Medicines and mental health – a brief overview
Medicines, drugs, pills, tablets etc. for mental health is one of the most complicated areas of medicine. It is complicated because of the science on which medicines are based, the professionals who can prescribe them and the individual nature of the patient.
Medication for mental health
- The science on which medicines are based is called the ‘reductionist’ approach and is based on the idea that a chemical imbalance in the brain is the cause of the mental health issue. Pharmaceutical companies invest a lot of resources into this type of approach.
- Getting a prescription, usually the GP and/or in certain circumstances a psychiatrist. To get medicines you must have a diagnosis. Other professionals who can prescribe and monitor the medications are specially trained nurses and pharmacists. These professionals support, in the main, the idea that mental health has a ‘reductionist’ or chemical cause.
- As someone with a mental health issue, how it impacts you is different from how it impacts someone else. There are seven key brain chemicals and medications are designed to alter one of these, by doing so it alters others. This may give rise to side effects, or the medicine does not work well with you. This is one of the reasons there is a large range and type of medicines.
Our bodies, including the brain, contains and reacts to chemicals. The world of science and medicine have names for these chemicals such as neurotransmitters, as well as specific names for them such as Dopamine and Serotonin. The things we eat, drink, creams we apply, medicines we take etc, all contain chemicals which affect us. The brain contains chemicals that are impacted by chocolate, caffeine, etc. There are no scans or blood tests to diagnose mental health issues/illness. The diagnosis by a doctor (GP or psychiatrist) is based on the symptoms. Psychologists, psychotherapists, and counsellors tend to use a formulation approach, which looks at a range of factors, as well as your symptoms.
Taking medication is an important choice, only you can decide, and it may help to talk it over with friends, family, the doctor, or others before agreeing. Medication is designed to manage the symptoms and it will alter the way you interact with others and the world around you. The dose (how much you need to take) may have to be adjusted; all medicines have side effects, some more noticeable than others and your body may take a little time to adjust. If anything about the medication becomes intolerable go back to the doctor and discuss it with them. Always follow the instructions on taking medications.
Some medications have, what is called, a narrow therapeutic range, which means they require closer monitoring such as keeping a diary of how you are, blood tests or regular check-ups. If you take one of these medicines everything will be explained.
Types of medication
There are many variations of the four main types of medicines. These are:
- Antidepressants: medicines used to reduce the symptoms of depression and mood. The main types are SSRIs, SNRIs, TCAs and MAOIs and some have well-known brand names such as Prozac, Efexor, etc.
- Antipsychotics: used for managing ‘a break from reality’ which could be seeing, hearing, or believing things others do not. Used also in bipolar disorder. They are divided into 'Typical' and 'Atypical' and well-known brand names include Largactil and Seroquel.
- Mood Stabilizers: used to treat unhelpful mood swings, or changes in mood. There are no types, as they are all different but well-known brand names include Tegratol and Lamictal. This medication is usually only prescribed by a psychiatrist or a specially trained GP.
- Sleeping pills and tranquilisers: mainly used to support relaxation, sleep and managing the symptoms of anxiety. Some well-known brand names include Circaden and Diazepam.
Generally speaking, the side effects of these medications can be emotional blunting, a reduction in the felt experience of life, sedation and effects on creativity and imagination. It is important to understand your medication, how it works and how it impacts on you and your life. Discuss the choice of medicine with the doctor.
You may get prescribed medications that are not specific to mental health such as those for the heart, used to support the management of the feeling of a racing heart which can be associated with anxiety.
It is recommended that medicines are prescribed at the lowest effective dose for the shortest period. It is best to have regular check-ups with your GP, or the nurse when on medication for mental health.
You may also be offered talking therapy whilst on medication or even in place of. It is important to tell the therapist about any medication you have been prescribed. The therapist will have knowledge of medications. For some, being on medication is a beneficial adjunctive symptom treating approach.
Some key points:
- Taking medication is a personal choice.
- Discuss the issue of medication before starting the medication.
- Talking therapy can be undertaken whilst on medication.
- Medications should be taken for the shortest period.
- Follow the instructions on how to take your medication.
- Information and resources about mental health and medications can be found at websites such as NHS, Mind and Rethink.
There are four main types of medicine and the type depends on the diagnosis and presenting symptoms.
All medications are effective, but it may take a little while to find the best one for you.
Talk about your medications with the doctor, nurse, therapists, and others.