Post No.: 0187
Some people with mental health conditions, such as depression or anxiety, don’t want to take pharmaceutical medications – as in drugs – for various reasons, including fears that they could be addictive, they can cause major undesirable side-effects, or they would change their very personality or the mental parts that they want to keep intact to the point they will no longer be themselves anymore. These fears might result in them not wanting to even go see their general practitioner/primary care physician at all.
Now it’d be wrong to generalise the various types of potential medications that can be prescribed (e.g. there are many different types of antidepressants for depression sufferers, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs), to name just a couple) but if a medication is to be prescribed by a respectable GP/PCP (with enough time per consultation) then their effects and potential side-effects should be discussed and made clear with each patient, the benefits would be deemed to outweigh the costs for the individual case, and each patient should be periodically checked up to see if that’s still the case. Medications don’t always work for everybody and therefore aren’t right for everybody, but they do help enormously for many. (Note that there is no evidence to suggest that depression is caused by low serotonin levels. Despite this, some people with depression will find that SSRI and SNRI medications help lessen their depressive symptoms. This is analogous to people experiencing pain relief after taking paracetamol, but this doesn’t mean that pain is caused by low paracetamol levels in the brain.)
But if one still really wants to avoid pharmaceutical treatments or medications, or one has tried them before but they didn’t work, or the benefits personally didn’t outweigh the unwanted side-effects, or one needs something more – there are many other kinds of potential treatments too. Some that are offered by mental health services have been discussed in Post No.: 0175 already so won’t be repeated here. But there are even more avenues one could explore too. For instance, there are psychosocial solutions, which are arguably safer and more effective for some types and some severities of conditions e.g. for milder cases of depression – joining a social games club, walking in the park amongst nature, even tidying and/or improving the house, or educating family and friends so that they’re more understanding and can treat a sufferer more considerately (because people can, not intentionally, say and do things that don’t help a sufferer). Psychosocial solutions are possibly safer and more effective because the causes of mental health problems are often largely social and environmental rather than purely biological.
Some people just want to talk about the experiences they are undergoing before considering all of their treatment options. They might want other people to figure out they’re not well because they don’t want to outright tell others so directly themselves because they don’t want to come across as a ‘complainer’ and/or they feel like they must put on a brave face because other people depend on them. They may want understanding but not other people’s preoccupation over it (e.g. patronising responses, or a flip from receiving no attention whatsoever to excessive mollycoddling, when neither extreme state is desired by most sufferers).
Being able to talk with friends and family who will listen and be compassionate, rather than dismissive or judgemental, helps enormously (e.g. no naïve ‘just get over it’, dismissive ‘I don’t believe you’ or ignorant ‘your life is all your own choice’ responses!) Social stigma, self-stigma or blame for one’s own condition doesn’t help (e.g. men thinking that they should ‘man up’ or deal with problems themselves i.e. to suffer in silence) thus addressing these social issues would help too.
So it’s vitally important to have access to the right social and environmental support at the right time, to be listened to, to not be stigmatised, to not self-stigmatise or be told to ‘get a grip’ for chronic sufferers, as if one can or should deal with it all by oneself, and for one to seek external and expert help (even when non-experts genuinely mean well and are trying to give someone their time rather than curt and uncompassionate ‘snap out of it’ responses, they might not have the expertise to truly understand mental health care or what to do).
One may be advised to get more physical exercise, to improve one’s diet and/or improve one’s sleep routine (i.e. the usual healthy living advice for anybody whoever they are – we should always remember to look at the basics too/first). One may be told about being amongst nature more often, looking after a pet if appropriate (furry ones are the best – woof!) or informed about some of the latest research e.g. cold water therapies, or mindfulness meditation (but maybe not whilst in the midst of a seriously low moment). This list is not exhaustive and there seems to be no ‘one size fits all’ solutions. In short, there are lots of different things one might be advised to try other than medications.
Some other people on the other side though, gravitate towards administering forms of self-medication, such as taking alcohol and recreational drugs. But self-medication can lead to drug abuse or addiction, or even without addiction these drugs can lead to undesirable side-effects that can make a mental health condition worse (e.g. psychosis, or debt problems for funding a drug habit). Cannabis – given the same levels of different cannabinoids such as tetrahydrocannabinol (THC) and cannabidiol (CBD) i.e. the same batch – will relax some people but freak other people out, so it’s not conclusive to say that it’s a treatment for anxiety. Psychedelics, such as psilocybin, and anaesthetics, such as ketamine, are currently being studied to see if they’ll help with depression or addiction. But whatever drug it is and whatever condition it’s supposed to treat, it’s best to wait for greater and more conclusive independent scientific research to be carried out and to not be fixated with only the potential benefits but also the potential side-effects and other costs. And it’s best to go to a doctor rather than self-medicate even if the scientific findings become clearer because you likely don’t have the expertise to fully consider things like dosages and contraindications (and if you don’t know what that last word even means then that’ll help serve that point!)
Mental conditions like post-traumatic stress disorder (PTSD) are often co-morbid (i.e. having multiple diseases or disorders at the same time) with drug abuse – so rather than only trying to treat the drug abuse or addiction, we must also treat the PTSD too because when PTSD symptoms decrease then so does the tendency or desire to crave drugs as a form of self-medication or escape. Comorbidities can interact to make each problem individually and collectively worse, such as in a vicious cycle e.g. PTSD with psychoactive drug abuse can lead to hallucinations that make one’s PTSD worse; although certain drugs that lower inhibitions are being researched to see if they will make it easier for people to express their feelings during therapy sessions – but again, any pros must weigh with the cons. Psychoactive drugs like cannabis obviously exacerbate symptoms for people who already suffer from psychosis.
So to tackle such addictions, we must also look at treating the underlying comorbidity (e.g. the depression, anxiety, chronic stress, mood disorder, PTSD, and even any socio-economic circumstances). HIV and sexually-transmitted diseases are also in turn correlated with drug abuse or addiction, possibly due to the sharing of needles (as a consequence of the impaired judgements of users because psychoactive drug use disrupts the normal homeostatic balance of brain functions).
It’s naturally difficult to try to give a general overview for the full range of mental health conditions and potential treatments available for each of them, but the objective of this post is that – if you’re avoiding going to see your local mental health services because you think all they will do or can do is give you some medications, then I hope you’ll realise that many other possible treatments or courses of action will be explored if you don’t want to take drugs or medications, or if they don’t work for you. So go see them if you have a concern about your mental health. Also, if you’re considering self-medicating without the guidance of a trained professional in the field of mental health then this is not recommended either. Again, please go see a doctor if you have a concern about your mental health.
Woof! All roads point to asking for help because there’s plenty of hope because there are plenty of different approaches you could try if you currently suffer from a mental health concern. Medications are hardly the only forms of treatment. And the fact that the field of mental health care is expansive and is still expanding is evidence that you’re hardly alone too.