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A Discussion About Using Medications

Deciding to take a medication for issues of mood or anxiety is not a trivial matter. You are ingesting a substance that will have an effect on your brain and possibly your physical well-being. The benefits can be positive. However, negative side effects can also occur, depending on the medication and the person.

picture of pill bottles as a representation of how perscription medications used for anxiety or depression can effect a person. Also intended as heading for this column which discussed overprescribing of medications driven by pharmaceutical companies, and opposed by some behavioral healthcare providers.

Some professionals argue that mood and anxiety medications are over prescribed and not as helpful as the pharmaceutical companies want us to think.

There is research1-2 that supports this point of view, to a degree.

Also to consider are anti - anxiety medicines (benzodiazepines such as Valium™ or Xanax™) that can be habit forming.

picture of person's head with brain illuminated as a representation of how perscription medications used for anxiety or depression can effect a person. also intended as heading for column that discusses how medications combined with counseling can be of benefit when communication with the prescribing person is maintained.

On the other hand, research 3-7 does support the position that when medications and counseling are combined, positive and long lasting results can be obtained.

If you decide to use a medication, continual communication with the person prescribing the medication is vital. My expereince with clients shows that so many times this does not happen.

Here is an example of what I mean:

A person goes to see their primary care physician and describes for her/him what appears to be a low level of depressed mood. (i.e., feeling sad, low energy, have lost their appetite, poor sleep, have no interest in sex, etc.)

After examination, the doctor prescribes an anti-depressant medication, discusses potential side effects, and tells the person to call if there are any problems.

The person fills the prescription, and the pharmacist discusses the possible side-effects with the added comment that the individual needs to contact their primary care physician if there are any problems.

The person starts taking the medication. Three days later they develop headaches, stomach problems and muscle pain. Do they call their primary care physician about theses side effects?

NO!

They just stop taking the medication.

Their reason for not calling:

        • Too much trouble getting another appointment.
        • Don't want to seem like a "cry-baby" or a complainer.
        • Don't want to be seen as "crazy".
        • If I had these side effects, maybe another medication
          would be worse.

the list of reasons goes on and on.

Because they are not taking any medication, or getting any kind of help for that matter, the depression remains. The person feels worse, frustrated, and develops an "anti medication" bias and belief structure.

Eventually, they go to a counselor who suggests anti-depressant medication combined with therapy. Guess who never returns for a repeat appointment, and now is also "anti counseling" ?

With a significant amount of time, their situation improves, their thinking about things changes, and to a degree, their mood readjusts and they begin to feel somewhat better.

The person never really does regain their "old self" again. They are not sure what to do, as they have become distrustful of both medications and therapy.

A lot of non-quality life time could have been prevented with a simple call to their primary care physician, so long ago.



You are not defective or "crazy" if you benefit from taking a medication. Often it may be for a relatively short period of time. Even if it is for a longer term, you are getting benefit, right?

There isn't anything to be embarrased about, and you don’t have to tell anyone you’re taking a medication. (To be on the safe side, a trusted family member or close friend might be important to inform in case of some medical circumstance.)

Many people from the recovery community don't choose to take medications period. Again, it is a choice. Your program is your program - work it for your continued sobriety.

Ultimately, the decision is yours to make.

Some no-cost, reliable information about medications (including possible side effects) can be found here:

Internet Mental Health©

While many individuals have found relief and benefit from the variety of treatments available, the use of prescription medications is an important decision, and never needs to be taken lightly.

If you choose to utilize a form of pharmacological treatment for mood or anxiety issues, I strongly urge you to include a behavioral healthcare professional in the mix, as well as maintaining a good level of communication with the person that prescribes for you.

For further information and consideration you can find benefit with the following books:



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References:

1Increased Recognition of Depression in Primary Care (Comparison between Primary-Care Physician and ICD-10 Diagnosis of Depression), Berardi et al., Psychotherapy and Psychosomatics 2005;74:225-230.

2A survey of prescribing practices in the treatment of depression, Petersen T, et al., Progress in Neuro-Psychopharmacology and Biological Psychiatry Volume 26, Issue 1, January 2002, Pages 177-187.

3Mental Health: A Report of the Surgeon General. Rockville, MD: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institute of Mental Health. Department of Health and Human Services. 1999.

4Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder,Barlow, D et al.,Journal of the American Medical Association 2000, Volume283:2529-2536.

5Combining psychotherapy and antidepressants in the treatment of depression, de Jonghe F,et al. Jpurnal of Affective Disorders, 2001 May;64(2-3):217-29.

6Psychotherapy and Medication in the Treatment of Adult and Geriatric Depression: Which Monotherapy or Combined Treatment?, Hollon et al., 2005, Journal of clinical psychiatry Apr;66(4):455-68.

7Enhancing the efficacy of antidepressants with psychotherapy, Petersen, T., 2006 Journal of Psychopharmacology, Vol. 20, No. 3 suppl, 19-28.


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