Choosing Psychiatric Dependence

Ms. Spechler lends, perhaps unintentionally, to the widespread paranoia about medication dependence: Truly relying on medication, our fearful culture would have it, limits our capacity for true health. Dependence is not, however, a categorical evil.
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I envy Diana Spechler, the author and essayist who chronicled her multi-month project to wean herself off psychiatric medication in Going Off, a set of poignant New York Times columns. I envy the luxury of a life that permitted her that much time to be less-than-okay and the emotional wellness to survive sans antidepressants. I wonder, and seriously doubt, if I will ever be in such a place. Even if I were well enough to quit the drugs that keep my anxiety, depression, and ADHD under control, the process of doing so would likely wreck the fragile pre-med GPA I have constructed in the last two years. My medical school acceptance depends on my consistent academic performance in these next two years, my residency on my performance in the following four, and so on. At this point, psychiatric medication is a well-engrained routine in my life: My anxiety fluctuated in severity but persisted until my first encounter with SSRIs at 17; when I became depressed in college, my psychiatrist recommended that we increase my dose, a measure that may have saved my life. Last fall, a positive ADHD diagnosis and stimulant prescription allowed me the realization that simply existing doesn't have to mean a constant struggle.

I am thrilled to have a found a combination of drugs that allows me to pursue my personal and academic dreams. I am also thrilled for Ms. Spechler's success going off meds. But the final installment of her column, 10 Things I'd Tell My Former (Medicated) Self, left a sickly taste in my many-pill-swallowing mouth. Not because any of the 10 things is poor life advice; in fact, all seem insightful and practical words of wisdom. They presume, however, that good self-care and personal satisfaction are victories tied to the ultimate triumph of medlessness, rather than aims in their own right. Ms. Spechler stresses transparency and communication with friends and family -- also important for those of us on medication. She suggests a clean diet, but also a commitment to forgiving oneself -- wonderful aims, and still in reach for those of us on medication. Valuing my free time as an act of healing? Definitely possible on medication. Avoiding a breakup? For sure on my list, along with taking my Adderall every day.

Ms. Spechler might only have been able to reach her current state of wellness by weaning herself off the medications she feels she no longer needs, and I share in her happiness for this newfound emotional and physical health. By advertising her personal achievements as the fruits of her psychiatric cleansing, however, she makes the implicit allegation that a drug regimen including her former treatment plan -- a regimen shared by many an anxious and depressed American -- is essentially exclusive to reaching full emotional, physical, and spiritual wellness. This is simply untrue, and a dangerous mythology for those hesitant to begin psychiatric medication, as well as those for whom medication is a lifelong commitment. Ms. Spechler lends, perhaps unintentionally, to the widespread paranoia about medication dependence: Truly relying on medication, our fearful culture would have it, limits our capacity for true health. Dependence is not, however, a categorical evil. True, I can't function without my psychiatric meds. But I also can't function without my contacts, and I've yet to see a column about the merits of quitting corrective lenses -- though they, like medication, have unwelcome side effects.

For many Americans, like Ms. Spechler, psychiatric medication will serve only as a temporary aid. For others, medication is a perpetual necessity. If the former population persists in characterizing their medicated selves as less-than-whole beings, sustained but always limited by their consumption of psychotropic chemicals, they risk convincing the latter that this semi-wellness is our ultimate fate. Who but our medicated selves can refute that myth? We have a right -- an obligation, even -- to share our own experiences in psychiatric treatment. To tell those who identify with us only as discarded, former selves: We too can be whole. We too can be well.

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