Last time with Mental Health Monday, we explored the different classes of psychoactive medications and how they work on neurotransmitters in the brain. Now you know there’s a lot to consider when prescribing these medicines, and when it’s necessary to see a psychiatric NP or psychiatrist.

When I worked at the psychiatric hospital in social work (as a therapist), medication education was an important component of medication compliance. After all, if you don’t know what to expect, or when to hang in there or when to quit, you’re left guessing. You might decide the medication isn’t working when it hasn’t even had a chance to do anything. Stopping and starting medications abruptly can cause them to become ineffective at best and dangerous at worse, so it’s not something you want to do.

One of my favorite things to start with when educating a patient on a medication they were prescribed was “The Pattern.” It is common enough in so many psychotropic medicines that it can be used for just about all of them.

I used to tell my patients to check in each day to see if The Pattern held true for them:

  • Week one: This shit is worthless, might as well take a sugar pill.
  • Weeks two and three: Huh, something’s working here. I feel a little more relief/better/like myself again.
  • Weeks four to eight: Oh, is this what relief feels like? Meh, it’s alright.
  • Weeks eight to eleven: Hey, this ain’t so bad! I’m feeling better! I can think and get chores done. I actually want to shower for a change.
  • Week twelve: Ah, this is pretty cool! Life still sucks sometimes but I got this. Go me!

That’s how you know it’s working. You check in depending on what week you’re on, and see if it matches The Pattern. If it stops feeling that way or you start feeling other unwelcome symptoms, call your prescriber and get in for a med check.

Conversely, you may start to feel full effects as early as six to eight weeks. That’s great, because it means you’re processing it with efficiency. Nothing wrong with that at all.

Medications are not going to solve your life problems. They won’t write a book for you, they won’t solve a marital argument, nor will they wash your hair or take you for a walk. What they will do is make these things a little easier to solve because you can think. You won’t run instantly to the worst-case scenario when your spouse tells you they’re going to be late from work. You’ll feel like getting out of bed and putting your fingers on the keyboard to start writing that book you always wanted to work on. You’ll get joy out of your hobbies again. You will want to go for that walk and even like it.

When you stop feeling this way, it may be a sign that your medicine has stopped working or is not working as well as it did. That is a signal to contact your prescriber and talk about it. Don’t pretend you’re fine. Don’t “man-up and shut up.” It’s okay to tell your care provider that you need a medication recheck. If you were diabetic and your medication wasn’t working, you’d hopefully speak up about that without shame, so treat your psychotropics the same way.

But some people say they don’t recognize the signs their medication isn’t as effective until it’s too late. That happens. It happens so often it’s painful. You are 100% not alone.

There are a couple of solutions for this particular problem. I have two I used to recommend.

  1. Keep a medication/mood/symptom journal. You can use an app like Daylio or another mood tracking diary. Just something that will allow you to keep track of your mood, daily activities, and a space for notes on each day. At the end of each month, you can look back and see if there’s a pattern emerging. Take this to your care provider and show them. You can also keep this information in a notebook or journal, or even a day planner instead. It’s up to you and what you’re comfortable doing.
  2. Have a life-line friend, family member, or support person who is allowed to tell you anything even if it is a harsh reality. This should be someone you trust and who loves you very much to be able to say when you are slipping. You agree ahead of time to listen to them if they note that your behavior or mood is starting to slip. See if you agree with their assessment. This can also be a counselor/therapist that you report to weekly.

Personally I prefer the journal method, but some people need help recognizing when things are starting to get bad again. That’s okay too. As long as you have a recovery method in place, it will increase your chances of long-term success.

As I’ve said before, medications can come with serious side effects and there are some you will want to watch out for. For these, talk to your prescribing doctor or your pharmacist who can help you sort out what’s a side effect that will pass and what side effects require immediate termination of the drug.

Adding these pieces to your overall healthcare plan and knowing what to expect can help demystify the process, increasing your knowledge and thereby increasing your chances of successful management.

This post is not a substitute for professional medical advice. This post is for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment.