Taking Antipsychotics Makes You Sound Particularly Crazy
I wish someone had asked me before naming a class of drugs “antipsychotics.” I mean, I understand that to psychiatrists it might not be a big deal, but to the medication-taking public out here, let me just say that the stigma around medication is about 10-fold when you say you’re on something called an “antipsychotic.”
Tell someone that you’re on “antipsychotics” sometime and watch them back away slowly. I’m not kidding. It’s like they think an axe is about to magically materialize and you’re about to use it to chop off their head.*
Psychosis and Why We Have Antipsychotic Drugs
Antipsychotics are, of course, anti-psychotics, or drugs that are anti-psychosis, and psychosis, itself, is not all that rare. Numbers vary, but possibly 5-8% of people may experience a psychosis in their lifetime, which is about ten times the number of people who are diagnosed with a psychotic illness.
Psychosis is not “crazy” or “scary” (although may be very frightening to the person who is experiencing it). I would characterize psychosis as a very pronounced “trick” of the brain. Psychosis consists of delusions – or believing in something in spite of overwhelming contradicting evidence – and/or hallucinations – sensing something (such as through sight or sound) that doesn’t exist. And truly, anyone can experience psychosis for any number of reasons, only some of which are related to a mental illness.
Treating Disease with Antipsychotics
And it is critical that some psychoses be treated, and generally antipsychotics are quite effective at doing so. They’re not Big, Bad Scary Meds, they are just medications used to treat a medical condition of the brain.
Antipsychotic Use Outside of Psychosis
But some while back it was discovered that antipsychotics were actually useful outside of psychosis treatment as well. Quite a few antipsychotics are approved in the treatment of bipolar disorder and one is even approved as an add-on treatment for depression. And it has nothing to do with psychosis in bipolar or depression (although that can happen) it’s just that these drugs have been found to be effective for those conditions.
It’s like anticonvulsants. Anticonvulsants are used to treat seizure disorders but it was discovered they’re helpful in bipolar too, and some are now a mainstay of bipolar treatment. Of course, no one runs away from you for taking an “anticonvulsant.”
My Experience with Antipsychotics
My personal experience with antipsychotics has been mixed. Generally, I swear off of them due to side effects (except for, you know, the one I take).
But what’s notable is that I had distinct, internalized stigma around taking something called an “antipsychotic” and that’s a shame, because they literally save people’s lives every day. And a couple of them have produced profound changes in me personally; which I would have never seen if I hadn’t gotten over my own prejudice about a silly word.
So, the next time someone squirms at the idea of an antipsychotic, tell them this, they’re dopamine modulators – which they are. They are simply a class of drugs that modulate a neurotransmitter – just like an antidepressant – the difference is in the specific neurotransmitter. There’s really nothing scary about that.
The important thing about medication, of course, is that it work for you, whether they call it an anticonvulsant, an antipsychotic or Fred.
* This is in large part due to confusion between the word “psycho” and “psychotic,” which are two completely different things. “Psycho” is a slang term used to refer to a psychopath while someone who is “psychotic” suffers from a condition that contains delusions and hallucinations.
Tracy, N. (2012, November 18). Taking Antipsychotics Makes You Sound Particularly Crazy, HealthyPlace. Retrieved on 2022, July 4 from https://www.healthyplace.com/blogs/breakingbipolar/2012/11/taking-antipsychotics-particularly-crazy
Author: Natasha Tracy
There is a problem with the stigma surrounding psychosis, but the answer isn't calling it by another name and the problem isn't about people who need to take antipsychotics but aren't psychotic.
The problem is people like you who hear psychotic and immediately think crazy. In your wish to not be connected to the disorder or people who suffer from psychosis in any way, you show that you still are scared of psychosis and in your video you still equate it with insanity.
Schizophrenia, the most serious of psychotic disorders, is actually quite common, with every 1 in 100 people being schizophrenic. And as you yourself pointed out, 5-8 out of every 100 people will experience a psychotic episode of some sort. Unsurprisingly, these people aren't all going out and stabbing people and being 'crazy' or 'deranged.' That's the minority of people who are affected, scared people trying to live there life and having to deal with stigma.
Through your attempt to hide the word psychosis, brush it under the rug so you don't have to deal with it, you only further the problem and the stigma. This isn't a way to deal with stigma, it's a way to hide from the work of helping. And as two people who have felt mental illness, the terror that it can cause, and have felt the misled judgment of others, I wish we could work together on this
Thanks for the article-so little info about antipsychotics. In 1992 in went to a mental hospital, paranoia, hallucinations and very bad behavior. Four law enforcement officers held me down to give me a shot of haldahl (sic) - that was my first experience with an antipsychotic - not pleasant. After some time I would take the oral medicine without force. After a couple of weeks the doctors concluded that it was "brief reactive psychosis" and I should take Risperdol for a while and I should be fine - wrong. Long story short - several bouts of no medicine, different etc. Life better with it--newer drugs better. Since Lithium due to proper diagnosis of bipolar I feel almost normal.
Well even the drug information for them refers in the paragraphs to them as anti-depressants, which they're not . . .strictly speaking.
But there's of course a huge difference between the first line antipsychotics and the newer second generation atypical antipsychotics.
There's really only one drug directly linked to diabetes, but even that can be modulated/is preventable. I know someone on it.
Sarah, good explanation later on. I couldn't agree with your point more.
Oddball, auditory hallucinations such as voices do not have to be interpreted as external, coming aurally through your ears. They can be external to you, but heard in your head. Check out this website for more info: http://www.mentalhealth.org.uk/help-information/mental-health-a-z/H/hearing-voices/
You can also look up the Hearing Voices Network, which may very well be linked to the previous page I cited.
VenusH is right, as long as crimes are easy to commit and get away with they will continue. Everything from peddling horse poop to murder is condoned with a pat on the back and profit results.
Apparently, the stigma is not as strong, since APs are prescribed left and right, for sleep, depression, anxiety, problem behaviour in kids and some people don't ever realize what they are taking, believe it's sleep aid, something you add-on to antidepressant or that it is indeed an AD.
"But some while back it was discovered that antipsychotics were actually useful outside of psychosis treatment as well"
yeah, they are actually useful at creating profit for Pharma companies.
Call em sciency schmiency names all you want, but they are still serious drugs for serious condition and to be thrown around as candy ("off labelling") is criminal.
At the start of my diagnosis, I got the antipsychotics because I was psychotic. Later on, I got them when I was manic or hypomanic, which is a very usual extra medication next to lithium. It also gave me the creeps to take them: it made me feel like I was close to psychosis again (which was, exactly, a scary experience on the inside, and in the Netherlands you often get locked up when this happens -> we're otherwise quite a reasonable and human country btw). My psychiatrist of course convinced me that I wasn't on the brink of becoming psychotic, but still... it's the word, yes.
hi i take a range of antidepressants as well as antipsychoic and just taking that extra pill has relly helped kick start my life while before i was a total mess and it also helps me relex and sleep well
Couldn't agree more. Great post!
i am on a low dose of an atypical antipsychotic med for PTSD and have had good results with minimal side effects at least so far. i was a little hesitant but not much because i was having a lot of unpleasant symptoms and figured it was worth a try. i've been on it for about 3 years and so far so good. thanks for the blog.
Do you mind saying what the drug is? I have been prescribed ability and risperidone for cod and anxiety and I am terrified of the side effects so I have yet to take them.
Neuroleptics is a more accurate description of this group of drugs, 'anti depressant' & 'anti psychotic' are very misleading terms. Abnormal brain chemistry theories of mental health are based on inconclusive, flimsy evidence so that inferring that these drugs correct a 'chemical imbalance' is also misleading. Indeed all drugs alter brain chemistry and it is this action that may be helpful or not in alleviating mental distress. I would recommend The Myth of the Chemical Cure by Joanna Moncrief for an explanation of a drug action model of treating mental distress. I also agree that these terms are not useful when considering the stigma attached to taking these drugs. However, I believe that certain mental health labels eg schizophrenia, personality disorder, still induce fear & misunderstanding.
What I meant by 'contradictary' is that in previous articles you have heavily defended your use of the words 'crazy', 'nutjob' and so forth, citing the need to call a spade a spade. Using that argument, an antipsychotic is an antipsychotic - trying to call it something else is not going to reduce the stigma and fear associated with psychosis, rather it will push it into the darkness making people more afraid of these things. If you were to say for example "I'm on an antipsychotic - it works by modulating the dopamine, a neurotransmitter in my brain" - makes it more enlightening if someone is afraid of that word, rather than saying you are on dopamine modulators, which avoids the nasty little issue of psychosis entirely
I think the use of any euphemism is going to increase stigma, rather than reduce it. This is one reason I like your fairly blunt and occasionally shocking writing.
My psych has been trying to convince me to add an antipsychotic to my regular meds. The thing is, I don't want to have to deal with more than one disease/disorder. Sure I'd feel a little better mentally, but I'd still have bipolar disorder plus potentially a whole new bunch of disorders/diseases (TD, Diabetes) that come with the antipsychotics. The stigma is bad, granted, but this is what really makes me hesitate; I'm not sure I'm willing to risk the rest of my health.
That being said, I don't know if I will get better without more help...
I don't even know if what I am experiencing is psychosis (I hear other voices, but they don't seem external to me; they're all in my head), but it's good to know that they're seen as add-ons as well.
You know, it's sad, but even as one who takes antipsychotics, I had stigma against the meds themselves. I was a psychiatric crisis worker when I started to take them, so that just totally freaked me out, even though I knew they'd help. I waited as long as I could before taking them, but once I thought there were helicopters following me and I had an incident at the store where I thought everyone was watching me, I knew there was no option left.
I'm okay about it now, but it was hard as a psych professional to take them.
The "atypical antipsychotics" actually do a lot more than modulate dopamine. Depending upon the drug, they have large, sometimes larger effects on various serotonin receptors, cholinergic receptors, and histamine receptors. But this is one case where I don't think the stigma is that bad a thing- I think that they should be last ditch medications. If a drug for heart patients caused tardive dyskinesia, it wouldn't last long. But because we are mentally ill, it is fine. Just don't let them be crazy, it is okay if they get diabetes and tardive dyskinesia down the road, we didn't expect much from them anyway.
I know they are primarily called antipsychotics as I live in the US. I'm just a nerd who does lots of research and its another way to throw off people instead of saying antipsychotic. I've been on a bunch of them, am not currently on any, but remember how scary it was at first because I was not psychotic. I eventually got over that and found a select few to be helpful at times.
That is one name, so is "major tranquilizer" but in North America they are primarily called "antipsychotics."
I wouldn't consider it contradictory, personally. I feel this is about dealing with other people's stigma in an effective way. I'm not suggesting that people be ashamed of the word, but I am suggesting this might be one way to deal with it.
The technical term for the class is neuroleptics.
Nice article but somewhat contradictory to previous arguments about using stigma-laden words. Change of heart?