It is on a daily basis that I get consulted about using alternative modalities to treat various mental health difficulties. By alternatives, I mean “other than the conventional psychotropic interventions”. Following are the points to consider when thinking about treatment options.
-Mental health problems come in various gradations. Some of them are minor and some of them are extremely problematic. One way to measure their severity is to see the impact they have in a person’s life. For example minor anxiety can be an hour of thinking about a problem and major anxiety is inability to go to sleep. Different treatments are most beneficial for different severity of conditions.
-Not all mental health problems are the same. Depression in a 12 year old child who has lost his dog in an accident is very different than depression in a 70 year old who has lost the ability to walk. Different treatments are most beneficial for different types of problems.
-There are conditions where time is of an essence. Delaying treatment can possibly result in loss of life or failure of a major developmental milestone. A medical example would be pneumonia in a very young child. A psychiatric example would be someone with suicidal ideations. There is no time to try anything but the most tried and tested treatment with the highest chance of efficacy.
-All tools have functionality if they are used for the purpose that they are best designed to address. Using one kind of a tool because of an emotional investment in it is dangerous and short sighted. Over reliance on psychotropics is as problematic as over reliance on supplements.
-The current psychotropics are designed and tested in the current world culture. If mental health problems are to be treated by keeping all the variables constant, we will be emulating a psychiatric research experiment. Nothing beats the psychotropics in the experimental system that they were designed for. For example, if a child with ADHD presents for treatment and like a research experiment no factors are changed except giving a medicine (which is exactly what happens in a double blind random controlled trial) then no herb or supplement comes close to the benefit seen by stimulant medications.
-Supplements used as medicines do not work. Meaning that high doses of Magnesium can never come close to treatment of anxiety as a benzodiazepine. Magnesium only works when we break away from the conventional model of medicine. So administering Magnesium plus psychotherapy plus psychoeducation to the appropriate anxious person cannot happen in the context of a 10-15 minute med check appointment with majority of psychiatrists.
-Not all people can afford to be treated with non conventional pharmacological agents. For example not everyone will have the ability and logistics to be able to follow an anti anxiety regimen that consists of drinking a tea three times a day, working out everyday, acupuncture once a week, massage once a week and psychotherapy once a week. The appropriate treatment for the situation has to be prescribed when the only energy or finances that a person has to go to a pharmacy pick a medicine and take it once a day. And that too 60-70% of the times as prescribed.
-Treatment with medications often causes guilt in people. A medication works against two things when it is treating depressive symptoms along with symptoms of guilt that come from taking the medicine. Sometimes an intervention that produces lesser guilt can produce a bigger benefit than a medicine. So Turmeric might be as effective as an antidepressant in a person who feels that going on antidepressant is an emasculating thing to do. (Actually there is a study that shows that it was as effective as Fluoxetine).
-Integrated services produce a bigger benefit than fragmented services. So one practitioner who does psychotherapy, spiritual counseling, medication management and optimization of health will produce a much bigger benefit than a nutritionist, therapist and psychiatrist working separately. Unless all three of these individuals function in an integrated manner and do not acted fragmented. So good communication between various helpers helps a lot.
-Illusory superiority is a condition of cognitive bias whereby a person overestimates their own qualities and abilities, in relation to the same qualities and abilities of other persons. so for example majority of the drivers say that they are better than average drivers even though standard testing shows them to be sub par. Similarly every person with a hammer feels that there are a lot more nails in the world than there actually are. This is a bias that is at play in everyone including yours truly. So these points are to be read with a grain of salt. By the same token seeking mental health care, is a decision that should be made with care. Uncle John who recovered from alcoholism discovered what works for him. It might or it might not work for you. A professional is a person who can be objective and has multiple lenses to see the problem through.
-It is a privilege to be able to work with individuals as they try to figure out what works for them and what does not. It remains the prerogative of the one seeking healing, to decide what modality is to be used. Exercising that decision is a goal of healing and is an indication that healing has started. The selection process gives the prescription its magic.
