When Medication’s What You Need
In direct correlation to the physical decline I experienced from my progressive eating disorder symptoms and behaviours, I unfortunately experienced a sudden decline in my mental health at age 20, where I ended up having numerous emergency appointments with my GP and local A&E department.
At this time, I had already been referred to my local eating disorder service, where I had been placed on an open-ended waiting list. We desperately hoped I would be invited for an assessment and offered support before I reached this point, but services were stretched and understandably I had to wait my turn.
My GP did his best to help me, prescribing antidepressants that we hoped would alleviate my depressive symptoms and escalating despair. But these medications didn’t help as much as we hoped, which was likely the result of my declining physical health, semi-starvation, and uncontrollable purging behaviours.
As I continued to struggle mentally, I had numerous visits to the local A&E department when I reached crisis point. I was often prescribed additional medication to take ‘PRN’, which meant as and when I needed it to help manage my overwhelming thoughts and urges to cause harm to myself.
Despite my emotional anguish and despair that were making each day a living nightmare, I was very concerned and reluctant to take psychiatric medications prescribed by the doctors. My primary apprehension was centred around the following:
- Terrified they would cause weight gain
- Ashamed of needing meds to function and be ‘normal’
- Fear I would become reliant
- Concerned about side effects
If honest with myself, much of my apprehension around taking medication was driven by my eating disorder, where it tactically fuelled and escalated my fears over the possible side effects. And no surprise, it sadistically capitalised on my existing ED symptoms and concerns, bringing out its most powerful weapon against me, which was my fear of gaining weight.
My mental decline and fragility allowed my ED to thrive, manipulating my mind so it could maintain control. It used all my concerns to convince me that medication was the enemy, I did not need it, and that I was better off without it.
Medications can have side effects, and they may not work as well as hoped, but reasoning with myself and rationalising the situation was a turning point in my mental health journey. Yes, I did not want to undo the hard work I had already done to get to my current weight, but I couldn’t live the way I was with the uncontrollable binging and purging.
I quickly learned that reading the list of side effects gave my eating disorder further ammunition to use against me. It was so powerful that I honestly believe I started to imagine some of the symptoms I was feeling, as my eating disorder planted any seed in my head to increase my reluctance to comply with my treatment plan.
Over the years I have tried and tested so many combinations of medications, antidepressants, mood stabilisers, antipsychotics, and anxiety medications, but finding the combination that was effective for me took many years. It was a tough fight against my eating disorder brain, but I persevered and tried every medication that I was prescribed by the psychiatrist and GP.
It can be really scary taking medication, especially when you’ve got an eating disorder and you read the side effects where weight gain is mentioned as a possibility. But what I tried to tell myself was that this wasn’t the case for every patient and that I needed to try anything I could to alleviate the daily mental battle and feelings of not wanting to be on this earth any longer.
Not only is the trial-and-error process frustrating and anxiety provoking when you’re not in a good place mentally, but it proved hard to remember to take my tablets due to my erratic, chaotic brain. This was dangerous and only hindered my progress because not only did it amplify the unhelpful feelings and emotions, but there was no way of getting a true representation of how I was responding to treatment or accurately concluding whether the meds were truly helping.
There were times I was naughty and couldn’t be bothered to take my medication, which was most often when I was feeling low and lacked the energy and enthusiasm to do anything, let alone sort out all of my tablets that at one point totalled 19 per day. But I quickly learned that this did not help my cause and sent me further down the spiral to desperate hopelessness.
Another obstacle I had to contend with in terms of getting the best from my medication was navigating when to take my tablets considering my frequent, daily, self-induced vomiting. Frustratingly, binging and purging was the first thing I did every morning and the last thing I did at night, so it was inevitable that I would likely bring up some — if not all — of my meds at some point in the day, so I would never get the therapeutic dose I had been prescribed.
In the early days I never mentioned anything about the issues around the timing of me taking my medication, because it didn’t really cross my mind and I didn’t realise it could have that much of an impact. But when I eventually raised it with my psychiatrist, they confirmed it could have a significant impact, so we worked together to devise a plan which involved taking most of my meds last thing at night so they would fully absorb into my system.
We had to be careful considering the number of tablets I was taking, because some can be dangerous if they are consumed all at once, so it was important for me to listen, comply, and stick to the plan.
What I Have Learned
Despite my reluctance to take medication, which was very much fuelled by my eating disorder, it has proved a key player in my recovery and mental health journey. Over the years I have tried many different types, doses, and combinations in an attempt to stabilise my mood and manage symptoms, allowing me to function in society and build a life in the outside world, where it once felt mildly tempting to surrender myself to a life of institutionalisation away from the overwhelming responsibilities that came with navigating life in the real world.
My need to take daily psychiatric medications is not my preferred way of life, but I accept it is essential for me to stay well and protect the life I have built in recovery, and that I am eternally thankful for each and every day. So I will continue on, suck it up, and swallow those pills — however much I hate it.
Please refer to the video at the top of this post to learn more about my concerns about taking medications, and how I managed to challenge these thoughts to comply with treatment
