Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Do you have fears about taking medication? You’re not alone

By Jenna Demmer

May 16, 20248 minute read

Reviewed byApril Kilduff, MA, LCPC

You probably know the feeling: You’ve been prescribed a medication, or know there’s one you should be taking—but you just can’t do it. Do you understand that you should? Sure. Will there be health consequences if you don’t? Probably. But no matter how hard you try, you just can’t bring yourself to take medication. 

“There are people who have trouble swallowing pills, but for others, it can be more than this,” says Patrick McGrath, PhD, psychologist and Chief Clinical Officer at NOCD. He explains that for some people, taking medication causes severe health anxiety that could be the sign of a mental health issue, such as a condition called pharmacophobia—which is a fear of medication—or OCD. 

If this all sounds scary, the good news is that if you have pharmacophobia or OCD, both are treatable. Let’s take a look at what could be behind your distress, and how you can find the right treatment and relief. 

Scared of medication? Our specialists can treat a variety of conditions, including OCD and phobias. Book a free call to get matched with a specialist.

Why do I have a fear of taking medication or pills?

There are many reasons you may be afraid of taking medication, says Dr. McGrath​​. Some of them include:

  • Stigma: While taking medication is normal—most American adults do it—there can still be a sense of shame surrounding it. “Some people ​​interpret taking medication as a failure on their part,” says Paul Greene, PhD, a licensed clinical psychologist and director at Manhattan Center for Cognitive-Behavioral Therapy.
  • Fear of relying on medication: You could be reluctant to go on medication because you’re afraid you’ll never be able to come off of it. Or you may be concerned you’ll become addicted or reliant on it.
  • Concern about possible side effects: Perhaps the fine print of the medication has your mind spiraling through all the “what ifs.” Even if side effects are rare, learning about them can be scary. And if you’ve had—or seen—a negative reaction to medication in the past, you may worry about it.
  • Fear of how medication will affect you: You might be afraid of how a drug could impact you physically, emotionally, or mentally. 
  • Distrust of medication: You may not trust medication, or the healthcare and pharmaceutical industries as a whole. Maybe you or someone you know has had a bad experience with medicine. Or maybe you’ve heard conspiracy theories that seem to make a little too much sense. 

How can fear of taking medication affect my life?

Being afraid of taking medication can stop you from getting treatment that could improve your quality of life. You may totally avoid it, or not use it as prescribed—for instance, you might go on and off medications against the guidance of your doctor, which can be really dangerous. More dangerous, in fact, than taking it. In some cases, this could prolong your illness or contribute to a relapse in, say, a mental health condition.

Fear of taking medication can also make matters worse when you do take it. Dr. McGrath notes that you might hyperfocus on your bodily sensations, and attribute anything you feel to possible side effects. For example, you might believe a slightly fast heart rate must mean you’re having an allergic reaction—you won’t consider the possibility that it may just be anxiety from taking your medication. This can rack up unnecessary doctor’s visits and medical bills. (In addition to all the distress it’s causing you.)

What to know about pharmacophobia

According to research, up to half of people don’t always follow their prescriptions as recommended. One major reason? Pharmacophobia—an intense and overpowering fear of medication, and it can apply to, well, all sorts of healthcare issues. Just a few examples:

  • Pills, including prescription and over-the-counter medications
  • Shots
  • Supplements
  • Topical medications

A 2020 study found that roughly 1 in 5 people described themselves as pharmacophobic. The disorder appears to be more common among people with anxiety or personality disorders.

“Pharmacophobia can be a serious health problem, especially for people who can’t get accommodated with a compounding pharmacy,” says Dr. McGrath. Compounding pharmacies offer medicines custom-made for you, which can sometimes help alleviate fears.

Pharmacophobia can be a serious health problem, especially for people who can’t get accommodated with a compounding pharmacy.

Sure, taking a new medication can make anyone a little nervous, but if you have a mental health condition like pharmacophobia, it can feel like something out of a horror movie. 

“Pharmacophobia can involve a wide array of fears, such as choking on a pill, a pill getting stuck in your throat, or anxiety about what the medication might do,” adds Tracie Zinman-Ibrahim, LMFT, CST, a therapist at NOCD. 

That’s why people with this phobia typically avoid medication whenever possible. When they don’t have a choice but to take their prescription, they’re often overwhelmed with fear or panic. Even thinking about medication can cause a great deal of anxiety.

If you have this phobia, you may recognize that your level of anxiety is irrational, or you might not. Either way, it’s hard to control.

You might have physical symptoms such as:

  • Fast heart rate
  • Shaking
  • Nausea
  • Fainting
  • Sweating
  • Trouble breathing
  • Tight chest
  • Dizziness

Children with this phobia may cling to an adult, cry, or have tantrums when they’re offered medication.

How OCD can cause fear of taking medication

So, how can you tell the difference between a phobia and OCD? “With phobias, there are no compulsions, and the fear is likely not a bother when you aren’t taking medication, whereas OCD health concerns would be all of the time,” explains Dr. McGrath.

But let’s back up and look at exactly what OCD involves:

Obsessions are unwanted, intrusive thoughts, images, or fears that hold your mind captive. They cause a great deal of distress and can be all consuming. For example, you might find yourself preoccupied with worst-case scenarios and the worst possible side effects of a medication, no matter how rare they may be.

Compulsions are repetitive behaviors that you feel like you need to do to relieve the distress of your obsessions or prevent your fears from coming true. For instance, you might repeatedly ask for reassurance from your doctor or other people—friends, family—that the medication you’re taking is safe. Compulsions do provide temporary relief, but they actually reinforce in your mind that obsessions pose a threat that you need to combat with compulsions. 

Often, medication-related obsessions and compulsions are tied into a condition called health concern OCD. There are many types of OCD, but this one revolves around fears of contracting or spreading germs or disease. In a 2023 survey, over 25% of NOCD members with OCD reported having obsessions related to health or contamination.

With phobias, there are no compulsions, and the fear is likely not a bother when not taking pills, whereas OCD health concerns would extend into other times.

Dr. Patrick McGrath

How do I stop being scared of medication?

Ultimately, the only way to know for sure if you have a mental health condition is to talk to a professional. For example, if you’re worried about side effects, you can weigh the pros and cons with a qualified healthcare provider who’s knowledgeable about your health condition and the medication. 

If the benefits outweigh the risks of the medication, this might be enough for you to get comfortable. But if your fears persist, interfere with your daily functioning, or get in the way of your health, it may be best to contact a mental health professional, as well. 

Professional treatment for fear of taking medication

If it turns out that you have OCD or an anxiety disorder like pharmacophobia, treatment often includes exposure and response prevention (ERP) therapy, sometimes referred to more casually as “exposure therapy.” ERP is the gold standard treatment for OCD and is also a first-line treatment used for phobias, including pharmacophobia. In ERP, you learn effective ways to accept uncertainty and sit with your anxiety and discomfort in the face of your fears. 

Decades of clinical research have backed ERP’s effectiveness. It works like this: In ERP to treat phobias or OCD, you’re gradually and safely exposed to the thoughts and situations that are likely to trigger your fears. If you have OCD, your therapist will guide and support you on how to resist the urge to respond with compulsions. And don’t worry. Your therapist will usually start with lesser triggers to build confidence before progressing to bigger ones. In doing so, you’ll become more comfortable facing your fears. The process actually teaches your brain that there wasn’t anything to be worried about in the first place.

You may also undergo panic treatment, such as interoceptive ERP. This type of ERP triggers physical sensations that would generally make you anxious. For example, you might be asked to run in place to raise your heart rate. You may notice the pounding in your chest that it causes, but learn that it’s normal and no danger is involved. Interoceptive ERP will get you used to the sensations so they don’t bother you as much if they happen after you take your medication.  

It’s important to note that, if you have OCD, it’s vital to connect with a mental health professional who specializes in the condition. That’s because treatments that work for anxiety disorders and other mental health issues can sometimes make OCD worse, so you need a provider who’s familiar with the nuances of the condition. 

How specialized treatment can change your life

Dr. McGrath recalls a client with OCD who was preoccupied with fears that he might hurt people. In an effort to protect others, he isolated himself from the world, including his loved ones. 

Medication and OCD don’t always go hand in hand. In fact, many cases of OCD can be treated with ERP therapy alone. But this patient suffered from delusions that he would actually harm his family, which made him resistant to ERP for these fears. He started out reluctant to take medication, as well. After he did ERP for his fears of medication, he started taking an antipsychotic that cracked open the door to do ERP for his harm OCD. Over time, he was able to reconnect with his loved ones without being plagued with anxiety that he would harm them.

The idea of taking medication might trigger a lot of fears and anxieties. But the reality is, sometimes it’s the best—or even the only—way to get your life back from health issues. You can manage these fears and reach a point where you can take the medications you need when you need them.

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