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Mental illness has long been vilified in popular culture and society, but these days, the panic over a potential diagnosis is mostly unnecessary drama.
Depression, anxiety and the rest of the mood disorder conditions are far more common than you probably think, and treatment for a mental health condition is increasingly accessible.
They’re also becoming easier to stick to. For many people, treatment can be as simple as remembering to take a pill every morning.
Mental health disorders respond well to a variety of medications these days, and while unpleasant side effects may occur, these are generally safe and effective ways of addressing imbalances that might be robbing you of your potential, your happiness or your ability to function in everyday life.
The point is, psych meds aren’t that scary once you understand how they work. Let’s start there.
The term “psych med” isn’t a legal or official one, but it represents a common way of referring to medications designed for mental health benefits.
This may mean that they’re drugs meant to regulate mood disorders, or that they’re specifically targeted to more severe conditions like schizophrenia or severe bipolar disorder. It’s a catch-all for medications that affect brain function and cognitive ability.
They may be described as mood stabilizers or treatments for chemical imbalances, or as part of “medication-assisted treatment” if taken in conjunction with therapeutic practices.
What makes psych meds special is that, unlike an antibiotic to treat a cut on your arm, for instance, these medications are specifically targeted to the treatment of brain and neurological imbalances and therefore have to be able to cross the blood-brain barrier — a very important protective layer around your brain that keeps many unwanted intruders out on a daily basis.
As we mentioned earlier, psych meds can be great treatment options for a variety of mood disorders. The common focus is conditions that affect many people, like depression and anxiety.
Depression is a serious and sometimes debilitating mood disorder, and it can manifest in many ways. Some subtypes of depressive disorder, like Seasonal Affective Disorder (SAD), occur only in certain circumstances.
But major depression has no boundaries, and if you’ve dealt with it, you may be able to vouch for that yourself.
Major depression affects sleeping, working, eating and other daily functions for a period of two weeks at minimum, but often will affect you for much longer.
Persistent depressive disorder, compared with the other forms, could be described as never ending, because it is typically characterized by a persistent low mood for two years (or more).
There’s also anxiety, which similarly has several variations from mild to severe, and also includes things like panic disorder and social anxiety disorder.
Treating anxiety with prescription medication is sometimes complicated. One of the go-to solutions for fighting acne in recent years has actually been SSRIs, which are antidepressants — in many cases, antidepressants can offer anti-anxiety benefits too, mostly as on-or-off label secondary benefits.
This is probably a good time to talk about the types of medication you might encounter.
There are several types of psych or mental health medications, all of which are designed to directly or indirectly address imbalances in certain brain chemicals. Let’s start with one of the most commonly prescribed:
SSRIs can treat depression, which research suggests has a root cause in serotonin imbalances.
SSRIs are typically the first-line option for medicating depression, and are the most commonly prescribed class of antidepressants today. Other medications are typically considered only when SSRIs fail.
Selective norepinephrine reuptake inhibitors, or SNRIs, are an SSRI cousin, and they similarly regulate brain chemicals for your benefit.
The difference is that SNRIs affect norepinephrine, which in the world of your brain, functions as a neurotransmitter and a stress hormone simultaneously. SNRIs are often effective when SSRIs fail.
SNRI off-label uses might include post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and others. They may also treat migraines and diabetic neuropathy too.
The drug pregabalin is predominantly used to treat nerve pain, but in recent years it has found a calling and second prescribing benefit for the treatment of anxiety — in generalized anxiety disorder specifically.
Pregabalin studies have shown it to be effective, but side effects of dizziness and feeling tired make it less effective for people looking for a medication that helps them function normally day to day.
We lumped this group of drugs together because, collectively, they boast bright potential for future anxiety treatment. Unfortunately they’ve not been thoroughly studied to offer proof of that now, yet.
Buspirone is the most readily prescribed of the three right now — particularly if SSRIs aren’t working or well tolerated.
Hydroxyzine, the antihistamine, has side effects that include drowsiness, which can lessen its anxiety fighting benefits for people who are just trying to perform normally.
If you’re keeping a running tab of medications that you should avoid unless told otherwise by a mental health professional, add tricyclic antidepressants, or TCAs, to your list.
TCAs have been around for more than 60 years, but in that time they’ve made a reputation for themselves as being fairly unpleasant to take, largely due to a series of adverse side effects including some risks for pregnant women.
It’s commonly believed that there are better options on the market today, like SSRIs.
The last drug class on this list are benzodiazepines, which aren’t actually medications to control anxiety, but rather a form of sedative that relieves anxiety symptoms when prescribed correctly.
Benzodiazepines are effective, but the benefits come at the risk of dependency, which can occur after just a few weeks.
They are not recommended for generalized anxiety disorder, although they offer benefits for acute anxiety.
So, you think you might benefit from mental health medications. How do you bring the conversation up with a healthcare professional?
It’s normal to worry about this exchange with your healthcare provider. Many people (especially those with anxiety) worry about advocating properly for themselves when asking for medication.
Asking your healthcare provider about psych medication is a simple process, though they may have questions about your symptoms and elements of your lifestyle that may need addressing.
They may, for instance, ask about your other medications, your medical history, your level of exercise or even your daily caffeine intake, as those things may be affecting your mood disorder issues (if they’re somewhat mild).
Before starting you on medication, they may have you make other changes to avoid putting you on a medication that isn’t necessary.
If you’re drinking six lattes a day, cutting back on the excess caffeinated beverages may solve some of your problems.
This is a good time to ask your own questions and get an expectation for how your treatment may work — a healthcare professional will be able to explain different medication options and make recommendations based on your particular symptoms.
They’ll also be able to explain how long you can expect medications to take to start working, and how to take them properly.
They will also explain the effects of medications for anxiety, including what may happen as a result of long-term use, and the resulting withdrawal symptoms if you suddenly discontinue use.
Delaying treatment for fear of the dependence on or side effects of these drugs is an understandable fear, but it’s not worth delaying treatment.
Speaking to a healthcare professional is important for your health and wellbeing.
That said, there are resources available to you if you’re not yet ready for the pill talk.
We can offer further information on a variety of topics. Whether you’re prepared to consider therapy for treating anxiety, or interested in an online psychiatry evaluation, this might be a good time for you to swallow a hard pill and give therapy a try with our online counseling platform.
Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.
She is also an active member of the American Academy of Nurse Practitioners.
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