A Story About Small Changes and What Holds You Back From Making Them

Last week I was talking to a lovely twenty-something woman about her medications. There were two things I wanted to talk about: one medication was new, so I wanted to know if it was replacing a medication she was already on and the other was a change in dosage. The two medications I’m referring to can be used for several things: anxiety, depression, and/or headaches, especially migraines. 

 In this case, the new medication was to help with her migraine headaches, and the dose change in the other was to help with her anxiety and depression. When I talk to patients about their medications, I’m not merely verifying that the prescriber sent the right prescriptions to the pharmacy, but I want to know what’s going on with the patient and how I can help her get the most out of her medications. Therefore, I asked her, “How many migraines do you get each month?” She said she didn’t know. I also asked her, “Do your medications for anxiety and depression help you feel better?” She said, she wasn’t sure and that her mom told her if she was feeling better or not. 

Let’s Pause for a Minute

I needed to regroup at this point since I wasn’t talking to the person I thought I was talking to-the one in charge of this woman’s health. It seemed she had delegated this responsibility to her mother. I’d seen this many times before- this inability or lack of desire to take care of oneself. Countless people I’ve tried to counsel about their medications either nod absently, turn their heads to let me know they’re not listening, or say something like, “I don’t know about any of that my _____ (insert title of person ex: wife, doctor, daughter) takes care of all of that.” 

It’s good to have an objective perspective when it comes to keeping track of how you’re doing on medications for anxiety and depression. Often you don’t see yourself clearly. When you feel very anxious, instead of making note of it to discuss with your doctor or therapist, you chalk it up to being extra tired and forget about it. 

Or you’ve been short-tempered and irritable with your kids. Instead of asking your spouse, “Have the kids been more annoying lately?” or, “Do I seem a bit off to you?”  to find out if your responses are rational, you just assume that the kids are the problem. It is easy to ignore that small voice inside that says you’re off, you don’t feel good, and something needs to change. 

You may even start to consume more sugar and caffeine in an attempt to energize yourself out of a funk without even realizing you’re in a state of anxiety or depression. You do this because it’s just easier to try to push through it. It’s hard to acknowledge that you don’t feel good. It’s hard to take the time to take care of yourself when you have a lot to do. It’s hard to admit that you don’t feel good- again even after medications, therapy, and lifestyle changes. It’s just hard living with anxiety and depression. 

It’s no wonder that my twenty-something patient has delegated the responsibility for her well-being to her mom. I understand completely. Her mom is probably a loving, wise, and wonderful woman. This younger woman, if she really wants to be well, has to become more involved in her own care. Now, back to the pharmacy counter- there I was with all my knowledge and wisdom and there she was having delegated authority to another. There was no way I was going to tell her things like:

You’ve got to start being responsible for your own medications!

You’re a grown woman! How can you NOT know how many headaches you have?!

Your generation doesn’t want to be responsible for ANYTHING!

You can’t opt-out of your own health choices!

I wasn’t even going to think any of those things or any rendition thereof. Experience and empathy have taught me that judging doesn’t help. Trying to force people to listen to my great advice, backfires every single time. I feel crappy after the encounter and more importantly, they feel crappy. The last thing someone suffering from anxiety and depression needs is for their healthcare people to make them feel crappy. They feel crappy enough already. 

Instead of advice, in this case, I went with inspiration. With all the compassion I could muster, I channeled my inner suffragette and said, “Women fought hard, suffered, and even died to give you and me authority over our minds and bodies. It’s incredibly empowering to start to keep track of how you feel. Just for you.”  I then left her with one small task – to jot down on a calendar every time she gets a headache. 

She softened a bit. She made eye contact, smiled, and straightened her back a little and said, “Thanks, I will.”

As of now, I don’t know if this young woman will remember to keep track of her headaches or even if she will begin to look at herself as the responsible person for her own well-being. Maybe if she hears it enough times and gets support for her efforts to change, I’m sure she can start to keep track of her headaches and how she feels. This will help her doctor and therapist treat her, this will in turn, strengthen those relationships. She will then make more good decisions for herself. It’s a virtuous cycle of health and healing. 

I can see myself in this young woman. Maybe you can see yourself. If you’ve lost track of how you feel, if you’ve been pushing too hard to feel better, or if you’re just tired, stop and tune in to yourself. Ask someone you trust what they’ve noticed. Not because that person is in charge of your health, but because they’re your ally.  Health and healing can’t happen without you. Take a small step toward taking charge. 

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