Abstract It is well established in the literature that people are active decision makers in relation to help seeking and medicine taking. This paper uses data from two qualitative studies that focused on mood-modifying medicines to illustrate how active engagement, demonstrated through help seeking and decisions about treatment, was perceived to be a crucial part of recovery. Data were generated from semi-structured interviews with 23 men and women in the UK and 12 women in Denmark. We argue that being active in decisions relating to help seeking and medicine taking for problems with mood is perceived as central in order to (re)find an ‘authentic’ sense of self. There is, however, an inherent contradiction in the fact that the majority of the respondents believed medicine taking to be necessary, yet the act of taking a mood-modifying medicine was in most cases perceived as a potential threat to agency and ultimately the achievement of an authentic self.