Anxiety: Chemical Imbalance, Cognitive Issue, or Both?

anxiety recovery

For a long time I’ve struggled with anxiety, and for just as long, I’ve struggled to understand its causes: primarily biological or primarily cognitive? Earlier this year, this indecision caused me forgo the antidepressant I had been on for the past nine years and start exploring other methods of treatment. After eight months of going the cognitive route, I’m back at the doorstep of the biological route.

Why I waited so long to consider medication again:

  • I figured most of my anxiety and depression was related to unpleasant circumstances. But all these things are far behind me now, and if I’m still upset, it’s probably related to a deeper issue.
  • I didn’t like the negative side effects of the med I was on, and didn’t want the hassle and unpredictability of trying another med.
  • When I first experienced life without medication, I figured that the level of mental turmoil was normal, and that my only problem was I didn’t know how to cope like everyone else who hadn’t been on meds during the formative years of high school and college. I believed that this level of mental turmoil was preferable to what I saw as the “blissful, medicated ignorance” that supposedly prevented me from dealing with my root issues. It felt noble to suffer alongside the general population who was experiencing the emotional roller coaster of life without medication.
  • I forgot about the idea of chemical imbalances in the brain, and thought that Cognitive Behavioral Therapy (CBT) – including the replacement of negative thoughts with positive ones – would ease my anxiety to the same degree as medication. While I don’t doubt this is possible in some cases, it depends on the person and whether there are biological factors at play that make CBT more challenging than it would be otherwise. In the 50s and 60s, the majority of Americans believed that anxiety was a moral or philosophical failing (read My Age of Anxiety by Scott Stossel for more info). However, this isn’t always the case.
  • I wanted to save money by avoiding psychologist fees.

Why I am now considering medication:

  • For the past six months I’ve been in a Bible-based recovery program through my church, called ReGeneration. Before starting this program, I was a relatively closed-off person taking care not to share too much with anyone. But ReGen taught me the value of emotional intimacy and vulnerability with those I trust. So I started sharing more. I shared with some people more than others, and one particular friend, unfortunately, got an earful. She was a close friend, and I allowed her to provide encouragement and challenge me when necessary. Recently, she challenged me in an area where I wasn’t ready to hear the truth, but deep down I knew what she said was true. She reminded me how happy I had been while on medication, and she reiterated a lot of the struggles I had shared with her over the last eight months. Seeing the struggles all in one list was nothing short of horrifying. This sounded like someone who wasn’t able to function in day-to-day life nor enjoy it. The frequency and intensity of the anxiety made every day into a struggle in both solo and social contexts. At first, I resisted my friend’s suggestion of medication, but as soon as I saw the list, I was sold. Also, the thought of reclaiming the life I had eight months ago was causing me high levels of excitement and joy just thinking about it.
  • I don’t believe in coincidences. During the same week, I received a letter in the mail from the mental health practice where I had been receiving treatment earlier this year: “We have missed seeing you . . .”

So am I abandoning ReGen in favor of medication? I’ll probably do both. ReGen is more focused on restoring your relationship with God than improving your issues. I like ReGen because I know that a major cause of my anxiety is that I sometimes view God as untrustworthy and mean. If I continue ReGen, I know I will be happier and healthier than with medication alone. I’ve struggled with my faith for years, and ReGen has been one of the main things that has increased my faith and helped me understand God’s love.

I’m looking forward to getting my joy back. Medication and ReGen should be a good combination. Until I receive further clarity, this is the path I will take for now.


One thought on “Anxiety: Chemical Imbalance, Cognitive Issue, or Both?

  1. I can relate to your viewing God as untrustworthy and mean. At least your brave enough to walk inside a church, I can’t do that, the people scare me and so does God. Not good because we need Him. It’s rough to try to mend a relationship with someone you’re afraid of. So happy that you are healing and on the right path.

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