I am not an expert on any story but my own.

My opinions are my own and my insights are based on personal experience, my therapy work, what Ive reading and observation of myself and others stories.

I do not have experience with situational-depression (caused by a one-time major life change, trauma or stressor). My experiences are as related to chronic symptoms, caused by PTSD the D being operative: Disorder, meaning it has interfered with my life for, not months, but many years (decades).

About Self-Medicating:
I will confess that at the start, when PTSD first reared its hateful, ugly head, when symptoms (flashbacks, not the least of them) were at their most debilitating and devastating level, when I didnt know exactly what was going on, when Id first started therapy, long before any headway was accomplished, I used selfmedication as a way of managing my distress (although distress is a hugely inadequate term for what I was living through). Self-medication (wine, mostly) did not serve me well. While it did manage to numb my brain, shut off my reasonable thinking and knock my body into unconsciousness, wine DID NOT get rid of the wretchedness I was suffering. AND, for me, self-mediating was both shameful (I hid it from my therapist and my psychiatrist for almost 2 years) and miserable because going to work and getting through the day with a hangover (headache, dry mouth, achy limbs, and sick stomach) was a horrible experience. Also, I didnt want anyone to know (more shame), so when I was drinking (nearly every night) I wouldnt leave my apartment or answer the phone; the result: I was utterly alone. It was truly fortunate for me that I did not become chemically dependent on the wine. I was emotionally dependent, but not physically/chemically. As a result, when I decided to stop drinking wine, I simply stopped with zero side effects. I am fully cognizant that I dodged a massive, menacing bullet; I know it is almost unheard of. If I had become physically/chemically addicted, it would have become yet one more problem I had to overcome, which is another reason I believe it important, if at all possible, that I avoid (or limit, cause total avoidance isnt always easy) self-medication.

Here then, is my personal experience/opinion:

To Medicate or Not to Medicate, that is a question.

I live with PTSD. The most consistent manifestations (symptoms) of my PTSD show up in debilitating depression and crippling anxiety. Each of those comes with an entire list of struggles. That saidMy pontification for today is this: My experience is that Medication is not an enemy. My experience is that Medication is not an evil. My experience is that eating organic and/or eating vegetarian and/or eating only healthy food and/or avoiding meat or milk or gluten or wheat are not, not a substitution for medication. These are all fine choices for overall general health; it would behoove me to try to make more of them, with more frequency. I would do nothing to discourage anyone from choosing healthy alternatives. However, if there is a true brain illness (PTSD, Depression, Bipolar, Anxiety, etc.) my experience is that diet alone will not resolve the symptoms. My experience is that having a psychiatrist (not a primary care, general practitioner, but a true specialist in the field of the brain and medications for the mind/brain), having the right psychiatrist was vital to finding the right medications for me. My experience has led me to the conclusion that, if I were king I would require that primary care physicians (general or family practitioners) refer to a specialist, all patients who need medications for the mind/brain, just as they are refer patients for surgeries. I would demand that the medical community begin treating problems with the brain in the same way they treat problems with the heart patients must go to a specialist. I believe that if this became the standard, if GPs were no longer allowed to prescribe Zoloft or Prozac or Celexa, then I believe that patients would get the accurate medical care they deserve and need. AND I believe our society, as a whole, would begin to eliminate the stigma that continues to be attached psychiatry. (I can become angry if I think too long about the lack of parity in our country, when it comes to treating people who have an illness involving the brain) If being sent to a psychiatrist became as ordinary as being sent to an oncologist, gynecologist, neurologist or podiatrist, then I believe more people would find the help they need AND more people would have a better chance of benefiting from the care given by doctors who specialize in the brain, including more comprehensive understanding of the ailments and the specialized medications that are available.

On many of the FB and Blog pages I visit, I have read a general dismissal and even demonization of medications used to assist folks with mental/brain health issues. I know it is popular to bash the pharmaceutical industry and I know it is trendy to say Im going organic and natural, or to say, I dont believe in medication. My experience, however, is that medication made a massive difference for me. My experience is that with a psychiatrist who is willing to be an active partner, and a therapist who is willing to be part of the process, finding a medication regime to help with symptoms changed my life from one of continual, unending, unceasing and debilitating anguish. With medication I reached a place, while not perfect by any stretch, my symptoms became manageable so I was able to function enough to make good use of the therapists Im seeing. Before medication, my appointments with my therapist were all about simply making it to the next appointment, which was always just a few days later. My time with my therapist was about trying to deal with the hell I was living and putting all our effort into keeping me from simply giving up. It took about eight months to find the right combination of medication and the right doses; when we did, my world began to change. Literally, it changed. My vision cleared; my head cleared. I no longer felt that I was, every moment of every day, on the very edge of shattering, like a sheet of glass. My sleep, while not perfect, became better. I could think real thoughts. I wasnt well by any stretch and I wasnt even recovered, I was different. Different enough to allow some of my mental and physical resources to be spent on working through the issues (stories) that were at the root of my PTSD. Over the years, as I have changed and as my brain has changed, we have altered my medication. Sometimes we had to adjust my meds because my situation had gone through a major change or there was a temporary, unmanageable crisis. My medication regime from 2003 is not the medication routine Im on now. Shifting medication is not an easy process; it is not one I look forward to. This brings me back to having a doctor that works as an active, respectful, caring partner. Even though some of the stages of finding the right medications were down right miserable, I dont regret going through it. (Please dont conclude that I look forward to changes.) Having the right medications helps me manage my symptoms so that I am better able to work on resolving the stories that caused the PTSD, depression and anxiety in the first place. When every second of every minute of every day is a struggle just to draw breath or get out of bed or take a shower or do laundry or turn on the TV or feed my cats, then there is nothing left over to work on healing my broken brain. Medication has helped me in a long, long list of things. Medication and hard work with my therapists make a difference.

What is different from 2003?

In 2003, I could not do dishes. In 2003, I could not tolerate the distress of folding laundry and putting it away. Eighteen months ago, I could not walk around the block. Each of these is an example of something that has changed (2 nd part of the story still a work in progress).

Medication: Not for everyone

I am NOT suggesting that everyone should go out and get or ask for medication. I am MOST CERTAINLY not suggesting anyone try to self-medicate. Absolutely imperative: a specialized doctor (psychiatrist) is vital for this decision. I will be the first to say that not all drugs are equal and that some drugs are less equal than others. My personal opinion is that some of the medications that are prescribed for depression and anxiety truly are more dangerous and more vile than the disease they are intended to help. And I know, because Ive watched it happen to others, that some medications that are meant to help are a nightmare to get off of. I have witnessed and heard horrible, hateful stories about medications. Therefore, I would never, ever suggest to any one that all medications are good or that medication is for everyone.

Not a Magic Bullet: Hard work is absolutely needed

I am not suggesting that medication will cure someone with PTSD, severe depression or a panic disorder. Medication is not cure. Medication is not a magic bullet. I know this from personal experience. I know for me, and I dont believe for anyone it will suddenly make life wonderful and/or easy to live. Medication will not suddenly resolve any of the issues that are beneath and behind PTSD, serious depression or an anxiety disorder; OR add-youown-personal-OR-here. Medication helped me by decreasing the physical symptoms, this in turn freed up some of my mental and physical resources so that I could make better use of my time with my therapists and time when I was working on my own. Medication decreases some of the physical symptoms so that when I attempted a task which I knew would trigger symptoms, there was room-in-my-cup for the added distresses, which made accomplishment possible.

In my experience, it is impossible to accomplish normal-life tasks when my nervous system has been stretched beyond its endurance; medication eased my physical suffering, leaving room for added-distress. I know that sounds counterintuitive. I also know it makes perfect sense to me. Medication changed my days from a sun-up to sun-down unbearable misery. It gave me some respite from the endless, constant mental and physical wretchedness. It gave me back the use of my mind.

Medication is NOT: One-Size-Fits-Most

I am not suggesting that medication is for everyone. I can, however, tell you my own experience. Before medication, I was a miserable disaster, bumping through life, always in excruciating mental pain, living life in a dark fog of depression, unable to climb out of the mire. Truly, my depression was so deep that my vision was affected and it wasnt until my mind began to clear that I was even aware of just how my vision had narrowed and clouded. Once the depression was somewhat managed (not gone, just not ruling every moment of every day), we then were able to address the anxiety that was another debilitating condition which was/is holding my life hostage.

Not a Cure-all: Struggles Remain

Medication has not resolved all my struggles with daily life. There are still genuine obstacles. Not all symptoms have been eradicated. Medication does not mean that those symptoms that have been managed, dont rear their heads periodically. AND, also true: Medication has made, and continues to make, an important and large difference. Medication has not fixed me, has not fixed my brain, has not fixed my life. Medication has helped me make better use of the therapy. Medication has made my days more bearable. Medication has helped make my sleep more restorative. Medication has helped me make progress with some of my struggles.

Let me return, to the beginning

To Medicate or Not to Medicate, that is a question.

Only you and your mental healthcare team can make that decision. Giving up wheat, didnt help me. Giving up dairy, didnt help me. Running from the question, didnt help me. Hoping the need for the question would simply go away, didnt help me. Wishing someone else would make the decision for me, didnt help me. Pretending nothing was wrong, didnt help me. Refusal and obstinacy didnt help me. I hope you find the answer(s) that is right for you.