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Medications and Mental Health - Fifty Shades of Gray

05/28/2013 11:42 am 11:42:31 | Updated Apr 15, 2014

By Kathy Morelli

Medications and mental health: an issue with fifty shades of gray. As a therapist, I deal with people's thoughts and feelings about this issues every day. Today, I discuss my take on two shades of gray.

If this conversation sparks thoughts and feelings about your own experiences with medications and mental health and other shades of gray, please participate and add them to the comments! I'm curious about and open to other's viewpoints and feelings on this complexities of this issue.

GrayShade 1001: I don't want to take meds; I don't like chemicals in my body, I like to manage things myself; I like to go natural

Whenever someone comes into my office who has anxiety or depression (who is not planning on harming him/herself or another), my reaction is: Hey, no problem.

I'm not the expert on your life. I'm not your personal mental health gate-keeper. I'm here to help you explore your feelings about the pertinent issues in your life and to help facilitate your personal growth. There are fifty shades of gray and let's explore.

So I say, let's have a thoughtful discussion about your situation; let's co-plan your path to better coping and health.

2013-05-28-Depressedmom2.jpgResearch show and clinical results indicate that, yes, in some cases, feelings of anxiety and depression can be managed using a consistent regimen of talk therapy and daily strict adherence to mindbody therapies.

You are correct, there is copious evidence that talk therapy helps people feel better. In fact, forty years of cumulative research indicates that talk therapy works but there is no indication that the school of therapy practiced by the therapists is what makes the therapy work.

The top three factors indicative of success in therapy are: client factors, the authentic presence of the therapist and the quality of the relationship bond between the client and therapist.

So, your willingness to be open and curious about why you think what you think and also why you do what you do impacts the progress you can make in therapy. In addition, you need to feel comfortable with your therapist and feel like you have a good working relationship.

Regarding mindbody therapies, there are decades of research to support the use of mindbody therapies to reduce physical and emotional pain. If mindbody therapies could be ground up and put in a pill, we'd be inundated with TV commercials and billboards everywhere sell, sell, selling them to us. There are a lot of mindbody gurus around. But, the truth is, mindbody therapies are free, low cost and available in your community. Hell, I was the Mindbody Specialist at a hospital for three years, I love this stuff. You can meditate for free everyday and do yoga or qi gong in your house with a DVD or book.

Getting back to not wanting to take meds. Let's design a mindbody program just for you; we'll see how you feel, and we'll re-evaluate your situation in a few weeks. And, just in case, I have back-up; I have the names of some trustworthy primary care physicians and psychiatrists who can help you with medication, if necessary.

So, instead of immediately reaching for the medication, you get to look at some complementary methods, the research behind these methods and you get to go home with some choices to think about.

But the thing is, what I find, is with most people walking into my office, a professional counseling office, is that they are usually too anxious, depressed or traumatized to adhere to a mindbody program. I wonder how it must have been for them to finally find me either online or from a referral, make the appointment and get to my office for the first time. I ask if it was a large emotional experience, if it required a lot of their energy and was a monumental step.

What I find is, in general, people who are paralyzed from depression and anxiety don't have the energy or mental space to devote to regimen of mindbody therapies. And usually when the habit of depression or anxiety has become so ingrained neurologically, psychologically, and behaviorally it's morphed into a life-crisis, not simply sadness or everyday stressful feelings.

They are suffering terribly.

So, a jump-start of medication can help someone who is depressed or anxious get going on a practical level with their lives. And the mindbody work can be added as complementary therapies to support their healing path.

There are fifty shades of gray here: after the crisis has past and some healing has occurred, some individuals with some diagnoses might be able to be weaned from the medication and sustained with mindbody work.

Going on medication is a decision and going off medication is a decision.
It is personal and clinical decision.

To get real-life information about medications, you can ask others who are taking the same medication as you, what their feelings are about medication dependency, what their side effects are and what happened to them when they stopped their medication. Support groups in the community such as MotherWoman groups and online groups such as #PPDCHAT and Mama's Comfort Camp can help you with gathering information and support.

But, there is no research or person to tell you what to do in your individual situation. It really depends on the diagnosis and the person. Some people may need medication for the rest of their lives, and others may need it just to regain their balance. Sometimes you just need to experientially see what you as an individual can tolerate.


GrayShade 1002: I feel better, so I want to stop taking my meds

Ok - so you feel better, that means things are going well - rock on! Fabulous! You think you want to disengage from the pharmaceutical machine. This is another instance where, as a professional counselor, I am not here to direct your life. I'm here to help you work out your thoughts and feelings about this matter, and to be a resource for you to help your make a conscious decision.

So, I say, let's talk.

Empower yourself by being mindful of your own choices about your own health.

A decision to go off of medication deserves as much thought as a decision to go on medication. These decisions are kind of life altering. If you were very ill before taking your medication and now you want to stop, you might want to think about how not taking your medication will affect your life and the people in your family.

With many psychotropic medications, it's actually dangerous to just go cold turkey. They should be tapered off gradually under the direction of a doctor.

You can become mindful of your choices by exploring your thoughts, feelings and options around this issue.

So, develop your own informed decision about going off your medications. Going on medication is a decision and going off medication is a decision.
It is personal and clinical decision.

Again, social support in this work can play a supportive and mediating role. Community groups where you feel comfortable sharing, such as a MotherWoman group, is a place where you can gain insight into managing your emotions and situation. You don't need to go it along.

Have a fact-gathering, thoughtful discussion on an emotionally mature level with your counselor, your partner and your medical doctor. Such questions to explore might be:

- Is it appropriate, in my individual situation, with my diagnosis, to try to live without a medication?
- What is the schedule to wean off of my medication?
- What are some therapies that can support my decision to live without medications?
- What would these complementary mindbody therapies entail?
- Can I actually adhere to the complementary mindbody schedule? Do I have the time and motivation? If not, can I get support to adhere to my mindbody work?
- How will me going off my medications affect my partner and family?
- What was it like for them on a daily basis with me going off of meds?
- How does my partner and family feel about me going off my medications?
- What is my back-up plan if I am feeling ill again?
- How quickly can I begin medication again if I need to?
- Is it easy to get an appointment with my doctor or psychiatrist if I need medication again?
- Can I jump ahead on their waiting lists if I am very ill?

Beginning a medication requires assessment, emotional commitment and planning. Stopping or tapering off a medication also involves thought, informed decision-making and support.

As I said before, there are fifty shades of gray here: after the crisis has past and some healing has occurred, some individuals with some diagnoses might be able to be weaned from the medication and sustained with mindbody work. It really depends on the diagnosis and the person. Some people may need medication for the rest of their lives, and others may need it just to regain their balance.

Empower yourself! Discuss your decision with your family and healthcare practitioners before discontinuing any medication.

Note: This article appeared in another form on the blog, MommaTrauma, and is reprinted with permission by the blog owner, Jennifer Antonik.

2013-05-20-KathyMorelly.JPGAuthor's Bio: Kathy Morelli, LPC, is a licensed marriage and family counselor in Wayne, NJ. Kathy specializes in helping women and their families with the emotions of birth, pregnancy, postpartum and in the adjustment to parenthood. Author and blogger, she is the author of the BirthTouch® series of books on motherhood. She writes at her own blog, BirthTouch®, is co-hosting the Postpartum Support International's May 2013 #PSIBLOG Hop, and has served as a Guest Editor for the Lamaze Science & Sensibility blog. Visit her at birthtouch.com and kathymorelli.com

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