Meds...so many options, so many opinions...where do you start? Who do you talk to? More importantly, how does the process of starting meds impact both you and the people closest to you?
Naturally, the answers to these questions are subjective, but there are some common threads worth discussing, particularly for those who are looking to start meds for their mental health in the midst of a busy parenting stage. So, let's discuss them!
At this point, I think it's prudent to provide a bit of context: first, I'm a parent with OCD, and I've spent time as a parent both on and off meds. I started taking meds for my OCD symptoms after bringing my symptoms from clinical to subclinical severity using CBT and ERP in both private and group therapy settings. The kind of medication I take is an SSRI, or selective serotonin reuptake inhibitor. If you're confused by that term, don't worry; it didn't mean much to me when I first heard it. Here's a site that I found helpful for learning about SSRIs and OCD:
Now, having just posted information about medicine, let me state the obvious: I'm not a doctor. That said, I think there's an even more important disclaimer to be shared: I'm not writing this post to say whether I think you (or anyone) should or should not take meds as a parent. I'm not suggesting that you've clicked on this post hoping I'll make that decision for you, but I think it's important to be clear about intentions: I'm writing this post to share the questions I asked myself about taking meds as a parent, how I answered those questions, what the first few weeks of meds were like, and where I'm at with my meds right now. My hope is that, by sharing those answers, you might be able to clarify your concerns and, ideally, quicken your path to a treatment plan that works for you, with the help of an expert. Clear as mud?
Let's get started!
They've Got Meds, I've Got Questions
Taking medication for mental health symptoms is not a new practice, but it certainly draws its fair share of opinions. As a parent, my questions were less political and philosophical, and more about what meds would mean for my family and I. Here's a list of the questions I thought about most:
Who should I include in my decision to take meds?
How would my thinking and behaviour change if my meds worked? What about if the meds caused an adverse reaction?
How long would it take for meds to work? How quickly would I notice results?
What are the side effects of meds, and how would they affect my parenting?
I suspect many parents would see common threads and worries in these questions, and understandably so. In an effort to help provide some real-world answers, here are some observations, straight from the horse, as they say:
First, let's answer the easy stuff: your decision about meds should include experts; psychologists, psychiatrists, family doctors...I'm sure that's nothing new...qualified experts who know you, and know your medical history. I know I said I wasn't going to express a lot of opinions in this post, but there's not really much to debate here; medical decisions should be made with medical experts.
In terms of who you include from your personal life, my process was fairly straightforward: I included my wife because I valued her perspective, and because she was most directly impacted by the decision. Later, I told my parents, siblings and a few friends. It's not as if I didn't trust those other people, or that I felt unsafe around them, there just wasn't much practical need to have that conversation. I also didn't know if I would stay on meds, or for how long, so I didn't see any point in starting a potentially difficult and lengthy conversation for a decision that might not even have a lasting impact. I don't mean to sound too cold or bland about this, but it really was that simple: in the early stages, practicalities won out over preferences.
In terms of how meds affected me, I confess that I learned quite a bit about just how warped my perspective on mental health meds had become after years of TV and movies. The biggest misconception I had about meds is that it would be like one of those scenes where someone gets jabbed with a needle and instantly begins to pass out, get excited, calm down etc. My experience was nothing like that. In fact, my meds took a few weeks to really kick in, and that's because my doctor started me off on a bare-bones, minimal dosage to help my body get used to the medication. He was also quite clear that we may need to try more than one medication to find the right fit for me. Each medication starts slow and small to let the body and brain adjust, and people react to different meds in different ways. Bottom line: the process, and the changes it brought were slow. Here are some specifics:
In the first two weeks, I noticed dull headaches and an occasional muscle twitch in my face, all of which are, apparently, quite normal when you're first taking SSRIs. After about a month, I upped my dosage to what medical professionals would describe as 'just above the therapeutic threshold', meaning it was a low, low dosage. A few weeks after that, I noticed that some of my OCD symptoms seemed duller. It's not as if they disappeared entirely, but when I felt an intrusive thought come in, my urge to perform compulsions felt like it had a weighted blanket on top of it; it was still there, but it was muffled and gently pressed down. Quite honestly, that was a good feeling. I've noticed a similar feeling since, and I've found that having the support of the medication has made me feel more relaxed about encountering trigger situations, both expected and random. That's also a good feeling.
In terms of side effects, I've been pretty lucky. No giant mood swings, no hallucinations, no brain fog. I get bad stomach aches if I take my meds without enough food, and I occasionally notice a mild headache, but overall I feel good. If anything, the side effects were most noticeable when I first started my meds. To help prepare for that, my wife and I reviewed the literature about my particular medication carefully and discussed how we would react if any side effects occurred. The headaches and twitches had relatively little impact on our family life, but I did consult with my doctor as soon as I felt them to make sure they weren't a risk to my cognition during higher impact activities such as driving and watching my kids.
All in all, I'm happy with how my foray into medication began, and I'm comfortable with my dosage and routine.
What Does It Mean If I Take Meds as a Parent?
This is the more philosophical question I asked myself as a parent: what did it say about me as a parent if I had to take meds to manage my mental health? Shouldn't the inspiration and motivation of being a parent be enough to pull me through? What did it mean if I needed the help of a medication to stay balanced? Did it mean I didn't love my kids enough? That I wasn't strong enough to be a parent? That I, plain and simple, wasn't enough?
I talked about this question in my book, and I'm going to quote it here because I think it speaks perfectly to these questions:
As a parent, I had an extra level of aversion to trying medication because I was worried about how it would impact my ability to take care of my boys. How was I supposed to be a responsible dad if pills made me drowsy, moody, or worse? And what did it say about me as a parent if I had to take pills just to be able to raise my boys? I didn’t see any of those effects as risks that I was willing to take, so I never took them, and at the time it all made perfect sense.
The thing is, I still wonder if I was wrong. What if medication could have helped bring my symptoms under control faster and more effectively than therapy alone? What if I had had no side effects at all? I’m aware of those questions now, but they never crossed my mind when my boys were first born; or, to be more precise, I never let them cross my mind. It pains me to say it, but I didn’t even bring my concerns to my family doctor at first. I was so focused on what it meant if I took medication that I forgot to consider what would actually happen. I followed a feeling without airing my thoughts or consulting a professional. I wish I had thought differently.
Here’s what I believe now: the roles of any medication, psychiatric or otherwise, are to start something that won’t start on its own, to prevent something that can’t be stopped on its own, or to relieve a symptom to make day-to-day living easier. Those are valid, sometimes vital functions. For some people with OCD, medication might be necessary for keeping overwhelming intrusive thoughts at bay; for others, medication might simply help keep their obsessions under control with less effort, which allows more energy for work and family. Ultimately, though, people who decide to take medication don’t owe anyone an explanation. Help should be available for those who want to relieve their suffering. Who can know other people’s reasons for taking medication, and really, who can judge them?
Medication is a tool, and its purpose is the same as any tool – to make work easier. I’m not saying that you, or anyone else, should or should not take medication; I just think it’s worth examining your thoughts, opinions, and potential biases about it. Read about medication. Talk to experts about it. If possible, talk to someone who has personal experience with the medication you’re considering. Also, take a good, hard look at how medication is portrayed in popular culture. I have yet to find a movie or TV series where the plot hinges on the main character returning to healthy day-to-day functioning because of their substance use, but in reality, that’s what medication does for a lot of people. I don’t have a perfect answer for whether or not to try medication as a new parent, but whenever anyone asks me whether they should take them, I always offer two thoughts: first, if you’re concerned about your mental health but you’re uncomfortable taking medication, you have all the more reason to get going with another therapy method. Second, if you haven’t shared your concerns with your family doctor and related professionals, you don’t have the full picture. Inform yourself first, then act.
And there you have it. My first round of observations from starting meds for OCD as a parent. If they seem imperfect or incomplete, it's because they are. I'm still reflecting regularly on how my meds are affecting my parenting, and I probably always will. In terms of whether I'll ever get off my medications, I confess I don't see much point in thinking that far ahead. What I know is that right now, they work for me. One day, they may not. The most important thing will be regular reflections and consultations with the experts and loved ones who know me best. So, if nothing else, I suggest you start there, and stay there.
Fighting forward.
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