Why Therapy?

True about blanket statements. Yes SSRIs are not schedule drugs like Ritalin and Adderall, but they are also not medicine in any way that would fit most people's conception. To my knowledge biochemical causes of depression have never been established, so anyone who purports to "treat" depression in this way is bending reality.

Modern medicine seems to be fanatically dependent on lab testing to quantify health, and yet oddly for mental disorders there are no such tests or objective measures. But somehow docs and patients alike overlook this in the case of psych drugs.

I'd say the number of people using psych drugs is more indicative of how pervasive these drugs are in our culture, the incredible success of pharma marketing and propaganda and lobbying, and how little critical analysis there is, rather than evidence for their effectiveness or legitimacy.

hero. you.

"And what about lifestyle? It is a know fact that half the people who smoke tobacco have mental health issues. It is just taken for granted that well, smoking is a stress reducer so let's be slack about it. It's taken for granted that oh well, people with mental health issues just need to smoke."

This is changing, however. More attention is being paid to this as an overall treatment issue and smoking often reduces the efficacy of medications and creates other problems (most which are well known). I think we agree more than disagree, but my observation is that many individuals with mental health issues struggle to the extent that being disciplined about lifestyle changes seems overwhelming, at least at the outset of treatment/recovery. The promise of meds is often having your cake and eating it too; feeling better without making any fundamental changes whereas most psychiatrists that I've worked with believe that therapy and/or lifestyle changes should go along with meds. We do what we can, pick out battles and try to make it as safe as possible for people to get help.

Well said. Apparently they haven't even established that low serotonin correlates consistently with depression. Example:
"I spent the first several years of my career doing full-time research on brain serotonin metabolism, but i never saw any convincing evidence that any psychiatric disorder, including depression, results from a deficiency of brain serotonin". -- Stanford Psychiatrist David Burns, 2003

Also as someone said, the idea that mental disorders can be reduced to simple chemical imbalances is a "cartoon version of reality". Is there a worldwide epidemic of serotonin deficiency?

Re: bipolar illness, have read there is a very strong correlation between the dramatic rise in SSRI use and the explosion of bipolar. In Robert Whitaker's "Anatomy of an Epidemic" he graphs this and the two curves are in lockstep. Evidently exposure to SSRIs is a significant risk factor for developing bipolar in the opinion of some experts.

Wow. I never heard of this. But when I took the SSRI back in August for a few weeks I didn't sleep AT ALL for 3 nights in a row, and felt like I was starting to hallucinate. I had to contact my doctor's office several times, almost screeching, before I was given a few pills for sleep. ChipperMonkey also said that if one takes an SSRI without the need for it, then, of course, that is going to mess with brain chemistry (serotonin) in a bad way. I feel like this happened to me. In other words, if I didn't take my medical care into my own hands I could be writing this down the line a couple of months as someone truly messed up not only from mental health issues, but from being improperly medicated. I feel so grateful today to be doing a holistic path, and grateful for the support I have gotten from this site to continue doing so. I am beginning to realize there is a lot I can do to help myself, with various workbooks, lifestyle changes, diet, sleep hygiene etc. It takes a lot of work but I am sure in time it will simply become habit. I am already feeling empowered. Thank you for this information. I have been reading a lot but this one slipped by me...

One of the main points in the above referenced book is that nearly all (or is it all?) psych drugs work by perturbing brain chemistry. That is how they have any effect at all, good or bad. The PR spin on this has resulted in the common misconception that the reverse is going on -- brain chemistry is being "fixed" by the drugs.

Absolutely - well said.

The issue of meds is a difficult one for me. I don't believe my problems are clinical. I can't wrap my mind around that. I feel convinced my problems are existential, related to trauma, related to a poor moral character, due to lack of exercise and poor life choices--related to anything other than some medical condition that has nothing to do with me as a person. I think that whole "chemical imbalance" thing is BS. I wasn't tested for some chemical imbalance when I came to the doctor, so why would I be given something to treat it? It seems like a lot of nonsense and guesswork that tries to stuff the fact that life is hard into a pharmaceutical framework.

But if all of that is true, why does everything go to **** when I stop taking my pills?

Be careful questioning the role of medication. In my experience, anyway, if it's prescribed to you, you should probably just ****ing take it.

Be careful and do not fail to question every single aspect of healing, including medication.

There is no conclusive test for "chemical imbalances", but there is plenty of clinical evidence that psychiatrists rely on and they have to go on how their patients respond. See eden1515's posts for an illustration of someone's struggles with medications.

I think most doctors would love it if their patients ate healthily, stopped smoking (as well as moderate or stop drinking alcohol or using other substances), exercised regularly, and left toxic work situations or relationships. Unfortunately, that isn't happening to the extent that it probably should, so patients often request meds to help them.

I quit smoking (10 months today) and I am working on diet, and exercise. I have rid my life of toxic relationships. I don't drink much. I have managed to restore my sleep without medication. Now I am going to add exercise. I guess these are all good and I am starting to stabilize, but it is very slow going. I wanted the quick fix of medication, but medications are rarely a quick fix. I have noticed a reduction in my depression and anxiety, but it is pretty subjective. I still need a more secure place to live, a good job, a few good friends. There is still a lot missing. I don't have a therapist. A good one might be helpful but that is rare and I don't have the energy to look for one. I don't yet know if lifestyle changes are enough to eliminate depression and anxiety. The problem with medications for me was that the side effects made everything much, much, much worse. And what is the point of that? It's cruel. It's very cruel.

I admire your discipline and tenacity in sticking with your program. I wish I could bottle it up and give it to others who are stuck!

Regular exercise makes a very big difference in my general mood. I think even low-key stuff like walking can help a lot. Good luck with it.

Personally I have never wanted to take medication, because I think my depression is a result of where I am in my life and my ineffective ways of dealing with that, and those are not things medication would change even if it made me feel a bit better. So, therapy.

Well... for one thing psych med's are cheaper. Probably close to 20 years ago now, when I was first becoming involved with the mental health system, I was referred to a "behavioral health" clinic operated by my health maintenance organization (HMO). I was being seen by a nurse practitioner who prescribed one useless psych med, or combination thereof, after another.

I also wanted to see a therapist, of which they had several right there on staff. However, they fought me "tooth-&-nail". They were determined I was not going to see one of their therapists. Ultimately, I won out & was able to see one. But, in the end, it turned out they were right to try to not arrange it. He was beyond worthless... I can't say that my experiences since then have been especially better...

It depends on the illness and its severity. Psychotherapy as a default treatment option is helpful for a lot of illnesses, but not all, especially psychotic disorders.

Therapy as a first option would have been inappropriate when I was very ill, because it would not have helped the disordered thinking I was experiencing. My mind has to be clear and in this reality for psychotherapy to be effective. This was impossible when I went through two periods of major mental illness. Medication brought me back to reality. After that I was able to indulge in talk therapy.

I am stubborn, but in this instance I think I just had to let go of the idea that anyone outside me could help me. In the past six months I reached out to friends, family, and medical professionals. I finally found my way to Psych Central and here is where so many of my questions about medication and therapy were answered, and I decided to embrace the holistic path. As I said, I don't know if this is the answer, but I feel more stable now than I did on various medications. So this was a major discovery. Discipline or desperation? I think a little of both.

One hope I have is that doing lifestyle changes will offer some protection against being victimized by the system. I am very unhappy with the inferior care offered by the health care system my crummy cheap new insurance plan has led me to -- and I was truly shocked when a nurse practitioner tried to prescribe a medication that I already told the doctor I did not want. I didn't even know the nurse practitioners were allowed to do this. I refused "therapy" because it was with a "counselor" of which we have literally thousands in the town where I live, half of them suspect. I allowed myself to become vulnerable. I also realized that previously I paid more for health care and got superior care. Now I am in a position where self-care is not only preferred, but pivotal.

I feel regular exercise is a good thing - I took up cycling for exercise but really enjoyed it and it turned into a hobby. I also take 5 htp rather than medication and it works well , along with mindfulness.

I cant reconcile your first paragraph, which makes sense to me, with your last one. Why not question medication, if the basis for it is BS?

As for why does everything go to shite when you stop, sounds like withdrawal syndrome. When you stop the drug, the compensatory mechanism that the brain initiated to try to counteract the effects of the drug runs unopposed. It's like the drug is a foot on the gas pedal. The brain then applies the brake in response. Take the drug away and now you have the brake applied and no foot on the gas. Hence, symptoms return and new symptoms and conditions appear in some cases. Creates a trap. And also the illusion of relapse, when in fact it might be withdrawal. That's what I read, don't quote me on this.

I shouldn't have even posted that, it was just my knee-jerk reaction whenever I see people talk about psych meds being BS because I can't personally reconcile the sentiments of the first and second paragraphs, either.

Yeah, withdrawal syndrome, foot off the gas, illusion of relapse, etc. etc. That's what I told myself, too, in between shopping for firearms and writing logical proofs in mascara on the walls of my shower.

What I learned?

p ---> q ---> Take your ****ing Pills.

In short, this is just my personal frustration bleeding into the forum. Sorry. Question away!

I think your input is valuable. This has been a long thread with much debate which makes for stimulating questions. Maybe you are trying to communicate that although treatment is not always the best, sometimes it is the only option. From what people have been saying I believe that perhaps medication is not always the best option for depression or anxiety. As far as having psychotic episodes or severe bipolar symptoms, that would be a different story, I think. If medications are administered than management needs to be improved. Your questions about how you feel after going off of medications should be addressed by those who are in charge of your medical care. It is your right to know about side effects and cessation symptoms. It is your right to have a say in the dosage so that you can reduce symptoms while not suffering unnecessarily severe side effects. Please know your voice is as important here as everyone else's voice, I hope all of us can agree to respectfully disagree, if that is how we feel.

Thank you, DD. That was diplomatically put. I was fortunate to find a pretty decent care team at a local community health clinic, and am really sorry you haven't had a positive experience with the system. I admire your commitment to a more holistic path--in fact, I think I envy it to the point of being defensive. Good thread.

Argon - I think I did suffer lousy care but it pointed me in a new direction. I am on a learning curve. I am also a little intense because I need to work, and I need to be functional, as I am on my own. Having good mental health care would make all the difference in the world for me, but I suppose a lot of us are frustrated with not being able to get the help we need, and that's why we are on this forum. A lot of us are bleeding all over the place, and I need to always remember that. Please pass me the band aids. Not kidding. I am always frustrated and I just want to feel better all the time instead of just some of the time.

I think part of the problem is that the entrenched therapy+meds thinking misses so much.

Example -- As a result of chronic Lyme disease and high toxin load, I have sensitivity to man-made EMFs (electro magnetic fields) aka electro-smog. When I am in proximity to Wifi and cell radiation I sometimes have increased anger, irritability, confusion, agitation. In short, I become "mentally ill".

I think the science is pretty solid on this. EMFs are a serious health threat.