In my last article I talked about making a resolution for good mental health in 2008 and I listed what good mental health is. To summarize, good mental health is comfort and well-being in one's thoughts or emotions and the absence of a mental disorder. But in the case when there is the absence of comfort and a mental disorder is likely, medication may be your first and best approach to treatment. Now mind you, I am a clinical psychologist. I am not a psychiatrist, a physician who specializes in mental illnesses and neurological disorders and who prescribes medication (though New Mexico is one of the few states that permit psychologists to be credentialed to prescribe medication).
But I often refer clients to psychiatrists for medication if I believe their emotional state or mental illness 1) threatens their life or the life of someone else, 2) prevents them from engaging in necessary activities of daily living, or 3) has long-term consequences that can severely impair physical or cognitive (thought) functioning. Illnesses that can meet these criteria include Major Depression with suicidality or homicidality, severe Anxiety Disorders such as Post-Traumatic Stress Disorder or Obsessive/Compulsive Disorder, and Bipolar Disorder and Thought (psychotic) Disorders.
Many people are wary of medications prescribed for mental illnesses because they think that they will have to be on them forever. The truth is that most people given medications for mental illness are on them for only a few years, though the data about average duration of treatment is difficult to find. Medication is typically prescribed to pull people away from the edge, to buy them time to do therapy and make changes in their life before they self-destruct. This means that the need for medication is typically temporary.
Second, people may believe that such medications can actually make you crazy. This is a concern about side effects. It's important to know that all medications have side effects. But there are some medications that require monitoring because they are hard on some organs and can cause toxicity in the body. These medications are usually prescribed for more serious illnesses and can still be valuable because they permit the person to lead a more normal life. Research and development in the pharmaceutical industry resulted in many newer medications that are selective in their functioning, meaning they act on very specific receptors in the brain rather than on a broad spectrum of receptors, thereby decreasing the likelihood of undesirable side-effects. A few years ago there was controversy in the media about Prozac "causing" people to commit suicide and recent warnings against prescribing certain medications to adolescents and children for the same reason.
I think caution should always be used. But we must also remember that many people who are severely depressed and suicidal lack the energy to actually harm themselves but may finally do so when medication improves their energies. It's not that medication makes people suicide; it's that medication improves clarity and energy permitting determined people to finally take the long-desired action to end their life. Biological improvement without psychological improvement is not recommended. That's why medication in combination with psychotherapy is necessary!
Third, there's often fear that psychotropic medications are addicting. Some are, particularly Benzodiazepines used to treat Anxiety and Sleep Disorders. But most psychotropic medications are not addicting and can be discontinued rather easily. Again, psychotherapy is a recommended approach and compliance with the medication treatment regimen can prevent developing a dependence on medication.
Finally, there's the stigma; the concern that being on medication to correct an illness means something far worse than the illness itself. Think instead about the possibility of feeling better, having a better life, and the people around you appreciating you far more if you correct the problem moods and behaviors they've had to deal with.
Did you know there are about a quadrillion synapses in the human brain? Can you believe it?! More neural connections than there are stars in the entire known universe. Frankly, it is arrogant of human beings to think that a human brain will always be put together correctly, be functioning adequately, and never need fixing or a tune-up. The average care has, what? 500 parts? And how many of our cars have ever malfunctioned? We need to be open to the idea that sometimes our brain is not functioning well, not in our best interest and needs a tune-up. Thankfully, most of it we can do on our own or with the help of a therapist. Sometimes it requires greater intervention, even medication.