The Reality of Psychiatric Medication

photography by Debmalya Ray | illustration by Monica Nguyen-Vo

It goes without saying that college is a stressful time. Anything from the overload of assignments, poor diets or struggle in finances can deteriorate a student's mental health over time. Many people who struggle with different mental illnesses might seek medication for the first time while in college, as I did. So what are some of the hard truths about psychiatric drugs?

Signs You May Need Help

One in six Americans take some form of a psychiatric drug, according to Scientific American. These types of medications alter the chemistry of the brain and nervous system and can be prescribed for a range of treatments, from cognitive diseases to ADHD. However, psychiatric medications are most commonly associated with treatment for mental health disorders.

This is especially true for college students — an estimated one in four adults between the ages of 18 and 24 have a diagnosable mental illness. More notably, according to the American Psychiatric Association, about 50 percent of mental illness begins by age 14 and a remarkable three-quarters begin by age 24. 

Andrew Cyrus Marcy, a psychiatric mental health nurse practitioner for Nazareth and St. John Fisher, advised when students should seek mental health treatment.

“It is normal to experience some degree of anxiety and sadness during stress and life transitions,” Marcy said. “If mild-moderate symptoms persist beyond a week, I recommend seeking treatment."

As always, the first step in getting help is receiving a diagnosis. In the midst of semester chaos, it can be difficult to notice your own red flags.  

Silka Houghton is a third year double major in Photojournalism and Business Entrepreneurship. When her parents noticed she was struggling to focus in school,they scheduled an appointment with a psychiatrist.

“In second grade, I was officially diagnosed with ADHD, OCD and major depression. At the time I wasn’t on medication because I was so young. Instead, I went to therapy through the school and private therapy,” Houghton said. 

Meds are Time and Money

Since many students aren't diagnosed early on, they end up having to balance consultation appointments with schoolwork.

I started my treatment plan for major depressive and anxiety disorder in my sophomore year of college. Even with consistent treatment, I am still considered “high-risk” for suicide, which is common.

No singular medication is a cure-all for mental illness. and college isn't quite the best environment for managing stress. This is why reaching out to a general practitioner or local prescriber sooner in the semester is a good idea.

“Unfortunately, there are often long wait lists to see a prescribing specialist [off campus] ...  Expect that you will see the specialist approximately once every month until your symptoms are stable,” Marcy said.

Typically, medications take four to eight weeks to take effect. It then takes another six to 12 months of symptom remission to be considered “stable." Yet any prescription works best if it’s a part of an overall treatment plan, and for psychiatric drugs that often means therapy. 

Many medical providers, including the Student Health Center, will not prescribe medication without proof the patient is under the supervision of a counselor. Fortunately, the Counseling and Psychological Center is free to students, although the wait times are typically long. 

“The first action should always be going to a therapist to see what’s best for you. Even if it’s not medication, but another alternative treatment plan,” Houghton said.

"The first action should always be going to a therapist to see what’s best for you. Even if it’s not medication, but another alternative treatment plan."

If medication is the best treatment option, the unfortunate reality of psychiatric drugs is that they are expensive. The ideal option is to work with local medical providers. However, college can make that complicated especially if students are competing for appointment slots.

Private counselors typically have more open appointments and offer a wider pool of cultural diversity. Some students, like Houghton, may prefer private counselors, even if it means paying out of pocket.

“I found a private therapist that works for me, but now I also need to find private psychotherapy. That’s like four hundred dollars out of pocket and it’s not covered by my health insurance plan,” Houghton said. 

Risks and Side Effects

There’s no sugar coating it — medications can be dangerous and there’s a lot of trial and error. It's important to communicate regularly and honestly about side effects and concerns.

“The majority of side effects experienced with these medications are adjustment side effects. They occur shortly after starting the medication and resolve within one to two weeks,” Marcy said.

For the first couple of weeks on antidepressants, I suffered several migraines. Though the migraines disappeared, some side effects persist no matter how long a person has been on medication. In my case, this meant random spells of nausea.

Usually, these symptoms are mild and the “tradeoff” for mental health relief. Every medication has its own list of side effects — possible headaches, nausea and libido — and everyone’s body responds to medication differently.

However there are serious symptoms that shouldn't go unchecked. 

“If you have an allergic reaction, your symptoms are severe, you feel disoriented or confused or you have increased/new thoughts of self-harm, you should contact your prescriber or seek immediate medical attention,” Marcy said.

I’ve experienced both a severe allergic reaction that resulted in hospitalization and a rapid increase in suicidal thoughts as the result of trying new medications. Both could have cost me my life if I was less receptive to changing conditions.

Medications that have warnings of an increased risk of suicidal thoughts have a black box warning attached to them — the FDA’s highest warning.

Houghton recalls taking a new medication that triggered the maniac phases of her depression. She was on it for two days, but called in three weeks of absence from work. 

“You don’t want to necessarily admit you have a problem that needs treatment. It’s really scary because you don’t know how your body is going to respond to the medication,” Houghton said. 

Change to Body Chemistry

A common misconception is that patients need to be on psychiatric drugs forever. This can be true in some cases, but is far from the truth for many antidepressants and anxiety medication.

I was once afraid to begin medication because I was convinced it would ruin my life as an artist. In reality, my art improved. It took a whole year of trial and error to find a regiment that works for me, but I do not regret seeking treatment. 

Medication is a tool, not a prison. Once you are stable, it’s completely okay to discuss with your psychotherapy providers about stopping.

At the same time, never feel ashamed to stay on medication. Medication does not change who you are. 

"Medication does not change who you are."