There are some situations in psychiatry that require medication and many that don’t.
For example, severe depression, panic disorder, obsessive-compulsive disorder, ADHD, schizophrenia and bipolar disorder are issues that are biological, medical conditions that are unlikely to improve without appropriate medication.
Relationship problems, or trouble coping with a stressful situation are often best dealt with using psychotherapy and medication may not be needed at all.
Every situation is different and that is why it is so important to put together an individualized treatment plan.
Let’s go over briefly the main classes of psychiatric medication as the names of the groups can be confusing.
Antidepressants are the treatment of choice for not only depression, but also for anxiety, panic attacks and obsessive-compulsive disorder. They are not addictive and are not “happy pills.” They don’t make you happy. They correct underlying chemical imbalances and allow your emotions to respond as they should. For example, if you are being treated with an antidepressant and something happens to you that would appropriately make you sad, you will be sad. The antidepressant will not prevent you from getting depressed, if the situation appropriately calls for a depressed feeling.
Here’s where it can get confusing. The benzodiazepines (valium, xanax, ativan, klonopin) are extremely useful and safe medications when used appropriately. When used inappropriately, of course they can be quite dangerous.
The problem with these medications is that they work. (I told you it would get confusing!) If one is very anxious, and you take a dose of xanax, you will feel the effect within about 20 minutes. This is very good if you are having an acute anxiety attack. I have many patients who are on these types of meds and if used appropriately, that is fine. All I am saying is that you don’t want to be on them longer than you need to and you don’t want to get in the habit of running to these meds every time you feel some anxiety. We all get anxious and sometimes the goal is not to get rid of the anxiety but to learn to master it.
The antidepressants don’t work like that. Whereas the benzodiazepines will take away the anxiety no matter the
source, antidepressants correct the underlying chemical imbalance. If a situation occurs where one should be angry, antidepressants will not prevent feelings being felt.
Again, the benzodiazepines are not bad medications. In fact, they can be extremely useful. They just have to be used the right way.
As the name implies, these medications are used to treat psychotic symptoms in schizophrenia, schizoaffective disorder and bipolar disorder. They are also used in severe anxiety as they are not addictive. They are also used to augment the response from antidepressants. Antipsychotic meds are sometimes used with eating disorders to help control the severe anxiety and lessen the urges to use eating disorder behaviors.
Mood-stabilizing medications are used to treat the mood swings of bipolar disorder and also are used to augment antidepressants.
There are other groups and many other things I could talk about regarding medication. Let me add some general thoughts about side-effects. These medications are usually well tolerated. If side effects do appear, they usually occur early, are usually mild and tend to resolve quickly. The most common side-effects are tiredness, nausea, diarrhea and insomnia. The overwhelming majority of people don’t have any side effects at all. If side effects do occur and don’t go away, then we stop the med and try a different one. In most groups, there are several to choose from so we are never locked into one choice. All meds have different side effect profiles, so always ask your doctor about the most common side effects of any medication that you are on.
The medications don’t change your personality. If you are suffering from a severe depression, or anxiety disorder, that will certainly change your personality. Being treated for these conditions, will bring back your personality, not change it.
Remember, the purpose of psychiatric medication is to make you function and feel better. If side effects are preventing that from happening, I don’t want you on that med any more than you want to be on it. Side effects can ALWAYS be dealt with because if we can’t get rid of them, we simply stop the medication.
If you have any other questions, please contact me and ask!
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