Content Warning And Disclaimer:- Contains potentially distressing material. The story/essay is based on my personal experience. It does not deny the usage and importance of psychiatric medicines. This blog/story/essay is not a therapy platform. Please do not self-diagnose if you experience a mental health concern. Consult a professional and if you don't know anyone write to me at [email protected] for mental health support.
On a beautiful day, I found myself en route to meet a psychiatrist for the first time. The journey to the hospital took an hour, a ride I usually relished, particularly when the clouds gently veiled the sun. This kind of weather often served as a muse for my artistic pursuits. I'd either create art at the moment or capture my emotions to write later. However, on this particular day, despite the allure of the weather, my courage to revel in its beauty was eclipsed by intrusive thoughts.
Even before reaching the hospital, my mind was already there, preoccupied with crafting potential scenarios to mitigate any alienation upon arrival. Ever since the trauma disconnected me from my soul, embracing the newness of anything had become a struggle.
The recommendation to see a psychiatrist had come from my therapist, Pallavi, following my admission of struggling to get up from my bed, enduring bodily tremors, dizziness, and self-harming tendencies. She recognized that my mental illness was affecting both my body and mind. She said, “To heal, you must be present in therapy.” This resonated deeply with me, it was enough for me to understand that therapy wouldn't help me address my trauma psychologically unless I address my physical symptoms.
Previous therapists had also advised a psychiatric consultation, a suggestion I had resisted till this moment. One factor fueling my reluctance was the stigma associated with psychiatric medications. Given my history of substance use and alcoholism, I had no will to discontinue either substance use or alcohol. I was not ready to be sober and face life's reality. I was worried about the potential drug interaction between psychiatric medications and alcohol.
However, shortly before beginning therapy with Pallavi, I had taken the decisive step of quitting substances and alcohol. Hence, when she recommended seeing a psychiatrist, I agreed. Upon arriving at the hospital's waiting area, anxiety gripped me, inducing numbness in my legs and a resting heart rate of 120 BPM. Gathering myself, I started walking, hoping to restore a sense of calm by reconnecting with my body.
"Ankit Gupta!" a staff member called out, and I promptly replied, "Yes, I'm here." As I entered the psychiatrist's room and seated myself, a wave of calm washed over me. A sip of water helped steady my nerves, and she ensured my comfort before initiating conversation. We delved into discussions about my family history and childhood.
Remarkably, the scenarios I had mentally scripted for discussion evaporated from my mind. A newfound lightness enveloped me, and the numbness receded. As I recounted my past, my emotions spilled over, but the psychiatrist listened without interruption. "I'm sorry," I apologized. Swiftly, she reassured, "Let me emphasize, none of it was your fault."
Understanding the root cause of my mental illness had been a gradual process, leading me to accept that the blame wasn't mine to bear. However, hearing it affirmed by a psychiatrist was profoundly validating and relieving. Our conversation continued, and as she documented her assessment, she revealed, "Ankit, you are suffering from post-traumatic stress disorder (PTSD), severe anxiety disorder, and severe depression."
A pause followed her disclosure - "Your physical symptoms—dizziness and trembling—are manifestations of severe anxiety," she elaborated. A question welled from within me, "Will I ever be okay?" Her response was assuring, "Absolutely, though it might take time. I'll prescribe medications, but please don't quit therapy." Her smile conveyed hope, and she set me up for a follow-up appointment in 15 days.
I had put my faith in the psychiatrist's expertise, a belief that was initially bolstered by her reassurances. However, after four days of diligently taking the prescribed medications, I observed no discernible change in my health. If anything, my body felt relatively more fatigued. An increased lethargy tethered me to my bed, altering my routine. I decided to reach out to her, detailing the lack of progress and the side effects I was experiencing. Responding to my concerns, she made a change to one of the medications. The total regimen consisted of 8 medicines, all classified as Selective Serotonin Reuptake Inhibitors (SSRIs).
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Following this adjustment, there were a couple of days when I noticed a subtle increase in my physical activity, a glimmer of progress that buoyed my spirits. In the midst of these changes, I scheduled a therapy session that turned out to be enlightening. Unearthing aspects of my childhood that were influencing my present, I experienced a sense of breakthrough. However, this burst of clarity was short-lived, as the fatigue and numbness returned two days later. Frustrated by the oscillations in my condition, I contacted the psychiatrist once again. In response, she altered two of the medications in an effort to address my evolving symptoms. Despite these fluctuations, I continued to have faith in her guidance and extended my patience to myself.
Though I clung to my belief in the healing process, a point arrived where I felt akin to a test subject, subjected to a succession of medications without any improvement. This frustration eventually led me to discontinue my visits to the psychiatrist. During this period of wavering trust in psychiatric medications, I am grateful to Pallavi for sustaining my belief in the healing journey, alongside the medication. Remarkably, Pallavi never explicitly pushed me to continue with the psychiatrist; rather, she allowed me the space to process the emotions stirred by the experience. Our dialogues gradually rekindled my confidence in seeking another psychiatrist's aid. Pallavi's approach was organic and non-intrusive, never imposing her views but instead inviting my input. While her methodology harmonized with my perspective, her receptiveness to my suggestions fostered a collaborative and effective approach.
Despite asking me to not quit therapy, my psychiatrist's approach seemed to be predominantly medicine-driven, reducing my mental health to a mere chemical imbalance attributed to serotonin deficiency. These impressions compelled me to seek out another psychiatrist, who, upon reviewing my history, concurred that the initial prescription of 8 SSRIs seemed excessive given my history.
“Are you seeing a therapist?” he asked. “Yes, I am and it is helping me more than any medicine.” My anxiousness forced words out of my mouth. “With all due respect to your previous psychiatrist, I wonder why would someone prescribe this amount of SSRIs for a history like you.” He was shocked and it was clearly visible on his face. He recognized the significance of addressing my trauma, and the subsequent prescription was composed of two milder medicines. He assured me that the bodily fatigue, dizziness, and trembling I was experiencing were reactions to the accumulated trauma and not solely a chemical imbalance. “Your healing could only be possible by addressing the underlying cause. “These medicines will only help you to get relief from your physical symptoms but your history with trauma needs to be addressed at a psychological level”, he further added. He emphasized the importance of therapy in tandem with medication. I embraced his approach, echoed by Pallavi in my previous conversations with her.
In a matter of days, my body's responses underwent a dramatic transformation. Fatigue lessened, and the dizziness and trembling diminished. This newfound relief allowed me to engage more fully in my therapy sessions, a crucial breakthrough. This experience led me to realize that psychiatric medications weren't inherently problematic; rather, it was their overuse and insufficiently holistic approach that required attention.
Beyond my personal journey, I encountered others who had been prescribed antidepressants by general physicians instead of being referred to psychiatrists. Instances of improper diagnosis, hasty prescriptions, and lack of informed consent were unsettlingly common. I witnessed this trend even within my extended family. A stark illustration was provided by a member of my extended family, who was grappling with frequent panic attacks. Initially, they attempted self-diagnosis, resorting to over-the-counter medications readily available at medical stores. As the panic attacks persisted, they eventually turned to their family doctor for help. Learning of their situation, I inquired about the prescribed treatment. To my astonishment, I discovered that the SSRI recommended to them was the same that I had been prescribed by a licensed psychiatrist. However, the shock didn't stop there.
Upon further inquiry, I unearthed another disconcerting revelation. The doctor who prescribed the medication had neglected to inform them about the diagnosis and the nature of the medication. Troubled by this lack of transparency, I urgently recommended to consult a psychiatrist before proceeding with the medication. My wife's experience mirrored this pattern. A physician had prescribed an antidepressant to aid her sleep without fully explaining the medication's nature. She was grappling with abdominal pain at the time. While general physicians are indeed authorized to prescribe antidepressants, these instances underscored the problem of excessive prescriptions, inadequate information sharing, and the absence of referrals to psychiatrists in severe cases. This disconcerting reality was also corroborated by a 2014 research paper suggesting that general physicians often employed psychosocial approaches rather than thorough biological assessments.
Indeed, SSRIs have emerged as invaluable tools in the realm of mental health treatment. Nevertheless, it's essential for medical professionals to recognize that mental health can't be distilled to an individual lens. Over-prescription, insufficient information sharing, and a lack of consideration for underlying causes can undermine the effectiveness of such medications.
Pallavi, with her empathetic and organic methodology, consistently reinforced the notion that my trauma needed addressing beyond a simple chemical imbalance. Our society's structures, including gender, caste, and disability, are fundamental determinants of our mental well-being. Conversations about these facets, however uncomfortable, are necessary to fully address mental health, preventing dominant medical paradigms from relegating it to an individual concern rather than a societal issue.
P.S. Thank you Samrin for your time to edit the story.