By Dr. Maryam Nouhi, DO · Board-Certified Psychiatrist · Valor Mental Health · March 2026
Every week, I see patients who have been living with treatable psychiatric conditions for years — sometimes decades — because a myth stopped them from seeking help. Not a fact. A myth. Something they heard from a friend, read in a Facebook comment, or absorbed from decades of cultural stigma around mental health care.
The stakes are real. A 2023 study published in ScienceDirect found that 76% of patients with depression reported internalized stigma around their condition, and 84.5% reported perceived public stigma. Stigma about medication specifically is one of the leading reasons patients delay treatment, stop medication prematurely, or never seek psychiatric care at all.
Below I've addressed the five myths I hear most often — with clinical honesty, not reassurance theater.
This is the fear I hear most often — and it's also the most clinically backwards. Psychiatric medications don't add something foreign to your brain. They reduce or correct the neurological symptoms — unrelenting low mood, racing thoughts, paralyzing anxiety, intrusive fears — that are already distorting who you are.
Depression tells you nothing matters. Anxiety tells you everything is dangerous. ADHD makes it impossible to follow through on what you care most about. These symptoms alter personality far more than any medication I prescribe.
The overwhelming majority of my patients who start medication for the first time say some version of the same thing within weeks: "I feel like myself again." Not a different self. Their self — the one the illness had been suppressing.
This myth conflates very different things. The most commonly prescribed psychiatric medications — SSRIs (like sertraline, escitalopram), SNRIs (like venlafaxine, duloxetine), mood stabilizers (like lithium, lamotrigine), and most antipsychotics — are not addictive. They do not cause cravings. They do not produce euphoria. They do not lead to dose-escalating behavior.
It's true that some medications — benzodiazepines like alprazolam, or stimulants like amphetamine salts — carry dependence risks. These are real risks that I discuss honestly with every patient before prescribing. But they are a small category of psychiatric medications, not representative of the field, and their risks are managed through careful dosing, duration limits, and regular monitoring.
Some patients do experience discontinuation symptoms when stopping SSRIs or SNRIs — dizziness, irritability, flu-like feelings — but these are physiological withdrawal effects, not addiction. They are managed with a slow, supervised taper. Dependence is not the same as addiction.
Duration of treatment is determined by your diagnosis, your history, and your response — not by a one-size-fits-all rule. For a patient experiencing their first major depressive episode, standard clinical guidelines recommend 6–12 months of medication after achieving remission, followed by a supervised taper.
Are there patients who benefit from longer-term medication? Yes — particularly those with recurrent depression (three or more episodes), bipolar disorder, schizophrenia, or severe anxiety disorders. But the analogy I use with my patients is this: if you have hypertension, your cardiologist doesn't apologize for recommending long-term blood pressure medication. Psychiatric illness can be chronic too, and treating it chronically is not a failure — it's good medicine.
The decision to continue, taper, or stop medication is always made collaboratively, with close clinical monitoring. You are never just left on medication indefinitely without reassessment.
Research published in Nature Translational Psychiatry shows that approximately 42–53% of patients respond to the first antidepressant they try. That number sounds discouraging until you understand what happens next: the majority of patients who don't respond to the first medication will respond to a second, third, or augmented regimen.
Psychiatric medication is not a one-shot gamble — it's a process of systematic refinement. Different medications work through different mechanisms. Someone who doesn't respond to an SSRI may respond beautifully to an SNRI, a tricyclic, bupropion, or an augmentation strategy. Newer options like esketamine (Spravato) now offer evidence-based treatment for treatment-resistant depression.
When a patient tells me "I tried an antidepressant and it didn't work," that's not the end of the story. It's a data point. It tells us where to go next. The worst thing that can happen is a patient giving up after one trial and concluding that medication will never help them — because the evidence says otherwise.
This is the most pernicious myth of all, because it turns a medical decision into a moral judgment. No one tells a diabetic they're weak for taking insulin. No one accuses a hypertensive patient of failing to "handle" their cardiovascular system on their own. Psychiatric conditions are medical conditions — involving real, measurable changes in brain chemistry, neurocircuitry, and neuroinflammation.
In fact, I would argue the opposite: recognizing that you need help, overcoming the stigma that says you shouldn't, finding a provider, and committing to treatment takes significant courage. The patients I admire most are not the ones who white-knuckle through a depressive episode for another year. They're the ones who decide enough is enough and take the step to get help.
Medication is also not a replacement for therapy, lifestyle, relationships, and meaning. It's a tool that helps level the neurological playing field so that those other things — the therapy, the exercise, the human connection — can actually work. Most of my patients use medication and therapy together, and the combination consistently outperforms either alone for moderate-to-severe illness.
I want to be honest about something: psychiatric medications do have side effects, and dismissing that reality would be doing you a disservice. Common side effects of SSRIs include initial nausea, sleep changes, and sexual side effects. Stimulants can increase heart rate and suppress appetite. Antipsychotics carry metabolic risks with long-term use.
But side effects exist on a spectrum, differ dramatically between individuals, and most improve significantly after the first few weeks as your body adjusts. My job is to monitor them, manage them, and work with you to find a regimen where the benefits clearly outweigh the costs. That conversation should happen openly, not be hidden from view.
The goal is never to put you on medication and forget about you. It's to find the right treatment — and adjust it as your life and needs evolve.
If you've been carrying one of these myths as a reason not to seek help, I hope this changes something. Your first appointment with me at Valor Mental Health is not a prescription assembly line. It's a 45–60 minute comprehensive evaluation where we talk through your history, your symptoms, your goals, and your concerns — including any fears you have about medication.
Nothing is decided without your understanding and agreement. I believe the best psychiatric care is fully collaborative. You deserve to understand what you're taking, why, what to expect, and what the alternatives are. That conversation is the foundation of everything I do.
No. Psychiatric medications treat neurological symptoms — not who you are. Most patients report feeling more like themselves once properly medicated, because the illness that was distorting their mood, energy, and cognition is no longer in the driver's seat.
Most psychiatric medications — SSRIs, SNRIs, mood stabilizers, antipsychotics — are not addictive. Some medications (benzodiazepines, stimulants) carry dependence risks that are carefully managed. Discontinuation symptoms from SSRIs are real but manageable with a supervised taper — this is not the same as addiction.
Not necessarily. For a first depressive episode, treatment is typically 6–12 months after remission, then tapered. Duration depends on your diagnosis, history, and response. The decision to continue or stop is always made collaboratively with close monitoring.
Clinical trials show 42–53% of patients respond to the first antidepressant tried. Most who don't respond to the first medication will respond to a second or augmented regimen. Not responding to one medication is a data point, not a dead end — there are many evidence-based alternatives to try.
This is a nuanced clinical decision best made with your psychiatrist and OB/GYN. Many psychiatric medications are compatible with pregnancy and breastfeeding when the risk of untreated illness is weighed against medication risk. Dr. Nouhi can help you navigate this with current clinical evidence.