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

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 .

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 . 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 . 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 .

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 .

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 .

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 .

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 . 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 .

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 .

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 . 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 .

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 .

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 .

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 .

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 . 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 . 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 .

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 . 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 .

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 . 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 .

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 . 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 .