Medication for Anxiety: Why We're Not Talking About It | Ep 320

I get asked about medication every single day. Can you get better without it? Is it necessary? What's the best one? Is it cheating to take medication?

Today I'm explaining why I don't answer these questions - and why you should be cautious about content creators who do.

In this episode, I cover:

• The three main reasons mental health content creators shouldn't give medication advice
• Why personal beliefs and autonomy matter more than you might think
• The countless variables that make medication decisions incredibly complex
• Why your recovery journey changes over time (and so do your needs)
• What qualifications actually matter when it comes to psychiatric medications
• A better approach to getting the medication support you need

The reality is this: There are too many personal, medical, cultural, and lifestyle factors that go into medication decisions for any podcaster, YouTuber, or social media creator to give you meaningful advice. Even as a therapist specializing in anxiety disorders, there are clear boundaries I must respect.

This doesn't mean your questions aren't valid - they absolutely are. It means you deserve qualified, ongoing professional support for these important decisions, not one-size-fits-all answers from someone who doesn't know your specific situation.

Whether you use medication or not, the principles of anxiety recovery remain the same. You can't make a wrong choice because you can always change course as you learn and grow.

For full show notes on this episode:

https://theanxioustruth.com/320

My medication story:

https://theanxioustruth.com/145

https://theanxioustruth.com/146

https://theanxioustruth.com/147

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Disclaimer: The Anxious Truth  is not therapy or a replacement for therapy. Listening to The Anxious Truth does not create a therapeutic relationship between you and the host or guests of the podcast. Information here is provided for psychoeducational purposes. As always, when you have questions about your own well-being, please consult your mental health and/or medical care providers. If you are having a mental health crisis, always reach out immediately for in-person help.

Transcript

Introduction to the Medication Dilemma

Speaker 1 0:01

In anxiety and mental health. Everybody wants to talk about medication. Everybody wants to ask questions about medication, but we can't talk about medication, and today I'm going to tell you why. So let's get into it. Hello everybody, welcome back to the Anxious Truth. This is episode 320 of the podcast we are recording in June of 2025.

Speaker 1 0:25

For those of you listening in the future, I am Drew Linsalata, creator and host of the Anxious Truth. I am a therapist practicing in the area of anxiety and anxiety disorders in New York. I am also a three-time author on this topic and a former sufferer of panic disorder and agoraphobia and depression and OCD for many years of my life on and off, but better now. Thank you very much. Psychoeducator, advocate, guy with a microphone. And yeah, back again for another episode of the Anxious Truth. This is the podcast where we talk about all things anxiety, anxiety disorders and anxiety recovery. If you're new here, welcome. I hope you find the podcast helpful and if you are a returning listener, welcome back. I'm always happy when you spend some time with me.

Speaker 1 1:03

Today, we're going to talk about why we can't talk about medication, because many of you do ask questions about medication and many of you ask if I would talk about medication. But we really can't, and there are three primary reasons why. So I want to get into that, but before we do, just a quick reminder that the Anxious Truth is more than just this podcast episode. If you go to my website at theanxioustruthcom, you're going to find links to all the other resources. It's all the free social media stuff, all the previous podcast episodes. You're going to find links to some very low-cost workshops and educational sessions that people find very helpful, the books that I've written. There's a whole bunch of stuff there. So check out theanxioustruthcom. Avail yourself of all the goodies. I think you'll be happy that you did, because people seem to find that stuff helpful. So let's get into the discussion for today, which is why we can't talk about medication Now. Everybody wants to talk about medication.

Speaker 1 2:00

I get asked questions about medication every day, all day long. The questions are usually pretty similar Can I get better without medication? Is medication necessary? Is it cheating if I take medication? What type of medication is the best one? Do you think you need medication in order to overcome anxiety? The questions are usually the same. Sometimes there are questions from people who are taking medication and would like to get off. So I do understand that the questions would be, you know, is it possible for me to stop taking my medication and will I still get better if I do that? So there's a ton of interest in talking about medication and I did do three podcast episodes many, many moons ago where I talked about my own personal experience with medication. You can go back and listen to those if you'd like.

Speaker 1 2:45

I can't answer those questions and I'm not sure that it's really fair or ethical for any podcaster or YouTuber or mental health content creator to answer those questions either. And the first reason why is the principles of personal belief and autonomy, which are really important in this equation, right? So no matter what I say about medication, no matter how I answer questions or respond to comments or requests to talk about medication, I am going to be opposing somebody's personal beliefs and I'm going to be challenging the principle of autonomy. That's not okay, because any therapist will tell you that one of the first things that we learn is that every one of our clients always has autonomy. That's not okay, because any therapist will tell you that one of the first things that we learn is that every one of our clients always has autonomy. We are not here to tell you what to do or tell you what is right for you. Only you get to decide that and honestly, I think that extends into this. And while this podcast or these YouTube videos or the social media content I create is not therapy, I still think that I have an obligation to respect your personal beliefs, everyone's personal beliefs, and to respect your right to autonomy. So no matter how I answer a medication question, I am going to run counter to somebody's beliefs, which means I'm going to kind of challenge that autonomy thing, because in a one-to-many environment like a podcast or a YouTube channel or a social media scroll, there's an expectation of authority from people who do what I do, and it could be very invalidating to hear somebody that you have come to, maybe know like or trust and be careful about that, but it may be difficult to hear somebody like me say something that runs counter to your belief about medication or your experience with medication.

Speaker 1 4:29

So if I say that people get better without medication sometimes just because that is true for some people, people who are emotionally invested in taking medication, who believe that it's working for them, who are having a better life, who see nothing wrong with it and who don't want to be medication shamed and I hear that I completely respect that. I get that are going to feel attacked. They're going to feel invalidated. So if I make any mention of the fact that there are people who do in fact recover without medication or choose to not use medication, it's viewed as med shaming and I don't want to do that because it's really not fair. I don't even want to accidentally invalidate or attack somebody's personal belief, especially about an issue as important as this.

Speaker 1 5:12

If I talk about how there are many, many people who make good use of medication, who find them very useful, who find that they've really improved the quality of their lives and who have no problem taking them, maybe for the rest of their lives, then people who have no problem taking them, maybe for the rest of their lives, then people who have a strong bias against the use of medication and anxiety and anxiety recovery, will pipe up because they may hold that belief because of lived experience. Maybe they had horrific side effects or maybe they went through a protracted withdrawal period and now they sort of have a bent against medication. So they don't want to hear anything good about them. So, no matter what I do, I am going to challenge people's personal beliefs and I'm going to, kind of accidentally, because of the relationship that we have in this one-to-many position of authority whatever influencer voice thing that somehow I wound up in it's going to look like I'm kind of challenging your right to autonomy.

Respecting Personal Beliefs and Autonomy

Speaker 1 6:03

Well, I like my meds, but the guy from the Anxious Truth podcast or YouTube channel says that people don't need meds. That's not fair. Like that wouldn't be a great way for you to interpret that and I wouldn't mean it that way, right? So we really have to look at that. In the end, medication is such a personal decision and there are so many different variables that go into that that the best I can do is to say it's a personal decision and that there is no right or wrong answer. We're going to get into this in the next segment too, but that's one primary reason why we don't really talk about medication here and I don't answer your medication questions and, frankly, I don't think any other podcast or YouTuber or social media content creation person should be doing that either. So, in the end, to wrap up sort of this first segment of the episode, I would say that you're going to have to be okay with a few facts when it comes to medication, one of which is that everyone gets to make their own choice. Second one is everybody gets to respect everybody else's choices and not question them, and that the third is that the experience of other people is not your experience, nor is yours, them and they never will be of other people is not your experience, nor is yours, them and they never will be. So there is no black or white, correct answer to this. It is very personal and a lot of it is going to have to do with personal beliefs and your right to autonomy. Okay, so what's the second reason why people like me shouldn't or don't talk about medication or answer medication questions? Well, in simplest terms, I will say because it's complicated. It is, it's very complicated.

Speaker 1 7:35

There are so many different variables that go into this. So many different variables that go into this. There are individual, physical, physiological and medical variables that go into this conversation and these decisions. There are social and family variables that go into this decision. Your family might be vehemently against medication or very for medication and Western medicine. Your family might be heavily invested, from an emotional or cultural standpoint, in Eastern healing philosophies or spiritual beliefs, so that factors into it. There are financial variables. Not everybody can afford the medical care that leads to the protracted use of medication. We got to take that into account. There are cultural variables and honestly, especially in the US today, and not to get into it too much but it's hard to argue that medicine and medication things that come out of pharmaceutical companies are not cultural. Now, because we're experiencing a really big cultural divide at the moment and that's one of the issues or that's one of the areas that is dividing us, at least in the US, and it seems to be in certain other Western cultures countries as well. Again from segment one, first principle, beliefs and autonomy everybody gets to pick their own path, but that's one of those variables that goes into that.

Speaker 1 8:51

Right, there are lifestyle variables that go into this. I have no idea what lifestyle you live. I don't know what your job is. I don't know what your demands are. I don't know if you have kids. I don't know if you're in relationships. I don't know if you're caring for an elderly parent. I don't know if you have pets. I don't know if you're active in your church or community, like these things go into that as well, because sometimes when we use medication, there are side effects that may impact your ability to live the lifestyle that you want to live. So that has to be factored in. There's your history with medication.

Speaker 1 9:23

So when we talk about medication, medication itself is a variable. Have you used meds before, psych psychiatric medications or medications in the anxiety and mental health context? Are you using any other medications? Do you have any other medical conditions that are presently being medicated? Because that may play a role in whether you can or cannot take the usual medications that are prescribed in anxiety and anxiety disorders. And then there's your specific presentation. Like everybody's going to show up presenting in a different way. While the principles, say, of OCD or health anxiety or panic disorder are the same from one person to the next, the way it shows up in someone's life, the obstacles it creates, the way it impacts their lifestyle, their functioning in many different domains, is going to change. So it's also going to depend on your specific presentation.

The Complexity of Medication Variables

Speaker 1 10:13

Like there are so many variables that go into should I take a medication? Can I take a medication? What kind of medication? What dose? Can I do it without medication? There are so many variables that go into this that you have to get to know somebody. It's frankly, in my opinion and I will give you my opinion here. It seems patently absurd to think that some dude with a microphone who's talking to 20,000 people on YouTube or 100,000 people on Instagram would know any of you to any sort of degree. That would qualify me even if I was medically trained and that's what I'm going to talk about next to give you any kind of actionable advice when it comes to medication. There are just too many variables that go into this right, and while we're on the topic, qualifications and training do matter. So unless you are watching a video or listening to a podcast or seeing a post or reading a blog or a book written by a medical doctor or someone in pharmacology or, specifically, a psychiatrist at least here in the US, somebody who is neck deep in qualifications, training and knowledge about the use of psychiatric medications, you probably shouldn't be asking about psychiatric medications Now.

Speaker 1 11:26

As a therapist treating anxiety and anxiety disorders, I have medication discussions with my clients all the time, but there is a scope within which I must stay. We can talk about it. I can help them sort of work out the issue when they're unsure of what to do, because that happens to pretty much everybody. A lot of people become unsure of what to do. That's okay. So your therapist can sort of help you work through those things and I have enough base information to help people make their own well-informed decisions.

Speaker 1 11:56

But otherwise I can't tell you that much about what those meds are going to do for you or not do for you, or if they're going to work, or if you need them or if you don't need them. I'm not even sure about that. When it comes to people that I talk to and get to know intimately, you know for weeks or months or even years on end. So it's simply not possible for somebody in this environment again one to many, one person talking into a camera or a microphone that many people are listening to or watching. We can't possibly know enough about you to give you actionable, possibly know enough about you to give you actionable, safe, ethical, okay information about your medication. So that's the second reason why we can't really talk about this and why I don't answer the questions when I get asked. So let's move on to the third reason why I think it's not okay for people like me to talk in detail about medication or to answer questions about medication.

Speaker 1 12:52

Reason number three why we can't really have this conversation in any meaningful way is that things change. That's right. Things change. You are a human being. You change all the time. Everything changes. Your body is going to change over time. Naturally, on the short term, your body will change. On the long term, your body will change simply because you're aging every minute of every day. Your mind is going to change, your beliefs are going to change, your experiences will get factored into your mental models of the world and that will change. Everything is in flux. Your morals might change, your ethics might change, you might be exposed to different cultural things and shift in your cultural beliefs or your cultural affiliations. That will change Depending on where you are in life. What's going on at any given time.

Speaker 1 13:38

Your sort of risk reward calculations, which every medication involves, will change also, like everything, is going to change over time, and so medication in anxiety, anxiety disorders, anxiety recovery and mental health in general is not a static point in time issue. It's simply not. It's a long-term issue. So medication you know, in the comment section on a YouTube video or an Instagram post on one day of one month, of one week in the year 2025, is kind of useless because, in the end, the information about whether or not you should use medication for your anxiety or your recovery. How it's going to work? Which one's going to work? Which dose? How long you have to take it? How are you going to work? Which one's going to work? Which dose? How long you have to take it? How are you going to get off it? Like one conversation, one answer to one question, one comment on one day, one fixed point in time, is kind of irrelevant, because that is part of a much larger issue.

Speaker 1 14:36

The decision to make medication, to take medication, the decision to keep taking medication, the decision to change medications, change doses or possibly discontinue your use of medication is a long-term, ongoing issue that's going to change over time. Sometimes you're going to be thinking you need more. Sometimes you might be thinking you need less. Sometimes you're thinking you need to change it. Sometimes your doctor's going to think that. Sometimes you and your doctor are going to decide it's time to get off the medication. But this all happens over time, as everything about you changes your body, your mind, your culture, your beliefs, your finances, your jobs, your relationships, your beliefs, your risk-reward calculations. Everything is going to change over time.

Why Things Change Over Time

Speaker 1 15:17

So we cannot look at medication, especially big, giant questions like which one should I take? Do I need to take any at all, can I get off it and are they necessary for recovery? Those are single point in time when you ask that question, but you're asking about a thing that is a long term proposition, right? So, when it comes to the use of medication or the continued use of medication or management in the way you are taking or using or discontinuing use of medication, or the continued use of medication or management in the way you are taking or using or discontinuing use of medication, unless your favorite content creator, instagrammer, tiktoker, youtuber, podcaster, author, is a physician trained and experienced in prescribing and managing the use of psychiatric medications in this particular context, and unless they are qualified to help you that way, and unless they're going to literally check in with you at least once a week to see how you're doing and watch you change over time so they can help you adjust on the fly and, by the way, no TikToker YouTuber, instagrammer, blogger, influencer is doing that, because that simply doesn't scale. That's how you work with individual people and that has nothing to do with the algorithmically driven platforms that we're on right now, like podcasts, videos and like endless scroll short videos. None of them are going to do that. So, unless you find an online helper that is literally going to act as your psychiatrist, your doctor, your therapist, all of these things in an ongoing, intimate relationship where they really get to know you and follow your progress over time and bring a shit ton of qualifications into that and feel like they want to take the time and effort to be involved with you on a regular basis for a very long time, don't ask them that Now.

Speaker 1 16:56

I know I'm being pretty animated and maybe a little bit forceful and a little bit aggressive about this, but honestly, why won't I personally answer your medication questions? Well, for the most part, it's because things change over time. I don't even know you today, much less what's going to happen to you over the next six months or six years, and I don't belong in that equation. When you interact with me or when you interact with anybody who's making videos or podcasts or writing books or making reels or TikToks about this, you are only seeing us in one small snapshot of time. You see me, I never see you, so I simply have no voice or role in your medication decisions or management. That's just the way it is in your medication decisions or management. That's just the way it is.

Speaker 1 17:44

This is not a simple point in time question, because when it comes to taking medication or continuing to take medication or not taking medication or going back on medication, this is an ongoing issue that changes as you change, because everything changes, including your body, mind and the circumstances that you were in. So it makes no sense for somebody like me to give you one answer to a medication question on one day in June of 2025. It just doesn't make any sense. So now that I've ranted into this microphone for a good 20 or so minutes, it's probably time to wrap this up. So just a quick recap I know you want me to answer questions about medication. I know you want other people like me to answer questions or give you advice or tell you what to do or help you clarify or.

Speaker 1 18:29

I do understand why you just would feel better or reassured or encouraged if I said you can get better without your medication. But I just can't do that and I'm never going to do that. I can't do that because number one, I don't get to counter anybody's beliefs or accidentally trample on your right to autonomy to make your own decisions and do what you think is right for you. It's not fair. I can't do it. I won't do it. Number two it's just a super complicated thing. There are so many variables that go into making these decisions and adjusting them over time, and I will never, ever, ever, know your variables. So there's really no reason for me to chime in, because I have no business chiming in. I don't know nearly enough about you and your specific circumstances to chime in, nor am I medically qualified to do that.

Speaker 1 19:15

And the third reason why I'm not going to answer medication questions or talk about this much more, if at all, at least on this podcast, is that you change, things change, everything change. And since all I can do to relate to you is to look into a camera or talk into a microphone in specific slices of time, we do not have an ongoing intimate relationship where I get to know how you're changing, why you're changing, what's changing or what you should do about that. So it makes no sense for me to insert my opinions or my advice or my beliefs about medication into your equation. That actually doesn't make any sense, nor do I think it's actually very ethical or safe. So that's it. That's why I won't answer your medication questions.

Speaker 1 19:56

Now, that being said, if you are interested in maybe hearing some expert opinions on that. If you follow the Disordered podcast that I do with Josh Fletcher and you can find that at disorderedfm we will probably be bringing on some people who are qualified to talk about that. We can have an educated, open discussion about the pros and cons, the things you probably need to be aware of as you're making these decisions, because, no matter which way you go, I'm a huge fan of well-informed consent when it comes to the use of medication or discontinuation of use of medication. So if you check out disorderfm pretty soon, we're going to have some people on who can have those kind of discussions with us and we think they'll be enlightening and informative and hopefully actionable for you guys. But the bad news is, even within those discussions with qualified experts, you're not going to be told what to do, because that just can't happen in this kind of model. All right, so we'll wrap it up here. I appreciate you listening to me rant for the last 20 something minutes. I hope that it made my position a little bit more clear not to dismiss you or to tell you to stop asking me, but this is why I don't talk about these things here and this is why, even in my other podcasts, we have to be very careful how we're going to talk about those things. This is why I've never written a book about medication.

Final Thoughts and Resources

Speaker 1 21:12

If you want to know my personal experience using medications for my anxiety and in my anxiety recovery, you can go back just search this podcast or, if you're on YouTube, search the YouTube channel for medication or antidepressants. There are three episodes I did in a row. I don't even remember which ones they are. I'll link them in the podcast description or the video description. You can listen if you want. That was just my own personal experience. People want to know, so I talked about it that one time, not going to really talk about it again. And that is it. If you are listening to this on Apple Podcasts or Spotify or some platform that lets you leave a rating or review, and you like this podcast and it is helping you and you dig it, leave a Firestar rating or maybe even take a minute or two and write a little review saying why you like the podcast, because it really helps me out. It helps more people find the podcast, more people get help and that's why I fired up this microphone to begin with.

Speaker 1 22:01

Of course, if you're wondering what to do next with all this information, it would be to just keep going right. Just keep going. Medication, no medication. There's no right or wrong. You may have to work through that issue as you go, as everybody who's been on the recovery path has had to do one way or the other. You can't make a wrong choice because you can always change course, you can always adjust and even if things go sideways whether it's a medication issue or not you always have the ability to stand up and sort of change direction and learn from that. So, no matter what you do today, take a different step in a different direction toward the life you want, and away from knee-jerk, blind, unconscious, unthinking reactions to fear that might be real but not have a basis. You are winning. All right, keep going. I know you can do it. Hang in there. I will see you in two weeks for episode 321 of the Anxious Truth. I don't know what we're going to talk about, but I will be here. Thanks for listening, take care.