So it had come down to this: A little paper cup and a green-and-yellow pill. I stood at the drinking fountain of the UCLA student health clinic, staring down at the innocuous yet ominous capsule resting in the palm of my hand.
The year was 1988, and the medication — Prozac — was being trumpeted as a revolutionary breakthrough in the treatment of depression. I had been wrestling with what Winston Churchill called “The Black Dog” periodically throughout my life. But this was a particularly nasty bout, one which I just couldn’t seem to shake. Believe me when I tell you that I tried every reasonable remedy — therapy, exercise, social support, meditation, and more…but with one exception: I had stubbornly rejected trying any kind of medication.
My concerns were numerous: What if I become dependent on the drugs? What if I get side effects? Could I bear the stigma of relying on pills? Shouldn’t the chemistry in my brain be off-limits to alteration? Shouldn’t I be able to solve this problem on my own, without resorting to medication (especially since I was becoming a psychologist, for God’s sake)? And maybe most frightening of all, what if the medicine changes “who I am?”
For each concern, however, I had a rational counterpoint.
I knew that these types of medications aren’t addictive, so
my becoming dependent was unlikely. As far as experiencing side effects, I could just discontinue the pills. And by that point, I was feeling so rotten, I didn’t really much care about stigma or what other people might think. Plus, I knew logically that there was nothing holy about neurotransmitters, since it’s all just physiology anyway. And finally, I had already attempted — unsuccessfully — to solve it “on my own.” But all of this notwithstanding, I was still reluctant to cross the Pharmaceutical Rubicon.
As I pondered this dilemma, it became apparent to me that I was not going to stumble across any clear, simple answer — because there was no escaping the truism that every decision or event in life involves some kind of trade-off. For everything we gain, we always give something up. Likewise, for everything we lose, there is some potential upside. If you gain a relationship, you trade off some independence. If you quit your job, you gain the prospect of new opportunity. But we can’t have it both ways: Whatever choice you make leaves all others behind. If you turn left, you give up turning right. If you eat your cake, you can’t then have it too. For any decision, the best we can do is to weigh out the costs and benefits, then go with the one where the balance is tipped.
And in this case, the cost involved a very specific type of risk. For years, I was afraid that taking medication would change “who I am.” But in that moment, I was faced with an even bigger fear: Now, I was afraid that it wouldn’t. I viewed medication as my option of last resort — something I could turn to if all else failed. And there was some comfort, even security, in knowing that I carried that option in my back pocket. But what if I tried it — and it didn’t work? I’d then be left empty, with no backup solutions at all. And that prospect was terrifying.
Unpredictable risks can be gut-wrenching. What if you decide to make a major career change only to find out later that it made no real difference in your life? What happens if you lose a massive amount of weight, or even undergo cosmetic surgery, and you don’t feel any better about yourself? What if you quit drinking alcohol only to find that you’ve only replaced one set of problems with another? What if you end your relationship and still feel miserable — or even more miserable?
Deciding about change is a matter of weighing risks. Do you risk failure by changing? Or do you risk remaining stuck by not changing? One useful tool I’ve found is to imagine yourself sometime in the future, looking back at the decision you’re facing. How do you think you might feel about yourself if you took the risk to change? And how about if you took the risk not to change?
But that thought experiment aside, how do we find out if we made a good choice? Truth be told: By actually finding out.
So, I did. From the palm of my hand and into my mouth, down went the pill. For better or for worse, I opted to take the plunge. How did it work out? Unfortunately, I had to discontinue the meds due to their side effects. But I don’t view the decision as a failure. In hindsight, I’m still glad that I took that risk of trying; for me, finding out was worth the trade-off.