Meditations on Anxiety Medications (Episode 175)

Drew Linsalata 0:02

Like, we can't tell you what to do here. And remember, we're coming from the therapist's point of view, not the medical doctor's point of view.

Josh Fletcher 0:09

I've equally seen people be like, well, actually, you know what? That that did kind of dull things down. And it gave me enough of a plateau to then go do tricky things.

Drew Linsalata 0:18

If it takes you to a point where you can start to do the tolerance and facing and exposure stuff, huge win. Like, that is not cheating. That is not going against the rules. That is not people get stuck in absolutes of like, but if I take medication, does that mean I'm never truly fully going to recover?

Josh Fletcher 0:35

That's just another kind of little uncertainty you've just got to take in there. There's no direct blueprint, as Drew said, of doing things there.

Drew Linsalata 0:43

There is no one single thing. There is no one single right way. There is no single outcome we're looking for. There's not. Welcome to Disordered. This is episode 175. We're entitling this one, Meditations on Medications, where we will speak very gingerly and carefully about the use of medications and anxiety treatment. I'm Drew Linsolata, one half of Disordered. I'm a therapist that specializes in the treatment of anxiety and anxiety disorders, and former sufferer of the stuff we talked about in this podcast, and an author and co-author with my co-host, uh social media guy, podcaster. We've been meaning to do this one for a long time, and here we are. And I'm joined by Hi everyone.

Josh Fletcher 1:26

I'm Joshua Fletcher, also known as Anxiety Josh, and I'm a psychotherapist uh registered in the UK uh who specializes in anxiety and anxiety disorders. Uh I've previous sufferer of anxiety and used my professional and lived experience to provide uh psychoeducation and um a road through to desensitization and feeling like yourself again. Uh good topic today. Uh always reluctant to talk about medication, but every week we get someone always asking us, what about medication? Different types though. So this episode is for people who ask questions like Um, if I'm if I take medication, does that mean I'm failing?

SPEAKER_04 2:09

Yeah.

Josh Fletcher 2:09

Is medication necessary? Um, will I be on this for the rest of my life? What or whatever?

SPEAKER_04 2:15

Sure.

Josh Fletcher 2:15

And we're gonna, you know, huge kind of disclaimer. We're gonna talk about our own opinions today, both uh someone people who've taken medication, work with people on medication, but we are not your doctor or psychiatrist. So if you are going to make any decisions about your medication, stuff like that, please talk and inform your doctors and psychiatrists about stuff, uh, which we can also talk about today as well, about talking to your professionals about it and things and being like that. But yeah, it's uh it's one that's taken us 175 episodes to talk about. And um here we are. Uh, you you didn't have a great experience on it, Drew, did you? But it doesn't mean that that applies to everyone.

Drew Linsalata 2:58

That's 100% right. I am my big no, I did not have a good experience. I mean, I had a great experience until I didn't. I talked about that in three episodes of The Anxious Truth many years ago, and I don't I wasn't really going to do any more on that. I I think the main reason why we've been wanting to do this, but I'm always reluctant to talk about this, is it everybody gets so emotional about this, and I totally understand. People are hurting and they want to feel better. This is one possible option, it's a perfectly acceptable option. And we wind up accidentally triggering the your med shaming if if we mention people who don't use meds or accidentally trigger the other thing where like meds are terrible, they're awful, they injured me, you should not be talking telling people to take them. We're not telling you to take do anything, like we can't tell you what to do here. And remember, we're coming from the therapist's point of view, not the the medical doctor's point of view. So just keep that in mind. Uh yeah, I did not have good experience medication when it was time to come off it. I wrote about it, I talked about it. You can guys go back and listen to that. But that is my experience. It doesn't mean it's going to be everybody's. I will tell you, and then I'll probably stop referring to my personal experience in this episode. Am I angry about what happened to me? Yes, but that doesn't mean that my anger tells other people what to do, and I cannot stress that enough.

Josh Fletcher 4:10

Yeah, because I've seen people do really well, and still I work with people today, like who take meds and do well. Yeah, am I sitting there going, oh no, they're failing, they're not doing it properly, they're not perfecting recovery. No, I'm not right. You can, and I'll answer that straight off the bat. Is it possible to get to where you need to be on meds and off meds? Yes, yes. I'm gonna answer that straight away. So any perfectionists out there, like, oh, but this and that, yeah, of course. With the exception maybe of I'm not a big fan of benzodiazepines, but I'm only saying that by referring to UK guidance, which is do not prescribe benzodiazepines for anxiety disorders. Uh, so if anyone's like, oh, we actually do that over here. Well, we don't in the UK, and it's very rare, so that's why I say it.

Drew Linsalata 4:59

Yeah, it's getting more difficult here too. I think you guys were ahead of the uh game there. Ten years ago, I would hear all my British friends talk about getting beta blockers, whereas here the doctors were still sort of doing their it wasn't the primary treatment, but it was adjunct, you know, maybe as needed sort of stuff. But many, many people here were taking benzos every day, like a daily dose to manage their anxiety. And you will be hard pressed to find a physician who will do that now. That is a very last resort because of uh uh dependency issues and physical issues. That that's why. So yeah, I would agree, same thing. It is not a thing that we tend to go to as the first thing here. So yeah.

Josh Fletcher 5:37

So so when people say meds, you have to look at what meds. So in the UK, it's usually some kind of SSRI or tricyclic medication, depending on what it is. So if it's GAD or OCD or whatnot, and it's usually a chat that you have with your psychiatrist or doctor. Um it's uh my master's dissertation was actually in the experiences of people with panic disorder seeking help. And I think in my own study, uh, which I got a distinction for 85%, and um it was um 58% of people, I think that's the number from my own study, I did it ages ago, uh felt that they were um rushed, hastily prescribed medication for what they were doing. Um, which means 42% didn't. Actually, no, I don't think I was uh hastily uh prescribed medication. Uh, but usually um prescribed some like cetalipram, sertiline, uh uh or whatever was going on there, um, and told to wait for your for your uh talking therapy or whatever. It's interesting for people in the disordered community and for can relate to the anxiety that we speak about on this podcast, you kind of expect antidepressant stuff to be like this magic pill that takes away just that one feeling, and then I feel like myself again. Uh, or if you're like me, given medication, took me two weeks to even take it, so I was too afraid. And then it made me feel even worse because I'm just then compulsively scanning to see has it worked yet? Is it working yet? Is it made me worse? Am I getting the side effects? Yada, yeah. Um, that was kind of my experience. Um, I just felt really dissociated, but not in a good way, and I quickly came off it. Um, I tried beta blockers and stuff. Um, but nothing addressed the fear of fear. Mine was a phobia. I was afraid of anxiety, and I felt like I needed to fix myself. And I felt that having a pill was not going to do that. Um, but while I'm waffling on here, Drew, um I also work with people with anxiety disorders and depression. So as we know, we talk about exposures and doing stuff and doing did it anyways. And sometimes you need a bit of a lift to do those things. But if you're struggling really badly with kind of clinical depression, uh you can't get any motivation because you're severely depressed to do the tricky things. I've equally seen people be like, oh, actually, you know what? That that did kind of you know dull things down, sure. And it gave me enough of a plateau to then go do tricky things, yeah. You know, or to actually remind myself what my values are to then go and do that. So again, it's nuanced, it's always nuanced. Please just don't just see copy what Drew and I did. We will never shame you for doing that. Just look, we just thought we'd have a conversation about I I agree.

Drew Linsalata 8:36

And I I I would offer an additional, you know, you're not you're not just trying to follow. We don't have a blueprint for you. Our personal experience is not your blueprint. And I I really would strongly, strongly caution against f anybody that you find online with a microphone or a camera or a big following who wants to tell you exactly this is what you exactly have to do with medicine. So my my biggest issue is I think people forget, like uh when we look at we talked about it before we went live, uh, you know, when we talk about treating OCD, the gold standard is uh is uh therapy plus medication. That is not a question that we just see it over and over again when we study that. Uh and in many instances, combining the two things is a really good idea. And like your experience, if if it takes you to a point where you can start to do the tolerance and facing and exposure stuff, huge win. Like, that is not cheating. That is not going against the rules. That is not, you know, but so people get stuck in absolutes of like what people will ask us sometimes, but if I take medication, does that mean I'm never truly fully going to recover? And the answer is like, that's a crazy question in a way. Like, we're not remember, recovery is so based on like what is your quality of life. So if the meds give you a quality of life that you are good with, then how do you call that not recovered? So it's very, very, very, very nuanced. Um, yeah.

Josh Fletcher 9:51

Um bear in mind a lot of people in this community as well, and it will call it community because it is, and we have a community app. So therefore it is a community. Uh, but in general, the community, anyone wherever you are in the world listening to us, where it's on the way to work, at home, maybe a line in bed, whatever. Uh a lot, a big universal trait is this am I doing this right? Yeah, am I doing this correctly? And when that question, you know, kind of absorbs the uncertainty of is medication doing it right, doing it wrong? That's just another kind of little uncertainty you've just got to take in there. There's no direct blueprint, as Drew said, of doing things there. And it's not the first thing. I never say in my practice, you know, we don't do that. Self-medicating, I do. So when some people like, you know, I need a couple of glasses of wine to get on the bus, and then I'm like, well, no, yeah, you don't need a couple of glasses of wine to get on the bus. You know, I need a couple of glasses of wine to listen to Nickelback. I'm like, finish the bottle. I will do it. Okay.

Drew Linsalata 10:53

Yeah. Only one bottle for Nickelback.

Josh Fletcher 10:55

Or Nickelback. Sorry, there's any Nickelback pantomime.

Drew Linsalata 10:59

There was somewhere, some member of Nickelback is like, it's an anxiety podcast. Why do they got to come for us? Sorry, it's what we do. Yeah, it it's I think it's really you're right. Chad Krog is a home now going, oh God, come on. He was all upset. I used to like that podcast. Uh and I think you're right. It's that like, am I doing this right? Or there's definite rules, or there's a definite optimal thing, and there's simply not. Like, I I as two people who I think would boldly declare ourselves experts on this topic, I will tell you as an expert, I I don't know. There is no one single thing. There is no one single right way, there is no single outcome we're looking for. There's not. So that's just the way it goes. The only thing that I might add to the conversation is my biggest complaint sometimes when people choose medication is the informed consent from the other side of the aisle, like the medical side of the aisle. And I understand physicians are trying to help you. You ask for help and they are trying to help using their tools. Sometimes those meds get maybe stole-I cannot tell you the number of people I worked with, and and it's fine, it's not a disaster, who who are told, no, no, this is the gentlest, lowest dosed one, and this one's this one does this. So just like we are not 100% sure of your outcome in therapy, whether with or without meds, we don't know exactly what it's gonna look like. I find it really difficult when somehow or other the meds establishment says, oh no, this one does this, it targets this trans that this transmitter and this receptor, and it does exactly this, and it does nothing else. And there's no side effects, and it's fine, it's gonna be great, and this is the one that's that works for you. And then maybe, maybe. So, you know, that's my only beef with with medication. Just a little bit more of like, you know, and and if you're talking to your doc about it, it's okay to say that. Hey doc, just give it to me straight. Like, if you're not a hundred percent sure, uh just tell me that. It's okay. I'll I I'm working with you here. You don't have to promise me the world to get me to take the meds or be compliant.

Josh Fletcher 12:49

So it's really interesting as well, isn't it? Uh, like I've got friends that are on antidepressants, but they don't have anxiety disorders. And it really helps them, you know, particularly that raging internal critic, that nihilism, all that stuff, that feeling of nothingness, and they can't really get anything. Yeah, you know, so what would I say to them if they suddenly developed an anxiety disorder? I'd say, well, you needed to do that for for your for the depression side of things. You know, so that's not saying we're anti-Mets, but this is a this podcast and our principals are for anxiety disorders, the fear of fear, OCD, and stuff like that. Uh, I know loads of people, particularly with OCD, who actually do find ERP a lot more accessible when they're on meds. On the flip side, I know people that find the side effects of meds so horrible that it doesn't help with the ERP because we're all different. We can't give you certainty or uncertainty. But what we can tell you is that there's not failure in that. Yeah. Um, I'm with you. Side effects. You know, so so someone from the community.

Drew Linsalata 13:59

One of the funniest comments ever in our in our live audience for sure.

Josh Fletcher 14:02

Let's hear, let's hear more from the community. Well, let's get a did it anyway. What we got?

Drew Linsalata 14:06

Yeah, let's do it. We have a good one. I think it's the first time we've heard from this country, so let's go.

SPEAKER_01 14:12

Hi, John Josh. My name is Irina, and I'm from Ukraine. I think it's the first time someone sent you this from Ukraine. Uh so I've been struggling with batting disorder or three, probably bad, and it's been really, really helpful my life. I've even become federal at some point. Um yeah, it gave you so much trouble for everyone. Um I just wanted to share my ideas anyway. I went on my English lesson. I was thinking so much. I love you all so much. Uh so yeah, I hope that you think so.

Josh Fletcher 15:33

Cool is that.

Drew Linsalata 15:35

Friends from the Ukraine.

Josh Fletcher 15:36

We're global. Yeah, that's really lovely. It's nice when you're here with some from someone from a new country, and well done. Going to an English lesson as well, and then practicing the English on a live thumbs.

Drew Linsalata 15:48

What the hell was that? I hit the wrong button. All right, okay.

Josh Fletcher 15:50

Is that another dit?

Drew Linsalata 15:51

It's another date anyway. That that's a tea.

Josh Fletcher 15:52

That's a teaser for later. Yeah, okay, cool. So there's a teaser for our next day anyway. Uh, yeah, cool. Um, yeah, well done. That's brilliant. You keep it up and uh yeah, a big well done from us and the community. Uh disordered.

Drew Linsalata 16:08

I would like to point out, by the way, I can't think of a harder, of a better example of attentional control than operating in a second or new language. Like that is a lot of cognitive heavy lift lifting. So I've DPDR, I'm my anxiety is kicking up, I feel really uncomfortable, and I have to work in a second language.

Josh Fletcher 16:30

Wow. I love attentional control as well. Would you like a written did it anyway that follows that same theme? I think so. That's a good theme. I love it. Um while it while it reminds me, uh, this is from Bill, and I really like this one. Uh hey Drew and Josh, this is Bill. Sending in a game changing, and hopefully, my last um sounds ominous, doesn't it? Hopefully, my last did it anyway.

SPEAKER_04 16:53

Vaguely.

Josh Fletcher 16:54

I've been working on panic attacks and anxious thoughts for about 10 years now. I recently started working with a therapist that specializes in ERP. She asked me what I was afraid of, specifically about the panic attacks and adrenaline surge. I realized the primary thing before a panic attack is the sudden brain race, as you guys have put it before. Did we? That's pretty cool. I've said we say that.

Drew Linsalata 17:18

I think I've said that a long time ago.

Josh Fletcher 17:20

I like that. Well, yesterday, after a little bit of caffeine, I got that sudden hit of adrenaline whilst in the work cafeteria. I realized that that's when I usually start to check in on bodily sensations and inevitably and inevitably find something to panic about. I decided that instead of using that extra focus to scan for threats, I was going to focus on my preference in pizza toppings. I actually turned it into a bit of a mindful eating exercise and thoroughly enjoyed my Blackberry Jam and Arugula pizza. Is that araguula pizza? It's better than it sounds, he said. Thanks again for all you've done. And for everyone else whose stress jugs are overfilled. Oh, that's really great.

Drew Linsalata 18:05

Thank you, Bill.

Josh Fletcher 18:08

I really like those. You know me, it's all about attention practice and all that stuff. Um, I think most anxiety disorders are about uh training our attention, our attention becoming lazy the more we're stuck into it. Because I say lazy, but you know, we're so frightened to to run away. And that's a really good example. What a lovely metacognitive intervention. Oh, I usually do this, I usually do that. Now I'm going to empower myself here by not stopping the adrenaline surge, but practicing with my attention during it. And Bill ended up enjoying his bizarre pizza. But I would probably eat it.

Drew Linsalata 18:46

Well, that may fall under the sour candy strategy. Arugula is nasty. I'm sorry. It's another one of the well, I mean, I what's arugula? It's a lettuce type thing. It's a veggie. Um, I don't know. I'm not I'm not a fan. So like powering through an arugula pizza. Yeah, sure. I'll take your mind right off that pattern.

Josh Fletcher 19:01

So you think that's more impressive? The exposure was the arugula pizza.

Drew Linsalata 19:04

The exposure was the arugula in that situation. It's kind of kind of gross. Well, sorry, arugula. Sorry, arugula, sorry, nickelback. We're just, it's we're really being rejected.

Josh Fletcher 19:13

No, I love that one. It's a perfect example of a fantastic exposure. It's not like, oh, I've got anxiety. You were like, no, I I I've got anxiety, but now I'm practicing my attention. Love it, Bill. Yeah.

Drew Linsalata 19:24

Oh, we have an arugula war going on in our chat section now. It's peppery taste. It's it's a hell of a lot of what it is. It's great with balsamic gray. I'm sorry, people, I can't get on board with the arugula. I mean, if you bury it in something, then I'll eat it, I guess.

Josh Fletcher 19:35

Because it's okay. Drew, talk about medication whilst I Google what arugula is.

Drew Linsalata 19:39

Oh, fair enough. Yeah, Google it. You'll see. So, okay. So another thing I think that we want to talk about with medication for sure is from the therapist's standpoint. And and you know what, for a second, I will just acknowledge the collaboration between the therapist and the rocket salad.

Josh Fletcher 19:54

It's just rocket leagues. Yeah, somebody just said rocket league.

Drew Linsalata 19:57

Rockets way better.

Josh Fletcher 19:58

Sorry.

Drew Linsalata 19:59

Because we're pretentious here and we need to say the proper name. Rocket salad.

Josh Fletcher 20:02

I don't mind rocket salad. I can have a bit of balsamic glaze. It's perfectly fine.

Drew Linsalata 20:06

Maybe I would eat it if we called it rocket salad. I would be fooled. Like a little kid. Just call it something yummy and he'll eat it. It's not easy that way. What the hell is they talking about? Well, totally derailed. Oh, it's talking about the collaboration between the therapist and the psychiatrist, which in my practice I'm grateful to have in many instances. I have one psychiatrist, I will sing his praise all the time, reaches out to me, which is really great. He calls me, like for coordination of care, which is really great. So we're working together. The the interaction would be from the therapist's point of view, if you medicate away the experience, then what is there to work on? But if that works and that gets you the quality of life that you want, then there is no fail. That is not wrong. If you come to my therapy room and say, hey, my meds are working great. I love this. I'm feeling awesome. I have my life back. Thanks for your help. I don't need you anymore. I'd be like, high five. Call me if you need me. Like I'm cheering for you. It's all good. But, you know, the only thing that we would say, and I think maybe people fall into that, like, oh, I'm cheating. The meds get the credit, like I need to get the credit. Like, okay, well, then then you get to make that decision. Like, all right, they got me on the horse, and now I'm gonna maybe choose to take them away so I can learn to ride the horse on my own. But that isn't any better or worse from an absolute standpoint than the person that says, no, I'm just gonna I'm just gonna keep taking them so I can stay on the horse. Okay, cool. You're both right. It doesn't matter. It's what what matters to you more, and then we'll support that either way. So I often say, you do not need my permission or my blessing or my disapproval for your meds use. You get to make the decision that's good for you, and I luckily get to cheer for you no matter what that decision is and support.

Josh Fletcher 21:40

And this applies to perfectionists, people who would just assume, and software like we exist outside of anxiety disorders. If you're someone who's grown up expecting criticism, being put down, stuff like that. You know, I often hear it like I don't know about you, Drew, but like sometimes when working my practice, like, Oh, you I thought you'd be disappointed in me. I was like, No, we never shame. Here we never put people down in this therapy room, you know. Um, unless you're bad mouthing rocket salad. Uh, we just don't look, you know, like we don't do that, but it's that assumption. So look at that inner Craig the Critic. Yeah, and it's just like, oh, is he there?

Drew Linsalata 22:15

Yeah, he's always there. It's Craig the Critic.

Josh Fletcher 22:18

Look at that inner Craig the Critic, it's just like, Oh, you're not doing it perfectly, you're not doing it properly. It's just like, no. Drew and I, hand on heart, we'll say, if you're happy and your things are working, you've managed to find that balance for you, that is great. We are rooting for you.

Drew Linsalata 22:35

Yeah, I agree that 100%. You I often see that with a person who maybe is using a rescue type. Maybe they do have a benzo. Like me, they drove around with it in their car for four years, and who even knows if it works anymore? That was me. It was my safety blanket, and I didn't take it. Like, they're doing amazing stuff. They're doing all the tolerance, all the exposure stuff. And then one time out of like six weeks, you know, they they take a little sliver of it to get through a wedding or something that's going to take six hours. And it's like, I went to the wedding, I actually wound up having a great time. Like, I couldn't believe it. I was so scared to do it. Yep, yeah, but I took that like quarter, that sliver of a benzo of my old Xanax. So uh fail, want, want. And I'm like, what are you talking about? You would have never gone to that wedding six weeks ago. And they just throw away all the progress because they, you know, they they combined medication with that. So what? Big deal. Yeah, yeah. Same thing with flying. I have people who do that too. They do things that they do once every three years, like get on a plane. Like, oh, take take the pill. It's fine. The doctor gave you two for your flights. Take it. Like you fly once every three years. It's just not fair.

Josh Fletcher 23:40

I didn't do it perfectly. I'm not mocking the person, I'm not mocking the inner correct critic. Yeah, but you didn't do it perfectly or whatever. It's just like, no, it's fine. Who cares? Right. Well done. Well done. Yeah. Um, let's address the question, Drew. I know what you're running you're gonna say. Do you do you think that meds work? What does that mean? If you listen to disordered, we are telling you you can tolerate willfully all of your emotions. Yeah, you are the coping technique. The cornerstone of our practices is teaching yourself that you are the coping technique and you can tolerate anxiety and uncertainty, and it's a skill you get good at, and therefore that's what leads to desensitization. When you say, Do they work? and there's plenty of WebMD medication forums, all this stuff, people give reviews about their medication, and they say, Oh, yeah, it works. I took one and then I felt amazing. What you're actually saying is, will this take away a feeling I'm afraid of? Right. Then what does then what works? And the I the answer is what what does define what working means?

Drew Linsalata 24:51

Right. And and I really feel so strongly that like everybody gets to define what working means. Um it's fine. I think there are many people, and by the way, I would absolutely pat you on the back and cheer for you and unconditionally accept you if this is you who listen to this podcast. Maybe they've been trying meds and it's not working for them, or whatever. I don't know. But if somebody were to able to say, This one for sure, we just developed this one. We have 50 years of research, it's been in secret, and it's been like there's a zillion clinical trials. This one for sure, you could take this pill, and tomorrow you won't feel the anxiety anymore, and you go back to real life. Many people would probably say, I'll take that. And I would be like, Okay, go ahead. So, what works?

Josh Fletcher 25:27

I wouldn't, would you would you, Drew? And bear mind, Drew. Well, think about it. Someone's offering you the opportunity now to never feel those horrible adrenaline rushes and intrusive thoughts ever again. Would you take the magic pill there with no side effects? Would you take that for the rest of your life? Or would you say no, thank you?

Drew Linsalata 25:47

That's a tough one because like desperate Drew might have taken. But now I would say no, because I value the experience that I had.

Josh Fletcher 25:55

But because here's the issue what you actually do there is that you've outsourced your resilience and ability to cope to something else. Now, don't get me wrong, doesn't apply to many things, particularly physical health, or that. Or if you need medication for other things, if you have, you know, like bipolar or mood disorders and things like that. Absolutely, you know, you know, chronic depression, seasonal depression. I'm not saying that. I'm just talking about the fear of fear. Yep. Yeah, you know, uh, there's no shame in taking medication that I'm just saying, think about it. Where do you want to get to with your desensitization? A lot of people, the most common thing I said to me is I just want to feel like my old self. I want to feel like I used to. This never used to feel like a thing.

SPEAKER_04 26:39

Yeah.

Josh Fletcher 26:39

And so in my head, I would say no. And I still get anxiety now and then, I still get intrusive thoughts now and then. My live a content life. It's that let's say, I don't know, the world ends, AI takes over, we're all dead, or whatever. And you can no longer have those meds. You've just had 10, 20 years of teaching your brain you can't cope with feelings. Sure. And then when those meds disappear, the panic's just gonna come back.

Drew Linsalata 27:06

You've not really learned much. Well, that is always the philosophical debate, right? As opposed to like a personal judgment of character, that's the philosophical or mechanical debate. And I agree with you on that. And I think when somebody asks, do they work? It depends on how you individually defined works. You know, there are there are some people that listen to this podcast who are thinking, maybe have come to the realization, like, wow, I'm terrible at feeling my feelings. Like, that's part of my problem. So, no, I really need to learn how to feel feelings. Okay, well, then what works for you is I get better at feeling my feelings. Other people may not agree with that. Other people may feel like, okay, uh, if it makes me feel better and allows me to function and it doesn't cause any negative side effects, I'm totally okay with that. Those are my goals. Okay. So you get to define what works. You know, if you're asking our opinion, Josh, I would agree with you. But again, you get to define what works. That's what makes this such a tricky and difficult conversation, right?

Josh Fletcher 27:56

Yeah. And it's uh, I like this comment from the community. I've learned more from my anxiety than almost anything in my life would not blast out a pill. Uh, I've learned more from my anxiety too. But it's the same thing, like, we're not here to tell you what's right and wrong. Right. Maybe you've just been anxious for so long and you can't, you know, whatever. It's not this is why we've got to episode 175 and not address this issue because it's so nuanced. But what we can say is, you know, you're not a failure if you take medication, there's no pressure on us for you to take it away. If it's really helping you, that's great. We support that, you know. Just try not to be perfectionist about it and reminded that the principles of this podcast generally is we want you to learn that you're more than capable of dealing with anxiety at those levels, you know. But sometimes life gets in the way. Maybe you're going for a really tricky part in your life. Maybe you know, walls are burning down around you and this and that, and you need something to stay afloat, then absolutely, you know, do those things. I agree. It's we can't outrule stuff. It's we cannot tell you, it's not part, and I keep coming back to the what Drew said, it's not a blueprint. We will not provide you a blueprint for your life, for your autonomy, for your decisions. Yeah.

Drew Linsalata 29:14

I think that being said, uh, we I have to at least acknowledge that the two guys with the expensive microphones and the millions of downloads are kind of and we we of course we have personal bias because we're human beings. While we while we can respect everybody's differences and support them, clearly we all come into things with personal bias. So, yes, we both tend to identify more with the people who say, Well, I learned from the process. I have written unabashedly and will continue to do so. I would do that again to know what I know now. I would go through that struggle again. And sometimes I understand that can sound like, oh, but then they did it the real way. And if I want to be like them or follow their advice, then meds are cheating. I cannot stress enough that all that's just crack the credit too. That's exactly right. I get to define for me, for Drew, personally as a human being, forget the therapist or the podcast or the author, I value that experience having learned that and being able to be a little bit more with my wide variety of emotions and be more flexible. If somebody sitting across from me says, no, no, I value functionality. I put no value on that. I you don't have to value your feelings. Like, it's fine if you say, like, no, I just want to be able to go on vacation and do my job and put my kids through school and like go to barbecues and root for my hockey team and like and have a good life without thinking about it. Okay, cool. Those are your values. If you achieve them, you win. I will shake your hand and hug you. It's all good. So like just because our values may be different doesn't mean mine are better than yours. There's no better and worse.

Josh Fletcher 30:44

I worked with someone ages ago, you know, and they they're a performer, you know, I'll leave it at that. Sure, but live a very content life, but sometimes they took a parallel beta block before they performed. Yeah, yeah. No. Oh oh am I am I cheating? Is that recovering? No, good for you. Do whatever.

Drew Linsalata 31:00

Like if you are acting in accordance to what we have what you value most in life, then I'm thrilled for you as one from one human being. Even as your therapist, if I was your therapist, if you're if you are acting in accordance to what you most value, and that involves using medication to to live a better life, I I am in the business of you being having a better life. So cool, love it. That's why I'm really very careful about when we talk about this stuff. And then you have to be very careful about when you hear, if you're in forums and different places online, if it's a medication nightmare forum, there's a bias there. If it's people who are heavily invested in biohacking, wellness, like biological control, that sort of stuff, they're gonna have a positive bent toward like control your chemistry, whether it's through meds or naturally or whatever. So just keep that in mind. But the the absolute thing, only you get to make the decision. Don't let somebody else make this decision for you. That's what I would say for sure about meds, including me and Josh. Yeah. Oh no. Should we hear another did it anyway after my little rant there? Yeah. Let's do it. This one's good.

SPEAKER_00 32:03

Morning, Josh, morning, Drew. Hope you guys are well. I've just joined your podcast and I've been listening every day. I just wanted to say that I have had a difficult four months where my son um unfortunately was sectioned under the Mental Health Act. So I feel like for the time that he was sectioned, I almost was in uh autopilot, if that even makes any sense. And then one evening I was laying in bed and I couldn't find my phone, and I had a vertigo attack, which left me feeling very dizzy. After that, my son came out of sectioning, but I still felt this data sensation, and my heart was racing, and I felt like I was still in this fight uh position that I'd never sort of been in, and I I just wondered if that's because I was on high alert and I'd been like that for nearly 10 weeks with the phone in my arms waiting for my son to message me, call me, or just to get any information from him because obviously it frightened me so much. Um, but when I did it anyway, is because um today was the first day that I woke up and allowed the sensation just to be there. I allowed it to flow with me and be there on everything I've done today, and actually the sensation wasn't as strong, and I felt like it almost disappeared at times. I did something really big today for me. I'm a uni student at the age of 47, and I finally got on a train for the first time in three and a half months, um, and I did it, and I'm so proud. And actually, yeah, that is a big win for me. But I just wanted to say thank you guys for doing what you do. I actually adore you, and I so wish I was in America, or I so wish I was in Manchester, because I would be literally on your waiting list regardless, just for the sheer fact that I just would love to have chats with you. God bless.

Drew Linsalata 33:49

I don't even know where to start. That's really good. A lot of good stuff in the watch.

Josh Fletcher 33:53

Well, that's really good. And you're going back to uni and doing all that, and I hope your son's alright and stuff, and what a lovely, uh lovely parent to have in the sense of allowing that it's okay to be vulnerable. Um, super duper, really like that. And I hope your uni studies go well as well.

Drew Linsalata 34:11

Yeah, yeah, and there's so much, it's like a whole recovery arc. And I know this person is still working out. I believe she's a member of our community, um, the disorder community. So there's like a whole mini arc in there. My stress drug overflowed. Understandable, very difficult circumstance for in a family, of course, for a parent. Like, yeah, I'm feeling that, I'm I'm feeling the effects of that. I'm on hyper alert because of what's going on in my family. Yeah. And then I realize, oh, I'm making the feeling the big problem here instead of the actual thing that's going on with my son. And I'm gonna change the way I operate with that feeling. I'm still concerned about my son and have to deal with that, but I don't have to make the feeling an emergency. Like, wow, it's like a whole little mini arc in in one little. Yeah, really good.

Josh Fletcher 34:49

It was so, so good. Well done. And and putting that comp directing that compassion inwards. Well done. Absolutely. Uh, would you like another one? Yeah before we promote our uh uh um uh we're we're now we're now get yourself some disorders anti-anxiety supplements. They're gonna 20% aragula, uh 20% kale, uh 20% uh magnesium.

Drew Linsalata 35:16

40% left 35% gabagul.

Josh Fletcher 35:22

But if you got the vegan versions, tofu, yes, uh, and then I don't know what other Ashwaganda is.

Drew Linsalata 35:29

Ashwaganda they're coming to Pes this bit.

Josh Fletcher 35:31

Yeah, yeah. Someone's uh someone's in Ashwagander, there we go. Gabagol.

unknown 35:35

Love it.

Josh Fletcher 35:36

Uh here's the deal anyway. Uh shut up, Josh. Uh okay. Um hi guys, my name is Eric, and you can use my name. I'm located in southern Maine in the US. Is that is that where like Stephen King writes his book?

Drew Linsalata 35:50

I think he I don't know if where in Maine he is. Maine's a big state.

Josh Fletcher 35:53

Is it big? Oh, okay. Yeah. I want to log a big win. When I got sick a few years ago, I listed out the things that would start a panic attack flying, driving, exercise. Um, one of the things in my list was a trail that is behind our house. I haven't been able to walk down it in 30 years or more. Wow. The last time I remember walking it, I was a child. Coming to the trail would cause a horrible fear response, hair upon my neck, the feeling of being attacked. Something must have happened out there, but I can't remember what. Friday, on a whim, I needed to get some air and decided to go for a walk in the woods. I headed down that trail expecting that I would need to turn back, but I set a timer for 15 minutes. I told myself I needed to keep walking till the timer went off, then I could turn back. When the timer went off, I found myself a hundred feet from the end of the trail. I'd finished the trail by accident. It was hard. I felt like I was in a haunted house. That feeling of wrongness and fear, but I did it anyway.

Drew Linsalata 37:01

Oh, that is so good. It's amazing.

Josh Fletcher 37:07

Love that one, Eric. Uh whoa, I've finished the track.

Drew Linsalata 37:10

Wow. Well, I'm here. Wow.

Josh Fletcher 37:13

30 years as well. Well done. That's so good.

Drew Linsalata 37:15

That's amazing. I love the timer, by the way. I'm a big fan of timing those things. You know why? Because it takes it takes away the judgment. Is it 15 minutes or not? If it's 15 minutes, timer's up. I execute my plan, win. That's it. I don't have to worry about how I feel.

Josh Fletcher 37:28

You're right about the timer. Yeah, I always associate it with like white knuckling, but actually, no, 15 minutes, all feelings are well.

Drew Linsalata 37:33

Because it's totally objective that way. You can't say, like, oh yeah, but I found or I'm gonna decide based on how I feel. No, I did my 15 minutes. You want to do more? Cool. Do the extra hundred feet, finish the trail. Love that.

Josh Fletcher 37:43

But might as well. Yeah. Yeah. Well done. Yeah, might as well. Absolutely love that. Brilliant, brilliant, brilliant, brilliant. Um, yeah. We've got anything else on meds. Obviously, please stipulate again. Um, what's the word? Please talk to your physician, your doctor, your psychiatrist. Uh, there's nothing in the show. It's like you should do this or you shouldn't do that.

SPEAKER_04 38:06

Yep.

Josh Fletcher 38:07

Um, it's a conversation for you, whether it's adjusting meds, stuff like that, um, whatever it is, you need to do that. But again, there's no blueprint here. We can just share our opinions and stuff, and that's all we've been able to provide here.

Drew Linsalata 38:20

The only thing I might add, and it's a whole other discussion in a way, is a lot of people get really afraid of taking meds because they just assume it's going to be a nightmare to get off them. It is true. That was my experience. Some people have a hard time getting off them. Many, many people do not. That's where that my anger over my experience cannot cloud my judgment. I I would want to shake my fist and say pharma is evil and you will never be able to get off it, but that's not true. So be careful about those cognitive distortions. I heard, I heard a story about a guy who had a really hard time coming off his antidepressant, so I won't take mine. Well, maybe. Again, the answer is we don't know. Talk about it with your doctor. They might not know too. And it's okay to ask for very complete informed consent. Like work as a team with your prescribing professional here. It's okay. They want to be a team with you. I believe they want to be a team with you.

Josh Fletcher 39:06

So remember the principles here is like do what non-anxious you would do. And maybe I'm a bit of a paradox, but you know, like maybe if you did want to try medication, there's lots of people that are afraid to try medication. So sometimes that is the exposure.

Drew Linsalata 39:19

Yeah.

Josh Fletcher 39:19

You know, but again, say that to your physician. Actually, I'm I'm pretty scared to to to to to do this here.

SPEAKER_04 39:25

Yeah.

Josh Fletcher 39:26

Um, and I forgot to mention that. So the problem where some people they'll compulsively seek reassurance, is it gonna be bad? Is it gonna be bad? Sometimes just taking it and being with that feeling is the exposure, the uncertainty. Yeah, but obviously do that with your doctor where the difficulty in the meta is very meta.

Drew Linsalata 39:42

It's not the medication, it's not the chemistry itself, it's just the fear of swallowing the pill and then what's gonna happen next. And then everything goes to pot because I have people who've said that too. Like, I took that my first dose of antidepressant five minutes later, I was a mess. It I it backfired on me. That hasn't the pill hasn't been digestive. That's exactly right. It's you know that was the meta thing where like I'm just terrified that I took a pill. So, like, it's complicated, but and there's no right or wrong. That's all I'll say. So, very good. What else we got? That's it. Yeah, 39 minutes. We did all right.

Josh Fletcher 40:10

It's very good, very good. If you want to send in your own questions and did it anyways, you can do at disorder.fm. If you want to join the community, you can do that. Disorder.fm. Uh no paywall. I mean, not paywall, there is a paywall, but there's no um thingy uh behind it, anything hidden or something that we don't talk about there. Special secrets. Not on the podcast. Yeah, yeah. The secret sauce. Um, if you want the uh if you have health anxiety, you can listen to, or not listen to, read the disordered guide to health anxiety. That's by Disordered Press. Uh and you can find it on Amazon. Um, you can read Drew's books, my books, whatever. Uh, or not, just catch us every Friday. Or not, completely up to you. Uh, we just wish you a lovely rest of your week.

Drew Linsalata 40:52

Yeah, thanks for hanging out. We'll do it again next week.