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Just_Justine's avatar

Why is medication "always" the seeming answer for mental illness?

Asked by Just_Justine (6453 points ) March 21st, 2010

I used to be a member of Yahoo Q&A and I recall if you asked a cat question the answer was “see a vet”.

If you were mentally ill, depression whatever, it was “Go on Medication”.

If medication works so well, why are so many people on it still so messed up? Still battling? What was the point of going on medication?

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71 Answers

dpworkin's avatar

Management of troublesome patients suddenly became much easier with the discovery of neuroleptic drugs in the 1970s. This is what eventually enabled the States to empty their mental institutions and inflict thousands of uncared for schizophrenics on the streets.

We do it because we are are lazy, and cost conscious, and selfish toward our suffering fellow man (look at the fight against health care reform) and primarily because the big pharmaceutical companies make enormous amounts of money from their well-advertised drugs, many of which may not even work (there is mounting evidence that Prozac is no better than placebo.)

janbb's avatar

I don’t want to give a lengthy answer but it isn’t the answer for everything. Some mental illnesses respond best to medication, some to therapy and some to a combination of the two, The pendulum swung toward medication for everything and now there seems to be a reassessment of that approach.

Just_Justine's avatar

@dpworkin the sad thing is people “buy into it”. You speak of the great invention lithium. Yes it did empty the nut houses, and very well. But at what cost.

Just_Justine's avatar

@janbb maybe the ones it is really working on, are out there having fun not on fluther. I mean I speak for myself, I am here because I am depressed :) so maybe if I do find a drug and I take it and it works, I’ll be gone!

j0ey's avatar

I see medication as just something that helps me function properly, when I otherwise could not.

I hate being on medication.. it turns my “deep, dark, complex” emotions, into a “numb, mechanical, tearless, smile-less” absents of feelings. BUT it does allow me to go to uni and keep my job.

Medication is not the long term answer…taking the necessary steps to learn how to COPE is the answer…I think seeing a therapist, exercising on a regular basis, eating well, getting enough sleep, being honest with yourself and basically taking care of your self are necessary steps..Medication just makes these steps a little easier…kind of like a safety rail.

partyparty's avatar

Medication is the cheapest and easiest answer. And it pacifies the patient in the short term. The problems start when the patient is feeling well enough to start weaning off the drugs. They have too many side effects, and these can make the patient feel even worse than they did in the first place.

There is a lengthy waiting list for therapy, which can, and does work. There aren’t enough therapists, so giving a patient medication works in the short term.

We need more therapists to help with mental illnesses.

jaytkay's avatar

The New Yorker just reviewed books by critics of psychiatry, particularly psychiatric drugs. There is also a podcast/MP3 discussion.

I have had experience with a severely depressed spouse and mildly depressed self, and I still have no idea if drugs helped or hurt. So this is not an opinion, I am just passing on some food for thought.

Head Case
Can psychiatry be a science?
by Louis Menand
http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100301crat_atlarge_menand

The Depression Debate
In the current issue of The New Yorker, Louis Menand examines a crop of new books about depression. Here Menand talks with Blake Eskin about why no one can agree on what depression is or how to treat it, and about the larger moral and philosophical implications of the debate.

Listen to the mp3
http://www.newyorker.com/online/2010/03/01/100301on_audio_menand

Vunessuh's avatar

I think a lot of it has to do with advertisement. I seriously can’t watch television without a commercial asking me if I’m depressed. They ask you questions like, ”do you have trouble getting through your day?”, “are you unmotivated and undetermined?”, ”are you no longer the person you use to be?” and when you watch them enough you’re eventually just like, ”Yeah! Yeah! That’s me!” when in reality, it’s not. I think people get misdiagnosed for depression all the time. I think a lot of people are also under the impression that medication will save them. They don’t understand it’s only short-term treatment so they avoid facing their issues and they continue to get worse.
I know that medication works for some, which is great.
But definitely not for everyone and too many people see it as a cure which answers your question as to why people are still so messed up.

Just_Justine's avatar

@Vunessuh excellent answer. Do you guys have adverts for that? Gosh I would feel down just identifying with those comments. I am sure many do that are not ill of course. Which is a problem.

CaptainHarley's avatar

Because most doctors have become little more than pill-pushers.

Just_Justine's avatar

@jaytkay thanks for the info.

cazzie's avatar

@Vunessah in many countries, pharma can’t advertise prescription meds on TV. Imagine that.

Vunessuh's avatar

@Just_Justine Yes. We have ads for them in magazines and I believe on the radio as well.
@cazzie & @Just_Justine How is medication advertised where you two live? It would be interesting to see the statistics on how many more people are on medication where advertisement is limited as opposed to America where it’s all over the damn place.

janbb's avatar

I do want to say, with all of this anti-drug talk, that it is my impression that for some disorders such as bipolar, medication is indicated as least for a period of time to balance mood swings. I’m no expert and I do not have direct experience of it, but I have seen instances where medication was very helpful in managing biipolar disorder.

jaytkay's avatar

in many countries, pharma can’t advertise prescription meds on TV. Imagine that.

That was also true in the US before the late 1990s.

cazzie's avatar

Regular medicine is advertised on TV, like cough drops, but the prescription only stuff is not advertised. Nor is beer and alcohol or tobacco products. Prescription meds and information is provided to health care providers who decide what medicine is right for people who are ill.

talljasperman's avatar

Mental health medicine is about making money and not helping the patient… at the very best medicine is used to help the caregivers have a more docile patient.

cazzie's avatar

But I’m with janbb, too in that there have been great leaps and bounds made with anti-psychotic drugs and drugs that work on the serotonin and other chemicals in the brain.

partyparty's avatar

@Vunessuh Gosh I can’t believe there are TV adverts SUGGESTING you might need to take medication for depression etc. They put the thought in to your head!

partyparty's avatar

@janbb Yes I agree that the medication can, in some instances work, but what about the side effects of these pills?

partyparty's avatar

@cazzie I totally agree with you there. A short term solution

janbb's avatar

@partyparty As with everything, you have to balance the pros and cons. My mother was suicidal and aggressive when she dropped the meds (at 90) and able to tolerate life when on them. Worry about side effects? I don’t think so.

Vunessuh's avatar

@partyparty Check out this commercial. Notice how in the beginning, the lighting is grim and there’s melancholy music. This particular commercial doesn’t ask you any questions, but they throw keywords in there like “sadness”, “loss of interest”, “trouble concentrating”, “lack of energy”. But the thing is everyone experiences at least mild cases of all of these things. It could be from having trouble concentrating on your homework, to being sad over the passing of a pet, to losing interest in something you once loved like a particular sport or activity.
Then, notice how as soon as they introduce the medication, the lighting brightens and the music becomes happy.
They’re all like this.
I’m not trying to discredit the fact that medication does help some people, but I just find these commercials to be rather manipulative and they easily target people who really don’t need to be on medication at all.

Trillian's avatar

Medication in the proper levels and prescription in conjunction with counseling and therapy. The reason for the medication is because of an imbalance in chemicals that affect the mood. Therapy alone will not alter this. Medication without therapy will not teach the person good coping skills.

CMaz's avatar

“Why is medication “always” the seeming answer for mental illness?”

1. Because it does help.
2. Because it is easy.

partyparty's avatar

@Vunessuh Gosh I have just watched the commercial. I am absolutely astounded it is allowed to be shown on TV. As you say the beginning of the commercial is dim, the wording is negative, then it brightens and becomes positive.
What really shocks me is a good half of the commercial states the side effects (which really distresses me), but at this stage in the commercial people will only be LOOKING at the sunshine, and the family interacting together.
It is disgusting! So glad we don’t have commercials like this in the UK. So misleading.

partyparty's avatar

@janbb That just reinforces my belief that the side effects are worse than the medication itself. I feel really sad that patients are not told about these side effects.

partyparty's avatar

@ChazMaz And the quickest and cheapest solution. Most certainly not the best solution.

CMaz's avatar

@partyparty – Yep. Easy, usually never does give good long term results.

Judi's avatar

The can help you to get your thoughts in order enough to help yourself out. I think they are probably over used and that is probably because of the marketing efforts of big Pharma.
I know from personal family experience though, that a person who really needs meds and doesn’t have them is playing Russian roulette with their life.

janbb's avatar

@partyparty I think you misunderstood what I said. I was saying she was sicker without the meds than while on them, not that the meds casued the suicidal thoughts or aggression. She had been exhibiting those behaviours before. As with most things, I don’t see this as a black or white, all pros or all cons issue.

majorrich's avatar

I believe we still only know a little bit about how the brain works, and that SSRI’s (Selective Seratonin Reuptake Inhibitors) are the quick and easy mood picker-uppers that a physician will instantly go to given his/her understanding of how depression or mental illness works. With Counseling and proper medication nearly any mental illness can at least be mitigated.

Still feel I should stress that the medical solution is based on a vague understanding of how the brain works and is primarily given to relieve the symptoms but not necessarily the cause.

jazmina88's avatar

mental illness can also be a chemical imbalance…..so it makes sense that a pharmaceutical solution is the fix. Lexapro works wonders for me.
I do love the human mind and condition and therapy is very good for understanding ones thoughts and moods. That has raised my self-esteem.

partyparty's avatar

@janbb Ah yes, I see what you were saying. She reverted back to how she was without medication. That is so very sad. Hope she doesn’t have bad side effects if she comes off her medication though.

Silhouette's avatar

People fall into the cure all trap. Medication is an aide, it won’t make everything magically delicious. Depressing shit will still depress you, as it should.

babaji's avatar

will share a story with you:
Some time ago was working as a psych tech at a major Mental Hospital, working the midnight shift so i could do college during the day.
As a patient would come into the hospital during those late hours for whatever outrageous behavior they were demonstrating, the first thing they did for unruly patients was to kick them in the stomach and while they were down, pump them full of Thorazine. (heavy tranquilizer)
That was just about normal for the patients.
And then with a heavy dose of Thorazine on a daily basis they were under control, and weren’t any trouble.
...,to your question, it’s been happening for such a long long time, it’s become tradition.

Hawaii_Jake's avatar

In my case, a combination a meds and therapy works to control my mental illness. The meds control the symptoms of the illness that do not respond any other way, like the mania, the depression, and the hallucinations. The therapy helps me to deal with life on healthier terms than I might otherwise employ.

phillis's avatar

Thanks to advertizing, combined with human nature that is forever looking for a quick fix, we’ve interpreted those commercials as something they are not. Big Pharmacy likes that, so they encourage it with pictures of happy, smiling people who are patient with thier children and have loving relationships with thier spouses, if they will just take this pill.

What they don’t say is that NO PILL eliminates depression or bipolar disorder completely, and in fact, can flatline your moods to the point that you can’t be creative or feel any real depth of joy, either. But hey – they told you it would stabilize your moods, right?

All these meds do is lessen your symptoms so that you can function with some semblance of normalcy to manage your responsibilities in life. You will still get upset if your spouse cheats, or your dog dies, or you didn’t get an “A” in math class.

What these pills do is buy you time, and that is invaluable. They slow your emotional outbursts down well enough for you to remember that there are consequences for your actions, and are intended to be used in conjunction with therapy so that you can redesign how you view things. Hence, your reactions will be more positive/productive. In that way, these pills have prevented countless costly mistakes.

gemiwing's avatar

Because not everything can be solved by talking about it.

My brain chemistry isn’t going to automatically level itself out because I go to therapy. It doesn’t work that way.

Yes, some drugs don’t work for some people. Yes, people can be over-medicated. Yes, meds are a multi-billion dollar industry.

Yet, I would be dead without them. Therapy doesn’t cure psychosis, yoga won’t make hallucinations stop and fish oil isn’t going to keep someone from hearing voices. Meds are an important facet of living well with a mental illness.

partyparty's avatar

@babaji So basically they were treated like animals. Thanks for sharing your story. I think it is disgraceful. They wouldn’t treat a person with a heart attack like that would they?

phillis's avatar

@babaji It happened for so long it became a tradition? How could that be, if you worked there and reported it to the proper authorities?

@gemiwing Therapy isn’t a cure-all, either. If you don’t have a therapist who injects themselves into a person’s toxic thought patterns to guide the patient towards more positive perspectives, then of course, nothing will change. Some patients don’t even realize that the way they view things is what’s hurting them. They didn’t draw the connection of cause and effect because it’s all they saw modeled for them the whole time they were growing up. As far as they are concerned, no other views, or ways of responding, exist.

Therapy isn’t about paying a peson to sit and listen to you bitch for an hour. It isn’t about a therapist doodling on his notepad, pretending to be engrossed in nedless cycles of complaints. Therapy is hard fucking work, and it’s painful as HELL. Human nature is to avoid those situations, which is why most therapists don’t belong in the mental health field, and why most patients never see significant improvement.

mattbrowne's avatar

There’s talk. There’s exercise. There’s medication. It depends on the illness and the severity. Often a combination is best. But always medication is not true.

gemiwing's avatar

@phillis I agree with you about therapy. My therapists were all invaluable. Very tough work, indeed.

Just_Justine's avatar

@phillis ‘Some patients don’t even realize that the way they view things is what’s hurting them. They didn’t draw the connection of cause and effect because it’s all they saw modeled for them the whole time they were growing up. As far as they are concerned, no other views, or ways of responding, exist.’ Brilliant

phillis's avatar

@gemiwing Mine, too! The ones who helped me the most were dedicated to the absolute core of thier being. They took a profession and turned it into an art. I won’t ever forget those who helped me. I am forever changed, and forever grateful to them. They are immortalized in my memories.

janbb's avatar

@phillis Beautifully said!

majorrich's avatar

I take Effexor with pretty good results. Therapy every two weeks and avoiding stress is keeping me on an even keel for now. I was on Thorazine for a while too. but this is much better.

phillis's avatar

@Just_Justine @janbb I learned so much from these people that I was able to build on long after my time with them drew to a close. I’ve said before that, if it weren’t for the human angels God sent me, I would not be here today. These were some of those angels. You just cannot repay something like that. I feel humbled amongst these extraordinary people. The work they did was astonishing. They were incredibly strong people who understood that, to help someone to this depth, you have to be willing to access your utter humanity in front of others, yourself. That takes guts.

LostInParadise's avatar

We don’t know how the mind works. We are leaning about the chemistry of the brain and maybe some day we will be able to put it all together, but it has not happened yet. We don’t know how to cure insanity and we don’t know the best way of teaching. We know of some chemicals that help some people with mental health problems, but nobody has much of an idea of how the chemicals function. It is all black magic and likely to remain so for some time to come.

RedPowerLady's avatar

I would argue that the premise of your question is incorrect. Many people in this country seek counseling and therapy instead of taking medication.

In other instances people take medication because that mental illness is known to cause a clear chemical imbalance. When working with such chemical imbalances we are mostly treating the symptoms and not the cause of the illness because that is predominately how our medical system is set up. Thus the reason why many people do not get better on meds. We aren’t curing them, we are just helping them manage their symptoms.

Pandora's avatar

Because doctors don’t charge by the hour. They can pump 10 patients with drugs in and hour vise actually try to cure 1 patient in 1 hours. Its always about the cash.

Hexr's avatar

It’s simple, because mental illness is a chemical imbalance and drugs are the only way to fix that. It’s about finding the right drug. Clearly the people you know aren’t on the right meds. There is also the fact that you need to combine meds with CBT (cognitive behavioural therapy). Meds themselves are generally not effective. It’s not magic, patients need to work for recovery (knowing from experience).

thriftymaid's avatar

It’s not always. Some behavioral problems can be suppressed with therapy and coping tools. Severe illness that has a chemical foundation usually requires medication.

serena933's avatar

I just answered a question like this a minute ago! A lot of people have this question, here are some things that I know:

Chemical imbalances in the brain can cause a variety of problems and illnesses. From what I understand, mental illness can be caused by chemical reasons, psychological reasons, or often a combination of both. That is why it can be difficult to treat, and treatment is different for each individual.
The way the brain processes information is that there are these particular types of cells in the brain called neurons. The body has many different types of cells (about 200 different kinds——although billions of total cells). This one type of cell called neurons are the cells that send and receive information in the body. They are connected by these little feelers that pick up information coming in, and one long feeler that carries information away. There is a gap of space where the feelers don’t quite connect, called a “synapse”. The way the information is carried across these gaps is by different chemicals in the brain called “neurotransmitters”. These chemicals are very important in how we receive and interpret information.
Serotonin is a chemical (neurotransmitter) that when not at normal levels will cause depression, obesity, obsessive-compulsive disorder, intense aggression, etc. This is because the body is interpreting information incorrectly. Another perhaps familiar chemical is dopamine which when too low can cause Parkinson’s, Schizophrenia, and Narcolepsy. When people become addicted to drugs it is because of changes in this chemical. When a person takes addictive drugs caffeine, alcohol, and nicotine, being the most common (but hard-drugs as well), dopamine levels are slightly increased. However over long periods of time dopamine is decreased causing the body to crave the drug in order to increase the levels again. Another neurotransmitter, acetylcholine, causes Alzheimer’s when levels are too low. Use of medications to try to balance chemical levels in the brain has had a lot of success, but since each person is different, may take a while to find the correct doses.
One thing I heard about recently concerning the differences between similar symptoms with different causes is that people who are hoarders (a disease long thought to be associated with obsessive-compulsive disorder) do not respond to the serotonin-increasing medicine that works for helping people who have OCD . It would make sense that hoarding is more often a psychological disorder, rather than a chemical imbalance, even though both OCD and hoarding have some similarities in symptoms.
There is often not one simple explanation for mental illness and people should not make the mistake of thinking they can control it on their own. Whether it is supposedly all chemical, all psychological, or some combination, anyone who thinks they may have a problem really needs to see a professional, because it is complicated!

meagan's avatar

Usually mental illnesses are a result of chemical imbalances. Medicine = chemicals.

susanc's avatar

@all:
1. Mental illnesses may be a result of chemical imbalances some of the time.
2. Some chemical imbalances are just bad luck. Great that we have correctives in these cases.
2. Many, many other brain-chemistry malfunctions are caused by trauma. Addressing the trauma can shift brain chemistry.
Drugs don’t address trauma. For that, you have to have time, and assistance from trained human beings.

I have some concern that every bad mood seems to be identified as “mental illness” and treated with drugs. But I worry about long-term use of drugs to solve problems that are not caused by illness, but by the human condition making itself apparent to consciousness.

Violet's avatar

If you were diabetic, you’d take insulin right? An illness is an illness.
Well mental illnesses, such as bipolar, are chemical imbalances within the brain. The medication helps to stabilize this chemical imbalance.

margot23annie's avatar

There are many wonderful, well-informed, and thoughtful answers on this page. As someone who is living a much better life due to good treatment (both therapy and meds) I am very happy to read them.

There are also several cynical, negative answers, obviously from people who have no direct experience with serious mental illness. I will comment on them:

Untreated mental illness can destroy a person’s life, and that of his family—and in some cases, the safety of society. Most of the mentally ill are NOT dangerous, and suffer themselves more than cause trouble for others. Most of us don’t feel that we are “being controlled” but are glad that we can control our own lives better with medication.

No one, unless he is a direct threat to the safety of others, may be forced to take these medicines. Still, it can be terribly difficult to persuade a person to get treatment, If he does not become aware of his illness. And it is hard to get someone involuntarily committed—for good reason.

Both insurance companies and cuts to public funds for mental health treatment have made it very hard to get therapy. My public clinic has almost eliminated individual therapy. This therapy used to be a big help in trying to get a good diagnosis , and to see how well the medication was working. It is a loss to patients that therapy has become less common, unless you can pay for it privately.

Doctors , unless they are really bad, don’t hand out these meds willy-nilly. Meds for less severe, or depression caused by a life event usually isn’t recommended, unless it is on a temporary basis. But serious, ongoing mental illness, which is ruining a person’s life, really needs to be treated medically, as well as with therapy, in most cases.

If you find that these meds are helping you, but the side effects are horrible, most of the time you can switch to another one that affects you better, and if you can communicate with your doctor, changes and adjustment are commonly made. You may have to live with the side effect until a med or combination of them can be found that works for you. One size does not fit all.

All people are somewhere on the continuum of very normal to very sick. It’s all a matter of degree that determines whether you are ill enough to need to be in treatment. Access to good medical care and mental health treatment is crucial to save many lives, and to make our society safe.

susanc's avatar

“Access to good medical care and mental health treatment is crucial to save many lives, and to make our society safe.”

Love it.

Maybe in some distant decade, when we’ve become an entirely communist country with full healthcare coverage for everyone, we can have that kind of safety.

Just_Justine's avatar

@margot23annie oh OK, I’ll go on medication, just to keep you all safe heh heh

margot23annie's avatar

Oh, get off it. I only threw that in because so many people fear people with mental illness. They should know (if they don’t) that most of us are not dangerous, and that good medications can help people live in the community, when without them, they might not cope very well. We’re not living in a communist gulag, by any means. Did you even read what I wrote about involuntary medication?

You can’t have freedom at all, if your malfunctioning brain is making your mind a nightmarish prison. If you haven’t had to experience this, count your blessings..

talljasperman's avatar

@margot23annie I’m being forced to take medications… and I’m not dangerous

Violet's avatar

@talljasperman are you in a mental hospital? If not, even minors can reject medication.

talljasperman's avatar

@Violet no i am not in a mental hosptial… I keep asking and they keep refusing… the doctors told me I was on them for life….and to accept it

Violet's avatar

@talljasperman (you’re bipolar, right?) it is hard to hear, and accept that. It took me a couple of years to accept that I was really bipolar, and that I would be on medication for the rest of my life. But bipolar doesn’t just go away. If you were diabetic, you’d take insulin the rest of your life, right?
I didn’t mean to offend you with the mental hospital comment, but it sounded like you were literally being forced to take your medication.

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Dog's avatar

[Mod Says:] Above quips removed at user request.

Ria777's avatar

@talljasperman: you can stop taking them and lie about it. or try to take them to court, if you want to make a bigger deal about it. I have sympathy for you. I have gotten put in a mental institution two times and I knew they would not release me unless I took their drugs. during the second time, they gave it to me in liquid form so I could not just pretend to take it in pill form.

cazzie's avatar

@susanc wrote: ‘Maybe in some distant decade, when we’ve become an entirely communist country with full healthcare coverage for everyone, we can have that kind of safety.’

I live in a democratic country with full healthcare coverage. In fact… most people in the ‘Western World’ do. Full healthcare is very democratic. Pay-only healthcare is cruel.

I’ve been on anti depressants as a temporary measure to get me out of a bad funk. It was combined with regular doctor visits and a mental health nurse visiting me at home and going to talk to a shrink. My hormones were messed up which didn’t help, so medicine was a very important part of pulling my life back together. I still take meds for my hormones and endocrine system, but went off the antidepressants under a year.

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