Psych Meds, Self-Care and Paganism

Recently my attention was brought to an image making the rounds online. Divided into two halves, the top half shows a forest and the caption “This is an antidepressant.” The bottom half is a stock photo of a bunch of random, unidentified pills and says “This is shit.” The implication is that people with mental illnesses don’t need psychiatric medications; they just need to go outside and play. It wasn’t just completely woo-woo New Agers passing this around with solemn nods, either. Some of my fellow pagans–who really ought to know better–were also sharing it unironically.

Look–as a Masters-level ecopsychologist, I am the first to bang the drum of “Nature is good for you! Look, here’s research saying so! There are tons of people with self-reported improvements!” Here’s a study, and here’s a study, and here’s another study, and oh, hey, look at this whole peer-reviewed journal! You really don’t need to convince me of the healing powers of nature.

The Mental Health Toolkit

Back when I was actively counseling I frequently suggested to my clients (the ones who were able to) to go outside on a regular basis. Here’s the thing, though: going outside was not meant to be a grand cure-all, and it certainly wasn’t meant to replace the psych meds that a lot of my clients were on. This was an inpatient addictions treatment clinic, and many clients were self-medicating with methamphetamine, heroin, alcohol and other street drugs as a way to cope with everything from depression and anxiety disorders to Borderline Personality Disorder, along with frequent trauma histories. These were not clients whose problems could be easily solved with a walk in the park.

So our in-house psychiatrists would work with the clients to find effective combinations of pharmaceuticals (for those who needed them). I and the other counselors would do both group and individual therapy with our clients, and I wove ecopsychology into my treatment a fair bit. The outdoor time clients got during daily walks and weekly field trips helped reduce symptoms and build coping skills to replace the drugs they were abusing, and the medications they took helped them to rebalance their brain chemistry so they were more able to approach and work through what drove them to self-medicate with drugs in the first place. Each client responded to the various parts of treatment–medications (if needed), individual therapy, group therapy, mindfulness work, ecotherapy, etc.–differently. There was no one size fits all treatment regimen.

When a person is dealing with a mental illness–or, hell, just a great amount of stress–they have to find the unique combination of mental health care that’s going to help them improve. There’s a whole suite of things to choose from; the following are just a few examples:

–Individual or group therapy (acute treatment/crisis intervention, coping skill coaching, talk therapy, cognitive-behavioral therapy, etc.)

–Medications (over the counter or prescribed)

–Physical self-care (exercise, better food, plenty of sleep and water)

–Mental self-care (good quality self-help books, mindfulness, meditation, “taking a break”)

–Spiritual self-care (engaging in one’s spiritual path, finding meaning in the self and/or the world around you)

–Social self-care (being around people you like and who like you, connecting with a support system online or in person)

As a therapist, I want to have a diverse toolkit available to help my clients. And as someone with a diagnosed mental illness–Generalized Anxiety Disorder–I also personally benefit from that diverse toolkit.

My GAD is not severe enough to where I need to be on medications. I’ve had the better part of three decades (and three years of graduate-level training) to figure out how to manage it day to day. I’ve learned its tricks pretty well, and I’m getting better every day at seeing through them. Being self-employed is one important piece of my mental health care, as the ability to sleep in most days, and the flexible schedule, both help me to stay relaxed and feel in control of my everyday life. I exercise fairly intensively almost every day; I run, I lift weights, I hike, and more recently I’ve joined a local dojo where I train in combat hapkido and Brazilian jiu-jitsu. I really like food, and cooking food, so having tasty nourishing meals is something that both helps me manage my brain chemistry and makes me happy. And yes, I get a lot of outdoor time, even moreso now that I spend part of my time each month on the Washington coast, and just being able to look out the window onto wide, open spaces has made major improvements on my mental health.

But I would never in a million years say that what I am doing is better than SSRIs or other medications for someone who uses those as part of their treatment. Sure, maybe if they were in my position and had access to the valuable resources that I do they might respond as well as I have. But maybe they wouldn’t. Maybe they’d need those SSRIs for the rest of their life to help them manage anxiety, or depression, or whatever they were being treated for, and that’s okay.

Mental Health and the Pagan Community

And I want to make damned sure my fellow pagans know it’s okay. As a whole, we’re more aware of mental illness than many others parts of the population. I don’t think we’re necessarily more prone to mental illnesses, but as a community we tend to be more open about taboo things.

Which is not to say we’re without ignorance. Ed Fitch’s “So You Want to Be a Gardnerian” condemns anyone “currently in psychological therapy.” I remember a number of years ago seeing a website from the Coven of the Wild Rose; the website no longer exists, but this writer captured one of their cringe-worthy comments on anyone in therapy or taking psych meds: “if you cannot function as a fully responsible adult individual in the mundane reality then you cannot function effectively in the magical/mystical realities and should not even attempt to do so until you have all your oars in the water and they are working all in proper tandem”. Ugh. Just…..ugh.

Even more recently the backlash against pagans managing their mental illnesses persists. Except the attacks are sneakily leveled at the medications some pagans take rather than the pagans themselves. See? We’re not discriminating against you, we just think you’re being poisoned by Big Pharma! Except it is discriminatory, and ignorant, and patronizing to assume that a person on SSRIs or other medications must just be the pawn of a massive corporate agenda. It’s also a big, glaring example of anti-science attitudes that still plague paganism. The people espousing these attitudes quite frequently have poor understanding of how these medicines work and show a broad mistrust of all pharmaceuticals based on misinformation and deliberate fearmongering. In doing so, they feed the harmful stigmas that are faced by people who use psych meds as part of their treatment and make it more likely that people who could really benefit from them won’t consider them an option because they’re afraid of being seen as a “sell out”, “a pawn to Big Pharma”, or just plain “crazy.”

Of the people I know who do take psych meds, overwhelmingly the thing they say is that these medications are crucial to helping them be able to function more effectively from day to day. Just like someone who takes medications for diabetes or lupus or other predominantly physical chronic illnesses, so someone with more significant depression or anxiety disorders may find medications are effective in alleviating symptoms. It’s not about weakness, and it’s not about being “broken”. It’s about making use of the diverse mental health toolkit that’s available to you.

“But they can’t possibly do spiritual work when they’re on drugs!” Phooey, and double phooey. Never mind shamans and other indigenous practitioners from cultures worldwide who use mind-altering substances as a matter of course. There’s a huge difference between showing up to circle three sheets to the wind, and remembering to take your Lexapro on time. To me, someone who is taking medications that reduce their illness’s symptoms is someone who is more likely to be able to engage in spiritual work. They’re more likely to be able to focus because they’re not as distracted, and they’re showing initiative in caring for themselves on all levels. And even if they’re struggling with symptom management, they shouldn’t be shut out from practicing their spirituality. Maybe they need to avoid active group work for a while until they get themselves settled, and do more intensive personal spiritual work as a part of that–but some pagans find that their spiritual group is able to help them more effectively manage their mental health. Again, case by case situation.

“But I took SSRIs and I was miserable on them and then I stopped taking them and I spent more time in nature and my illness went away!” Good! I’m glad you found something that worked for you and that you’re feeling better! And these other people are finding what works for them, too. Some people having bad experiences with psych meds doesn’t mean those meds are universally bad. Maybe you had the wrong combination of drugs; some people can take years to fine-tune their medication. Or maybe you just don’t do well on them and you found other things that work.

“But you don’t take drugs!” No, I don’t. I’ve been able to make enough lifestyle changes to keep myself on a relatively even keel, and, for pity’s sake, don’t forget I have a graduate-level degree in this stuff! There IS truth to the idea that psych students get into psychology because we’re trying to figure out what’s wrong with ourselves! Don’t hold me up as the gold standard. I’m just one of millions of people dealing with an anxiety disorder; I was just lucky enough to find a combination of tactics that works pretty well, and meds don’t happen to be a part of that.

Both/And, Not Either/Or

You’ll notice that in the graphic at the top of this post I made my own modifications to the original meme. I state that both nature and psych meds are “one of many tools for managing mental illness.” When it comes to living with an illness–any illness–I believe it’s important to make as many options available as possible. That means that I see the nature/meds situation as a both/and one, not either/or.

Come on, pagans. We’ve had experience with both/and. Many of us came out of heavily Christian backgrounds where we were told you were either a member of your church, or you were going to hell. And we figured out that no, it’s a both/and situation–there can be Christians and pagans and the world won’t come to a screeching halt. We’ve even found ways to include many different pagan paths in the same events–even the same rituals–and we made it work.

So we can make this both/and thing work when it comes to supporting pagans with mental illnesses in our community, and in treating our own illnesses (for those who have them.) We don’t need to shame pagans who use psych meds to make their day to day life easier to walk through. And we shouldn’t be ostracizing pagans who, even with meds and other treatment, still show symptoms of their illness. Just as it’s a really shitty thing to exclude pagans with physical disabilities or chronic illnesses, it’s also wrong to not make a place for those with long-term mental health issues.

After all, paganism can be a really effective way to get people more engaged with the healing qualities of nature. And isn’t that what you were trying to get them to do in the first place?

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12 Comments.
  1. >>“Nature is good for you! Look, here’s research saying so!”

    Yeah, when I was getting to hike in the woods at least once a month (before my divorce), my depression did the mental illness equivalent of going into remission: I was happy, healthy, and productive.

    Fast forward three years after my divorce; the woods I used to hike in are 30 miles away, and there’s nothing even close to it within walking distance (I don’t own a car, or even a bicycle). My depression came roaring back and some days I can’t even get out of bed.

    I’ve been on medications, and they helped too, but they had some unpleasant side effects that weren’t much fun. Mostly, instead of restoring my happiness, they just took away the suicidal ideation and left me with a flat, unemotional affect that was almost as bad as the depression, just didn’t leave me wanting to exit the earth, stage left, with the help of jimsonweed and foxglove.

    • I’m sorry you’ve been having a tough time of things since all these changes occurred. I hope as time goes on more opportunities for healing open up to you so that you can go back to being happy, healthy and productive.

  2. Thank you so much for this! In my old coven, we used to have the “no psych meds” rule, which I hadn’t really thought about at the time (I also didn’t challenge my ex-coven leader on it, mostly because he was abusive and didn’t like callenge, but that’s a long story…)

    Anyway, when it came to starting my own coven, we basically decided that if a person is managing/coping as best they can, than it’s all good. But if someone’s going off the rails (which we’ve had in the last year), we try to be as supportive as we can, but our coven also knows that there are things we *can’t* do and we try our best to help the person find any support that they need. It’s not always easy, but I’d rather help someone find support and keep the door open than turn anyone away. Spiritual community can be a huge part in someone’s managing/coping toolbox.

    • You are most welcome! I feel like I see the “no psych meds” thing a lot less than I did as a baby pagan twenty years ago, which makes me feel better, but our community still has a long way to go.

      When someone is having acute mental health crises, or at least significant symptoms, it is important to place boundaries with them, but without shutting them out entirely (unless they are to the point where they are a danger to others, which is less often than assumed.) More pagan clergy are learning good spiritual counseling skills that can help someone in a bad mental place find the resources they need to re-stabilize, but a lot of coven and other group leaders don’t have this background and don’t always know how to deal with it when it happens. That and it’s really easy for people in the throes of mental illness flare-ups to be marginalized by community members who, again, don’t know how to respond. So I think more education and support is needed.

  3. As someone who has had mental illness since birth, I have discovered that staying far, far away from idiots who blither on about Big Pharma being evil (or any other conspiracy theory) is a good way to keep out some out of the stupid surrounding this topic.

    As for those coven/group leaders who insist on no psych meds, that trips my alarm bells. I am suspicious that these people are making that rule as a way to control their members and keep them dependent on the group. A mentally healthy, happy person is probably less susceptible to abuse and control.

    • Unfortunately anti-med folks often like to insert themselves into discussions, which makes them a bit tough to avoid. (Which I’m guessing you’ve run into before.)

      That’s an interesting theory on the group leaders. I’m guessing in some cases that they just had a bad experience with someone with a mental illness, but I also bet there are at least some instances where there’s an attempt to avoid outside support for members to breed dependency. Yikes.

      • Another possibility is that some leaders are suffering from mental illness themselves and don’t want to be found out, or they don’t know they are mentally ill and need treatment. This meme sounds like an awful lot of projection is going on.

  4. I actually love you for writing this. My partner and I are both on psychiatric drugs, without which we’d be dead. I’m not being melodramatic or exaggerating. My husband in particular – he has psychosis! Yes, being in nature helps us, and we get out as often as my physical problems allow. But no amount of exercise, fresh air and country walks are gonna stop him from seeing and hearing things that, if left untreated, eventually make him irrational, confrontational and, finally, extremely violent. Only antipsychotics can stop that. His meds actually allow him to engage in his spirituality, not stop him. They allow him to engage with *reality*. I love him and he’s never hurt me, but I would honestly be terrified if he decided to ditch his meds for more walks in the park.

    • And that is exactly why I wrote this 🙂 Because not everyone’s reality is the same, and not everyone’s coping strategies are identical, either.

  5. I don’t have any degree in mental health or medicine, but I do have experience with those who are dealing with mental illness. My boyfriend’s sister was on a number of anti-psychotic drugs and thrived in life. You might never know she had personality disorders, borderline schizophrenia, and acute bi-polar thanks to her meds. I only ever saw her off her meds a few times and I can say that if you don’t believe in the power of medication for mental illness, you should see unchecked mental illness for yourself. She was a completely different person. She absolutely needs her meds to be balanced. That said, of course nature can heal and enrich your life, but for some people, that alone is not enough.

  6. I looked thru all the comments and, yes, I agree, for psychosis or bipolar disorder, meds are absolutely essential. But, speaking as a MD with a psych degree and 26 years of clinical experience, I need to add a few things. First, the large majority of SSRIs and SNRIs are prescribed by internists, family practitioners, and pediatricians. There has been no study to show that either drug class “cures” depression, in fact, I recently read a metanalysis in Annals of Internal Medicine that showed St. John’s wort outperformed the drugs studied, SSRIs and SNRIs. Yet, most of the drugs are prescribed indefinitely without a single thought to CBT or any other therapy. Secondly, most people prescribed these drugs have persistent symptoms, prompting these same primary care doctors to add truly dangerous drugs like Abilify and the like. Yes, I know they work well in schizophrenia, but there the “risk-benefit” consideration is safety v obesity/diabetes. For people with depression, I consider the clinical issue to be consideration of adding non-pharmacological therapy to the first choice of a medication and avoiding the issue of marginal clinical benefit v vastly increased risk of diabetes, but, in many cases, DTC marketing makes my recommendation moot. The patient saw a glitzy ad and has made his/her decision. When I was in private practice as a general internist, I rarely prescribed any medication without a recommendation for a psychological evaluation, but many patients were not interested in investing any time beyond my 15 minute visit for a med check. It does not help that psychiatrists have dropped counseling for med checks, either. So, forgive me if I’m not rah-rah about drugs. I admitted one of the very first patients I prescribed Prozac to in 1991 for hyponatremia and was one of the first docs to report hyponatremia as an adverse drug effect to the FDA. Older drugs like TCAs/MAO-Is are truly dangerous.

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