Navigating Anxiety and Medication: Finding Balance in Mental Health Care

A feeling of significant fatigue?

I have been visiting a community clinic (which specializes in insomnia and neurosis) and I am currently taking medication: one Serlin at night and one Sulnine in the morning and evening.
However, I am concerned about medication dependence.
I asked my doctor about it, and he said he wants me to continue with this dosage, stating that it is very low.
I inquired whether stopping the medication and then resuming would require a higher dosage.
The reason for my concern is that I am preparing for a teaching examination, which leads to periodic cycles of low mood.
Now that summer has arrived, I have just completed the exam and have a temporary teaching job, but as I age, I feel increasingly lost about the future.
The doctor mentioned that the medication has a preventive effect and assured me that I wouldn’t experience a major breakdown by next July when the pressure peaks.
I tend to struggle with adaptation, even though I have been preparing for exams for eight years.
However, my family seems to think that seeing a psychiatrist is a cure-all (they even believe that as long as I take medication, I can take the exam, which is great for prevention).
Their expectation is that I should take medication before the exam (like a month in advance), which frustrates me.
Fortunately, I haven’t rejected the idea of seeing a psychiatrist; my family thinks it’s a normal mindset, similar to treating a cold.
However, this pressure is transferred onto me, making me feel like a guinea pig! They suggest taking medication only during exam times and question why I need to visit the clinic weekly to pick up my prescriptions.
They even say, “You look fine; you don’t need to see the doctor anymore or take medication.” This makes me very angry.
It feels as if they think I should just take medication when I want and stop when I don’t.
This pressure makes me fear that stopping and starting the medication will lead to bigger problems! I feel like I am the one going crazy, and I struggle to adjust.
But taking medication continuously makes me doubt myself—why do I need it if I seem normal? Three years ago, I faced a similar situation and visited a public hospital.
Eventually, after about six months of visits every three weeks, the doctor told me I could decide whether to continue coming.
He suggested activities like watching movies, reading self-help books, hiking, and listening to music, advising me not to overthink things.
This year, I waited until I couldn’t cope anymore before seeing a doctor because I felt that my family didn’t believe in my abilities, and I wanted to manage on my own (especially since I get extremely nervous before exams).
However, I recover very quickly, to the point where even the clinic doctor remarked on my rapid emotional recovery (this was after my second week of treatment).
I had just finished my exam by then! So, I have been in treatment for six weeks now (because I am taking medication, I am afraid to stop).
When I asked the doctor: 1.
When can I stop coming to see you? 2.
Can I reduce my medication? (I dislike my family’s unreasonable demands, yet I still try to ask if I can stop taking the medication).
The doctor mentioned that he is concerned about the pressure of adapting to a new substitute teaching position when school starts, so he advised me to continue with the current dosage.
Everything feels so confusing and exhausting because perhaps the only solution is to work hard to pass the teaching exam or civil service exam to alleviate my emotional distress.
But this is not something I can just will into existence.
The dual pressure leaves me unsure of which direction to take.
Even thinking about it is painful, and I don’t know what to do.
The doctor asked if I have any goals or things I want to do, and I said I didn’t know.
He said that without knowing, he couldn’t help me, which made me feel even more helpless! It’s true that I don’t even know what I want, so how can others help me? I have been trying very hard: 1.
Participating in religious activities 2.
Reading self-help books and motivational articles, etc., but the situation has worsened.
I feel more trapped and powerless, and I envy others (for example, those who are good at English; if I spent my worrying time studying English, I might also achieve something).
But everything makes me unable to believe in my own abilities, and I feel scared.
This message is very long, and I keep repeating myself, but I genuinely want to ask the doctor for guidance on what I should do.
Because if I tell the doctor when I can stop seeing him, it seems disrespectful.
Yet my family keeps saying I don’t need to go anymore! Hearing this repeatedly makes me feel like—if I continue to see the doctor, nothing seems to change? It feels like just a routine visit to pick up medication.
Is that how it should be?

sel, 30~39 year old female. Ask Date: 2011/08/14

Dr. Liang Sunyuan reply Psychiatry

Hello Sel, in the treatment of depression, besides medication, psychological adjustment and environmental factors are also very important.
If we can address all three aspects, the treatment outcomes are usually the best.
The goal of depression treatment is to achieve complete recovery and prevent relapse, as the more frequent the relapses, the higher the chance that depression will become chronic.
I wonder if becoming a teacher has always been your aspiration or if it was suggested by your family? Currently, the teacher recruitment exams in Taiwan are indeed quite challenging.
Sometimes, when we cannot achieve our first choice, our second or third choices may also be good options.
Family inquiries often express their concern for us, and it is not necessary to interpret them as a form of denial.
They may hope that you can avoid medication and medical treatment, which likely reflects their desire for you to be healthy, leading them to express such thoughts unintentionally.
Your decision to seek medical help is a way of facing reality, wanting to collaborate with your physician to achieve your goals.
Essentially, the ultimate goal is the same.
Therefore, try to reinterpret your family's inquiries as expressions of care for yourself, which may help alleviate feelings of disappointment.
Visiting a doctor is actually about leveraging their expertise to collaboratively address your current challenges and is a proactive step towards improving your well-being.
It is important not to view seeking treatment too negatively.
I agree with your perspective that discussing how long to take medication and when to stop should be clearly addressed with your outpatient physician, as this is the safest approach.
To manage stress, it is best to consider multiple strategies; sometimes if one method does not work, you can try another.
If you are temporarily unsure about your life goals, you can "return to your original intention" and reflect on what you wanted as a child or during your student years.
Consider whether the adult you can fulfill any of those childhood aspirations, even if only partially.
Another approach is to explore and inquire more; the world is vast, and perhaps you have not yet encountered what you truly want to do.
Gaining more knowledge about different things may reignite your passion for work and life.
Religion and community involvement can provide a protective power for emotional tranquility and are also good options.
People cannot be compared due to differing starting points; as long as you are making progress today compared to yesterday, that is something to celebrate.
I hope this is helpful to you, and I wish you all the best.

Reply Date: 2011/08/14

More Info

Navigating anxiety and medication can be a complex journey, especially when compounded by external pressures and personal expectations. It sounds like you are experiencing a significant amount of stress related to your mental health treatment, family expectations, and the pressures of upcoming exams. Here are some insights and suggestions that may help you find balance in your mental health care.

First, it’s important to acknowledge that anxiety is a common response to stress, particularly in high-pressure situations like exams. The feelings of uncertainty about the future, especially regarding your career and educational goals, can exacerbate anxiety symptoms. Your doctor’s recommendation to continue your current medication regimen is based on the understanding that these medications can help stabilize your mood and reduce anxiety, which can be particularly beneficial during stressful periods.

Your concern about medication dependence is valid and shared by many individuals in similar situations. However, it’s crucial to understand that when prescribed appropriately, medications like Serlin (an SSRI) and Sulnine (a benzodiazepine) can be effective tools in managing anxiety. Your doctor’s reassurance that you are on a low dose is significant; many patients require higher doses for effective management. If you are worried about long-term use, it’s essential to have an open dialogue with your healthcare provider about your concerns. They can help you understand the risks and benefits of your medication and discuss potential tapering strategies if and when you feel ready.

Family dynamics can complicate your mental health journey. It seems that your family may not fully understand the nature of mental health treatment and the importance of consistent care. Their expectations for you to only take medication during high-stress periods can add to your anxiety. It might be helpful to communicate openly with your family about your treatment plan and the importance of maintaining a consistent approach to your mental health care. Educating them about anxiety and its treatment may foster a more supportive environment.

You mentioned feeling pressure to perform well academically and the fear of not meeting expectations. This pressure can create a cycle of anxiety that makes it difficult to focus on your studies or enjoy activities you once found fulfilling. It’s essential to set realistic goals for yourself and recognize that it’s okay to take breaks and prioritize self-care. Engaging in activities that bring you joy, even if they seem small, can help alleviate some of the pressure you feel.

In addition to medication, consider incorporating other therapeutic approaches into your routine. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety and can help you develop coping strategies to manage your thoughts and feelings. Mindfulness practices, such as meditation or yoga, can also be beneficial in reducing anxiety and improving overall well-being. These practices can help you stay grounded and present, reducing the tendency to ruminate on negative thoughts.

Lastly, it’s crucial to have a support system in place. Whether it’s friends, family, or support groups, having people to talk to about your experiences can provide comfort and understanding. You might also consider seeking out a therapist or counselor who can provide additional support and guidance as you navigate your mental health journey.

In summary, finding balance in mental health care involves open communication with your healthcare provider, understanding the role of medication, managing family expectations, and incorporating therapeutic practices into your routine. Remember that it’s okay to seek help and that you are not alone in this journey. With the right support and strategies, you can work towards a healthier, more balanced state of mind.

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