Warning: This story discusses generalized anxiety disorder, panic disorder, and the use of medication. Please read with caution if these topics trigger you.
I knew that patients with mental health concerns often received poor health care. I knew that doctors were more likely to be dismissive of female patients, and I knew that accessing quality mental healthcare was a challenge for those utilizing the public health system. But while I was aware of all of this, I was still shocked when two doctors in a row brushed off my mental health concerns and suicidal ideation last winter. I was even more upset when these experiences led me to develop pharmacophobia, also known as the fear of medications.
As a patient with generalized anxiety disorder (GAD) and panic disorder, I experienced a particularly terrifying panic attack back in January. At the time, I didn’t have a primary care physician, so my therapist advised me to seek medication options by going to a walk-in clinic.
My experience at this walk-in clinic was terrible. The doctor told me she didn’t believe that anxiety was a mental illness and condescendingly asked me, “Are you just really stressed? Do you work out and eat healthily?” I explained that I was working through some trauma with the help of therapy and that it was becoming all too much. I also explained how I spent every day fighting off spiraling into another four-hour panic attack. She eventually prescribed me Xanax and sent me off. I knew the medication was highly addictive and vowed not to take it unless absolutely necessary. But after being exhausted from weeks of insomnia, I eventually took it to help me sleep. Unfortunately, it caused me to be even more anxious and to have suicidal thoughts for the first time in my life.
A few weeks later, I finally set up an appointment with a primary care physician. He prescribed me Mirtazapine and then casually told me that it might make my anxiety worse before it got better. I told him, “I don’t know if I’ll be able to survive if things got worse.” And he dismissively responded with, “Don’t overthink it!” While I left with the prescription, I never filled it at my pharmacy.
Thankfully, my anxiety has drastically improved through regular workouts, a new living situation, and continued therapy, but I often wonder how much more quickly my life would have improved if I hadn’t encountered such dismissive medical professionals. Would I have never developed an intense fear of medications if I didn’t go through this experience? Now, medications terrify me because my anxiety is rooted in the fear of being out of control. And because of this, I wonder if they will ever be a possibility for me.
I’m not alone in my fear of taking anxiety medications. A 2015 study showed that one-third of participants would rather die earlier than take them. But for many people with mental health disorders, sometimes taking medication is a matter of life or death.
To help me understand when anxiety prescriptions are necessary and how to cope with pharmacophobia, I spoke to Celeste Viciere, LMHC, host of the Celeste the Therapist podcast to get the 411 on this difficult subject. Here’s what she had to say:
How do I know when it’s a good idea to take medication?
According to Viciere, it’s important to identify when exactly you need to start medication. “I always tell my clients to make sure that they’ve exhausted everything they can do in their own personal power. Are you sleeping well? How’s your eating, how’s your exercise, do you have any stress?” she says.”[The lack of those] four things can really complicate your life and cause mental distress.” However, if you examined these areas of your life and still want additional help, medication might be a solution.
If you do make that decision to start medication, the next step is mentally preparing yourself to start it. “I like to look at the medication’s side effects and find out what it’s supposed to help with,” says Viciere. “Think about it as an added bonus to what you’re already doing for your mental health. Tell yourself that you’re just adding another piece to the puzzle to relieve some of your anxiety and that [it’s normal] there’s going to be a fear when starting something new.” Viciere suggests explaining to your doctor what you’re afraid of and what you may think might happen if you take this medication. It’s important for them to answer these questions so you won’t feel blindsided during this new experience.
How can I feel in control while taking new medication?
I can often work up enough courage to take a new pill, but it’s once I’ve already ingested it that irrational thoughts begin to overwhelm me and I begin to spiral. Viciere suggests finding ways to feel in control of the process.
For instance, if you’re feeling paranoid about how the medication is making your body feel, she recommends making a log of the physical symptoms you’re experiencing and checking in with your doctor. “When you get the confirmation or have the conversation with your doctor, it give you permission to not be your head so much about it,” she explains. Keep in mind that while it’s always a good idea to talk with your doctor about the symptoms, it’s best not to google them beforehand. This could potentially make things worse.
What’s the best way to manage anxiety around medication?
When it comes to managing medication anxiety, Viciere suggests working with your doctor and therapist to create a plan to gracefully govern your anxious thoughts if the medication does exacerbate them. “Ask your doctor, ‘If I do become more anxious, what should I do about that?’” she says.
She also adds that it’s important to challenge those intrusive thoughts and replace them with hopeful ones. “Challenge [your] thoughts because [the heightened anxiety probably] hasn’t happened yet. There’s also the possibility it may not even happen, and you may respond well,” Viciere says. Either way, “don’t get stuck in the negative; look at the positive. And then if you don’t respond well, you have the option to get off the medication. [It’s important to] give yourself options because the fear [can] make you feel stuck.”
Are there other ways I can manage my anxiety in addition to taking medication?
Throughout our interview, Viciere stresses the idea that medication is only one part of a big puzzle that is our mental health. You should still consider your sleep patterns, eating habits, and external stressors.
Medication anxiety is common and nothing to be ashamed of. It’s important, though, to not let your fear of medication prevent you from being your best and healthiest self. “Look at it from a holistic view and let [medication] be one [of the] things on top of other things that you’re doing,” she adds. From creating a symptoms log to talking through with your doctor to creating a plan with your therapist to challenging intrusive thoughts, there are many solutions for coping when you are afraid of losing control of your body.
Viciere’s solutions helped me realize that going on medication does not mean that I will lose control of my body. Thinking about anxiety in this way has helped me realize that I have options and that I’m able to listen to my body to find out exactly what it needs. It’s about taking baby steps—and at the end of the day, you know exactly what’s best for your body.
If you are struggling and need help, call the National Alliance on Mental Illness HelpLine at 1-800-950-NAMI (6264), available Monday through Friday, 10 a.m.–6 p.m., ET. If this is an emergency, you can call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or text NAMI’s Crisis Line at 741-741.
Too many of us have stories of doctors not believing our pain, years spent being misdiagnosed and struggles in accessing the care we need (from exorbitant costs to previous intimidating appointments). Often, health care obstacles are directly tied to medicine’s gender bias, as well as stigmas relating to our race, ethnicity, sexuality, non-binary gender identity, age, and income. In our series Pain Today, we are highlighting these stories through personal and reported essays, hoping to empower each other to advocate for our health in a way that much of the medical community does not.