This post is in response to the fact that the world is terrible.
Well. This blog is in response to that. But this specific post regards a specific terribility. Namely, how the instant that a mentally ill person stops taking their medication, they become evil, irresponsible, terrible, sub-human non-people. Even in secular, pro-social-justice spaces, Not Being Medicated is regarded as pretty much a crime. Because HOW COULD YOU, mental illness is clearly so heinous that you are but one missed dose away from eating a basket of kittens alive or something like that. As such, mentally ill people are obligated to take their pills. They don’t get choices. Nope.
Now, see here, that is fucked up something awful. Aside from the basic notion of bodily autonomy that is “you get to decide what goes into your body,” which of course doesn’t apply to mentally ill people because we’re not people with things like bodily autonomy, there are a lot of damn good reasons why we can say we don’t take our pills.
Some reasons can be summed up under the broad topic of “not fucking worth it.” Psychoactive drugs are not magic. Mental health care is not magic. Because these things are Not Magic, there are flaws. Some are minor, some are big and blinking with neon signage and their own zip code. For instance, there’s money. My pills all together, after insurance, cost me $60 a month (on top of the co-pay at the doctor). If I was on a tighter budget, that’d be a choice between pills, or… cutting my eating for the month in half. Or not buying gas. And what good are pills to make you happy if you’re starving with a dead car? NOT MUCH GOOD. And that’s with insurance. Being mentally ill people, we sometimes have trouble with the whole “keeping down a steady job” thing. Which messes up the whole “having insurance” thing. Which leads to the fun little catch-22 of not being able to buy pills, because you don’t have a job with insurance, because you can’t afford pills. Yay!
Then there’s the whole deal of side effects. psychoactive drugs have a lot. There’s nausea, dizziness, drowziness… I once took pills that made me drowsy and tired. Not like “Oh gee I sure could use a nap!” tired. Like, my-mom-found-me-passed-out-on-the-bathroom-floor tired. Same pills, for depression I will add, also made me suicidal. LOL. Now, yes, that’s a matter of them being the wrong pill, and you can always change pills. Unless… you go on to the pills I am now, which thankfully work because if they didn’t, I would be completely screwed. In short, miss a dose? You get a magical thing called brain shocks. They’re about as fun as they sound, I promise. And they can last a loooong time after you go off of that pill. (My doctor didn’t feel the need to warn me about this. If she had, I would have nope’d her to the moon.)
But wait, I could just fix my brain zap problem if I just stuck to my pills!
Except no. Because for me, sticking to my pills is not a choice. I try. I try really hard to. But with autism comes problems with executive function, and with depression comes lack of motivation, so all at once I have difficulty doing tasks like “take pills daily at same time every day” and on the other I have “Oh god, I need to take my pills… but I can’t even move. Lol guess that’s not happening.” This results in a bajillion missed doses, and even more doses when the same issues mean I don’t get my prescriptions refilled in time and just straight up don’t have pills. Of course, I could commit myself to an institution or live with my parents and have people who constantly remind me to take my pills, but that would honestly trigger so many issues in my brain that it would counteract any benefit the medication would give me.
Which leads to the third part of why it’s okay to hate pills, which is… the mental health system. I’ve written about the fun adventure I’ve had with it before. If you haven’t read those posts, the short story is “holy shit fuck the mental health system.” It’s an abusive, ableist structure filled with a whole lot of power-abusing authority and not enough people who are decent. I’ve seen abuse and neglect, I’ve seen terrified patients, I’ve seen threats and fearmongering, I’ve seen some shit go down in the name of helping people (helping them, my ass- it’s more an industry of fucking with them until they’re normal or killing them off) and it overall gives you a bad taste in your mouth for the idea of mental health in general. So when you’re surrounded by people buying in to the hate perpetuated by abusive doctors, insisting that you’re not human until you take the magic pills, insisting that you relinquish all of your rights the moment you stop medicating yourself, insisting that if you don’t take your pills of your own free will you’ll end up being forced… the natural human reaction, the natural human rebellion, is to say no.
Say, “Fuck you, I am a human being no matter what I choose to ingest or what I choose not to, and I’m not going to do what you want.”
It might hurt to do it. It hurts to be off your pills, after all. Whether it’s withdrawal or the feeling of the pain of mental illness creeping back into your brain, it just hurts. But it doesn’t always hurt as bad as the memory of the “therapist” from the mental hospital you’d been abused in telling you that if you don’t admit yourself to their hospital you’ll just try to kill yourself. It doesn’t always hurt as bad as the scorn you feel cast upon you when you admit you’ve forgotten to take your pills. It doesn’t always hurt as bad as the inherent judgement embedded within the phrase “did you remember your pills?” And sometimes, saying no, saying that you will be a human being who can make their own choices no matter what pills you do or don’t take, feels sweeter than all of the pain in the world. Sometimes it’s just plain liberating.
So if someone confides in you that they didn’t take their medication for whatever reason, the answer is not to scold them. It’s not to call the cops on them. It’s not to threaten them, or declare them a threat.
Offer them support. They’re probably hurting in some form, from withdrawal or from hatred, and the one medication that mentally ill people can use more than anything- yet are so often denied- is unconditional care, support, and understanding. Give them that.