Mental health blogger Fiona Kennedy talks about her journey to finding the right treatment
Put three people dealing with mental health difficulties in a room together, ask them what they think the best approach is, and I’m reasonably confident you would get three very different answers. Some favour the medical model, with treatment primarily taking the form of medication. Some are at the other extreme, eschewing drugs entirely in favour of psychological therapy only.
Still others, myself included, are firmly in the middle, availing of a combination of both, and occasionally switching sides over time depending on the success (or lack thereof) of these options.
Regardless of which side of the fence you’re on, treatments for mental health difficulties are many and varied, just as they are for physical health difficulties. I’m not a mental health professional so I can only speak from my own experience, but in general I believe there is recognition that talk therapy can be of huge benefit. However, it’s not always the first port of call, and in many instances it’s easier and quicker to prescribe rather than to talk, not least of all because it can prove so difficult for many to access talk therapy.
Over the last eight years my treatment has gone from medication only, to therapy only, to medication and therapy, back to just therapy, again back to both, more recently to a lengthy period of just medication, and now finally, a more structured form of therapy with a clinical psychologist in conjunction with medication. Yes, it really has taken this long to happen on the combination that is proving most effective.
Apart from periods due to either pregnancy or breastfeeding when I couldn’t take medication, I have been prescribed psychiatric drugs for the best part of the last 8 years, and consistently since 2012. It has been a complicated process of trial and error – my pattern for the first five years of that time was to start a medication with great success, but within months it would stop working and so the prescription would change, either with an increase in the drug I was already taking, or by switching to a new one.
In 2012, another drug was thrown into the mix, a mood stabiliser. This one has proven consistently effective, although the dosage has increased over time. Three years ago, I finally happened on an anti-depressant that was to prove effective in conjunction with the mood stabiliser, and I’ve stayed with that combination since.
But - and that’s a really big but - medication can only do so much. For me it provided something resembling the stability that would allow me to do the necessary psychological work, and that’s where the real progress is happening.
I needed to first understand, and now have to try to change, so much about how I think, how I react, how I behave, and medication alone simply cannot do that. As it turns out, neither could long term psychotherapy. Both were stepping stones to where I am now.
I needed the medication to stabilise me enough that I could function (some of the time at least), and I needed the support of a psychotherapist to help me through a really difficult period in my life. But once I got past the crises, the difficulties I was having with my mental health didn’t go away, if anything they became more apparent. That was when the decision was made to look for the more structured form of therapy that I’m now undertaking.
I think what’s most important to bear in mind with all of this is that there is no one size fits all solution. Some people experience mental health difficulties as a direct result of a life event, and it may be that the support of a therapist will be enough to get them back on track. Others, like I had, will destabilise to the point where normal functioning is impossible, and then medication will have a role to play. In my experience, the combination of the two is the most effective, or at least, at this precise moment in time it is.
Of course, it could be argued that had I had access to a psychologist 8 years ago, things could have been very different, but hindsight is 20:20, and back then we had no clue what we were up against. Difficult and all as it has been, I think that period of trial and error had to happen before we could fully recognise what was going on and start to find a way out.
I would like to think that medication is something that will not be part of my long term future, not least because there are some rather unpleasant side effects that require management in their own right, but I accept that for now it is necessary.
There was so much that I didn’t understand about how our minds work, about the physiological reasons behind my behaviour. I’m very much still learning, but if I were to make the decision to come off medication now, I would run the risk of destabilising to the point that I can no longer engage in therapy. I could find myself back in the land of crisis control, and all the progress of the last few months would stop.
I’ve been advised that I need to be symptom free for a year before I can consider coming off medication, because that process in itself can be extremely difficult as our bodies readjust, and I need to be mentally and emotionally ready to handle that challenge.
So for now, I’ll keep going as I am. I’ll continue to take medication as long as it’s required, but I know that if I put in enough effort with my psychologist, both in terms of understanding what she’s teaching me as well as putting it into practice, then it’s within my power to bring about real and lasting change for myself and my family. The labels I was given no longer have to define me. In fact, I’d go so far as to say they don’t really matter anymore. There’s huge freedom in that.
Fiona Kennedy writes regularly about mental health issues on her blog sunnyspellsandscatteredsh
If you are affected by any of the issues raised in this article you can contact Samaritans free any time from any phone on 116 123 or visit www.samaritans.ie to find details of your nearest branch. You can also find online information at www.yourmentalhealth.ie