A Bitter Pill to Swallow

I was sitting at my desk, talking to a friend on the phone. I put the call on speaker phone and had laid down my cellphone to be perfectly parallel to my laptop and coasters. My eyes moved from the black reflective screen to notice the bright June sun shining on the oak wood grains of my desk surface. My friend was taking stock of my depressive symptoms and doctor’s feedback, as has become customary of our calls for the past few months. At that point, I had had five doctors strongly recommend that I start anti-depressant medication (two in professional capacities, and three personal). I genuinely wanted to start medication, but I was afraid. In fact, after months of cognitive behavioural therapy and commendable improvements in my ‘behaviours’ yet persistent blackness of depression, my therapist told me quite distraughtly, “There is no reason for you to still feel the darkness. We will need to start you on medication if this persists for another week.” With those words, I panicked and ghosted him for two months.

My line of thought went like this, “If I try just a little harder, if I am just a little stronger, I will be okay and won’t need any medication. Let me wait one more week and see how I’m doing.” … But I had already waited one-more-week twelve times…

That morning, I had taken my prescription printout to the pharmacy and picked up my bottle of Happy Pills after a week-long incessant persistence from my support system. I now had the pill bottle on my desk, with one pill sitting against the wood grains of my desk and next to my phone where my friend’s voice came out from saying, “Nesma, I do not understand your logic. You strongly recommend following medical advice (and taking medication) for psychiatric illnesses. Why can’t you apply the same to yourself?”. And I knew she was right. And I wanted to be able to swallow the pill.

But for many of us, its not that easy. As Kay Redfield Jamison, Professor of Psychiatry at the Johns Hopkins University School of Medicine, writes that in the 1960’s, she was hesitant to take antidepressants for her manic-depressive illness (today known as bi-polar disorder). “Somehow, like so many people who get depressed, we felt our depressions were more complicated and existentially based than they actually were. Antidepressants might be indicated for psychiatric patients, for those of weak stock, but not for us. It was a costly attitude; our upbringing and pride held us hostage.”

Then and there, I asked my friend to not hang up until I have swallowed my first pill, because of how apparent my aversion to medication has become. Taking that first pill would mean that I am truly unwell. It would mean that I am broken and that I might break again and again in the future. It would mean that my brain has failed me and that I am sometimes not strong enough to weather life’s storms. All these thoughts roamed around my mind like shapeless demons as I stared and that small, white, oval pill…

After about twenty minutes of staring, I took the pill in my hand, fought back my tears of fear, and swallowed it. I quickly took the pill bottle and hid it away, as though to lock the scary demons away.

…

Throughout the first month of medication, I would sometimes catch myself feeling disappointed that the medication has helped. Clearly, my bias still lingered. Soon after, a pharmacist helped me put things in perspective. He said, “Some of the factors of your depression are your worldview, reactions, etc., all of which you are dealing with in therapy and your application of it, and another factor is your chemical imbalance. So, as you address the psychological factors, you still need to address the chemical one”. For some reason, it just clicked, and my bias disappeared.

So here I am, going on month seven, and I must admit that the medication has helped greatly. I have been able to experience a wider variety of emotions, my irritability has drastically decreased, and I do not see all things through a dark lens. I still struggle—no doubt, but there has been a noticeable improvement in the condition of my brain. Alhamdulila.

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Photo: Notice the stickers my beautiful niece stuck on my laptop :).