me down so many times don’t seem so tempting anymore.
- I can actually read a page, a lot of pages, without stopping, and can actually remember what I just read.
- Things don’t look quite so black to me, as if somehow I can see things a little differently now.
- I went to a party and actually enjoyed it, even though it seemed very daunting at first.
These are just a few of the things that can happen when people set out on this journey to heal, to discover more of themselves, to be more themselves: real, focused, energized, connected, in short, to be their best. You can take this journey, too.
Dr. Donald Schiermer, MD, PhD, MPH, is a family physician and clinical psychologist with decades of experience in clinical practice and psychopharmacology. He provides compassionate counseling and comprehensive medication oversight to help you reclaim a hopeful, fulfilling life. Contact Dr. Schiermer today to schedule your appointment.
Image Credit: Clem Onojeghuo