Define Crazy. Psych Disorders and Treatment

[AcronymAllergy]

I like to think of meds as a bandage. When you cover a wound with a bandage does that mean the wound is not there anymore? No we all know that the wound is there and needs to be treated to go away. I believe that medication should be used in conjunction with psychotherapy.

My professor told us that anti-depressants only work on those that are severely depressed w/ chemical imbalance. Those that are depressed due to situational/environmental stuff won't benefit from anti-depressants as much as those that have a more genetic biological source for their depression. Has anyone else heard this? If this is true, it would make sense that my aunt has not benefited from the anti-depressants she continues to take because she is still depressed!

Technically, any depression could be seen as a "chemical imbalance," as the precursors to any emotion (or thought or behavior) are electrical and chemical activity in the brain. Whether the "imbalance" causes the depression, the depression causes the imbalance, or a little bit of both is still open for debate.

However, as a whole, anti-depressants will work on the majority of people who suffer from depression (just as does CBT). One thing to keep in mind, though, is that some anti-depressant medications are contraindicated in people diagnosed with bipolar disorder, as they can precipitate a manic episode.

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[robinsena]

The tricky thing with antidepressants though is that while effective, they are not so great at preventing relapse as therapy like CBT or IPT. It's been a couple of years since I've read up on that research though, so I could be wrong. I think meds are necessary in some cases, but I definitely think in general there's an overdependence on meds when talk therapy combined with meds may actually lead to better long-term outcome. But since meds are the 'quickest' way of 'treating' depression that carries the lowest risk of stigma, it's often hard to get people on board with committing to psychotherapy. That's why I think community psychologists can be very powerful in terms of implementing good community-based prevention, intervention, or psychoeducational programs to address help seeking issues like these.

 

[sunlioness]

Prozac was a bad example. But nevertheless, even if an individual was in gitmo (Lol can't get more hopeless than that) if they were on an ssri or mao inhibitor then wouldn't they still not become depressed? Or to a lesser extent than if they weren't?

Nope, the meds just don't work like that. They won't make you care any less about being in a horrific situation, nor should they honestly. They may make anxiety/depressive sx slightly less severe, but when you're in a situation that bad I don't know that you'd notice. Even in "normal" circumstances anti-depressants aren't magic pills. They're not all that much better than placebo, honestly, if you really look at the studies. For some few people, they are miracle cures. For many people they are helpful tools that make things more bearable while they go about their business and work more in psychotherapy. For some people, they don't do anything. And for some, they actually make things worse.

I think the whole environment/biology thing is really a false dichotomy. They just can't be separated. Environment affects biology intimately and vice versa. It just can't be divided like that.

 

[KillerDiller]

Also, regarding phobias, could antianxiety med like lexapro or even Valium be used to help the person desensitize themselves from the anxiety arousing stimulus. Because with a phobia the individual knows their fear is irrational the problem is the physiological symtoms that keep them confronting it, right? So if they were on a benzo and their inhibitions low , wouldn't their fear be gone....phobias are anxiety related disorders.

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Actually, I think it is preferable to treat someone with a phobia who is not on medication. When the person avoids a feared stimulus, they are also avoiding the fear and anxiety response the stimulus causes. Exposure works because it conditions the person to the anxiety as well as to the stimulus. The person then realizes they are able to get through it much easier than they thought--and that the experience of anxiety in the presence of the feared stimulus is actually something they do not need to avoid.

This is more of an issue in treating GAD as opposed to a specific phobia, but I believe the principle is still the same.

 

[Therapist4Chnge]

My professor told us that anti-depressants only work on those that are severely depressed w/ chemical imbalance. Those that are depressed due to situational/environmental stuff won't benefit from anti-depressants as much as those that have a more genetic biological source for their depression. Has anyone else heard this? If this is true, it would make sense that my aunt has not benefited from the anti-depressants she continues to take because she is still depressed!

If you view depression along a continuum, it is a bit easier to conceptualize the role of medication. Generally medication is not going to eliminate the presence of depression, but it can move where a person is on the continuum. For instance, if a person is normally at an 8, and behaviorally that translates to not getting out of bed, having a flat affect, lethargy, etc...then a medication may help bring them down to a 5, which represents a decrease in some of those symptoms, but it won't "cure" them of their symptoms. More likely the person may be less effected in certain areas, though they would still need talk therapy and/or other interventions to decrease the symptoms further.

I read a study that said that they are starting to realize that the long term effects of all these ADHD medications on the brain are similar to that of long term cocaine users. How scary is that!

I guess it's no surprise that the drug of choice of addicts that have ADHD is usually cocaine.

A person's brain/body is be effected by most anything you put into it, particularly things that purposefully interact with the various neurotransmitters in the body.

Cocaine works on some of the same receptors as the medication for ADHD, so it is not surprising, though the desired effect can be different for someone who has ADHD. Stimulant use/abuse is quite dodgy because what can be therapuetic for one person, can be quite abusive (in terms of dosing/use) for someone else.

Even in "normal" circumstances anti-depressants aren't magic pills. They're not all that much better than placebo, honestly, if you really look at the studies. For some few people, they are miracle cures. For many people they are helpful tools that make things more bearable while they go about their business and work more in psychotherapy. For some people, they don't do anything. And for some, they actually make things worse.

Well said.

Actually, it is preferable to treat someone with a phobia who is not on medication. When the person avoids a feared stimulus, they are also avoiding the fear and anxiety response the stimulus causes. Exposure works because it conditions the person to the anxiety as well as to the stimulus. The person then realizes they are able to get through it much easier than they thought--and that the experience of anxiety in the presence of the feared stimulus is actually something they do not need to avoid.

This is more of an issue in treating GAD as opposed to a specific phobia, but I believe the principle is still the same.

Yeah behaviorism!!

A huge pet peeve of mine is benzo use/abuse for people with phobias. Good 'ol exposure therapy is more effective and shows better long-term results, and the chance of abuse is absent.

 

[AcronymAllergy]

Actually, I think it is preferable to treat someone with a phobia who is not on medication. When the person avoids a feared stimulus, they are also avoiding the fear and anxiety response the stimulus causes. Exposure works because it conditions the person to the anxiety as well as to the stimulus. The person then realizes they are able to get through it much easier than they thought--and that the experience of anxiety in the presence of the feared stimulus is actually something they do not need to avoid.

This is more of an issue in treating GAD as opposed to a specific phobia, but I believe the principle is still the same.

Very true; exposure-based therapies for phobias (e.g., one-session treatment) are some of the most effective treatments available for any mental health condition.

That being said, GAD (unfortunately) can be very difficult to treat.

 

[Therapist4Chnge]

That being said, GAD (unfortunately) can be very difficult to treat.

The curious thing about GAD is that I see it in charts more frequently than I'd expect (based on prevelance rates), though in most cases it isn't true GAD. Anxiety related Dx's are one of my least favorite things to treat, though some of my favorites (EDs, BPD, NPD) aren't high on other people's lists.