Stigma Surrounding Psychiatric Medication
It's dark when I pull into the parking lot. I'm nervous--will he have what I need? Will the price have gone up? What if I can't get it? How will I get through tomorrow--the next day, the day after that--if I don't? My fears are unrecognized, but I can't help noticing the smug, disapproving look on his face as he hands me what I came for.
Anyone who fills psychiatric medications, either for themselves or for their children, has taken part in the above-described scenario. For parents, the anxiety associated with refilling a child's prescriptions comes from multiple sources:
Will there be a problem with insurance coverage for this medication? There was that one pill Bob couldn't swallow last week, which he spit out once the coating wore off and the bitterness hit his tongue. We swapped it out for a new one, leaving us off by one pill. Of course this medication is a controlled substance (Focalin for ADHD), meaning getting it filled even under the best circumstances is an event. If I try to fill it a day early, will the insurance company reject it, claiming it's "too soon?" Will I have to choose between letting Bob flounder, unmedicated, for a couple of days or paying out the nose for the full price of the refill? (No partial refills are allowed for controlled substance medications--I've asked.)
What if our insurance coverage has changed? This happens from time to time--either the medication moves to a new "class" of coverage requiring a higher copay, or the policy changes, creating all new copay levels (usually higher).
Will the pharmacy refuse to fill the prescription for one reason or another? On multiple occasions over the years, I've had problems filling/refilling prescriptions for various reasons. The doctor's signature wasn't clear enough. The dosage was entered incorrectly. The prescription, itself, was written incorrectly. The number dispensed didn't match up with the psychiatrist's directions. Some of the reasons I've been given for refusing to fill a prescription have been, well...crazy.
What must the pharmacy employees think of me? This is mostly an internalized, personal issue, although I can understand how it could cause one to delay or avoid filling certain prescriptions. I was once put on hold by a pharmacy employee--except, she neglected to actually put me on hold until after I heard her say, "who puts a 4-year-old kid on Zoloft, anyway?" Of course, I was outraged (and put her in her place as soon as she picked up the phone). But I was also embarrassed, ashamed, hurt, and incredulous someone should judge me and/or my son based on a prescribed medication. Who, indeed?
If you didn't already, I'm sure you now understand why pulling into the pharmacy drive-through makes me nervous.
And don't even get me started on what I have to do to get my allergy medication.
McClanahan, A. (2012, May 11). Stigma Surrounding Psychiatric Medication, HealthyPlace. Retrieved on 2020, September 29 from https://www.healthyplace.com/blogs/parentingchildwithmentalillness/2012/05/stigma-surrounding-psychiatric-medication
Author: Angela McClanahan
i have been actually shamed acussed of drug dealing and drug abuse by a pharmacist in the u.s. i changed pharmacies but it's gotten worse. i see a psychiatrist for severe social anxiety and chronic insomnia. the new pharmacy is requiring that i go off my meds for one week every month before they will fill,by this time i am physically ill,paranoid and exhausted. i feel like i have nowhere to turn
First of all, if at all possible, you need to find a new pharmacy. I'm in the U.S. and my husband deals with the pharmacist. They know him by first name because me and my two sons have bipolar disorder. They also have ADHD and one some has restless leg syndrome. We've had many times when we were one pill short but thankfully all of us take the same thing except for one or two things and we can get by. But our pharmacist has never treated us this way. Maybe because there is so much competition for our business?
Second, I'm glad you gave her a piece of your mind about the 4 yr old on zoloft comment. She's a pharmacy tech, not a psychiatrist. My son's were on Bipolar meds and ADHD meds by 3rd grade. And yes I was scared, but I also recognized myself in them both and know how many times I came close to suicide myself as a child with undiagnosed Bipolar Disorder.
And unfortunately when I was misdiagnosed as Depressed and given an antidepressant, it sent me into full blown mania, not sleeping, incessant talking, nervous energy and a suicide attempt. When I was finally diagnosed correctly, I thought, so this is what everyone else feels like. I'm so sorry for your loss Sandi, if you read this. But the cause of depression is a chemical imbalance and that's why the drugs. Same for BPD.
And I am sorry but the stigma is not imagined. I get it even from my family. My neighbor, who was a very good friend, told me I was a burden to my family when my meds stopped working and I became depressed. I had to tell the DMV that I had BPD and what meds I take and they almost didn't let my son get his learner's permit. There is a lot of stigma. But I don't whisper it. It's the least of my worries. I have to watch my sons' behaviors and worry about little changes if they mean a decline in their mood. But yeah, there is still a stigma.
And Catherine Zeta Jones may say it's "totally controllable" (BPD) but I beg to differ.
You have a wonderful site Angela and I'll be checking it often!
Wow some of these stories are horrible glad that does not happen here in Australia, well not that I have heard, glad my clients don't have to put up with that
I had my own stigma about going on the last resort medication, Thorazine. My grandmother had been on it back in the day, and we've all heard of the "Thorazine-shuffle", right? Well, I caved in out of desperation and went on it and it works! Yes there are still issues to work out with this med, but my own stigma almost cost me my own life. Had I not gone on the Thorazine, I might not be here now. It's wordless, it just is... wordless.
When you get your psychotropic medication in one mental clinic or especial distribution place for this type of medication, all the people that go there are in similar circunstances and you won't feel "diferent". Remember allways that more people than you think have some type of psychiatric problem.
Just a small comment, treat the problem....Pills are not wonderful when just using a 'Wheel of Diagnosis'. Depression and mental illness now seems in Canada treated by here's your medication now go home and feel better. It just doesn't work. Too many are given medication that makes the problem worse and sometimes it is too late when that is figured out. My 17 year old daughter was given anti-depressants for depression that I discovered after her death from suicide should not be perscribed to anyone under the age of 20 (in my opinion from research should not be given to anyone.) Let's try treating the illness by finding the cause instead of the instant cure. Julie my daughter when on 'Zoloft' (after a suicide attempt which she was to stay in hospital for 2 weeks and was released after only 3 days) suffered from then not being able to sleep properly, nervous shakes,paranoia and more thoughts of suicide. She passed away from suicide on Aug. 5, 2009....The medical community needs to ensure that a patient is seeing a therapist or pyschologist plus one Hell of alot more monitoring is needed when these medications are dispensed. Thank you medical community.
I can fully relate to this and this is not your imagination or in your head. I have had problems accessing my medications for anxiety and have also received dirty looks when I go to pick up my meds with my children as if I am a horrible mother.
My worst experience was when there was a huge line behind me and I went to fill my prescription a few days early and the pharmacist very loudly proceeded to chastise me and tell me that she could not fill the prescription. She then told me that she would need to check my file and once again said that she would not fill it. At this point I was beyond mortified as she was making it seem as if I were a drug addict. I started getting visibly upset and told her that she needed to do her job which was to fill the prescription that my doctor had written. She then started making a huge deal saying loudly and as if she were being threatened "calm down, calm down" I ended up leaving shaking and in tears as the others in line stared at me as if I were a junkie. To this day I always dread going to the pharmacist for my medication.
I think you have a self imposed stigma. When I was young I had the same feelings buying condoms. When you are embarassed or flustered every reaction and gesture is heightened. Mental illness does have stigma but you dont have to accept it. They can only affect you if you let them. Maybe counter his look by saying great pills these my son is doing great on them. Challenge people it is amazing how many people start talking about their MH experience when you open dialogue. People parrot accepted beliefs from ignorance and fear.
I can understand getting my sons medicine but I have worked in a pharmacy as a pharmacy tech and I never thought anything of the person getting controlled medication. Maybe that's because my son is on it and so am I.