myths

Myth Busters: Psych Meds Edition

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It is sad to see the person looking for a chemical fix to all their problems.  Equally discouraging is seeing marriages torn apart, lost dreams, and lives ended early- when psychiatric medication might have made a difference in the big picture.  Not “pro-meds” or “anti-meds,” as a mental health clinician I am “what is your situation, and could psychiatric medications possibly be a better option to what you are facing?”

Is it better if you don’t have to take medications?  Of course!  Why add anything to your body that’s not needed?!  But the question really is, do the possible benefits outweigh the likely risks I run in not taking medications?  Does the likely negative impact on myself and/or others suggest I would want to consider medications? Suicidal thoughts can lead to suicide, manic episodes can lead to marital unfaithfulness, addiction can lead to prison, anxiety can lead to ruined relationships, and ADHD can lead to job loss.

My paradigm on taking psychiatric medications comes from a framework that sees it as more of a philosophical and psychological decision in nature than it is about finding the “right scientific argument.”  There’s no perfection in science, and even the medical treatments we know and love involve a lot of guesswork and uncertainty.  We can’t know all possible interactions, side effects, and possibilities for every person.  What it often comes down to is risk and trust.  Taking Advil for a headache is a fairly low risk, with fairly certain outcomes- for some people.  Taking Abilify for Bipolar is less certain.  But if it works, is it worth the risks?

I submit to you that deciding to take medications really comes down to two questions: 1) Is what you are facing worth considering the cost/benefit of medication? 2) Are you willing to try something different? 

 

Top Myths On Taking Psychiatric Medications

If I take medication, it means I am crazy.

First of all, what is meant by crazy?  Most folks I talk with say ‘crazy’ is something along the lines of becoming “controlled” and losing their choice.   With psychiatric medications, this is a phenomenon mostly relegated to the movies.  Seeking a trained professional to affect biological changes in order to help a person with outcomes they desire isn’t crazy; it might be wise.

Also, the opposite of this myth may actually mean a person is in WORSE shape.  It is usually those who seek help who are healthiest; those who leave their problems to chance are most likely to be overcome by them.

I will become a drooling vegetable.

This is a movie concept, not a real world reality of Psychiatry (unless if there are illegal, wholesale abuses/uses occurring).

Psychotropic meds need to be taken if you are depressed.

This is the opposite, yet equally erroneous view that medications are always beneficial.  Sometimes they are not.

We really don’t know exactly how psychiatric medications work.

True.  This is absolutely true.  However, if we are to get honest about the process of research (and for that matter, science), we don’t know a lot about a lot of things.  Even in cardiovascular science and treatment, there are many unknowns.  Even in the treatment of heart disease, that formidable foe of American health, there are many treatments that have uncertainties as to how/if they will work on the individual.  But remember, the business we are talking about is saving lives.  And so it is with Psychiatric medication.  Saving and/or improving lives is the question.  If you know with certainty that taking medications will do neither, then there is no reason to take them!

When I am in session with clients, I don’t seek to win this (or really any) arguments by sheer data.  Most often, it comes down to our a) belief in what makes change possible and b) our willingness to change.  These choices we make are based on values, goals, perceived risk, and the beliefs we hold.  And each of us must decide for ourselves.

If I go to a Psychiatrist, they are just going to give me a pill.

To be fair, this does happen a fair amount.  But also to be fair, Psychiatrists have to gather a reasonable clinical rationale to prescribe, and there are many who do not recommend medications in every situation.  You have choice whether or not to follow the suggestions given and/or to get a second and third opinion.  To increase confidence in the process, bring up your concerns and ask around for the best Psychiatrists.

Medications will change who I am.

At their best, medications help address what is dysfunctional, not the enduring qualities of a person.  The prescribing doctor can track your symptom profile to determine- with you- whether or not a prescription leads to positive or negative changes.    Please remember that ANY medication used in medicine can cause unwanted effects- this is why it must be tracked and monitored, especially initially.

I will go crazy if I take medication.

Psychotropic medications are meant to help correct problems.  The higher risk of problems is when a person doesn’t take medications when they could help prevent or intervene with major issues.  If you are concerned about having a very negative reaction to a medication (whether due to Drug Allergies, past experience, or fear), consider setting up some supports such as regular follow-up with your psychiatrist, blood tests, and having friends/family monitor how you are doing when first starting on a medication.

There will be nasty side-effects.

Due to regulations, drugs used by Psychiatrists in the U.S. are highly researched to ensure that they do not create public health concerns.  That being said, there are certainly bad experiences and side effects that can occur.  In the end, it’s not a perfect science, and it comes back to those two questions of whether 1) what you are facing is worth considering the cost/benefit of medication, and 2) having willingness to try something different

I will become addicted.

If this is a concern, please raise it with your doctor, especially if you have a history of addiction.  There are MANY meds prescribed that are non-addictive.  However, it is true that benzodiazepines, sedatives, etc., have addiction risks.  Many patients can use these medications without becoming addicted, with a substantial improvement in their quality of life even short-term (e.g., through better sleep or less anxiety).

Psychiatrists force medication on their patients.

A respectable doctor will not force medication on you.  Unique, individual focus is made by seasoned professionals, including your involvement with the process.  The concept of against-your-will medication is mostly made up for entertainment/story purposes and rarely exists in the realm of actuality (even in the EXTREME situations where medication is forced, it is to guard a person from being a threat to human life, but this is not the usual we are discussing here).

Medications are a quick fix.

Some medications are only indicated for short-term use and all but do away with presenting symptoms when they are taken (e.g., panic).  However, medications do not change the environmental and personal factors that interact with your overall well-being, so those areas must be addressed for holistic improvement.  However, sometimes meds can help to get a person to a better spot as a co-treatment so other areas of life can also be improved.  Therefore, involving medications, personal work and change, spiritual growth, environmental adaptations, and so forth, a person will usually secure a greater likelihood of improvement.

I’ll have to take medication forever. 

Many medications are meant to be taken only for a time.  However, just like with other medical treatments, some clients will find that maintenance on medication really is the best approach.  This is usually only recommended when the cost of not taking the medication consistently is too high or risky because of the condition or problem being faced.

If certain prescriptions work for my friend, they’ll work for me. 

CONVERSELY: If prescriptions didn’t work for my friend, they won’t work for me. 

Each person is incredibly unique.  Whether through diet or exercise or blood pressure, people have to have different approaches and combinations to make their health the best.  Patience in the process is called for.

Caveats and Disclaimer:

Some of my readers are inevitably asking, “What about the wholesale problems with Big Pharma?”  “What about all the abuses with medications?”  That is another topic for another day; I do not deny there are some MAJOR issues and concerns to be addressed related to greed, regulations, and abuses.  But consider this article as a thought-provoker and encourager in the realm of appropriately administered and utilized psychiatric medications.

I am not an MD, nor do I give medical advice.  I offer feedback based on counseling experience and research.  Medical questions are to be handled by a medical provider.

Thanks for reading!

Yours truly,

Justin K. Hughes

Myth Busters, Counseling Edition

What are some misperceptions about counseling?  You probably don’t have to think very long before conjuring up an image of an “insane asylum” (ala Cuckoo’s Nest) or a highly pedigreed analyst who only listens and grunts acknowledgment of what you say.  Courtesy of media portrayals, cultural views, and personal fears, there are many myths which abound concerning counseling.  Here is a comprehensive guide to the most common (go to my resources at http://www.JustinKHughes.com to download a printable version).

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 “Counseling is for those who have severe mental and emotional problems.”

There is a wide range of needs and goals addressed through counseling.  Different challenges are met with varying degrees of support- from mild to severe.  A great reason to address problems early, while they are still mild to moderate, is to prevent them from becoming severe.

 

“Going to a counselor is a sign of weakness.”

Being vulnerable and open about thoughts and feelings takes maturity and courage.  It takes risk.  It takes strength.  Counseling at its best is simply a) a pursuit of truth in what is really going on for a person and/or b) a pursuit of solutions that may really help in addressing problems.  Every person needs help and support in miscellaneous respects.

 

“I don’t have a problem; there’s a reason for the way I feel.”

Disorders most often spring up as a result of stressors, and this is where a mental health professional can assist in identifying when a problem crosses the line into a disorder.  For example, it’s difficult to differentiate when someone’s grieving turns into depression.  Though there may be identifiable and explainable stressors, this does not insulate a person from having one of two things: a) an actual disorder or b) a need for support and help in working through problems.  Counseling can address both.

 

“Counseling is not a proven science; it is theoretical and hypothetical.”

Yes and no.  What is usually meant by this is that a problem in counseling may not have an obvious causal link.  And often this is true- which is why clients usually end up in counseling in the first place.  However, there are very good and reliable outcomes expectable from many approaches of counseling (and evidence/research to back them up).  The question to ask might be, “Is what you’re doing working?”  You may want to give something different a try.

[Additional note: As of yet, most disorders are still determined and treated based on clinical interview rather than biomarkers- e.g., pinpointing a disorder through a blood test.  Remember, though, we are dealing at a minimum with the most complex physical matter in the empirical universe: the brain.]

 

“Counselors are too expensive.”

There are certainly special reasons where some types of counseling cannot be afforded.  However, did you know there are many community and state-sponsored resources for either free counseling or support?  There are additionally many places, such as universities and clinics, where counseling is offered at a very minimal cost, or even pro-bono.  Payments are tax-deductible as a medical expense.

Rationalizations to not spend money on counseling can be an issue of priorities.  For instance, if a marriage has been struggling for several years, will 8 therapy sessions really cost that much (the price of a new TV)?  If drug/alcohol addiction has cost thousands of dollars and many hurt relationships, is it worth getting better?

 

“I don’t need to go to counseling.  Someone else does.”

We can only take responsibility for what is in our control.  Counseling gives the opportunity to take charge and seek success despite whether others do or not.

 

“It’s not my fault that I am where I am- I shouldn’t have to go to counseling.”

Similar to the last concern, a person can find themselves in need for many reasons: suffering caused by self, others, authority, medical problems, etc.  Counseling provides the space to work on troubles, despite where they originate.

 

“A counselor is just going to tell me what I already know about myself.

Though new information can be useful and stimulating to discover, the concern of counseling is more about how to bring about change and overcoming barriers that hold a person back.

 

“I can handle problems on my own.”

Human beings require the support of others on many levels- evident as an infant, but equally true as an adult.  Living with electricity, a phone, food supplies, and using currency are examples of ways we are dependent on other people.  Mental health is really no different.  No one person has all the answers; being open to possible solutions by others, especially through professionals who work extensively with the challenges you face, might just yield some different results.

 

“Counseling doesn’t work.”

As a whole, a widespread body of research advises that counseling is effective.  Sometimes it does not work for a particular individual.  Some reasons it might not have worked are that the person was not ready, there was a bad fit/connection with the professional, specialized work is needed on specific issues, and many other reasons.  You may want to try again; be honest about your concerns; that is the best way to identify what will work for you.

 

“There are so many different perspectives and approaches with counseling.  I can’t trust a counselor when they all disagree.”

With over 300 registered schools of counseling theories, it’s understandable to think of counselors as a confused mess.  However, a counseling theory is a paradigm simply to understand disorders and problems, and how to bring about change.  No one approach in counseling has all the answers, but each can offer particular insight and options.  There are unquestionably moments when counseling theories get something wrong- just like in the medical world, business world, etc.  However, there is an increasing evidence-base for many approaches (CBT, Behavioral, Family Systems, Psychodynamic, and more).  At the end of the day, there only has to be a shred of willingness to try counseling- taking the opportunity to get a different result from what you have been getting.

 

“Counseling makes things worse.  My family member went to counseling and it messed them up.” 

I am truly sorry- I really hate to hear when someone has a bad experience in counseling.  Sometimes this happens; there are various reasons why.  Similar to the feedback given concerning “Counseling doesn’t work,” there may have been a bad fit, an inexperienced counselor, specialized focus might have been needed, or maybe the client was not ready.  One experience- or even multiple bad experiences- does not determine future experiences or the overall benefit and effectiveness of counsel.  Let me encourage you to share your concerns and talk with a provider up front to figure out how they respond and if they are a good match.

 

“Counselors just focus on the past; I want to find solutions for now.”

Different counselors have different styles.  Check with them to see what their methodology/theory is.  Many counselors only reference the past insomuch as it influences, guides, or impacts the present.  Then, often, tools and skills are developed to live most effectively in the present.  Think of how a past injury may have to be considered in the present in order to guard against re-injury.  It is no different with counseling.

 

“All I need to do is trust God and/or pray.”

Without getting into particulars of theology, it is important to consider how the help of others fits into trusting God.  Each person has to examine this for themselves.  Consider what responsibility is yours to act on, all the while considering how trust and prayer fits into the picture.  Mental health care might (though not always) be a direct result of trusting God to bring about growth and healing.

 

 “Counseling has only been invented in the past century.  Why do we need it now?”

Though counseling psychology as a field of study traces its roots back to the late 1800’s, “counseling” in some fashion or another has been documented for centuries through pastors, priests, mentors, teachers, guides, and so forth.  Nonetheless, professional counseling for-fee is relatively new.  Most of what occurs in medicine and healthcare has arisen in the past century.  This does not mean every advance is good.  However, reflect on how you might benefit from the level of specialty and expertise that is offered by a professional counselor- much in the same way a person can benefit from a doctor or college professor.

 

“Other people will find out what I share.”

If you locate a state licensed professional, every U.S. state has limitations on what information can be released to others.  Unless you are in a situation of immediate harm to yourself, others, or another rare condition, your information is protected as highly confidential.  Check with each provider and licensure type.  Our policies can be found at www.JustinKHughes.com.

 

“Mental health professionals are getting rich off of the problems of others.”

Unfortunately, this is a blanket assumption that might be true in some extremes, but it doesn’t look at the reality of costs associated.  Extensive and expensive training and education is required to become a professional counselor, in addition to costs related to keeping up a practice.  There are always costs associated for receiving specialized help.

 

“You can’t change people.”

Half-true.  You can’t change anyone except for yourself.  And you can always be an influence on others without forcing change.

 

“I am past changing.  Old dogs can’t learn new tricks.”

Just ask someone experienced in the mental health field to share stories of hope and healing to encourage you that change is possible at any age.

 

“I can get all the answers I need from my family doctor.”

Primary care physicians as a whole are incredible people.  In fact, the trust in these doctors is so strong that they are a “front door” to mental health issues, prescribing a majority of all mental health medications.  Nonetheless, every treatment provider has limitations.  If you need someone with unique and particular training in human psychology, you may want to contemplate working with an authority on your particular challenges (such as a Psychiatrist for medication and a counselor for skills and guidance).  Don’t be afraid to ask any practitioner about their proficiencies and expertise- it is their job to be honest about it.

 

“Counselors tell you how to fix your problems.  Their role is to be an expert advice-giver.”

Though some problems have more immediate solutions, there are very few quick fixes in counseling.  A professional counselor helps you explore your thoughts and emotions, and to explore the options you have based on your goals.  Rarely- if ever- is it telling you what to do.

 

“Counselors just sit back, nod, and grunt their understanding.”

A common misconception, most counselors are much more dynamic than this.  There are many different styles of counseling with varying levels of interaction.  You can discover how active your counselor is by looking at their theoretical approach, or simply by asking them.

 

“The counselor can’t understand me.  They need to have the same experiences or background.”

Counselors are trained to be sensitive to a wide range of human struggles.  To be licensed necessitates that counselors 1) cannot falsely advertise what issues they work with, and 2) they must have skills, techniques, and insight relevant to the specific problems they treat.  Sometimes it is a nice bonus to find a professional with a similar story; however, this can be unrealistic and a rationalization to avoid confronting problems.  One of the unique offerings of a professional is being more objective and less impartial, and thus being able to see more clearly into your life so you can discover remedies that will work for you.

 

“Change is not hard.”

Long-lasting, meaningful change takes time.  And work.  Consider managing money well, raising a child, getting good at an instrument, playing a sport, etc.  Mental health is no different.  It’s going to take some investment if it’s of any lasting value.

 

 “Counseling takes a long time.”

Determining the length of counseling is structured on numerous factors: the client’s goals, the severity of problems being worked on, client motivation, and counselor expertise- to name a few.  Some clients only need a one-session evaluation, some stay for several sessions, and others are invested in counseling for a couple of years or more.  Talk with your clinician to determine roughly how long it will take.

 

“Sessions will vilify my parents.  OR, they will find a scapegoat for my problems.”

Counseling requires focus on the client’s experiences and perceptions.  Sometimes this brings up points of reference involving hurt from others.  However, responsibility can only be taken by the person who is present.  Any work that devolves into a blame game of others is missing the point, as empowerment to take personal responsibility is central to successful counseling.

 

 “Counseling will change me (and who I am) forever.”

First of all, a counselor cannot change you; you must choose the change you want.  If you desire anything to be different in sessions, you can address this directly with your counselor.  If still not satisfied, you can always discontinue meeting with that particular counselor.

 

“I already have a good support system.  Seeing a clinician for my problems is unnecessary.”

Friends and/or family are essential to a healthy support system.  When needed, seeking a specialization in mental health can offer solutions and possibilities that may go beyond the feedback and support of friends and family.

 

“I don’t have the time for counseling.”

It may be worth considering how much time, cost, and impact various problems are costing you.  Counseling is an investment- of time, energy, money, and emotion.  You get to determine if it’s worth it to you.

 

“I am uncomfortable sharing my private matters.”

Confidentiality highly protects what you share to the extent the law provides.  Personal issues are explored only when they are relevant to your growth, and it is always up to you what you share and what you don’t.  It can be very hard to open up to another person, but the benefit just might outweigh holding in your emotions and thoughts.

 

“The clinician is going to spend all the time talking about my childhood.”

This really depends on the focus of your goals and the counselor’s approach.  Some counselors barely reference childhood, but others explore it extensively.  Your childhood will only be examined if it is seen to be relevant to your goals.

 

“I don’t want some shrink getting inside my head.”

You cannot be forced to share something you don’t want to.  Plus, even the best clinicians cannot know your mind without input from you.

 

“I only need medications to feel better.”

Research study after research study report an increase in positive outcomes when counseling is sought in addition to medication for many types of problems.  A medication does not help a person develop tools and skills to resolve distress and discover solutions when problems arise.

 

 “My genes determine my struggles.”

Without getting lost in a philosophical battle of genetic determinism, if you believe any of your thoughts and actions affect your existence, counseling can help you determine how you want to live and give you the tools to get there.  On a scientific note, we are discovering more and more how much impact our choices have upon the expression of genes.  In fact, some genes might not even express themselves if a person doesn’t have certain stressors present.  Choice does affect even our genes.

 

“Nothing can help me.  I’m hopeless.”

This is a common feeling of those who come into counseling, and there are many success stories of those who report significant progress in what are considered the most hopeless of situations.

 

“Going to therapy is selfish and self-indulgent.”

Psychological and emotional pain can affect every part of life.  Working on these areas commonly impacts how a person interacts with others- and can free them up to better love, serve, and invest.  Bear in mind, for example, how feeding the body can nourish and generate optimal functioning.  Feeding and nourishing a person emotionally is vitally important, as well.

  

Disclaimer:

Unfortunately, there are instances where the ideals listed are not met.  Please know that is a factor of an individual situation and not counseling as a whole.  Please never hesitate to talk to a counselor about setting up safeguards in counseling that help you feel protected.  Best wishes!

Yours truly,

Justin K. Hughes

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