Obsessive compulsive disorder - OCD treatment and therapy from NOCD
What is OCDOCD SubtypesI’m scared of taking medications and pills. What can I do?  

I’m scared of taking medications and pills. What can I do?  

9 min read
Erica Digap Burson

By Erica Digap Burson

Reviewed by April Kilduff, MA, LCPC

Nov 28, 2023

Possibly related to:

If the thought of taking a medication or swallowing a pill makes you fearful and anxious, you aren’t alone. There are plenty of people who have a fear of taking medications—even their prescriptions—and a number of causes where this fear might stem from. 

Unfortunately, this can become a problem, especially when those medications are necessary for keeping you healthy. 

If you’re wondering why medications trigger such a big fear in you and want to know if there’s anything that can be done to make sure you’re getting all of your important medications, keep reading. We spoke with NOCD therapist April Kilduff, LCPC, LPCC, LMHC to discuss the many reasons that might stop someone from taking their medications and what they can do to conquer their fears and better manage their health. 

4 reasons that could explain your fear of taking medication 

You have medication anxiety (pharmacophobia)

If your fear of medications is so severe that it leaves you feeling extremely stressed or even draws a physical reaction from you, you might be dealing with a phobia. 

Pharmacophobia is a fear surrounding taking medications. There are many different reasons someone might develop this phobia, including bad past experiences or a generally negative view or distrust of medications and the medical field as a whole. As is true with other kinds of phobias, the thought of taking medication can cause extreme anxiety and panic, and this can manifest in a variety of reactions from avoidance to physical reactions like sweating, shaking, or nausea. 

You have pseudodysphagia

If you don’t object to medications themselves but do object to the idea of swallowing a pill because you’re scared of choking, you might have pseudodysphagia. Pseudodysphagia is a fear of choking, and it can lead to difficulty swallowing, panic before or during the act of swallowing, and total avoidance of swallowing pills as a result. 

You have OCD, particularly Health Concern OCD

OCD (obsessive-compulsive disorder) is a condition that is defined by the presence of obsessions and compulsions. Obsessions are repetitive intrusive thoughts, images, urges, sensations, and feelings around specific themes that cause significant discomfort and anxiety. People with OCD then engage in compulsions, which are ritualistic actions, thought patterns, or avoidance behaviors that temporarily soothe that anxiety or superstitiously prevent a bad thing from happening.

More specifically, if your fears are related to the thought of taking your medications, you might be dealing with a subtype of OCD called Health Concern OCD. People who have Health Concern OCD tend to be very concerned about the potential side effects of taking their prescriptions, which often leads to incorrect medication use or total avoidance (we’ll talk more about Health Concern OCD in a bit).  

You’re just skeptical about medication in general.

Finally, your hesitation to take medications might not be linked to a mental health condition at all; instead, you might simply have reasons to distrust medications as a whole. Many people who avoid taking important medications do so specifically because they don’t trust their medications or are skeptical that they will actually work. 

This can also stem from a variety of places, from bad past personal experiences to a systemic distrust of the healthcare and pharmaceutical industries as a member of a marginalized group, or a fear that they may need to rely on medications forever if they start taking them. While this might not bring intense fear and panic in the same way that pharmacophobia or OCD would, it does lead to an unwillingness to take important medications. 

This is especially true when it comes to medications that are used for mental health. “There’s still a really big stigma against mental health medication,” says Kilduff. “There’s also this fear that they’re going to have to be on this for the rest of their lives, which isn’t always how it works. Sometimes, we use medication to help someone engage in therapy, and then they can get off it once they have gained important coping skills.” 

Still, people who have had bad previous experiences with other mental health medications or are worried about becoming reliant on them might balk at the idea of a psychopharmaceutical if they aren’t properly educated on how it can help them. 

More about the OCD fear of taking a medication 

Health Concern OCD is a subtype of OCD in which people have intense and recurring fears about their health and the possibility of becoming seriously ill. In most cases, people with this kind of OCD are specifically worried about their own health and how they themselves might develop some kind of disease or health condition. However, some people with Health Concern OCD may also have fears that involve the health of those around them, like family, friends, or even pets.  

In addition to general fears, another common fear that can be seen in people with Health Concern OCD is a fear of medications and the kinds of side effects that they might have. People with OCD often have a hard time tolerating uncertainty, which means that the potential for side effects from medications can become a point of great distress—no matter how small the chances of developing those symptoms and side effects actually are. Since one can never feel 100% certain that they won’t experience their medication’s most serious side effects, OCD makes this uncertainty feel intolerable.

Some common compulsions that people with Health Concern OCD might act on that are related to medication fear include:

  • “Doctor shopping” to find other opinions 
  • Doing compulsive research about the potential side effects of their medication or possible physical symptoms they may be feeling 
  • Checking for any physical or mental sensations that could potentially be a sign of a side effect
  • Repetitively seeking reassurance from doctors/pharmacists that their medications are safe 
  • Compulsively seeking out alternative, non-pharmaceutical treatments 
  • Incorrectly using their medications (ie: going on and off medications, taking them sporadically, or taking them with other substances to ease their anxiety) 

At worst, people who have Health Concern OCD might refuse treatment altogether out of severe fear of their medications, which can have huge negative consequences when those medications are important for their health. 

How to tell if you have an OCD fear of taking medications/pills

If you are trapped in a cycle of avoiding important medications out of fear and uncertainty, you might wonder whether you’re dealing with OCD or something else. 

Remember, obsessions and compulsions are the hallmarks of OCD, which means that you can start finding answers by evaluating whether these are present. If your thoughts regarding your medication are intrusive, repetitive, and cause high levels of anxiety and fear, they might be obsessions. If you then feel the need to cope with these feelings with compulsive actions like excessive research, checking your body for signs of side effects, or seeking reassurance from poison control, these are telltale signs of OCD. 

There are other signs that your fear might stem from OCD as well. According to Kilduff, some indicators that someone’s fear of medication might be related to OCD include: 

  • Looking for a medication that has zero side effects
  • Blowing side effects out of proportion to what they are 
  • Having a mindset that they’re going to be among the 0.01% who experience horrible side effects of a medication
  • Being too afraid to mix multiple medications out of fear of negative interactions, even when the mix is recommended by their doctor

If your fears of medication follow patterns like this, there’s a chance that you may be dealing with OCD. 

What to do about your fear of taking medication 

Avoiding medications can be detrimental to your health and your well-being, which means that overcoming this fear is crucial when you have an important medication. Luckily, there are ways to overcome this fear no matter where it may stem from. 

If your fear of medication is due to OCD, exposure and response prevention (ERP) therapy is your best treatment option. ERP is a highly effective form of therapy in which a trained therapist helps you gradually experience anxiety and discomfort, then learn to sit with distress and uncertainty without engaging in compulsions that only serve to reinforce your fear in the long run. 

Kilduff explains that some possible ways that she might work with people experiencing these fears include reading the side effects of their medications before taking them as recommended. Treatment could also include reading stories about people who have had extreme side effects or problems mixing their medications, or writing a worst-case scenario situation of what could happen. 

The exposures might start even smaller if your fear is extremely high. “Depending on how severe it is, it might just be looking at a pill or having the prescription filled and having it in your house,” says Kilduff. “You don’t have to take it yet, but just get it and spend time being around it.” 

From there, ERP-trained therapists can help you learn to deal with that discomfort without turning towards compulsive responses to feel better. Ultimately, the goal here would be to work up to taking those medications as recommended by your doctor.

If you believe that your fear of medications stems from OCD and are interested in hearing more about how ERP can help, I encourage you to learn more about NOCD’s evidence-based, accessible approach to OCD treatment. Our therapists all specialize in treating OCD and receive ERP-specific training to provide convenient, highly effective virtual treatment. 

If your fear of medication is due to sensory issues or difficulty swallowing, it may be helpful to start by looking for different forms of medications that you can take, like liquids or shots. 

If other options aren’t available, you can start overcoming the fear by starting small and working with a therapist to deal with the phobia. For example, using a pill cutter can help you make large pills easier for you to swallow and ultimately work your way up to taking a full pill. Kilduff even describes an instance where she worked with a client with swallowing issues by using a “candy progression” rather than pills themselves: they started by swallowing very small candies, then worked their way up to a pill-sized candy, to get used to the sensation without actually using the medication itself. 

Finally, if your fear comes from uncertainty, bad experiences, or mistrust, education about your medications is a huge first step in conquering your fears. 

Talking to someone who is knowledgeable about medications can help you better understand the risks and, more importantly, help you weigh them against the potential rewards. This can also help by removing some of the stigma that surrounds taking certain medications like prescriptions for mental health conditions. “I think you have to weigh the pros and cons of a potential side effect versus feeling much better, feeling more able to be back in control of your life,” Kilduff says. 

In the case of mental health medications and OCD, Kilduff advises speaking to a psychiatrist to determine the right medications for your mental health needs, as they have specific expertise in psychopharmaceuticals, rather than the broader knowledge of medications a generalist may have.

Final thoughts

Prescription medications can give people the tools they need to feel better and live happier, healthier lives. If your fear of taking medications is stopping you from receiving the right treatment, there is help. With the right therapy and education, you can become empowered to take those medications and improve your well-being. 

 

Learn more about ERP
April Kilduff, MA, LCPC

April Kilduff is a NOCD therapist who has exclusively treated OCD and anxiety disorders, as well as their intersection with the Autism spectrum, for over a decade. Her path to this career started with her own journey dealing with panic attacks, perfectionism and a couple phobias. When not working on exposures with members, you can find her at home reading books and hanging out with her two cats or out taking pictures and traveling the world.