Fears about taking medication

What is OCD fear of taking medication?

A person with OCD centered on fears related to taking medications can experience fears about oral medications, shots, injections, supplements, procedures, topical medications, or anything that may alter the body in a manner that could cause a negative reaction.  In OCD, these worries and fears cause distress and anxiety, often involving rumination on the worst-case scenario or the worst possible side effect of a particular medication. Due to the attention, one may pay to their physical sensations and functions, someone with fears about medication may perceive “reactions,” even when nothing is wrong, including feelings that result from their own fear and anxiety. For example, someone receiving a local anesthetic may notice slight physiological sensations, leading them to assume that they are allergic to or having a reaction to the medication. In reality, they are likely experiencing feelings of anxiety triggered by OCD.  The unwanted, intrusive thoughts, images, or fears about medications and reactions are called obsessions. In response, people with OCD will perform compulsions, which can be mental or physical, that serve to neutralize uncertainty or worry or prevent a feared outcome.  People with this form of OCD may frequently research side effects or physical symptoms they may experience in response to medications. They may ask their doctor or practitioners for excessive reassurance about a medication and its safety or seek out alternative treatments. In some instances, a person may refuse treatment altogether, which can have a severe impact on their health and safety. Someone experiencing these fears may go on and off medications regularly or take them sporadically, against the guidance of their doctor.

Medication related OCD – Common obsessions

• What if I have a life-threatening reaction?
• What if my throat closes shut?
• What if I die?
• What if I feel really uncomfortable or experience horrible pain?
• What if my heart races?
• What if I break out in hives?
• What if, even though I have never been allergic to it, I become allergic to it?
• What if the doctor gives me the wrong dose?
• What if this is the wrong prescription?
• What if these pills are expired?
• What if my medications counteract each other?
• What if I drink alcohol and it affects the medications and causes a negative reaction?

Common triggers

People with fears of taking medications may be triggered by situations involving interactions with medical providers, mental health providers, or pharmacists. They may avoid seeking medical attention, even when it is warranted. They may be triggered by taking over-the-counter medications or prescription-strength medications.

People experiencing these fears may also be triggered by commercials involving side effects. They may avoid reading side effects on packages altogether, or may obsessively read side effects. Individuals who have these fears may hyperfocus on physiological sensations and attribute these to the side effects of their medication. They may also find that their fears are triggered by symptoms of illness or injury that would cause them to require medication.

Triggers for people who are afraid of taking medications include:

• Hearing about or viewing side effects of medications they are prescribed
• Watching commercials about medications
• Hearing about allergic reactions
• Being prescribed a new medication
• Feeling physical sensations after starting a new medication
• Touching other people’s medications
• Signs of sickness or injury that could require medication

How can I tell if I have a fear of taking medications or if I am actually reacting to a medication?

This is an excellent question. To know if you may be suffering from OCD, you need to learn to recognize the OCD cycle.

The OCD cycle is composed of: 1) intrusive thoughts, feelings, images, or urges; 2) anxiety or distress that comes as a result; 3) compulsions performed to relieve distress and anxiety. Understanding this cycle can help you distinguish OCD from other conditions. Something to keep in mind is that if you are feeling an intense urgency to know something immediately and with certainty, that is a red flag that OCD may be at work.

Intrusive thoughts or doubts can and do happen to everyone. Most people who do not have OCD are able to brush these thoughts off rather easily, or trust in their own decisions and intentions. However, people with OCD struggle to do this, believing that they cannot tolerate the slightest uncertainty about the safety of their medication. This is where OCD holds its power. People with OCD focused on a fear of taking medication can get better by learning that they can tolerate uncertainty about medication, just as they do in other areas of their lives.

Common compulsions

When people with a fear of taking medications experience intrusive thoughts, images, feelings, or sensations that cause distress, they may engage in compulsions, which are physical or mental acts done to alleviate the distress and discomfort caused by intrusive thoughts or fears. Compulsions may provide temporary relief, but do nothing to keep obsessions from returning again and again, with an even stronger urge to perform compulsions. Performing compulsions inadvertently strengthens obsessions and fears, reinforcing the idea that obsessions posed an actual threat or danger. 

Here are some examples of common compulsions done by people with OCD focused on taking medications: 

• Repeatedly asking others for reassurance about their medication
• Repeatedly Googling/researching the medication and any known side effects
• Repeatedly asking a doctor or practitioner if a symptom is caused by a medication
• Avoidance of taking medications, particularly new ones they’ve never tried
• Avoidance of reading or hearing about medications and their side effects
• Confessing every physiological change to others or a doctor for reassurance that this is not a “bad reaction”
• Repeated bodily checking to scan for physical sensations

Some of the above compulsions mentioned often lead to decrease in sleep, decrease in energy, low mood, difficulties in interpersonal relationships, or difficulties with functioning at work and/or social situations. Due to these challenges, OCD can become quite debilitating for individuals with a severe case.   

How to treat fear of taking medication

OCD focused on a fear of taking medication can be debilitating and interfere with your health, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with an OCD specialist, you can find freedom from the OCD cycle.  ERP is the gold standard treatment for OCD and many other anxiety disorders. It is backed by decades of clinical research proving its effectiveness and shows promising results within 12-25 sessions on average. With ERP, you will learn effective ways to accept uncertainty and sit with anxiety and discomfort. In ERP, you’re gradually and safely exposed to the thoughts and situations that are likely to trigger your fears and resulting anxiety. With your therapist’s guidance and support, you will resist the urge to respond with compulsions. By doing this continually over time, you learn that you are able to tolerate anxiety, and you will feel more confident in your ability to sit with uncertainty and discomfort.

Examples of possible exposures done to treat a fear of taking medication may include: 

• Taking a medication that is prescribed to you at the recommended dosage and intervals
• Trying an over-the-counter medication that is recommended to you 
• Watching commercials about possible negative side effects
• Read about people who have experienced side effects
• Write a script or listen to a recorded tape about taking medication and having a negative side effect

If you’re struggling with OCD, As an OCD specialist, I’ve used ERP to help many people regain their lives from OCD. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

We look forward to working with you.