One of the easiest things to do is to pop down a pill especially when we know it’s for our own good. And yet, here we are facing this dilemma of our lifetime whether to continue taking the pill as advised by our doctor or drop it off. No one likes taking any kind of pill, even health supplements, neither for physical health nor so for mental health. If given a chance each one of us would want to cheat on our pills. To understand the pill aversive psychology, I would like to think of the reasons as to why that thought is so overpowering.
- Taking pills every single day is tedious, may be annoying. Often times, we tend to forget them, or much worse, we run out of them, then we need to order them, then we need to organize the prescription, so on and so forth. One intriguing finding, however, is that longer you take your pills, better are the chances of remembering to take them, even better is the efficiency of organizing them.
- Financially, it could be burdensome to buy or continue pills especially when they are expensive. An interesting point to note here is, that people tend to forget taking the cheaper medicines far more commonly than the expensive ones!
- Psychologically to most people, pills often make them feel less of a person. I listen to heartwarming stories everyday where people confess that taking pills daily makes them feel abnormal about themselves. What I understand from their stories is that the reason they take pills is more of a problem for them and not really the act of taking pills. Basically pills remind them of their illness and that makes them feel inferior about themselves. Counterintuitively, pills are meant for recovery, which means no illness, which means better health, which means better quality of life. Pills need to be equated with freedom from being abnormal, and not with being abnormal.
- The fear of getting dependent on pills, or a broader category of “side effects’ is a potentially serious reason for people not to want to continue their pills.
- A very strong belief that they do not have any kind of problem and the very reason that pills were forced on to them is another big subset of reasons why individuals don’t want to continue meds, especially in mental health.
- Narrative that the problem was never big enough to warrant meds initially and now, though I feel much better with meds, I don’t think I should be continuing them as they are not giving me any benefit, despite the fact that there are no side effects at the moment. We have an official medical term for this – Retrograde Falsification! Remember you came to meet the doctor because there was a problem in the first place, big enough to warrant her attention. And about the benefit, well, If you are doing so very well that you have forgotten what made you start the process, the credit must go to the ongoing meds.
- Then there is this ancestrally inherited prejudice that medicines, all kinds, are harmful for my body. What harm exactly – no one is able to elaborate but the pills are harmful!
- Then there are bigger existential questions that we have medicines because it is a pharma driven industry, money flows in the R&D protocols, it has to come back to the big shots, medical industry is too commercialised, etc etc.
I understand it when an individual sitting in front of me picks up one or more of these thoughts while our discussion is swinging from one pole to another about medicines. My heart goes out to their struggle, and I feel helpless, yes I do! I totally empathise and yet here I am – telling everyone that we must normalise taking pills whether for Diabetes, Hypertension, Heart problems, Cancer, even health supplements and for that matter, mental health too. Your reasons could be outnumbering mine, because I have just ONE reason why I should take my pills, and that supersedes every other – I should take my pills because they make me better, they improve my quality of life and that’s priceless!
If anything is coming between you and your pill, it can be worked upon. Side effects, fears, apprehensions, confusion about the prescription, prejudices – everything has a way out if you open up about your thoughts. Whether to continue or to stop the meds need to be mutually decided by you and your doctor. Exploring the benefit-versus-risk profile should be able to answer all the concerns. And it is not only true for mental health, but also valid for all physical ailments.
If we talk about mental health specifically, the role of medicines can’t be over emphasised. I must tell you that pills have significantly averted suicides, saved families from falling apart, eased out caregiver’s burden, patched relationships through the harshest of times and prevented many disastrous outcomes. Also, failure or delay to seek help in time has resulted in equally outrageous and catastrophic consequences. Here is a heartwarming anecdote from my clinic.
I met a gentleman in his forties suffering from severe anxiety for almost a year, completely incapacitated and exhausted because of his mental health issues. Medicines had such a dramatic positive impact on him, he realised anxiety was present much longer than that one previous year, probably he grew up with it, probably he endured it so much, he had started to consider it a part of his being. During his recovery journey, his self-awareness and pragmatism touched me so deeply, I must share it with all of you. In one of our conversations, he confessed candidly – “Doc, if being normal feels like this, I can take my pill for the rest of my life, I think popping down a pill is the easiest thing to do for a person like me, who abhors therapy and wants to accomplish so much. You may call it vagaries of modern life, but if stress can’t be reduced, I would much rather boost my serotonin system to fight that stress. Don’t we take a cup of coffee every morning to improve our attention, enhance our mood and elevate our motivation, I am sure my pill is doing the same for me. As far as side effects are concerned, adverse effects of anxiety are much more harrowing on me. So yes, let me know till when I should be taking my pills, and I will follow what is being advised.”
I would like to conclude this article by leaving you with this thought to ponder.
Either we invest in our health, or we will have to invest in our illness. Both are difficult but we will have to choose our difficult. Despite our best efforts or no efforts to preserve health, whenever we are into an illness, going to a doctor helps only if we are willing to follow the evidence-based practices. Next time before going to a doctor, have a descriptive dialogue with yourself as to what do you really want from the doctor? Because if you do not have that answer, chances are that your doctor too won’t have it!
Wishing you the best of mental health today and always!
Dr Apala A Tuteja