Why Consider Seeing a Psychiatrist and Taking Medication?

Why consider seeing a psychiatrist and taking medication?

Let me be clear: I will not serve as a shill for the pharmaceutical industry. Indeed, I strongly agree with the psychiatrist blogger who said: “Psychopharmacology without therapy is like treating an infection with Tylenol”. We clearly agree that medications do not cure a “psychiatric disease” and that psychiatrists are “not even sure what the disease actually is”.  

            So why take a medication then? One might take them because medications reduce symptoms. Symptom reduction can give you an opportunity to look at your situation without feeling overwhelmed with symptoms; allowing space, time and energy for understanding and learning a new point of view and new more helpful behaviors.  This is usually when I suggest that a client seek a psychiatric assessment and considers taking medications. 

            For instance, treating depression with an antidepressant is not the solution. But consider, one prominent symptom of depression involves a feeling of having lost or not having enough energy. Other symptoms include a lack of concentration, sleep, and self-care, and any of these can make new learning more difficult than it needs to be. The correct medication(s) can help with these while you figure out how to handle depression in the long run.

            Change almost always requires learning new ways of interpreting and coping with one’s environment. According to Acceptance & Commitment Therapy (ACT) depression can involve, amongst other problems, a lack or loss of both a focus on what life-directions one regards as important and the commitment to pursue those valued directions despite those discomforts which we often regard as uncomfortable symptoms of depression.   This may not represent the entire story for all depressive symptoms. Bipolar disorders in particular appear to have a strong biological component with symptoms that result from biology or chemical imbalance, and may require ongoing medication and special care regarding sleep, schedules, exercise, diet and stress.

Does that mean that medications are always required? There is evidence that changing behavior can lead to changes in brain chemistry similar to those linked to taking medications, so in the long run medications are not always required for a lifetime. And even when ongoing medication is necessary, as in the case of bipolar disorder, medication without other support is a bad choice.

            Of course the choice of whether or not to even consider taking medications temporarily is ultimately yours, but well informed consideration may prove more helpful than blind prejudice. For this reason I have written this little essay inviting you to weigh out the pros and cons of your decision, and to honestly discuss the decision with the people in one’s life who know who your moods and behavior impact your life as well as a qualified professional.

The New TLC: Therapeutic Lifestyle Changes

Therapeutic Lifestyle Changes (TLC)

Want to reduce feelings of depression and anxiety, increase feelings of well-being and preserve and optimize your cognitive functioning, using methods which are safe and proven? Here are some things you can do today and from now on that can lead to the emotional life you’d prefer. Few people choose to do them all, but each one you adopt can help.

1. Exercise – Assuming you have no medical contraindications, exercise not only improves your physical health, but it also your mental health. To get the maximum cognitive and antidepressant gains exercise duration should be at least 30 minutes of strenuous activity preferably combining strength training with aerobics. Not sure what all that means – discuss it with your therapist or get on the web.

2. Nutrition, Diet and Supplements – Become a pescotarian! The healthiest eating includes a “rainbow diet” of mainly multicolored fruits and vegetables, some fish of the cold-deep-seawater variety which are high in omega-3 oils like salmon and low in mercury (so avoid shark, swordfish, king mackerel and tilefish), and reduce excessive calories. The “pescovegetarian diet” is naturally low in calories. Omega-3 fish oil has been found the best supported supplement for neurological (brain) health (and also note: Avoid omega-6 which undoes the good from omega-3’s and is found in the corn sweeteners so over used in processed foods). Consider as well Vitamin D for brain health.

3. Time in Nature – has no down side, and has been documented to promote improved cognitive functioning and a sense of well-being, and perhaps it may counter excessive immersion in media (screen time) and other versions of hyper-reality.

4. Supportive Relationships – of all sorts: intimate, family, friends, and others who can act with kindness, compassion and empathy. Humans evolved as social creatures, hardwired for empathy and contact. But supportive relationships don’t often just happen. Like everything on this list, it requires taking action, saying yes to invitations, seeking out common interests, joining and even starting groups, letting people know that you are interested, and learning to be a present and interested listener.

5. Recreational activities – may overlap with all of the forgoing as we exercise, eat, and romp through nature, perhaps with other people or alone. Enjoyable activities may include both physical engagement, like sports, both competitive and individual, or engagement in games, hobbies, the arts (music, dance, painting, theater, poetry, reading, writing, and etcetera) and humor in all its forms.

6. Relaxation and Stress Management Skills – may include some special practices like yoga or relaxation exercises, but most especially the regular practice of meditation. Meditation can mean setting aside time to “let go of” or just sit with, whatever is being experienced, anchoring oneself in the present moment, perhaps using the breath as an anchor, deliberately observing the breath while one’s thoughts, feelings and sensations come and go, with an attitude of patience, compassion and curiosity, and without trying to hold on to or push away any of these internal private experiences. Some see these as spiritual or religious, or find them embedded within such a context, but a secular meditative practice need not include any such trappings.

7. Altruism – contributing and serving others freely, voluntarily, without expectation of a return, “fosters qualities that serve the giver”. Engaging in altruistic behavior, like all of these therapeutic lifestyle changes, shows enlightened self-interest.

“If you are going to be selfish, be wisely selfish – which means to love and serve others, since love and service to others brings rewards to oneself that otherwise would be unachievable” – The Dalai Lama

The extensive research supporting TLC is summarized in “Lifestyle and Mental Health” by Roger Walsh (American Psychologist, Oct. 2011, pp. 579-592)*. This brief and necessarily incomplete summary of that article reflects the preferences of this author,

Dr. Henry Steinberger, and may not include some items which Dr. Walsh might have given greater coverage or emphasis.

* http://www.drrogerwalsh.com/wp-content/uploads/2011/04/Lifestyle-Mental-Health-Advanced-Publication-PDF.pdf

Blogger: Why I Sometimes Suggest a Client Consider Taking Medications - All posts

Blogger: Henry Steinberger, PhD: Help with Addictions and Emotions - All posts

Why consider seeing a psychiatrist and taking medication?

Let me be clear: I am not a shill for the pharmaceutical industry. Indeed, I strongly agree with the psychiatrist blogger who said: “Psychopharmacology without therapy is like treating an infection with Tylenol”.  We clearly agree that medications do not cure a “psychiatric disease” and that psychiatrists are “not even sure what the disease actually is”.  

            So why take a medication then? When clients first see me I find that somes have chosen me as a psychologist because they know that a psychologist can't prescribe psychiatric medications and might even share their bias against the use of drugs.  Such clients may even start out saying: I don't want to take any drugs. And they often have very clear and understandable reasons for this a priori decision. As I see it, there is usually no need for medications and so no need to argue over this. But when it becomes clear that medications might be useful or even necessary, then I must answer this question if we are to move forward towards a successful outcome.

     The whole point of taking medications is symptom reduction. Reduced symptoms or a respite from their intensity can give my client an opportunity to look at their situation without feeling overwhelmed with symptoms; allowing space, time and energy for understanding and learning a new point of view and new more helpful behaviors.  In my book that’s the point of medications. 

            For instance, treating depression with an antidepressant is not the solution. But consider, one prominent symptom of depression involves a feeling of having lost or not having enough energy. Other symptoms include a lack of concentration, sleep, and self-care, and any of these can make new learning more difficult than it needs to be. The correct medication(s) can help with these while you figure out how to handle depression in the long run.

            Change almost always requires learning new ways of interpreting and coping with one’s environment. According to Acceptance & Commitment Therapy (ACT) depression can involve, amongst other problems, both a lack or loss of focus on what life-directions one regards as important and the commitment to pursue those valued directions despite those discomforts which we often regard as uncomfortable symptoms of depression.

            This may not hold true for all depressive symptoms. Bipolar disorders appear to have a strong biological component with symptoms that result from biology or chemical imbalance. A lifetime commitment to taking medications may result in a significantly better life as I've seen repeatedly in my years of practice.

    Does that mean that medications are always required? There is evidence that changing behavior can lead to changes in brain chemistry similar to those linked to taking medications, so in the long run medications are not always required for a lifetime. And even when ongoing medication is necessary, as in the case of bipolar disorder, medication without other support is a bad choice.

            Of course the choice of whether or not to even consider taking medications temporarily is ultimately yours, but well informed consideration may prove more helpful than blind prejudice. For this reason I have written this little essay inviting you to weigh out the pros and cons of your decision, and to honestly discuss the decision with the people in one’s life who know who your moods and behavior impact your life as well as a qualified professional.