Most people don’t particularly like having to take medicine—doctors included.

People not taking their meds regularly is one of the biggest issues any doctor has to deal with. And there are all kinds of reasons why. For many, it’s the very act of taking medicine at all: having to add a new routine to their days. For others, it’s that medication makes them feel somehow weaker, like they need some stupid tablets just to do what others do without thinking. If you’re in a country like Nigeria, it might be that it costs too much to keep taking it.

But perhaps the biggest reason of them all is side effects.

I hear it all the time. They report that the drug made them gain weight, made them lose their sexual drive, made them constipated, made them sleep too much. And those are just the “milder” side effects.

So they stop, and if we’re lucky, they let us doctors know. Often they just stop and you don’t see them again until, say, there’s a relapse of the disease.

And that’s precisely the problem.

See, the side effects problem is really a trade-off problem.

Life is all about trade-offs, what economists would call opportunity costs:

For every single thing we take, we are always giving something up. And that’s happening whether we realise or acknowledge or like it or not. For every opportunity we take, there’s another we’re giving up: the opportunity cost.

Just reading this essay means you’re not reading something else—or, I dunno, watching Ted Lasso. Wherever you are now means you’re giving up being somewhere else. The fact that you’re awake at all means you’re giving up sleep. You get the idea.

The fact is, many people (me included, believe it or not!) aren’t exactly keen to visit doctors, we won’t hesitate once we feel convinced that an illness is a far bigger disruption to our lives: we choose the disruption of a hospital visit for the possibility of being free of the disruption of illness. Soon as we feel a little better our dislike wins again, and we do the trade-off again, but in reverse.

But…

Trade-offs raise 2 problems

The best deal problem

The obvious one is that with every trade-off, we run the risk of trading off the wrong thing. It’s why a friend of mine was excited about finding the Mr Men series of books at a charity shop for about 10% of their retail price. She had “got a good deal”: traded off money for something far better in value to her. (Of course, people who buy luxury goods feel the same way about what they get in value for what they pay.)

In short, we can think of the trade-offs we make, as making a deal, a bargain with reality. We give something up in return for something else, immediately or later. And every day we’re making these micro-transactions with reality, trying to figure out the best deal for ourselves…

Or we tie ourselves up in knots about taking a bad deal.

That anxiety is why some people put off decisions and procrastinate: instead of taking a deal, they analyse it to death or simply don’t deal. The problem with that, of course, is a trade-off will happen anyway, and not necessarily in their favour.

But there’s a more insidious issue with trade-offs.

The wrong deal problem

This is when we fail to realise what the trade-off actually is. It’s the kind of trade-off conmen hoodwink you into making: you think you’re trading off a bit of money for something valuable, only to realise after the fact that you’ve actually traded off a lot of money, for…well, nothing. This is also the trade-off problem that happens with clickbait: you trade off a bit of your attention for what looks like an interesting article or YouTube video, but find it wasn’t worth it. It’s also the trade-off problem that’s often happening with patients and side effects.

Basically, people are choosing what to trade off, but don’t realise they’re looking at the wrong trade-off.

WIth side effects, the people I see are typically considering it as trading off between side effects versus no side effects. It’s like, if I stop this medicine, the side effects will stop. Usually, this is when the disease has got better enough that it no longer feels like it’s in play.

Except it very much is, still. In long-term health conditions, which includes most mental disorders, the presence of the condition is often a lifelong fact—or at least, consideration. For the ones that require long-term or lifelong meds, to simply stop the meds is to run the risk of a relapse, with all the attendant ill-health.

And that right there is the real trade-off: side effects versus relapse.

That’s an entirely different deal to consider, isn’t it? Because let’s face it, however much you don’t like medicine, you almost certainly like being sick far less.

So while, you’re free to do as you please—it’s your body after all, and your health and your life, and you alone know what matters to you—it’s what asking if you are clear what you’re trading off?

That’s a good question because it can sometimes spotlight an opportunity in trade-off that we sometimes miss.

The hidden opportunity in trade-offs

I said earlier that all decision-making is a bit like looking for the best bargain at the stock exchange of reality. But…

Have you ever got a bad bargain because you thought, misguidedly, you could get only one of two options?

Because, what if you don’t have to trade off?

Who says you have to choose between being quick and being thorough? Who says you can’t deliver excellence at a low price? Who says you can’t be both gentle and firm? Who says you have to sacrifice being human to be professional? Or— as I had to challenge myself on when I started publishing regularly—who says you have to give up quality because you’re producing your art in quantity?

Why choose when you can have both (or more)?

To be clear, it’s not always possible. Maybe it’s not even often possible. But that’s only makes it that much more valuable when it’s possible. But to recognise those exceptions, you need to be thinking in terms of trade-offs and getting yourself a smashing deal.

What life-deals are you taking now that could use a second look?

Published by Doc Ayomide

I’m a medical doctor with specialty training in psychiatry, and I love thinking and writing about what it means to be human.

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2 Comments

  1. What to trade off is an ailment which can be possible by regular intake of drugs.As long
    as we eat food daily,taking drugs on a daily basis shouldn’t be a burden. This is a big truth for all who cares about their health/lives.

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