I am not anti-medication for psychiatric conditions, but I am an advocate for many proven individual and combination non-prescription drug based therapies for treating these conditions. I also believe that there is a lack of information in the medical community about alternatives and that a more inclusive process is not being followed where medication is the last considered option when nothing else works.
My concerns are with over-prescribing and hasty prescribing.
Because here’s what I see in my practice regularly.
- poly-pharmacy treatment with no follow up or weaning plan
Teens and adults on multiple medications and rapidly increasing dosages reporting 30-50% improvement in symptoms at best and only temporary relief. No regular check-ins with their prescribing doctor and no plan to come off them from their doctor. Single or multiple medications with increasing doses and additional medications added often prescribed by a GP and not a psychiatrist. - prescriptions first, counselling…maybe?
The majority of were never told by their doctor to see a counsellor regularly first to see if symptoms could be reduced with psychotherapy. - Lack of information on any other treatments and on the brain in general
Almost none prescribed daily exercise.
None were recommended to see other professionals or offered information on supplements.
Exercise and certain supplements that have been published in peer review journals that show both outperform SSRIs. Placebo effect is actually higher in effectiveness than some SSRIs. Placebo means you got better and took nothing. You just believed you might be taking something that might help. Placebo is actually best case scenario – the suggestion of healing that translates into biochemical changes that support desired outcome. We should all be looking for the placebo effect.
I find it irresponsible , knowing that the brain is flexible and can change, to not prescribe instead… and first:
- 30 days of daily exercise,
- weekly counselling appointments,
- evidence-based, well researched supplements or even better –
- a referral to a functional medical doctor or naturopath for therapeutic doses of supplements that support brain health and are proven to reduce the symptoms of depression and anxiety.
So I challenge you, to challenge your doctor.
I challenge you to be informed and bold. If you are suffering from depression and anxiety and your doctor reaches for a prescription pad – find a new doctor. Or at least have a conversation that takes some options in for discussion.
If you doctor does not know about the gut-brain axis, that you make most of the serotonin in your gut and therefore should support and heal your gut first – including with high dose quality probiotics,(and holistic gut healing plans), they shouldn’t be prescribing a chemical instead.
If your doctor is prescribing an SSRI but doesn’t know that exercise, turmeric, and other holistic measures have outperformed that SSRI, they shouldn’t be prescribing a chemical.
Even worse – drugs are prescribed to teens with developing brains for which we don’t know the full impact on their brain development. Beyond that the side effect of all SSRIs is increased suicidality of which teens are at greatest risk demographically.
Warnings:
If you doctor prescribes Prozac for your teenager, go get a second opinion. Prozac has dangerous side effects including psychosis. A high level of irritability or feeling zoned out is nothing compared to the risk of psychosis, suicidality and dissociation. I encourage every teen I see on Prozac to check another alternative. If your teen is given an SSRI and doesn’t have close to 80% reduction in symptoms – meaning they are still regularly symptomatic for anxiety of depression – get a second opinion. Paxil was just deemed unsafe for teenagers as well.
If your doctor prescribes Seroquel for sleep – do some research – it was almost pulled for an association with liver cancer. In addition – it’s an anti-psychotic – it should only be prescribed for psychosis. Not for sleep. It’s dangerous and people on it come into their first session of therapy like zombies from it. Ditto with Abilify (which can cause parkinsonian shakes)).
If you have tried all of the above and i mean all of the above for at least 30 days but preferably 60, then look at getting a prescription from a psychiatrist, not your GP, and one that will prescribe one medication only with monthly check ins and a weaning program by the 1 year mark.
I have many clients that take gabapentin for their depression or anxiety and have no side effects, no insomnia and no chronic pain from this drug. Even on a medication you should be in counselling until you feel happy. As teens they are setting up their brain to either succeed or fail – help them build resilience now.
I know a lot of people say they’ve tried everything and drugs are a last resort. For some, that is true. For others, “everything” means they tried positive thinking, reading a self help book or picking up some supplements from the health food department off the shelf. These are good efforts, but this is not trying everything.
You should be consulting professionals in all these areas, not trying to shop the aisles on your own.
Do you want symptoms reduction, or drug reliance, only temporarily and for the rest of your life? Or do you want to heal your brain and change it so that you are happy and healthy for the rest of your life without drugs or suffering?
Dig in, do the work – daily – fight for your brain – daily and it can get better – permanently.You can have lifelong health naturally without chasing symptoms daily.
Once you’re on a drug – if you’ve been on it for 5 years straight – how do you know if you’re still depressed? Or anxious. But at this point it might be scary to try and come off of it. Never come off of a prescription on your own or cold turkey. These are highly potent psychoactive drugs -they can be dangerous to go on, as well as come off. You need a plan and support and all of these other resources to manage the withdrawal effects in a healthy way.
You want to work with your brain to increase your resiliency and ability minimize your own anxiety, increase your coping skills and ability to manage symptoms of both depression and anxiety. Both states are normal in life and the goal is to be able to tolerate them and come out of them.
If you educate before you medicate, you give your brain the opportunity to change and build neural pathways to support a life of healthy emotional regulation without lifelong drug dependency.