When therapy is needed

Psychiatric problems are usually the result of prolonged stress and/or a physiological problem within the body. For some people, a change in mood, sleep or thinking is one of the first signs that something is not working properly in the body. There are many physical reasons for troubling feelings and behaviors – from thyroid imbalances to ingestion of toxic substances to allergic reactions (yes, the brain reacts to allergies).  Many sudden, intense bouts with depression in women can be traced to a recent change in, or start of a new birth control medication. Hormone changes are closely linked with mood changes. Many women with nutrition deficiencies experience poor moods just before their menstrual cycles. (Keep track with the app:Redzone) A good vitamin and/or mineral supplement may make a difference. Alcohol consumption may result in low moods the following day. Some over the counter medications can even cause strange reactions in some people.

With a good medical workup, these problem sources can be identified. If you track your feelings, diet, and behaviors you may be able to identify them yourself.

What about medication? Won’t that fix it immediately?

The prescription rate of psychotrophic medications has skyrocketed in the black community. We are a profitable and emerging market for drug companies for several reasons: 1) We are used to having problems & will expect that we qualify for medication; 2) We don’t ask enough questions about the side effects and over the counter or dietary (or lifestyle, i.e. exercise) alternatives; 3) We are exposed to layers of stress from financial, career, racism, environmental and interpersonal sources.  We often want a quick fix.; 4) We often don’t secure proper food, rest or support for our problems.

Medications don’t permanently cure problems with thinking and feeling for everyday emotional discomfort but some may reduce anxiety and depression in a way that really helps.  There may be troubling or long term side effects for some. The problem situations and learned behaviors will remain in place. Medication when combined with therapy has been proven a very effective combination. Usually continuing therapy will allow you to learn to regulate your emotions so that you will no longer need medication.

Deciding when medication is a better first step rather than therapy depends on several factors – primarily the urgency and the intensity of emotional pain or inappropriate behavior that is happening. If a person is suicidal, they need immediate hospitalization. Even if they tell you they are okay but they’ve made an attempt or expressed a plan, they may need evaluation and assistance. People can even fool themselves about their capacity for self-harm.

If a person is seeing things or hearing voices, hospitalization with medication should be expected. Psychosis can be difficult to manage and, again, may be the result of other medical problems that can be assessed in the hospital.

If a person is experiencing increasing and unrelenting depression and/or anxiety and they can’t identify or can’t limit the source, then medication may give them some relief but they should be in weekly therapy as well. If a person is taking medication but gets worse or shows symptoms of new or worse physical, movement or thinking abnormalities, notify the doctor immediately. People do have negative reactions to some medications. You should not expect medications to make you worse before you get better. Despite what you hear, many providers have seen deterioration with some generics. If there is a brand name drug that has been working for you and you experience a decline after switching to a generic, it may not be your imagination. Your prescription may need to show a brand name in order for you to receive the brand.

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