But What If it Works Out?

     As I've previously mentioned, I've had a lot of changes in my life so far in 2021. As a person with OCD, those changes have caused me a lot of anxiety, even though I wanted the changes and even though the changes are good things. Since I graduated with my certificate, I've been filled with anxiety. 

    All these worries kept piling on. What if this certificate course was a waste of money that we didn't have to waste? What if this certificate course didn't teach me enough to be prepared for the job I wanted to do? What if nobody wanted to hire me because I had "just a certificate" instead of the more acceptable associates degree or even a bachelor's degree in this new field? What if I did get hired, but then it turned out I actually had no idea what I was doing? What if I made too many mistakes and got fired? What if I got hired, but then it turned out that the job was so stressful that I started regularly having panic attacks again? What if getting this certificate and the job I wanted wasn't the step in the right direction that I thought it was? I was spiraling, my friends. 

    My brain kept taking me to the worst case scenario automatically, and then I would unpack and live there. At one point during my first week on the job, I was so anxious that I cried in the car. I just knew I was going to screw up so badly that my boss would fire me before I had the chance to even correct my mistakes. (That didn't actually happen. My boss is nice and understanding.)

    Again and again I brought these worries to my bi-weekly phone sessions with my therapist. Again and again, she would ask me for evidence that I had to support my worries that I wouldn't do well in my new job. I never had any evidence. In fact, I only ever had evidence to the contrary. So she would always say something like, "Stop that anxiety-inducing thought before it gets too far. Stop it and say: But what if this bad thing doesn't happen? What if it works out?"

    WHAT IF IT WORKS OUT?! What if it WORKS OUT? Asking that question felt like I was daring the universe to make it not work out just because for a moment, I'd had the audacity to think it possibly could work out. Asking that question felt like I was too confident, and too much confidence is never a good thing, is it? So, of course I said to her, "But, it might not work out." To which she replied, "But what if it does?"

    So, for the past few weeks, I've basically had to train myself to stop when I feel the anxiety rising because I'm living in the land of the worst case scenario and ask "But...what if this works out?" My anxiety doesn't really know what to do with that question, it doesn't know what to do with the little bit of confidence that question brings. After I ask that question, I feel my anxiety leveling off as the worst case scenario is replaced by images of things going well, or at least not going terribly wrong. That little breakdown in the spiral gives me the minute I need to be able to get to a calmer place so I can logically realize that everything isn't as drastic as I originally felt like it was. 

    I'll end with this: It's so easy to spiral into the land of the worst case scenario. It easy to get so lost there that we can't possibly see how our worst case scenario isn't the only option for how something will go. All it takes is a second to challenge that thought. Surprisingly, simply asking, "But what if this works out?" has been a thing pulls me back out of the worst case scenario to a more realistic place. 

The Medication Misconception

    People tend to feel one of two ways about medications for mental illness. (1) They hate them and think they turn people into "zombies" or addicts. Or, (2) They think they're magical, fast-acting, simple cures for mental illness. In a recent conversation, I encountered the latter. Someone recently said to me, "There has to be a medication for that," in a tone that suggested I should just take whatever medication is offered up to treat my OCD and panic disorder and be finished with the whole unpleasant ordeal of having mental illness. The person seemed genuinely surprised that getting the right medication to "fix" my mental health conditions wasn't as simple and easy as they originally thought. (And no, your family doctor really shouldn't be prescribing you psychotropic medications. They should actually be referring you to a psychiatrist for that prescription.)

    Yes, there is medication to treat my OCD. It didn't work with my brain chemistry. Technically, there is another medication I could have tried, but, since it's one of the older medications, my therapist warned that it was hard for people to tolerate because of the side effects. I had also been warned previously that, once I go off the medication, the symptoms might come back for a bit, meaning I could relapse, once the medication that was chemically re-wiring my brain was taken away. So, to me, the risks outweighed the benefits at the time, and the risks still currently outweigh the benefits. 

    A lot of people think about psychotropic medications (AKA medications that help a person achieve the right levels of brain chemicals so that illnesses like depression and anxiety are less severe) the same way this person did. Many people view psychotropic medications as these magical cures for mental health conditions. Many people think that, as long as a person is taking the medications, then they no longer really have to manage or even deal with the symptoms of their mental illness, and that the medication is the only treatment the person needs. That actually isn't how these medications work.

    Even when a person is prescribed medications for their mental health condition, that person is still a person living with a mental illness. The mental health condition isn't going to go away, but the whole point of the medication is to get to the point that the mental illness is no longer debilitating all the time. Symptoms and bad days will still occur even with the medication. That's why medication is prescribed (usually) as part of a treatment plan that still requires a person to attend sessions with a therapist and have regular evaluations by a psychiatrist. Therapy and medication work together to make the most effective treatment plan for the person.

    These kinds of medications also don't work for everyone. If two people have the same exact mental health condition, with the same exact symptoms, the medication commonly used to treat that condition might not help both people. Each person's brain chemistry is different and reacts differently to medications. Some people can even have medication-resistant types of mental health conditions. 

    Another thing that people don't tend to understand about these medications is that you can't just pop a pill and feel better that same day, unless you're prescribed something like Ativan or Xanax, which are addictive and not prescribed as often by mental health professionals as they were in the past. Most psychotropic medications need to build up in a person's system to become effective, and this can take at least two weeks. Then dosage and time of medication get tweaked until a person finds the dose and the time each day to take the medication that is most helpful. Then if medications need to be switched or if a combination of medications is needed, the process of finding relief is longer.

    When treating mental illness, there is no magical finger snap moment that suddenly makes everything better. Treatment, even with medication, is a slow, and sometimes painful process. There also is no medication (to my knowledge) that can permanently "cure" a mental health condition. 

    I'll end with this: A lot of people, especially if they haven't experienced mental illness themselves, view the medications that treat mental illness as a quick and easy cure for those illnesses that is easily obtained and effective for everyone. There isn't a cure for most mental health conditions, there is only treatment and then management over a person's lifetime. Psychotropic medications are treatments, not miracle drugs. The point of these medications isn't even to "cure" a mental illness, but to treat the mental illness so that it is no longer debilitating.