Treatment Of Psychiatric Disorders
Frequently Asked Questions - Treatment Of Psychiatric Disorders
Can problems of mind be simply solved only with some advice / counselling?
When a cluster of symptoms leads to a decline in work & social functioning, medications play an important role in treatment. These complaints are neither imaginary, nor fabricated, and hence cannot be wished away. In spite of severe emotional turmoil a person can maintain composure or appear normal physically, and hence often does not receive any sympathy. When he / she complains, common sense advice is given which can be damaging (eg. “Think positive”, “Don’t take tension”, “Make your mind strong”, etc.).
Some medical intervention as decided by the Psychiatrist becomes necessary for symptom relief.
Some problems like interpersonal conflicts, stress at workplace, marital disharmony, parenting attitudes, etc. can be helped with counselling. Counselling off late has become a hype and hence one should ensure that it is done by a qualified professional.
What is the need for medication?
Medication is essential part of treatment of many psychiatric disorders. Medications restore the balance of chemicals present in the brain and help to achieve normalcy (eg. Antidiabetic medications help control sugar levels in Diabetes Mellitus). These are symptoms beyond the control of the patient and hence medication gets priority.
My friends advise me to join Yoga, Gym, or dance or music class, which will rejuvenate me & get rid of my problems. Can problems of mind be solved with some hobbies or alteration in life style?
Many techniques mentioned above, especially Yoga & exercise promote health in general for all, and are more of healthy life style patterns. These are not treatments for specific problems. Medications & psychotherapy of different types are needed for specific illnesses.
Last time, she got better on her own with sleeping pills for 3-4 days, why can't the same improvement be seen now?
Probably, last time she was suffering from acute but minor episode of psychological ill health but it may not be of the same intensity this time. In fact, research shows that with each new episode, the illness may aggravate in severity and duration.
How long should we continue medication?
It varies for each psychiatric disorder. It should be continued under strict supervision and guidance of a qualified Psychiatrist. Any problem in continuation of medication should be discussed with the Psychiatrist as she will offer you a solution to your problem. Medications should not be altered or stopped on your own.
What are the common side effects of antidepressants, antipsychotics, and anxiolytic pills?
Each group of medication has few peculiar side effects and some side effects pertain to an individual drug. It is best to discuss this with your psychiatrist. The psychiatrist will inform you about important side effects at the time of starting medications.
Do these medications always give excessive sleep? Are they sleeping pills?
All medications do not necessarily cause sleepiness. Most of the newer medicines are designed to adapt to the active lifestyle of the patient by minimally interfering with day-to-day activities. Few patients may experience sedation in the beginning, but that effect wears out soon. In case, you still find it a problem, please discuss it with your psychiatrist.
‘Sleeping pills’ is a loose term and a misnomer for psychiatric medicines used by chemists and patients. The purpose of medication is not necessarily to induce sleep, but to correct the underlying chemical imbalance.
Everyone keeps talking about side effects. Will medicines damage my kidneys & other organs when taken for a long time?
Psychiatry medicines are like any other group of medicines (eg. medicines for heart or stomach). Any treatment which offers significant relief is acceptable even if minor temporary side effects occur. The same is true for psychiatric medicines if you look at harm:benefit ratio. Psychiatric medicines are just one of the scapegoats for the stigma associated with Psychiatry in general. Medicines, when taken under supervision, do not affect the kidneys, the liver or heart, as is believed. Discuss with your doctor if any periodic monitoring is needed for the drugs you are on.
I am told that these medicines can weaken my brain nerves when taken over a long period. Is it true?
This is a myth propagated all the time without any basis. Many people have taken them life long, for 30 – 40 years without any adverse consequence to their brain.
These medicines are marketed after years of research and study. Like any other treatment, medicines should be taken under proper supervision for the best outcome. Similarly, there are medicines designed specially for children to help with their problems.
What is Psychotherapy? What is Cognitive Behavior Therapy?
Psychotherapy is commonly known as “Talk Therapy”. In this, psychological principles are used to manage some psychiatric disorders. Psychotherapies are done by skilled professionals.
Cognitive Behaviour Therapy (CBT) is a widely used form of psychotherapy. It is based on the principles of thinking and behaviour.>
Why can we not use Hypnosis to remove the illness from within the mind?
Hypnosis is a therapeutic technique that has applications in certain types of psychiatric problems. It is a common misperception that it can remove all deep seated
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Doctor, I was reading on internet about the medicine that you have prescribed to me. I do not think I need that medicine.
The Internet has made a lot of information available to people at the click of a button. However, it is a mix of reliable and unreliable data. The information can often be misleading. It cannot determine one’s treatment. The treatment is best left to the psychiatrist.
I often read advertisements about Homeopathy clinics, claiming that treatment offered by them is totally free from side effects. Is it not a better option?
One can always choose alternative therapies according to one’s preference and faith, but not on the basis of advertisement and hearsay. No treatment is free from side effects, efficacy is equally important. Once diagnosed, no delay is justified in controlling conditions like Depression, Mania and Schizophrenia; and hence, speed of recovery is equally important.
You need to inform doctors of either specialty about your decision to switch. Do not continue allopathic medication without supervision by the Psychiatrist.
Is it not better to use herbal remedies or naturopathy compared to allopathy medicines which are "Chemicals"?
All the substances used for medical treatment are “chemicals” by nature. Only their source varies, i.e. herbal, animal or synthetic. From the psychiatric perspective what is important is concrete and quick recovery. Allopathic medicines are refined after years of research. All treatments have their share of adverse effects.
What is ECT? Is it shock treatment? I thought it is not used anymore.
Electroconvulsive therapy (ECT) involves passage of small current through a device which induces seizure like activity in the brain. This seizure like activity brings about changes in the brain cells and neurotransmitters which help in improvement of symptoms in psychiatric patients.
Electric current is used for treatment of many diseases in body, hence shock is a misnomer.
ECT is still a very scientific treatment option for many psychiatric conditions, and is used all over the world. Due to various reasons, including stigma and fear attached to it, the use in day-day clinical practice may have gone down; but it is one of the best options in some of the psychiatric emergencies.
Isn't ECT dangerous and inhuman as portrayed in movies? Is it painful?
No, ECT is a relatively safe method of treatment. ECT portrayed in movies is just sensationalised. In real life the patient is given anaesthesia and muscle relaxation. So, the pain factor is minimized.
Is the patient that mentally sick to warrant ECT treatment?
ECT is a safe treatment modality. It should not be considered a last resort. It is extremely effective when patient has active suicidal thoughts, or is extremely aggressive and violent. It also helps in resistant cases.
What are the side effects of ECT? Does it not cause memory loss, and brain damage, as shown in movies?
Patient may experience headache and muscle pains which respond well to pain killers. Some disorientation and memory problems may be seen immediately after
treatment, these effects diminish quickly after the course ends.
Dramatized depiction of ECT has done immense harm to public perception. Research has shown that there is no damage to the brain in scientifically conducted ECT.
Once we give ECT will we have to continue giving it for life?
Usually a course of ECT is planned depending on the patients’ illness and response. The course may involve about 6-10 ECTs. Some patients may be put on a maintenance ECT regimen. There is no need to presume that it is always necessary.
Is there any surgery available to treat mental illnesses?
Yes, some surgical procedures are available for treatment of Major Depression and OCD (Psychosurgery), for cases which are chronic, severe and debilitating; have
already undergone an exhaustive array of available established treatments, and still have severe illness.
Deep Brain Stimulation (DBS), which is a new procedure and under evaluation, may be helpful in certain psychiatric conditions.
What is Repetitive Transcranial Magnetic Stimulation (rTMS)?
rTMS is a non invasive technique for stimulating brain cells by applying a localised magnetic field over the surface of the head. It is helpful in patients with Depression, and is under evaluation for use in other disorders.
Do psychiatric medications cause weight gain and how can one manage it?
Weight gain occurs due to multiple factors like, food habits, physical exercise, sedentary lifestyles, alcohol and other addictions, sleeping patterns etc. All of this gets changed when person suffers from a psychological illness. Moreover, not all Psychiatric medications cause weight gain. Hence, even if one gains weight after starting certain medication, it can very well be managed by modifying diet and adapting healthy life styles. In cases, where this doesn’t help,
a frank discussion with treating Psychiatrist is warranted so that he/she may prescribe an alternative medication.
Do medicines like Bupropion, Nicotine chewing gum and likes really help quit smoking?
Yes. Research has shown benefit. However, it should be used in a correct manner. Most of the times, failure to quit smoking is due to incorrect ways of using
medications or Nicotine replacements (i.e. gums, lozenges patches etc.)
Hence, they should be taken after consulting Psychiatrist and under his supervision.