May 02, 2010


I went to the book store yesterday and found myself at the check out with arms full of the memoirs of people with mental illnesses. The first one I picked up to read as soon as I got home was "Bloodletting" by Victoria Leatham. I suppose I picked it to read first because it was the only one that was even remotely applicable to me. The book is a written record of Victoria's experiences with Bipolar II and her struggle with self-injury.

Victoria struggled with her Bipolar Disorder for approximately 15 years before a doctor finally recommended she try Cognitive Behavioural Therapy (CBT) as well as medication. In the past, doctors and psychiatrists had done seemingly nothing except give her various forms of psychiatric drugs. She had never done any form of psychotherapy except for partaking in some group therapy on the occasions that she was hospitalised.

I want to use this book as an example for explaining my number one psychiatric pet peeve: Drugs do not make you happy.

That last statement may come as some sort of surprise to you, but it is true. There is no magical medication that will make you happy. Antidepressants are mood stabilisers. Meaning that they regulate your mood so that you do not have extreme highs and lows, thus making your mood easier to deal with and handle. They do not make you happy, and they should never be the only form of help you seek for depression issues. If you only ever take medication and never once try psychotherapy, you are likely to relapse because you never changed your behaviour in the first place.

I am not saying, and I never will, that medication is not useful. It certainly is for many people (and then it isn't for other people as well), but medication alone cannot "cure" depression because it is often more than just a chemical imbalance. We have a lot of negative, self-defeating behaviours that are often learned, and unless you unlearn those negative behaviours and thinking patterns, you can take all the medication in the world and relapse.

I definitely believe that doctors in Australia are incredibly script happy when it comes to psychiatric medication. Most GPs will be only too happy to give you a prescription for a psychiatric medication and then send you on your way. Some won't even bother to suggest you see any form of mental health support group, let alone seek an appropriate counsellor. I always wondered why a GP was even allowed to write prescriptions for psychiatric medication when they often have no idea about the medication or how it works.

A doctor I saw once prescribed Fluvoxamine when the medication I was on (Venlafaxine) was making me drowsy and I was experiencing suicidal thoughts. Fluvoxamine (or Luvox as it was branded when I was taking it) has the very common side effect of making you incredibly drowsy. The psychiatrist I saw after everything went a bit pear-shaped on the Luvox front (Lets just say that I was only awake for a few hours before being so exhausted I had to go back to sleep) was aghast that I was prescribed it in the first place considering I was complaining about drowsiness and the fact Fluvoxamine was withdrawn from the American market after a tasty little scandal with a school shooting. It isn't a very popular medication (and a very old one, since it was one of the first SSRIs on the market) and I still wonder why a GP was able to prescribe medication that he had no idea about, and that had the potential to go very wrong, and then of course I wonder why he opted to simply prescribe medication to me (and not recommend I see a psychiatrist) when I told him I was suicidal.

My experience isn't unique, and I wonder if a lot of problems with recovery could be prevented by medication only being prescribed by psychiatrists and used in conjunction with an appropriate psychotherapy (CBT, DBT, etc).

Would Victoria Leatham had to have suffered for so long with mental health issues if she had been told about CBT in the first place? Maybe they could stop a whole lot of people suffering for so long if they could just use psychotherapy and medication as the first response to mental health conditions, and perhaps they should stop letting GPs prescribe psychiatric medication when they have no specific psychiatric training.

So, the moral of the story is that medication won't make you happy, but it can be very useful in the successful treatment of various mental illnesses when used in conjunction with an appropriate and supportive psychotherapy.

Obligatory disclaimer: I am not a medical professional, and my opinions are based on a metric fuckton of personal experience and a whole lot of experience with others who are receiving treatment for

1 comment:

  1. I think I agree with you on pretty much everything here. Reminds me of recent discussions with my father, who's long been taking lithium for bipolar without any recommendation of further therapy from his psychiatrist.