Though psychiatric medications are widely used, their diverse effects upon all aspects of patients’ lives are still understudied. In her groundbreaking book Psychiatric Medication and Spirituality: An Unforeseen Relationship, Dr. Lynne Vanderpot focuses her attention on the positive and negative ways that psychiatric medications affect the spiritual and religious experiences of patients.

Alexandra Nichipor of the Initiative on Health, Religion, and Spirituality was able to ask Dr. Vanderpot some questions about her recent book. 

Alexandra Nichipor: One of the most interesting things about your book was the diversity of experiences among interviewees. What were some of the different ways that your interviewees described the impact of psychiatric medications on their spirituality? 

Lynne Vanderpot: It’s really true that the people I interviewed for my research shared a fair range of experiences. There’s an obvious reason for this—each participant had a subjective understanding of spirituality and what it meant to them, so perceptions of how psychiatric medication impacted spirituality were also therefore unique. Modern expressions of spirituality have shifted from their traditional location, and beliefs may come from a variety of religious and non-religious sources. It’s been said that no one has been able to articulate the hodge-podge spirituality that our culture has produced, and yet through research we know it is a significant, even crucial, aspect of recovery from mental illness for many patients.

In my research project, the participants had their own conceptions of spirituality, but several common themes emerged, including connectedness, meaning and purpose, religion, transformation and growth, and creativity and perseverance. In broad terms, people fell into one of two groups: those who perceived medication as spiritually helpful, and those who perceived it as spiritually harmful. Within the helpful group, one participant described how medication enhanced his spirituality by helping him persevere, and face the world, day after day. The desire to give up, he said, and succumb to a fear of leaving the house, would expand if he didn’t take his medication. He also felt it allowed him to go to work to fulfill his purpose, as a peer support counselor, helping others recover from severe and persistent mental illness. Another interviewee described how medication calmed his frenetic mind, which improved his relationship with God by allowing him to be more open and receptive. Another person I interviewed, a nun, felt that psychiatric medication improved her feelings of connectedness to others by allowing for a deeper experience of empathy. She said that as a hospital chaplain, it enabled her to be more present to the suffering of others. So those are some examples of the different spiritual side effects that were positive.

Other interviewees described negative spiritual side effects of medication. One participant said that medication diminished her sense of connection. She talked about how the drugs acted as a blockade to her sacred longings for the transcendent. In addition, she said taking medication led to indifference toward other people and toward nature. Another interviewee talked about how her mother’s psychiatric medication use impacted her entire life, because her mother has been taking medication since she was an infant. She described the drugs as a barrier to attachment in those crucial early years, and she believes this hindered her own journey of transformation and emotional growth. Another interviewee felt that medication inhibited his spiritual growth by reinforcing his tendency to avoid dealing with grief and sadness in life. Those are just some of the different ways people talked about engaging spiritually with medication in both positive and negative ways.

AN: Many of your interviewees cited relationships as an important aspect of their spiritual lives. How did psychiatric medications help or hinder their ability to form relationships?  

LV: You’re absolutely right, a sense of connectedness—to oneself, to others, to nature, and to the transcendent—was an integral aspect of spirituality for many of the people I interviewed. Relationships provide a sense of meaning and purpose in people’s lives. Some people perceived that medication helped their ability to form and/or maintain relationships. One participant, a nun (not the same person mentioned earlier), saw being in right relationship as central to her spirituality. She said that medication allowed her to remain in right relationship, and to honor her commitment to the sisters in her community, by managing the intensity of her mental states, and keeping her within the realm of proper functioning. Another interviewee described how he became disconnected from the church during the time his bipolar condition was untreated. Before taking medication, he said he would vacillate between feeling low and unworthy of being in church, to feeling high and extra special, almost like a celebrity. When he began medication, it helped him re-establish a sense of belonging. He said that now he feels just like the next person in church, neither better nor worse than anyone else. There was one participant who primarily felt that medication had harmed her by suppressing the intensity of her spiritual feelings, but she talked about its positive impact on her relationships with her husband and daughter. Taking medication had returned a sense of normalcy to their home, she said, by making her behavior more stable and predictable. On medication, she said she was much more reliable and grounded in family life.

Some people reported the opposite experience, saying that medication had hindered their relationships. One participant described how the side effects made her talk very slowly, in a monotone voice, with no facial expression. She noted that this distanced her from her friends, because they couldn’t relate to her anymore, even though they didn’t understand why. She also said that on medication, she could no longer discern her relationship with God, because it took away her inner sense of what felt right and what felt wrong. Several participants had described how medication hindered their feelings of attachment to others by blunting the full range and depth of their feelings. The felt that the drugs had a way of obstructing their desire for intimacy and closeness with others.

One other important point to mention is the prescribing relationship and other therapeutic relationships around medication. My findings indicated that the quality of professional relationships strongly correlated with perceptions of medication as spiritually helpful or spiritually harmful. Positive relationships were correlated with spiritually enhancing effects, whereas negative relationships correlated to perceptions of spiritually inhibiting effects.

AN: What does your work suggest about the role of spirituality in mental health care – both what it is now, and what it could/should be? 

LV: I think this is a really good question, and one I’d love to open up to the wider group of people working in this area. At the very least my work suggests that something unforeseen is happening that doesn’t fit within the central narrative of biopsychiatry, that psychiatric medications are strictly biological interventions treating biological conditions and neurochemical disorders. It’s important to recognize that this study supports previous findings, in the sense that subjective responses (not necessarily spiritual) to psychiatric medication have a significant impact on recovery outcomes (Deegan 2005; Larsen-Barr 2016). It suggests that some people are engaging spiritually with their prescriptions in ways that significantly impact the course and outcome of treatment. This work identifies spirituality as a non-pharmacological, or secondary effect of psychiatric medication, so I think spirituality needs to be included in the conversation around psychopharmacology. A new dialog needs to be opened up about how these medications actually work, and what role spirituality may play in their perceived effectiveness.

I think it also speaks to the tricky intersection between the spiritual/the biological/and the psychological. There’s a paradox between our need as researchers and practitioners to distinguish and categorize different dimensions of lived experience for the sake of coherent discussion…yet at the same time, we need to acknowledge how these dimensions become unified in the patient’s lived experience. And in terms of what should be or could be, moving forward, it’s important to see the narrative the patient lives as equally impactful on treatment outcomes as the larger medical narratives of diagnosis and etiology. I think being validated and heard by a professional is an incredibly powerful intervention in itself, and that the connection between doctors and patients is an inextricable part of the spirituality/health care equation.

Readers who have questions for Dr. Lynne Vanderpot can contact her at lynnevanderpot@hotmail.com