SomnusNooze
IMPORTANT NOTE: If you think you may be experiencing side effects from your treatments, be sure to discuss these with your healthcare providers, who can help you consider other treatment options.
By TONI BERNHARD, JD
Many of us who suffer from chronic pain and illness are on medications that carry side effects that, in some cases, can be as difficult to cope with as our initial health problems. I’ve recently started a medication that I’m 
scheduled to be on for five years. I’m taking it because it significantly reduces the risk of a recurrence of my recent bout with breast cancer.
And so, yes, I’m taking the medication … but I’m also struggling with its physical and mental side effects. This article is not a substitute for talking to your doctor about any difficulties you’re encountering with a prescription drug. That said, I want to share two strategies for coping with the side effects of medications.
Start where you are
In my book, How to Wake Up, I write about Pema Chödrön’s practice called start where you are. I describe how it’s helped me make peace with living day-to-day with a number of unpleasant symptoms associated with a chronic illness I’ve suffered from since 2001.
With the help of this practice, instead of mounting a daily–but ultimately losing–battle against those symptoms by telling myself how much I hate them and how I must get rid of them, I say to myself: “OK. These symptoms are my starting point today: I feel sick, and I’m in pain. Now, how can I make the best of this day?” Pema Chödrön’s start where you are enables me to be present for my life as it is and to try and enjoy it, instead of spending my time complaining about a life I can no longer lead.
This new medication has brought along with it a new start where you are challenge for me. In addition to coping with the flu-like symptoms from my longstanding illness, I’m now having to live with half a dozen side effects of this new drug. Three examples: sleep is even less restorative than it used to be; my right thumb is so swollen and painful in the morning that I can barely bend it for a few hours until it loosens up. (“Joint pain or stiffness” and “Problems with your fingers while gripping” are included on the list of possible side effects for this medication.)
And I’ve been feeling low mentally. (“Mood changes” is also on the list of possible side effects.) Despite being chronically ill for many years, I’ve almost always looked forward to the day, no matter how sick I’ve felt. But on this medication, I can feel a change in my mental chemistry. I experience it as a low-grade dread of the day ahead and a lack of motivation, as if I can’t be bothered to do anything. This is very unlike me.
At first, I felt tossed about by these physical and mental side effects. I was irritable most of the day and complained a lot about the medication, even though I continued to believe that its benefits outweighed the negatives from its side effects. No doubt about it: I was at a loss as to how to skillfully handle what was happening to me.
Then I remembered Pema Chödrön’s start where you are. I thought about how complaining about side effects did nothing to diminish them; in fact, it increased my mental suffering. I decided it would be better for me to stop fighting what was happening and to begin treating how I was feeling as my starting point.
I’ve been working on this, and it’s turned out to be more helpful than I’d imagined. This change in perspective has even opened my mind to the fact that no medication’s side effects are set in stone. My body may adjust to some or all of them (the initial side effect of shirt-soaking night sweats has already improved). I’d been so busy complaining about the medication that I hadn’t considered the possibility that some of the side effects might be temporary—despite the fact that the drug information sheet contains that very statement.
If you’re on a medication that has unpleasant side effects, I hope you’ll try Pema Chödrön’s practice. I’m confident it will feel better than being trapped in anger and resentment over something you don’t control (just like you don’t control having medical problems in the first place). To start where you are, acknowledge how you feel—side effects included—and let that be your starting point for the day.
OK, having started where you are, then what? That takes me to my second suggestion.
Find a work-around
As with start where you are, finding workarounds is something I’ve been doing for years to cope with the symptoms of my chronic illness. If I have a task that has to get done, such as pruning some bushes, instead of doing it all at once, I make it a two- or three-day project. If I wake up feeling too sick to leave the bedroom, I try to come up with ways to enjoy myself on the bed that day.
Since I’d already been looking for workarounds with my chronic illness, I decided I should try it with the side effects of this medication.
I started with my right thumb. Because I’m right-handed, until my thumb loosens up, I’m limited in what I can do. I can’t get the toothpaste cap open, let alone hold onto the cord I use to pull the blinds up in the bedroom. Some days, I can’t hold a pen. When this first happened, I spent my mornings complaining to my husband and resenting the injustice of it all. He was sympathetic and supportive, but this was not pleasant for either of us.
Then one morning I said to myself: “OK, first, start where you are: your right hand is of limited use for a few hours after you get up. That’s the way it is.” Then I looked for some workarounds. I discovered I could use my left hand for simple tasks, such as unscrewing the toothpaste cap. I’ve learned to pull the blinds up without using my right thumb. I postpone other tasks until my thumb has loosened up. Life is much more pleasant for me and for my husband since I’ve started working around what I simply cannot do.
Finding a workaround for my low mood has proven to be more of a challenge. How do you work around the feeling that you don’t want to be bothered to work around a feeling?! It took a while, but here’s what I discovered works for me: gentle force. By gentle force, I mean compassionate force, which means I start by acknowledging how hard it is to feel down and motivationless … and how it isn’t my fault. Having done that, I then force myself to start doing something.
Without that initial dose of self-compassion, I don’t think force would work for me. Being kind to myself helps me muster the energy to get going, and once I’m “up and running,” my mood improves. It reminds me of a lawn mower that’s stubborn to start. You have to keep pulling on the starting cord. It may take a dozen times, but once the mower starts, it hums away.
How I came to write this very piece is an example. The idea for it came to me when I’d gotten up in the middle of the night to use the bathroom. Before I started on this medication, when I’d have one of those middle-of-the-night ideas, as soon as I’d I get up in the morning, I’d want to get my thoughts down on paper. But not this time. When I woke up, I couldn’t be bothered to write anything. I felt too down.
It was time for a workaround. First, I acknowledged with compassion how sad this lack of motivation is for me. Then I forced myself to open a document, label it “side effects of medication,” and type something—anything—about this topic. Having forced myself to do this, I was off and running like that lawn mower; I even enjoyed getting my initial thoughts written down. When it came to editing (and I do a lot of it), I had to go through this same process again—a little self-compassion and a little force—but once I got going, I enjoyed it.
I recently had to use gentle force as a workaround with my friend Dawn. We had a date to meet at a nearby café for an hour. I came close to canceling, even though I was feeling up for it physically. Mentally, however, I couldn’t be bothered. I didn’t want to see anyone or visit with anyone. Fortunately, I tried a “mental” workaround: I gently forced myself to leave the house and go meet her. I had a great time.
***
So that’s my plan for coping with the side effects of this medication. If they persist, it may turn out to be a five-year plan (although I will raise what’s happening with my doctor at our next appointment).
If you’re experiencing side effects from one or more medications, I hope you’ll start where you are and then look for some workarounds. My heartfelt best to everyone.
Toni Bernhard is the author of the award-winning How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers and How to Wake Up: A Buddhist-Inspired Guide to Navigating Joy and Sorrow. Her newest book is called How to Live Well with Chronic Pain and Illness: A Mindful Guide. Before becoming ill, she was a law professor at the University of California—Davis. Her blog, “Turning Straw Into Gold,” is hosted by Psychology Today online. Visit her website at www.tonibernhard.com.