by Monica Ross
I’m going to navigate to a topic that is really such a sensitive one for so many reasons. And I’m going to try to treat it as delicately as I can. While I’ve written in the past about the medical model approach to psychology and have given it some criticism I wouldn’t want for my readership to assume then that I am anti-medication.
It is not my job to decide for others what to and not to take prescription-wise. I am not a psychiatrist. I was once called to court to testify and on cross examination was asked, "In your opinion should your client be on medication for the rest of their lives?"
First of all, as I said, I'm not a psychiatrist. Second, how can I possibly answer a question like that even if I were a psychiatrist? When working with clients, I point out a range of possibilities in terms of symptom management but ultimately it is up to them to discover what they believe to be the right choice of treatment for their own health.
For some that means taking Zoloft and Xanax and for others it means taking whatever natural remedies are available to them like St. John's Wort and Rescue Remedy. For some, it means taking both. It’s a very personal decision, as personal as choosing whether or not to take birth control or undergo chemotherapy and radiation treatments in the case of cancer.
I have known people who have started out on mental health medication and have been on it their whole lives. I have also known people who have never been on mental health medication who only start to take it in their 70s or 80s. And then there are those who have never been on mental health medication and never will.
Some people in this profession take a hard and fast stance on the topic. At this time, I do not. There are those in behavioral health who rail against the prescription and over prescription of drugs. A well known example is William Glassner, the founder of Reality Therapy, a psychiatrist himself he wrote a book called Warning: Psychiatry Can Be Hazardous to Your Mental Health.
There is also a non profit organization called The Icarus Project that has published a free resource for those choosing to ween off of psychiatric medication recognizing that there is no single solution for every person. The Icarus Project emphasizes the harm reduction model and offers support in people’s decision making process.
Just to balance this post out there are also those who emphasize the importance of taking medication exactly as prescribed. The U.S. Food and Drug Administration lists this on their website a section called “The High Cost of Not Taking Medication as Prescribed.” There are those clients who have been successful in weening off of medication and there are those clients who tell me that every time they have tried to ween off of medication they have faced adverse affects.
I have heard some psychiatrists tell their patients, "If a person has diabetes would you tell them not to take insulin?" They say that medication for mental health is one and the same—it is about taking medication to treat a nascent illness. In other words, mental illness is caused by biology, by chemical imbalances and the like--just like any physical illness.
There is another theory out there called the neurogenesis theory and when I was working at an MHMR clinic in deep east Texas I often told my clients about this theory, as well. According to the neurogenesis theory, taking mental health medication in some instances can actually lead to the regrowth and regeneration of cells in the hippocampus where, like in cases of major depression, their is a deterioration of cells.
This video called "The Science of Depression" talks a bit about that theory. But later in 2016 this article came out criticizing this theory somewhat stating that if neurogenesis in fact does take place, it takes place at such low rates in humans as to render it statistically insignificant. Argh.
Some argue that mental illness is more complex than reducing it to simply biology. These resources here are offered to assist in the decision making process but as you will see there are people on polar opposites of the camp. With many health care professionals you will find an attempt at a balanced approach that acknowledges both sides of the argument.
Psychiatrists might start their patients on low doses and suggest psychotherapy as an adjunct to treatment. What sometimes happens is that the lower dosages slowly increase and patients find themselves on not only higher and higher dosages, but a multiplicity of medications. This is just something that I have observed.
Again, it’s about personal choice. In a place like Austin with a culture that promotes alternative therapies and treatments and leans more on hippie tendencies and all that comes with that--like shirking the pharmaceutical establishment, there is at times more pressure for those who choose to take mental health meds. Some therefore feel that it is something to be hidden, a form of weakness, or of giving in to the establishment.
This aggravates me a bit. It makes me think of moments when I've had to hide my Starbucks purchase or admit to forgetting to bring my own cloth bag to the grocery store in an effort to save the environment only this time we're talking about healthcare and what people decide to do with their bodies.
Again, it comes down to personal choice. But choice needs to be an informed one that ultimately is led by self-determination. I will say that the people making these decisions about their health and whether or not to take medication or not deserve all the respect and support that they can get because it is not an easy decision to make for some.
There are pros and cons to taking psychiatric drugs with some experiencing symptom relief while others complain of the negative effects like reduced sex drive, or foggy brained-ness, or numbness of feelings. Some claim that medication has saved their life and that they are able now to get up and function where there was no functioning before.
With statements like these I find it hard to be insensitive on the matter, especially when people are talking about symptoms that for some that are very debilitating. So first and foremost I think it's about respect for people's ability to make decisions about their own healthcare.