Clients frequently ask me what I think about psychotropic medications; whether they should take it; what kind would I recommend, etc. So I thought I’d give this question a few words here.
Foremost, this is what I’d like you to remember about me and medication.
I am a Marriage and Family Therapist. I am not a doctor. I have no medical training. I do not prescribe medications. It is out of my scope of practice (as legally defined) and competence (as by experience or training) to advise you on whether to take medication and what kind. If you are interested in taking meds please consult your psychiatrist and make informed choices.
Why to See a Psychiatrist for Meds as Opposed to a PCP?
It is my understanding that most psychotropic/psychoactive medications are prescribed by PCPs (Primary Care Physicians) who usually do not have enough training in the specialty field of mental health. They know a little bit about everything to make a diagnosis and refer you to a specialist, but have little deeper insight in specific areas. That is why I would recommend you to speak to a psychiatrist who is a specialty doctor in mental health issues.
A psychiatrist is a specialist in mental health the way a pediatrician is a specialist in treating children, or a cardiologist would have a more thorough understanding of the matters of the heart than let’s say, an orthopedics (specialist in bones and joints issues).
A Psychotherapist’s Relation to Medication
My personal opinion is not a medical advice and is out for debate. But for what it’s worth, here it is.
A supervisor of mine once advised me that the clients have to be in the room for me to help them. This to me means that if only their bodies are present and their minds are on another planet, I cannot do much good. Therapy is based on two minds connecting and simultaneously self-regulating in a safe place. The chance for such connection is minimal if the client has no capacity to tune in to another person’s communication. It is like having a wonderful radio broadcast but no receiver (radio) to translate the signals and help benefit from the broadcast.
When someone is very depressed, freakishly anxious, hallucinates, thinks in delusions to the extent that it interferes with their everyday living (fear is super high), or is even in a limbo state between living and dying (feeling suicidal) they tend to be too self-centered (defending their own perspectives for their dear life) to be able to connect with another person, learn from them, and change their behavior with the information received. When fear is too high, the instinct to self-preservation takes precedence to learning new ways of living. (Learning, by the way, is a high-stress activity that works best when a person can keep other stresses down.)
To chisel off the sharp edges of the intensity of the feelings, the right medication from a trusted medical specialist (psychiatrist) may be a good idea to consider. Once able to tune-in, the person is able to benefit from behavioral interventions, which certainly take some time and practice to be useful.
At times, people decide to take meds for their own peace of mind and they work with their doctors to get there. They say that they feel better with the medication. Relying on something other than themselves puts them in a relaxed state of mind, which is winning half the battle, given that the trigger for mental health disorders is stress (feeling overwhelmed by life, or the perception that “I-can’t-do-it-alone”).
Communicate with Your Psychiatrist and Make Informed Choices
It’s good to know that medications have “personality profiles” of their own, just like the patients do, and what works for me may not work for you for the same “illness”. A good psychiatrist will know that and will work with you to figure out the right meds and the right dosage (dosage = how much & how often).
You have to provide feedback to your doc, however. They can’t read minds and they have no X Ray vision. Their medical training allows them to know the meds but not to know you. You have to share your concerns with them. No, they won’t get mad for that. If they do, they are not the right doctors for you. You have to find someone who works with you and does not want you to blindly trust their “insights”. It is your life and your body that you are dealing with and you have the last word in what you bring in to them. Consider pros and cons of each and every option before you give that last word.
Do Medications Cure Mental Health Disorders?
There are many opinions out there for this questions. Personally, I don’t believe they do for the most part. Whatever the chemical makeup of our brain is (arguably defined by genes), successful behavioral adaptation to our environment is the key to mental health. This means that each of us have to find the set of useful actions and a winning narrative to support those actions (together they are “coping skills”), in order to live “happily” (with the least amount of friction) in connection to other people around us. The social milieu constitutes the primary environment for human beings. Succeeding here takes skills. Skills are created by people, not by medication.
I believe that we, humans, are hopelessly and inevitably, social beings. Countless research shows, to the extent that we now accept it as a fact, that we are hardwired to attach to other people. From the moment we are born our mental radar is out to find the signals of friendly people to depend on, to feel safe with, who can help us co-regulate our raw emotions. This is true even for the most-isolates amongst us. Rarely do we find a person who does not have at least an animal companion to relate to. To live a sustainable life, we need to learn to negotiate between our need to depend on others and our need to stand alone and be independent of them.
In the movie Cast Away, the man felt compelled to create a human face out of a volleyball in order to avoid going completely nuts in his isolation. He needed to relate to another “creature” who even slightly reminded him of a fellow of his kind in order to make it for another day.
“Chemical imbalance” in the brain is a bad excuse for not developing this crucial aspect of our lives: healthy coping skills. Medication may change your brain chemically (arguably) but it won’t change your behavior. You change your behavior. We have to make the right choices to successfully coexist and even collaborate with other people in a way that is sustainable in terms of mutual satisfaction. Medications may smooth out the sharp edges of strong feelings that may interfere with seeing situations clearly and developing the most effective approaches but meds don’t replace coping skills. Good coping skills are indispensable to living “happily ever after” and and they come from learning to make the right choices.
The right choices come from analysing and understanding our environment then developing, testing and modifying our responses to it to maximize benefits. Medication won’t give you that apart from bringing your feelings down to manageable levels.
In fact, distress feelings are your body’s signals that something is not safe and not ideal for your living. I recommend that you go after the cause of your distress and change it instead of tuning down the danger signs, if you are to live an integrated and meaningful life.
How Can Psychotherapy Contribute to Mental Healing?
Psychotherapy is a place where you can re-evaluate what you are bringing into this cosmic game of the human society. Here you can learn the missing skills to de-personalize the world (learn to read the signs and use the information wisely but not to take them personally) and build supportive relationships. You can discuss and evaluate pros and cons of taking or not taking your meds. After that you make your choices whether to take your controlled meds in controlled ways if you need to instead of getting hooked on uncontrolled “meds” that can kill you in an instance. Then go on your merry ways to shine as a new star in our universe and share your personal blessings with the rest of us. We all have a gift for this world. I believe that neither a god nor nature would send us here empty-handed.
That is my concept of therapy and its relationship to medication. I hope some of this information makes sense to you. Consider the ideas and spit out the information that you don’t find fit for you. Not all of this is good for you or fit your needs. Continue searching for other opinions as well for there are many, to make the best possible choice for you.
Drop me a line and let me know what you think.
