Medication

I wanted to talk about the use of medications in the healing process again. About 15 years ago in the earlier years of my counseling profession I was asked to do a presentation for a large group of women on depression. I talked about a variety of things including the use of medication. I had a lady come up to me afterwards who seemed angry with my presentation. She stated that I had made it sound all too simple. Her daughter had suffered from depression and they had tried counseling and many different medications -without any reprieve. Around the same time I was giving another presentation on depression to some church members. The conversation became heated as some of the participants started voicing misinformation about medication. I will always remember those two presentations, because it helped me understand better how sensitive the topic can be, how not simple the topic is, and how much misinformation is out there.

Previous to this-the topic seemed more simple to me. It just made sense-why would you not try something if you were sick and you knew it could help? I had seen first hand how much medicine had helped so many of those I counseled. Over time and more professional experience-I am more sensitive to the fact that the decision to turn to medication is not always so simple. 

That said, I do feel that there continues to be misinformation out there. Just in the last few months I have had friends post various things on Facebook, that got my "knickers in a bunch." For example here are some titles of a few of the articles written, "ADHD Does Not Exist.", "Antidepressants Don't Work"  and then a meme that said "Take a Walk Not a Pill."  All of them made me grumble, but I was the most frustrated with the last one. It frustrated me because on the surface it doesn't seem like a hurtful message. How could encouraging someone to take a walk be a bad thing. Exercise is a vital and scientifically proven method for improving mood and lowering depression and anxiety. I am not arguing the validity of that. In fact exercise is one of the first things I encourage all those I counsel to do. But,come on! If it was really that simple --don't you think people would have tried it already.  The, fact is that those I have counselled sometimes can not get themselves to do these healthy behaviors, because of their mental illness.  

My own experience. as I have counselled people, is not that people are too quick to medicate away their problems, My experience has been the opposite, that by far there are too many that don't consider the option that medication may help. By discussing the benefits of medication, I do not want you to think that I am advocating that medication is the only route to healing, or that it should always be used. I am not saying that. Each person has to prayerfully consider their own situation and feelings as they make decisions for their own lives. But I do want to make sure that you have correct information as you make those decisions. 

We definitely have a very long way to go in understanding the human brain, but I believe that the Lord continues to provide knowledge and technologies to help us. I love Elder Morrison's writings on the topic. He says .

“Among the most painful trials an individual or family can face is that of mental illness... We still do not know exactly how the brain works nor exactly how and why parts of it may malfunction. One thing is certain, however: no individual, family, or group is immune from the effects of mental illness. Furthermore, we are learning that many mental illnesses result from chemical disorders in the brain, just as diabetes results from a chemical disorder in the pancreas…

 Remember that God has given us wondrous knowledge and technologies that can help us overcome grievous problems such as mental illness. Just as we would not hesitate to consult a physician about medical problems such as cancer, heart disease, or diabetes, so too we should not hesitate to obtain medical and other appropriate professional assistance in dealing with mental illness.“-Elder Morrison

Elder Holland also gave a wonderful talk on mental health. I have posted it in my recommended speeches. He says, 

"If you had appendicitis, God would expect you to seek a priesthood blessing and get the best medical care available. So too with emotional disorders. Our Father in Heaven expects us to use all of the marvelous gifts He has provided in this glorious dispensation."- Elder Holland, Like A Broken Vessel.

Like I already said-we have a long way to go. But we are slowly learning more about the brain. More recently there have been studies on the effectiveness of medication on PTSD. The FDA  has approved sertraline (Zoloft), a drug commonly used to manage depression, as the first medication specifically for the treatment of post-traumatic stress disorder.

"New research has revealed how severe trauma can produce long-term changes in the nerves in the brain. In particular, it is now believed that the problem is caused by alterations in the chemical substances that nerves in the brain use to communicate with each other, substances referred to as neurotransmitters. These alterations in neurotransmitters may be responsible for the symptoms and behaviors.Treatment of post-traumatic stress disorder has therefore shifted to drugs that target these chemical substances. For example, antidepressants including imipramine and phenelzine (Nardil) that alter neurotransmitters such as serotonin, norepinephrine, dopamine, and acetylcholine have been found do more to reduce flashbacks and the feelings of helplessness more than placebo (a dummy pill).A trend that emerged from these studies was that greater improvement was seen with drugs that altered serotonin more than other neurotransmitters." 

http://www.medicinenet.com/script/main/art.asp?articlekey=12516&page=2

There are a number of biological changes that have been associated with PTSD and medication is being used to help some with these symptoms. 

"Some of the main biological disturbances in PTSD can be conceptualized as dysregulation of the naturally occurring stress hormones in the body and increased sensitivity of the stress and anxiety circuits in the brain. There is dysregulation of adrenergic mechanisms that mediate the classical fight-flight or freeze response. Yehuda and others have found that patients with PTSD have hypersensitivity of the hypothalamic-pituitary-adrenal axis (HPA) as compared to patients without PTSD (4). Patients have a much greater variation in their levels of adrenocorticoids than patients without PTSD. Other researchers have found differences in both brain structures and brain circuits that process threatening input between patients with PTSD and those without.

The medications prescribed for treating PTSD symptoms act upon neurotransmitters related to the fear and anxiety circuitry of the brain including serotonin, norepinephrine, GABA, and dopamine among many others. Studies show that a number of medications are helpful in minimizing the three symptom clusters of PTSD. Most of the time, medications do not entirely eliminate symptoms but provide a symptom reduction and are best used in conjunction with an ongoing program of trauma specific psychotherapy for patients."

http://www.healthquality.va.gov/guidelines/MH/ptsd/


So, my advice when you are considering medication. 

• Remember that it is not simple. 
• It takes a willingness to work closely with your psychiatrist and may require that you patiently try different medications. 
• Don't just read things you find on the internet. 
• Keep an open mind. 
• Talk with some reputable professionals and research reputable sources. 
• Don't feel that you have to rush into any decision. 
• There is no such things as a happy pill. Getting better requires change and work-along with medication.
• Studies continue to show that the combination of medicine and therapy bring the best results.
• There is no "one size fits all" when it comes to deciding whether to take medication or not. 
• And as always-pray about it.