Psychiatric Medications: The Gifts and the Challenges

Let me paint the big picture of current global mental health treatment. Researchers at UBC and Harvard medical school found that only 6.9% of individuals with mental health or substance use disorders receive effective treatment (Vigo et al, 2025). That is a very, very worrisome statistic. Furthermore, it was found that lack of insight is part of the issue but also that the treatments offered are not working for everyone (Vigo et al, 2025). No wonder some people feel very hopeless about their recovery.

What I want to look at more deeply is what happens around treatment. The study states that even though less than half of participants reached out for medical treatment, those that did only received minimal levels of treatment and less than half of these received effective treatment (Vigo et al., 2025).

This does not speak well of mental health treatment around the world. I wonder what mental health recovery statistics would be if people received, not only traditional options for treatment (medications and psychotherapy), but programs to teach about recovery including many of the interventions in this blog? I wonder what statistics would be if families (and other supporters) and those with lived experience of mental illness had access to comprehensive services and the support they need?

I do believe medications can make a difference for people, especially in helping with very distressing symptoms such as psychosis. If medications can reduce suicide, prevent violence, improve quality of life, reduce hospital admissions, and help someone enjoy their lives and be well, then I consider them a crucial part of treatment.

Here is part of a personal story from the website Wondermind (co-founded by Selena Gomez, an actress with bipolar disorder):

“I have been lucky in my experience with medications to treat my depression. In high school, I was suicidal, and my mom forced me to see a doctor, which I resented, but it undoubtedly saved my life. I had the fortunate experience of the first med I tried working for me. It took time to find the right dose, but I’ve been on it for a decade now and can’t imagine my life without it. I grew up in a very small town where I think there was likely a lot of mental health stigma, but I have always been very open about it, and I think that worked to my advantage as a teenager and into adulthood. I feel awful on the rare occasions I forget my meds, but, in general, they make me feel like the life I want to build is possible.” —Lexie N., 26

I want to make it clear before I talked about the drawbacks of psychiatric medication that there are many people who use medication(s) to treat their mental illness.

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Before I discuss the limits of psychaitric medications, I want to note that even though lack of insight is most often attributed to people who don’t use medications to treat their mental illness, there is a much bigger picture. The article, “Attitudes toward and patterns of medication use among people with serious mental illness: There’s more than meets the eye”, debunks the myth that the only reasons patients do not take medications for mental illness or just stop or lower medications is because of lack of insight (Asher, et al, 2023). The article talks about the factors influencing a person with lived experience of mental illness as they carefully consider medication choices (Asher, et al., 2023). Here is a link to this research article: Attitudes toward and patterns of medication use among people with serious mental illness: There’s more than meets the eye – PMC. If you take a look at the results section, you can see factors that influence patients decisions around medications. Their own words are italicized. I think for those in recovery, their supporters and professionals, its important to understand the complexity of medication decisions for people with lived experience of mental illness.

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Let’s explore two of the main reasons people have trouble with psychiatric medications: one, that medications don’t always work, and, two, that they often have intolerable and/or dangerous side effects.

There is a medical term, treatment-resistant, that refers to people who are treated with medications and/or psychotherapy, who don’t get better. It was very difficult for me to find clear statistics and studies about how many people don’t get well on medications and who have tried many different medications. But through personal stories and research, I know that many people with mental illness who have had standard treatment don’t get relief from their symptoms. To me this speaks to underlying causes that aren’t being addressed.

Luckily, there are some new branches of psychiatry, as well as new research, that is branching out to explore complementary or alternative possibilities to psychiatric medications. The movement for metabolic health which is gaining much ground is a promising approach.

I have mentioned metabolic therapies in earlier posts but thought I’d revisit it. Here is an introductory article on the research around metabolic health and mental illness. It is very interesting to read: Pilot study shows ketogenic diet improves severe mental illness

I think it’s also important to note that a strict medical keto diet may not be needed for improvements in mental health. Eating something like a Mediterranean meal plan in addition to good sleep and moderate exercise would likely help a person with lived experience of mental illlness improve things like mood and sleep. However, if medications do not work or side effects are not tolerated, people with lived experience of mental illness might greatly benefit from medical keto in combination with other metabolic therapies (this includes therapy, and other wellness tools). If a person decides to do medical keto it must be done with support and nutrition coaching because it can have side effects and change how you metabolize medications. Also it is known that mental health can get worse in the beginning of this intervention so a person needs to be carefully monitored with this intervention.

There are people managing their mental health with alternatives to medications. Some are offered by mental health, like ECT (electroconvulsive therapy) and some are independent of the system. Some naturopaths focus exclusively on helping treat mental illness. Now many of these practitioners have prescribing rights to certain psychaitric medications as well. The bottom line is if a person with lived experience is not getting well with medications and therapy, there may be other options (or combination of options) that work.

It is also important to note that researchers are finding that some instances of mental illness are caused by physical illness. Psychosis for example can be found in some people with autoimmune disorders. Treating the autoimmune disorder can clear up the psychosis. There are clinics in the states who now do extensive health testing before admitting a patient into a mental health facility. I consider this important care. Selena Gomez who I mentioned earlier has lupus as well as a diagnosis of bipolar disorder. I wonder if any connection was made between the two and wonder if when the lupus was treated whether the symptoms of paranoia and hallucinations disappeared. I know she has taken psychiatric medications but I am not sure if this was before the lupus was treated. Here is a research article if you want to understand this connection more: Autoimmune Diseases and Psychotic Disorders – PMC. Also there was a recent article in the New Yorker about this topic which you can access here, Mary Had Schizophrenia—Then Suddenly She Didn’t | The New Yorker.

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I have experienced many side effects from my medications, including severe dry mouth, heart functioning changes, kidney functioning changes, lowered blood pressure, fainting, hair loss, weight gain, and being overly sedated. There are probably more health symptoms that I am unaware of that are related to the medications. Some medications become dangerous for your health at certain levels and over a period of time, like Lithium did in my case.

It makes sense that some people want off these medications. Again, I can’t emphasize enough the importance of working through this with a supportive team of professionals.

Here is a link to an online article by an organization that advocates for better mental health treatment in the states. ‘All I Wanted Is to Be Healed’: Alternatives to Psych Meds for Foster Youth with Mental Health Issues – MindSite News

The article tells of foster youth who have significant trauma who were given a lot of medications which only caused more problems (Henry, 2025). This article speaks to the need to not have simple fixes but to address not only trauma but the other basic needs that create stability, safety and support (Henry, 2025).

It is obvious that medications are often used a band-aid for deeper issues and this outdated approach needs to be challenged. Recovery is a multifacated approach.

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There is something else that really bothers me about pharmaceutical industry. In the research article, “The Environmental Side Effects of Medications: Reducing the Carbon Footprint of Psychiatry – Journal of Psychiatry Reform,” researchers outline some of the environmental impacts of pharmaceutical industry (Hategan, 2022). Basically, the article’s author calls on psychiatry and doctors to advocate for change (Hategan). I am not promoting guilt for people who need medications but there are negative environmental impacts of the pharmaceutical industry which need to be addressed (Hategan, 2022).

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Here is a summary of general guidelines I follow around medications that have been helpful for my recovery:

• Get informed about the side effects of your medications and track them
• Have a team follow you closely when trying medication or changing medications
• Go slowly when making medication changes, if possible, to reduce withdrawal side effects
• Include a recovery wellness plan as a significant part of your recovery
• Reach out for support if you are struggling

Okay, are you ready to dive into making art? 🎨

Therapeutic Arts Activity

Medications in psychiatry can feel like such a weighty topic that can bring emotions to the surface. I’d like this activity to explore these feelings using colours.

Instructions

Paint an abstract painting with watercolours.

Materials

• Watercolours
• Watercolour paper
• Brushes
• Container for water

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Once you’ve completed this activity, here are some questions as guidelines for your personal explorations:

1. How do you feel about psychiatric medications and your mental health journey?

2. If you used medications, describe how they have been helpful.

3. If medications haven’t been helpful, what has?

4. When you look at your painting, what does it tell you about how you feel about this topic?

My greatest hope is that people get well from mental illness. There are many ways to do this. Although the choices can be challenging in terms of treatment, there is much more information and options out there than ever before. The reearch into mental health is growing, as well as stories by those with lived experience about how they got well. Remember that resilience is built on a multitude of healing interventions and daily practices of wellness.

❤️❤️❤️ With care and kindness, Meegan

In the spirit of creating a community of reflection and art making, your comments are welcome. If you choose to leave a comment, it is important to know I respect your privacy. Your information will not be given, lent, rented, or sold to anyone. However, when making a comment on the site, your IP address and browser user will be collected. Please see full Privacy details on my Privacy Policy Page Privacy Policy. If you are having a mental health emergency, please take care of yourself, and call 911 or take yourself to emergency at your closest hospital. 

Sources:

Asher M, Roe D, Hasson-Ohayon I. Attitudes toward and patterns of medication use among people with serious mental illness: There’s more than meets the eye. Front Psychiatry. 2023 Feb 17;14:1133140. doi: 10.3389/fpsyt.2023.1133140. PMID: 36873214; PMCID: PMC9983815.

Hategan, M. et al. (July 2022). “The Environmental Side Effects of Medications: Reducing the Carbon Footprint of Psychiatry.” Journal of Psychiatry Reform, Vol 9, #12.

Henry, April. April 2025. Mindsite News: Shining a Light on Mental Health. “All I Wanted Is to Be Healed’: Alternatives to Psych Meds for Foster Youth with Mental Health Issues” ‘All I Wanted Is to Be Healed’: Alternatives to Psych Meds for Foster Youth with Mental Health Issues – MindSite News

Vigo, D. et al. (February 2025). “Effective Treatment for Mental and Substance Use Disorders in 21 Countries.” JAMA Psychiatry.DOI: 10.1001/jamapsychiatry.2024.4378