I recently published a book exploring the complex relationship between psychiatric medication and spirituality. The book is based on the findings of a qualitative research study I completed in 2015, which I wrote about in an earlier post. It was the first study to identify Spiritual Side Effects (SSEs) as a non-pharmacological factor in psychiatric medication use. SSEs are any perceived effects concerning interactions between psychiatric medication and the spirituality of the user. Broadly speaking, the participants fell into one of two groups. The first group viewed psychiatric medication as spiritually helpful and enhancing, which correlated with greater wellness and recovery. The second group found it spiritually hindering and harmful, and subsequently experienced delays to health and recovery.
Of course, it is not possible to make sweeping generalizations about these findings which hold across cultures, or for long periods of time. Readers are trusted to keep the small sample size of the project in mind (twenty people), and to make their own judgments about the transferability of the findings, should parallels emerge which resonate with their own experience. My impression is that this phenomenon is relative to a significant minority of people, and my hope is that the book provides a sense of affirming relief. The larger narratives put forth by psychiatry and neuroscience often eclipse the equally important stories of lived experience. The easiest way to understand how people are engaging spiritually with their prescriptions is to hear it in their own words.
The focus of this article is on one particular SSE: how spiritual feelings of connectedness were impacted by medication, in both positive and negative ways. While everyone’s spiritual life is unique, several common themes of spirituality emerged from my study, and connectedness was one of them. Narrowing our attention will allow us to go deeper, rather than broader, into the subject. What follows is a sampling of direct quotes and extracts. People’s actual names and identifying information have been changed.
Medication Enhances Spirituality
Many people described feelings of connectedness to themselves, others, and the transcendent as central to their spirituality. Some of them perceived that psychiatric medication increased and enhanced these feelings. Eric didn’t think of himself as a very spiritual person.
“People talk about spirituality all the time in my circle, which is AA (Alcoholics Anonymous). You know, you have to have a spiritual life, spiritual principles, spiritual this, spiritual that. It goes right through me.”
Yet feeling connected is one thing he associates with spirituality:
“I think being connected is an important thing… When I share at an AA meeting, if I share honestly, truthfully about what’s going on, I feel connected and there is a spiritual element to that… When I play music, I feel most connected to people.”
It’s not as if Eric didn’t connect to others, or enjoy playing music, before he began taking an antidepressant three years ago. But he believes that it allows him to experience a deeper sense of connectedness:
“If you ask me what I would like to do today, I would say I would like to be by myself, I would like to just sit and sort of sulk, that’s my natural inclination, to sit and feel bad. So maybe it’s the medication that helps me not to give in to the temptation to sit and sulk. It’s a tool to enable me to be present in a way that I’m not able to when I’m so preoccupied with my fears. So I would say that medication allows me to have a fuller spiritual life.”
Like many users of medication, there was a level of ambiguity in Eric’s experience. Even as he spoke about the affirming effects on his relationships, he knew it was more complicated than that:
“It has had a positive impact on the things that are most important to me, my music, and my relationship with my wife, and it has enabled me to be a better son to my mom and dad. But, see, I’m attributing all of this to 15 milligrams of Buspar and it’s not just the medication as we both know, but it’s helped. I believe it has helped.”
Maria spoke about the uncertainty of her prescriptions this way:
“The thing is, it feels like I get relief from the meds but how do I really know that? Things get better, and things get worse. Because meds are so nebulous.”
Maria is a Catholic nun. She lives in a religious community and works as a hospital chaplain. She perceived that medication enhanced her spiritual connectedness to the divine not by increasing, but by decreasing the intensity of her spiritual feelings.
“My experience is that I’m still able to have spiritual intensity on the meds. And if anything, they seem like they keep it from getting too intense… I think that the meds and the other supports that I’ve chosen, keep me from being flooded. Yeah, that’s the only way I can say it. A couple years ago, I was in DBT (Dialectical Behavior Therapy) and we got to take strings and make a boundary in the room as big as we wanted the boundary to be. And when I got to do that I stood up on a chair and I put the yarn up on the ceiling and then had it draped down. And what I was doing was, what I said to the therapist, is that I wanted a boundary from God. That I didn’t want God to be able to just overwhelm me all the time, or to kind of flood my senses.”
Anne is also a nun and hospital chaplain. Her work involves supporting people during illness and crisis, and connecting with them on a spiritual level. She credits psychiatric medication with allowing her to do her job.
“You know, today’s a day I can believe in who I am, and I can know that the people I touch will be different, and I will be different because of that. There comes a point where I say spiritually, I owe it to myself, and to everybody that I serve, to take that medication. Because that makes me the person who can sit and listen to you. Who can empathize with you. Who can say, I know what you’re feeling, and I promise you it will end. I promise you it’s not always going to be this bad. Medication allows me to do that piece of it.”
There are some people who think that because Anne is a religious figure, she shouldn’t be vulnerable to depression. It’s an attitude that troubles her.
“Some people would think because of my being a Sister of Mercy or a chaplain, religion would be the thing that I could grab onto. And a lot of times, in the middle of the depression, that’s the first thing that I throw out the door. It feels like everything around me is falling apart, including religion.”
Though she believes that the medication fortifies her spiritually, a persistent question for Anne is, “If I could be a stronger person spiritually, would I not need the medicine?” Anne knows that she has tremendous inner resources, yet she often sees her ability to be successful as inextricable from her prescriptions. The medication enhances her connection to herself:
“Every day, I take my medicine, and every day, it’s a choice to take it or not take it. Because I don’t like it. But I do know, that without it, I can’t be who I am.”
These quotes reveal how some people are experiencing SSEs positively, in ways that led to improved wellness. The journey toward recovery was supported by increased feelings of connectedness to oneself, others, and the transcendent. Now we will hear from people on the other side of the fence: those who felt that medication decreased or inhibited their feelings of spiritual connectedness.
Medication Hinders Spirituality
Many people reported that taking medication resulted in unwelcome, negative SSE’s which led to decreased wellness and delays in recovery. They described how they experienced diminished feelings of connectedness to themselves, others, and the transcendent. Joan is an artist and former school teacher. A big part of her spirituality is based on her feelings of connectedness to God:
“For me a lot of my spirituality and spiritual practice is about relating to what I’ll call God. I don’t think there’s like a God in the sky with a big white beard, pointing at us or anything. But I relate to a personal God, it’s the only way I can relate to that whole abstract sense of, there’s a God out there.”
When she was on high levels of psychiatric medication, it disrupted the connection:
“Looking back what I notice is that I was just kind of turned off to the world. Basically I was not able to discern anymore, and I didn’t realize it at the time. The main thing with the medicine though, is I think it just took away my ability to discern my relationship with God. It took away my ability to sense, what feels right and what feels wrong. What I couldn’t feel when I had the psychiatric drugs was what was in my heart.”
Hazel perceived a direct link between her emotions and her spiritual life. She talked about how the drugs created a disconnection within herself:
“I don’t feel the joy that I used to feel, which is a sad way to be, if you’ve got such great beliefs about spirituality… I’d say we need those emotions to feel as a spiritual being. The medication blunts emotions. So I know I’m not experiencing life the same as other people… I don’t cry, which I’d love to have a good cry, because I feel as though I should cry. I’m not in awe of things… I don’t feel the joy in living and the joy in being spiritual.”
Lisa noted how her experience of disconnection changed when her prescription did. When I first interviewed her, she was taking Abilify. “Abilify allows me to feel a certain amount of emotion, a certain amount of spiritualness.” Then, four months after our interview, she sent me an email:
“I thought I would just write to you and update you on my thoughts about your research project, now that the medication has truly kicked in. When I spoke to you in March, I was still a bit fanciful, and still feeling connected to all things spiritual and loving. Now that I have been placed on a depot injection of Piportil (typical antipsychotic) I find that all spiritualness has gone from my mind and I am no longer connected in such ways.”
Frequently, people said that they did not recognize the negative SSEs until after they discontinued use. This was true in Tom’s case. It was only after swallowing his last pill that he saw how the medication had reinforced his propensity to avoid connection:
“I do think that eventually, they came to reinforce a tendency I have to move toward books and abstraction, and at least indirectly, to move away from engagement with people and social engagement… over time I do think that they were part of this sort of tamping down of emotional, spiritual connection.”
Hillary is a 21-year-old college student in a creative arts therapy program. She talked about noticing the spiritually hindering effects of medication during the process of withdrawal:
“Taking medication as an adolescent really hampered my ability to feel spiritually connected… I was very shocked as I started getting off the psychiatric medications, how much spirituality, which had been very prominent for me as a young child, started to come back. I feel that it created a barrier between being able to experience feelings of being connected to a higher power, and to humanity as a whole, and just being able to feel like part of the universe… I think that particularly the last medication that was ever added for me, which was Risperidal, was extraordinarily deadening. It really, medications really decreased my ability to feel pleasure, really stifled my ability to connect with others.”
Kelly was certain that the only way she had been able to feel what she called ‘God consciousness’ was by stopping her medication:
“And that was the moment where, for the first time in my life, and I was completely off psychiatric medication, I’d been off for about a month. It was the first time in my life where I recognized the existence of a loving creator. Not just like an energy in the world, because I could always take on the idea of karma, or a balancing energy in the world. But I mean like a conscious power that was acting in my life… I don’t know if I could find that while I was on medication… I’m not sure how to explain how it works. I just know it was something I never found before. It wasn’t until I got off of it, that I felt it. I couldn’t feel it before.”
These passages show how some people are experiencing negative SSEs, which resulted in delays to recovery. Wellness was impeded by decreased feelings of connectedness to oneself, others, and the transcendent.
What can be made of the fact that each person had a different experience, and that in the journey toward recovery, the two groups managed to discover contradictory roads to the same destination? These findings are part of the push for a new paradigm which recognizes the diversity, complexity, and potential for harm of psychiatric medication use. My work in the area of spirituality builds on two key components in the shift toward more effective treatment practices: identification and recognition of the non-pharmacological correlates of medication use, and the primacy of individual variation in medication use. We are moving away from the dominant, one-size-fits-all pharmaceutical approach, and toward care that is more personalized and uniquely suited to the individual. This is necessary not simply on humanistic grounds, but because doing so improves treatment outcomes. For some people, more effective care may include an awareness of the medication/spirituality relationship.