There are many people who believe that all pharmaceuticals are bad, or who think that medication for psychological issues are a sign of weakness. There’s a stigma associated with them and today I want to lay out a few things to consider when it comes to Psych Meds.
First: Your Brain is actually part of your body! People often separate them, thinking of the body and the mind as separate, and they are different aspects of mind and body, but the reality of it is that our brain is primarily a chunk of fat and proteins that functions when it has the blood, air, nutrients and stimulation that it needs.
Second: The Brain is physically and chemically different with Depression, Anxiety, and other disorders. There’s a lot of good research that shows that when someone is Depressed their brain structure changes, the neurons that fire change and the chemicals are different. Now here’s my caveat-Pharmaceutical companies want to tell you that Brain Chemistry causes depression, and that is true, but it is only part of the truth.
Depression also causes changes in brain chemistry. But... so does our thinking. Yep! When we change how we think or act we change the chemical and structural makeup of the brain.
So it should look more like this, with each of the arrows meaning “influences”:
So brain chemistry affects our mood, our Mood affects our thoughts, actions, and responses. But our thoughts actions and responses affect our brain chemistry and thereby affect our mood. This is a simplified version, because there are many, many, factors that influence our brain chemistry and structure: genetics, temperament, childhood experiences, trauma, loss, meditation, gratitude, service, prayer, and lots of other things have been associated with changing the physical brain. Plus I'm sure there are more to be discovered. So when we look at creating a healthy brain we need to explore all the resources that we can to get ourselves healthy.
This cycle of influence can be for the positive or the negative. When someone develops a mood disorder, they get stuck in a downward spiral that they can’t escape on their own. They are so depressed that they can’t get themselves up to do the things that make them feel better-exercise, socialize, think about things from a new perspective, etc.
It’s like when someone is in a dark pit, and the people on the outside of the pit are saying “Come on! You can do it! It’s bright out here! We promise it will be better!” But for the person inside the pit they can’t even see enough light to find a way out of the pit. They need help to see a little more clearly and take action that they haven’t been able to do on their own. Medication can help people start feeling better so that they can actually start making any changes that keep them feeling better. In this way Medication can be something that kick-starts the recovery process.
Another way of thinking about the brain is to think about the Neural Pathways- Each of our thoughts (and lots of other stuff like memories, instincts, impulses, sensory processing, etc, etc) travels through our brain on electrical and chemical pathways called Neural pathways.
These are like roads in our brain, but not all pathways are the same, some roads are well traveled like a highway, we can think these thoughts or take these actions easily and quickly. These highways could be something we are very good at-like our jobs, or a thought that we frequently think like “I can do this” These highways can also be unhelpful habits or thoughts like “I am just such a failure” or every time you have a bad day you curl up in bed with a gallon of ice cream.
We also have less-well traveled paths in our brains, small roads, footpaths, and even paths that are barely established like a bushwhacking trail through overgrown woods.
When I ask someone in therapy to think about their problems in a new way, it is like asking someone to get to Salt Lake but instead of taking the highway, take the Bonneville shoreline trail. It’s tough, our brain likes the smooth and wide and habitual roads (Neural pathways) that it is used to. Taking medication can help the brain develop those new chemical and electrical pathways and make them into nice smooth roads (positive habits and thoughts). Once those roads are developed, as long as they are used they will stay in the brain even if you decide to stop medication later.
Lastly, some people and some disorders really do best when they take their medication long-term, perhaps their entire life. Each person is different, and each person should work with a Doctor/Psychiatrist/Psych Nurse to find what is going to help them have a good and functional life. Some disorders including Bi-Polar, Schizophrenia, OCD, types of mood disorders, and many others really are best treated chemically over the long-term.
One last thought-For medication to be effective in changing the brain in the long run, it is always best when paired with therapy. Therapy helps make those brain changes stick and be more functional, it helps people understand what their disorder means and how they can live a good life.
Now, there are some downsides to medication.
Many medications have side-effects that aren’t great.
It can take a couple of tries to find the right medication (it usually takes a couple of weeks for the meds to build up in your system and a couple of weeks to come off a med, so that means months to figure out what will help).
There is some new research that anti-depressants in teens can increase suicidality.
Some people feel like they can’t tell what is “them” and what is the “med” as far as their mood goes
There is so much to consider when you work to find a treatment approach that works for you. Each person has different needs and wants. Try to get as much information as you can on your options, develop multiple resources in your recovery, and don't rule out medication without really exploring the pros and cons for you.