How ‘Pill Shaming’ Hurts Those Who Take Medications for Mental Health
Earlier this month, musician Kanye West ranted about politics and slavery following the season premiere of NBC’s Saturday Night Live.
Among other elements of his speech, he told audience members that this was the “real” Kanye speaking and he was off his medication, a nod to his earlier revelation that he had been diagnosed with bipolar disorder.
“Public figures talking about their mental health issues can help bring awareness and combat stigma surrounding these common conditions,” said Dr. David Hu, medical director at Behavioral Health of the Palm Beaches in Florida.
“Some people with mental illness never seek treatment because they feel shame. Knowing that they are not alone, that someone they admire has mental illness too, can be a powerful motivator to seek the help they need,” he said.
Comedian Pete Davidson, who is a cast member on Saturday Night Live, has openly talked about his own mental health issues. Davidson encouraged the rap singer in the subsequent episode of the weekend variety show to take his medicine again.
“There’s no shame in the medicine game,” Davidson said. “I’m on ‘em. It’s great.”
Davidson’s plea to West is perhaps just what the doctor ordered when it comes to opening up a conversation about mental health.
Turning the page from recognizing the need for help to getting someone in front of a doctor for help is a struggle that doctors, therapists, and other experts face.
Davidson’s own experience may help individuals recognize the risks of not seeking help and not continuing their treatment.
“Many people with mental health issues lack insight and do not believe that they have a problem,” Hu, who is certified by the American Board of Psychiatry and Neurology, told Healthline.
“This lack of insight can be particularly profound with mentally ill celebrities because they often find themselves surrounded with industry people that reinforce their problematic thinking and provocative behavior for the benefit of the tabloid persona and not for the benefit of the person,” he said.
A 2015 study found that only 50 percent of people diagnosed with schizophrenia actuallyfollowed their treatment regimen and took medication as it’s prescribed to them.
Another study, this one from 2016, found that between 10 and 60 percent of patients didn‘t take their antidepressant medications regularly.
In both studies, the reasons people gave for not taking medicine varied — from physical to emotional, financial to forgetfulness.
“Treatment adherence to medication is one of the most difficult challenges for people who have a mental illness,” Colleen Koncilja, a licensed clinical social worker with a private therapy practice in Illinois, told Healthline.
Here are reasons why people with mental health disorders stop taking their medicine — and why that can be so problematic.
‘I don’t have a problem.’
“A lot of people are in denial. They don’t recognize how bad their mental illness is,” said Raffi Bilek, LCSW-C, director of the Baltimore Therapy Center. “Starting to take pills is an acknowledgement that ‘I can’t handle this on my own.’”
Bilek told Healthline this same issue doesn’t plague as many people when it comes to physical illnesses.
“If you have diabetes, you don’t try to go through it on your own. You take insulin,” he says. “With many mental illnesses, trying to go it without treatment is not a great idea, but people have this idea that, ‘If I can’t handle it, I’m weak. Something’s wrong with me.’”
‘Needing medicine says something bad about me.’
“Taking medication is a continual reminder that one has ‘something wrong’ with themselves that needs to be treated,” Koncilja said. “People can often struggle with negative beliefs about themselves, thinking they are ‘less than’ if they have a mental illness or if they need medication.”
These feelings feed shame. It perpetuates behaviors and emotions that leave someone feeling alone and isolated.
That can, in turn, make symptoms of the mental illness more severe.
‘I feel better. I don’t need medicine now.’
“Most individuals with severe mental illness take medication until they begin to feel better,” Ashley Hampton, PhD, a licensed psychologist and author in Alabama, told Healthline. “In illnesses like schizophrenia and bipolar disorder, it is extremely common for individuals to not be medication compliant.”
For people with schizophrenia, Hampton notes, the medicine can make hallucinations stop, and patients can then believe they’re cured. They discontinue their medications.
“When they stop taking the medication, it is only a matter of time before symptoms reoccur,” Hampton said.
‘I don’t have the money.’
Some health insurance companies do provide mental health treatment and pay for psychotropic drugs.
However, Hampton says, not all do.
Plus, not all individuals want to use their employer-provided health insurance to seek mental healthcare.
That’s because in some professions, such as law enforcement, seeking treatment could jeopardize your standing in your occupation.
“Financially, those people may not be able to pay private pay rates,” Hampton said.
‘The side effects are worse than the symptoms.’
Side effects of antidepressants, anti-anxiety medicine, and psychotropic drugs can include sedation, insomnia, drowsiness, dry mouth, weight gain, and sexual issues.
“That can be a powerful deterrent if someone is already ambivalent about taking medication,” Koncilja said. “Often, side effects subside after our bodies acclimate to the medication, but some do persist. Like any treatment, the pros need to outweigh the cons.”
‘I don’t like feeling shamed.’
Unlike treatments for physical illnesses, mental illness diagnoses and treatments still carry an air of shame for many people.
“In society, there is a common misconception that if you take medication for a mental health diagnosis, it means you are not as strong as you should be, or that you’re ‘crazy,’” Robyn Gold, LCSW, a therapist in private practice in New York, told Healthline.
When someone does accept treatment and begins to take medication, they may experience “pill shaming.”
This experience is one of the strongest deterrents for people wishing to continue medical treatment for mental health disorders.
Let’s say you’ve finally decided to talk with your doctor about what you’re experiencing.
You’re even open to taking medication to help rebalance your brain’s chemistry.
Then a friend tells you that you don’t need pills. You just need to work out more, or eat better, or spend a bit of time meditating.
This is a form of pill shaming.
Pill shaming occurs when someone expresses negative opinions or disdain when you tell them you’re using medication to treat a mental health issue.
They assume — wrongly — that taking medication signifies weakness of character or an inability to work through tough times.
“The reality is, psychotropic medication is being prescribed to assist in medically balancing a chemical imbalance,” Gold explains. “Unfortunately, many individuals suffering from this condition do not wish to be treated with medication due to societal stigma and a misunderstanding of what this diagnosis actually means.”
It’s not just friends, families, or strangers on the Internet that may attempt to weigh you down with this shame.
“This belief is pervasive in our culture as a whole, but is even found in some self-help books or mutual-help support groups,” Hu said. “It is never helpful to shame individuals struggling with mental health issues and to discourage them from getting help in the same way that they would for any other medical condition.”
Treatment for mental health conditions can help end symptoms, restore quality of life, and allow you to feel healthy once again.
But it requires adherence to the medication and treatment plan your doctor gives you.
“Mental illness is not a moral failing or a lack of motivation and it doesn’t only affect people who don’t try hard enough,” Koncilja said. “Instead, mental illness is a chemical imbalance in our brains, and in order for us to not experience symptoms or active illness, we need to seek out and receive ongoing treatment.”
Oct 18, 2018
By Kimberly Holland