I Am Scared to Take Medication (Managing Medication Anxiety) | Ep. 358

If you are scared to take medication, you are in the right place. Today, we are going to take a deep dive into a very common fear that impacts many people and their recovery, and that is the fear of taking medication. If you’re someone who needs help with this, I think this is going to be really helpful for you. 

Hello, my name is Kimberley Quinlan. I am an anxiety specialist, and I help people with anxiety. My hope is to make it an easy and a kind recovery for you. 

FEAR OR TAKING MEDICATION

Now, today we’re talking about the fear of taking medication, and a lot of what I do with my patients in my private practice, which is in California, is really helping them work through that fear. In addition, on my online platform called CBT School, I often get a lot of questions about this, such as whether or not people can take meds, should they take meds, and so forth. But before we get into all that, what I want to share with you first are a few housekeeping points that will keep us on point and in the right direction today. 

If you’re someone who is scared to take meds, we first have to acknowledge that this episode is not going to cover whether you should take meds or not. I am not a medical doctor. I am not a medical professional. I am a mental health professional, and I do not prescribe medication. I am not licensed to do that. But I am here to help you manage the fear around it. If you are someone who wants to take medication but is afraid of it because of the side effects, or maybe because of the shame, the guilt, and the stigma around it, my hope today is that we can work on managing that fear and getting you the information and skills you need so that you can speak with your medical professionals and make a decision based on what is best for you. 

It is important to remember that every person is different, and it’s important that you make these decisions with your medical doctor so that we’re making a decision based on your medical history, where you’re at in your mental health recovery, your genetics—all of the things that you need to discuss with your medical doctor. But today, let’s get going. We’re talking about managing medication anxiety. 

Where did this episode come from? I actually made a post about this on Instagram not long ago, and the response was overwhelming, with people saying, number one, “I’m too afraid to do it. Help me,” and number two, a lot of people said, “I had a lot of anxiety around taking medication. I got the help I needed and I managed it, and now I’m so relieved that I did.” I wanted to spend some time today talking about the reasons people are scared to take an antidepressant or other psychiatric medications or even medications in general. 

REASONS PEOPLE A SCARED TO TAKE AN ANTIDEPRESSANT OR OTHER PSYCHIATRIC MEDICATIONS

There are multiple reasons patients do not take their medications, due to fear. In this episode, we are coming the core reasons fears stops people from taking their antidepressants or other medicines. 

1. FEAR THAT MEDICATION WILL CAUSE SIDE EFFECTS

The number one reason that people reported being scared to take medication is the fear that medication will cause side effects. This is a very common fear around taking medication, and it is true. We will talk about the side effects here later in this episode, but that is a valid concern. But often, people are afraid of the side effects, even though they are not afraid of it being a catastrophic side effect. They’re often afraid of just change, or they’re afraid of what is uncertain and unknown, and that is a big thing for them. 

2. OCD FEAR OF TAKING MEDICATION

Another reason that people are afraid to take any kind of medication is an OCD fear of taking medication. The reason I say it like that is, it’s beyond just a generalized fear of the side effects. It’s often around a belief of what this medication will do to you. 

One example I’ve had in my private practice has been the subtype of OCD called emotional contamination. They’re afraid that by taking the medication, it will dramatically change their personality or that they’ll turn into a different person. There’s a lot of compulsions around that, rumination around that, and avoidance around that. They’re also doing this kind of avoidant compulsions in other areas of their lives as well. 

3. HEALTH ANXIETY: WHAT IF MEDICATION CAUSES AN ILLNESS

Another OCD fear of taking medication is under the umbrella of health anxiety. A lot of people are afraid that the side effects will be catastrophic, that it will give them some catastrophic medical condition if they were to take this psychiatric drug or any medication in general. 

4. PHARMACOPHOBIA (PHOBIA OF DRUGS AND ALCOHOL)

Now, in addition to that, there is actually a specific medication phobia called pharmacophobia, which is a phobia of drugs and alcohol. This is a specific phobia where people are afraid of any and all drugs. Often, in this case, they’re afraid to take headache medication or allergy medication. They’re even afraid to look at pills for reasons that could be plentiful. It could be a learned behavior around medication, particularly if they’ve heard stories of people who have misused drugs and bad things that have happened. That is another reason why people are often scared to take meds. 

5. FEAR OF MEDICATION SEXUAL SIDE EFFECTS

Another common fear, as we’ve already discussed, is fear of medication’s sexual side effects. Now, for those of you who have a specific fear around the side effects, you have a valid concern. There are some medications that do cause sexual side effects, and we did an entire episode on Your Anxiety Toolkit talking specifically about the sexual side effects of anxiety medications. We had a psychiatrist come on and speak about this. It’s episode 332, and I will link to it in the show notes if your interest is specifically more in-depth information about that. But I will also give some tips and tools to use around that later on here in this episode. 

6. I AM ASHAMED TO NEED MEDICATION (MEDICATION STIGMA)

Another fear around taking medication includes the fear of being ashamed or the fear that you’re weak or that you’re stigmatized for taking medication. This is a really, really big one. A lot of people feel that they are weak, faulty, or wrong for needing medication. Now, this is where I slow down and get very transparent. I am very comfortable sharing that I take medication for anxiety. I have, through different stages of my life, needed to take medication for this, and I’m an anxiety specialist, guys. I want to tell you that, not because I want to make this about me, but because I want to share with you that you can have all the tools and skills, and they really do work. 

Research does show that if you were to compare medication and CBT, especially for anxiety disorders, Cognitive Behavioral Therapy is actually the number one way to get recovery from these anxiety disorders. But even better than that, the research shows that combining medication and cognitive behavioral therapy is the gold standard. And so, if you’re really struggling, by combining these, this is where you can get massive help with your mental health struggle. 

Again, I want to really share with you that even though I have the skills and the tools, I take medication. There’s no shame in that. A lot of times, we often will compare that you wouldn’t feel ashamed for taking diabetic medication. You wouldn’t feel ashamed if you needed medication for another medical condition. There is no shame, no guilt, and no stigma that I want you to take away from this episode from taking medication. 

Now, I want to also validate, yes, there is still a stigma. There will be some people out there who may even respond to this episode by saying, “You shouldn’t take meds, and you should try this other treatment,” and so forth. That’s still going to be there. But I want to offer you a degree of compassion and a degree of education that there is absolutely nothing wrong with you if you want to take medication or need to take medication. 

7. FEAR THAT I WILL BECOME ADDICTED TO MEDICATION

Last, the fear about taking drugs is the concern that the medication will be addictive or that the person will become reliant on the medication. We’ll talk about that here in just a little bit, but the one thing I want to mention here is, if you are in contact with your doctor—you’re being constantly followed by your doctor and checked in by your doctor—you can bring up these concerns with them, and they can help determine that. Again, each of the questions you have, you should go to your doctor and bring it up because if you do have a history or if, in generations above you, you have a history of addiction, then absolutely bring that up to your doctor and they can help make decisions around different medications that can help prevent that for you.

MANAGING MEDICATION ANXIETY (SKILLS & STRATEGIES) 

Now let’s go into managing medication anxiety. This is where the good stuff comes in. Number one is, I want you to prioritize finding a skilled and trustworthy psychiatrist or medical professional. It doesn’t have to be a psychiatrist. In fact, there are other people who can help prescribe your medication, whether it be your pediatrician, your medical doctor, or your intern. It could be a nurse. There are psychiatric nurses who can prescribe medication. You want to find somebody who’s going to slow down, take their time with you, not just push you through really fast, and answer your specific questions. 

Now, when it comes to managing anxiety, OCD, or health anxiety, we usually discourage asking compulsive questions, repetitive questions, or going overboard with the questions. But I do think that it’s important that you give yourself permission and honor your need to ask the questions that you have about the medications you want to go on. That will help you understand the medication, understand the side effects, and understand the pros and cons so you can make an informed decision.

As we’ve said before, we want to understand questions about side effects, sexual side effects, addiction, how long you should be on medications, and what specific side effects you should be looking out for. We want to understand this. We want to know what the norm is for these medications on what it would look like, how fast you can see results, and what this process is going to look like. Don’t be afraid to ask lots of questions. 

Now, if you have OCD fear of taking medication or pharmacophobia, a thing you might want to consider is finding an ERP therapist. I’ve had a lot of clients come to me who have consulted with their doctor, and they’ve agreed that medication would be helpful for their recovery and that they required some mental health advice in moving in that direction. What we did is either start by just looking at pictures of medication or we might fill the prescription of the med that they need to take and just have it with them, hold the medication, put it in their hand, smell the medication, and take one with the care and following of a medical professional. Start that process by slowly exposing them and practicing being around that medication to start with. 

If you are someone who’s struggling in that area, absolutely consider seeking out an ERP therapist (exposure and response prevention) who can help manage all of that as we go and help with the response prevention piece. Because remember, exposure is not the main work; it’s also catching any compulsions that you’re doing around the medication. Maybe you’re doing a lot of compulsive checking with the medication and so forth. 

Another thing I want you to think about is being able to challenge your faulty thoughts and beliefs about the medication. As we talked about before, with those reasons that people are afraid, there is often a lot of faulty, catastrophic thinking around medication. Ones that are common that I see with my patients are, “I won’t be able to handle the side effects.” Let’s say a common side effect for a medication might be some nausea. Then we will say, “Okay, let’s talk about your ability to handle nausea. Have you handled nausea in the past?” Let’s say it’s headaches. “Okay, what could you do if those headaches were to appear? How might you speak with your doctor about those? How might you be able to plan for that?” Maybe it’s like, “What if I have a panic attack if I take the medication?” “Okay, let’s talk about some skills and talk about challenging your ability to manage the anxiety that you feel.” 

A lot of people say, “I already have a lot of anxiety. I don’t want to do things that create more anxiety.” Again, we’ll say, “Are you willing to tolerate that anxiety? What are you telling yourself about your own mastery of riding waves of discomfort and so forth?” If you have, let’s say, emetophobia, the fear of nausea and vomiting, “What do we believe about vomit? Do you believe that you can’t handle that?” And again, you may need to defer to an ERP therapist to help you if you have emetophobia, the fear of vomiting and nausea, to help you manage that so that you can take the medications if that’s something you’re wanting to do. We do want to challenge faulty thoughts, and we want to challenge faulty beliefs about medication. 

Again, here is where I get really, really passionate about saying: There is absolutely no shame in taking medication. Taking medication does not mean you’re weak, does not mean you’re lazy. It doesn’t mean you’re doing anything wrong. It doesn’t mean that you’re never going to get better, and it doesn’t mean you need to be on it forever. Again, we’re here to encourage you to consult with your medical doctor and be flexible with your recovery. 

Now, being flexible is so important here. So often, patients of mine will say, “But what if I don’t like the medication? What if I get on it and I really don’t like it, or it makes me feel terrible and I can’t function?” Well, okay, we’ll cross that bridge when we get there. We’re going to be flexible with this. We don’t have to stay on it forever. Once you get on it, if then there is an issue, we will address that issue. Then we’re not going to spend time before taking the medication trying to troubleshoot all the possible catastrophes and scenarios. We’re only going to take one day at a time, and with each day, we’re going to make measured, skillful, and wise decisions based on the actual events of that day, not on the possible scenarios that may happen, that may be catastrophic that haven’t happened yet. 

So often, people who have a fear of medication are responding to things that haven’t even happened yet. I know when I got POTS (postural orthostatic tachycardia syndrome), I was not functioning, my anxiety was through the roof, I was depressed, and the doctors strongly advised me to take medication. A big part of me was absolutely like, “What if this makes it worse?” and all these things. I had to just say, “Kimberley, be present. Stay with what’s happening today, and we will address that as it goes. We’ll cross that bridge when that happens. If that does happen, we will speak with a medical professional. We will take one step at a time and we will do what we need to do.” We want to catch that anticipatory anxiety about medications and the anticipatory anxiety about the side effects. It’s very, very important that we catch and manage that as we go. 

Another thing to remember here is, you have to be willing to have side effects. As you go on medication, you have to be willing to feel some feelings that may be uncomfortable. As I mentioned, common side effects: headaches, nausea, tiredness, maybe a little jittery, and so forth. Again, I want to keep prefacing: please speak to your medical professional about the side effects because each medication is different. But be willing to have side effects. Again, being flexible, knowing that if this medication doesn’t work for me, we can try something else. I know for me personally, I had to try five medications before I found one that fit me. Five. It took a long time. I had to taper up and then I had to taper down, and I had to try another one, which brings me to the next skill I want you to practice, which is patience. 

I just kept honoring my own needs and said, “I’m going to be patient with this process.” A lot of my patients have found one medication that was prescribed by their medical professional and found that it was great. It’s worked for them straight away. But we want to be patient, and we want to be willing to have a lot of different sensations. I’m not saying you will, but we want to be willing. I actually have a whole other episode on Your Anxiety Toolkit called How to Have Uncomfortable Sensations. If you’re struggling with that, that may be a good resource for you to use as you go through this process as well. 

Now, if you have, or if you’re afraid of sexual side effects, again, I talked about listening to that episode, but I will also say one thing that they did say in that episode: It is okay to seek out a sex therapist or try other skills, such as a skill called sensate focus, or speak to your medical professional about that. 

Now, there are a lot of meds that do not have sexual side effects. If that’s something that is a concern for you, please mention that when you’re seeing your psychiatrist or your medical professionals so that they can pick a medication that will reduce the likelihood of that. Again, we don’t want to catastrophize about potential problems that haven’t happened, but it is okay to bring that up if that’s important to you. 

Now, of all the things and skills I’m going to give you today, the one thing I really want to emphasize is, please give yourself lots of space and lots of permission to rest during this process as you begin medication. I remember when I first went on medications, my mom actually said to me, “Hun, why don’t you just use this time? Thin out your schedule and give yourself lots of time to rest. If you do have side effects, then you won’t be overwhelmed with trying to work and push through.” 

Any way you can during this process, take as much help as you can, whether that be neighbors helping you pick up the kids, grocery delivery, whether it be you don’t clean the house this week and you just let things sort of slide a little. You let your colleagues, your teacher, or your coworkers know that you’ve started a medication and that you might be feeling well. 

Take as much space and take as much care as you can as you start this process. It is scary. It is anxiety-provoking. I’m not here to tell you that it won’t be, but what I am here to say is we can do hard things. How can we support you as you make this value-based decision? How can you find help, support, and care as you lead forward with your values? You’re not letting fear stop you anymore. You’re doing the hard thing. You’re taking the step for your long-term recovery, even though it’s the hard one. How can we be very kind, compassionate, and effective moving forward as you move through this process? 

The next tool I want you to think about is being mindful around the side effects. What I mean by that is, when we do have side effects, we can be non-judgmental, we can stay present, and we can stay in non-resistance to that side effect if you have any. What we know here is, research does show that mindfulness practice does reduce people’s experience of suffering. What we mean by that is, if you’re suffering, your experience of it could be, “This is very, very bad,” or your experience could be, “This is tolerable and doable, and I can handle it.” 

How can you take the judgment out of the side effects? When you’re having them, are you catastrophizing, saying, “This is terrible, this is bad, I can’t handle this,” or are you saying, “This is neutral and tolerable, and I can manage this”? If you’re having a side effect, are you resisting it, pushing it, and fighting it, or are you giving yourself permission to be uncomfortable, and are you willing to allow those sensations to rise and fall? 

As I’ve already discussed, one of the points I had here in my notes is to remind you to always put your values first. If you believe that medication is the right choice for you, lead with that value. Do not let fear interfere with your decision here. That was a lot of rhyming words, but we’re going to go with it. 

The next thing I want you to think about is to talk with your doctor about whether it would be helpful for you to log any changes. I find that it’s very beneficial to log your symptoms. The day you start taking your meds and how many days you take that meds, you probably will need to taper up maybe, depending on what your doctor has told you to do. Take note of when you change any medications. Are there any changes in your anxiety? Is there any change in your mood? What side effects are you experiencing? And that will be there to help when you talk with your doctor next about how it’s going and whether it’s actually the medication. 

I know a lot from my patients, they’ll say, “The medication is definitely causing this problem for me. I’m tired all the time.” But actually, if they’ve logged, we can see, “Actually, around that same time, you started getting less sleep for reasons like around school, or maybe you had a lot of travel, or it was the holidays. Could that be what’s actually causing your symptoms?” Take that log to your medical professional and let them help you decipher whether it is in fact the medication or if this is actually a lifestyle change that has happened in your life.

Again, let’s challenge the stigma here. My main hope here with this whole episode is to take the stigma out of it. There is absolutely no reason for you to feel ashamed for taking medication. There is no reason to believe that you are weak for needing medication. I personally am proud of myself for saying and honoring that I matter. My wellness matters. I will do nothing but put my wellness, my mental health, and my medical health as number one, and I will do that proudly. If that means taking medication, so be it. If other people want to judge me, that’s fine. I don’t really mind if they judge me. Yes, it hurts my feelings sometimes, but they can have their opinion. I’m still going to do what’s best for me. 

I hope that that empowers you to, again, learn from your medical professional what’s best for you. Decide for yourself whether this is a value-based decision. Decide whether you’re going to let fear stop you, and take baby steps. I cannot emphasize how important it is to take baby steps and to stay present. Only deal with problems as they arise. Do not make decisions based on potential problems that may show up in the future. Because if that’s the case, you’ll never move forward with your values. You’ll always move forward with fear. We recently did a whole episode about how to act according to your values, not fear. This is another very important step for your recovery. 

The last thing I’m going to say is, it’s a beautiful day to do hard things, and you can do hard things too. If you have a fear of taking medication, if you’re scared to take medication and it’s impacting your recovery, I hope that this has helped you to manage medication anxiety, to give you a little bit of empowerment, a lot of hope, and hopefully help you to manage your anxiety as you move forward. 

Have a wonderful day, everybody. It has been a pleasure being with you again. I know your time is incredibly valuable, and I’m so honored that you chose to spend your time with me today. I’ll see you next week.