Although we have many concerns about taking psychiatric medications, we rarely skip a beat when our primary physician prescribes medicine for a stomach ache or a headache.

One reason for this could be that we can’t see mental illness; we can only feel its presence or observe it in others’ behaviors. Just like an autoimmune disease, mental illness is an invisible disease that can significantly impact your well-being.

According to the American Psychological Association, there is strong evidence that mental conditions like depression, addiction, eating disorders, schizophrenia, and bipolar disorder benefit from the combination of medications in addition to therapy.

What Are Mental Health Medications?

When one’s mental health is altered, therapy may only be partially effective to process thoughts and feelings. Mental health medications can help stabilize your mood and maintain your “normal” level of mental health For this reason, medications can thereby enhance the effectiveness of talk therapy and make treatments more sustainable.

Types of Mental Health Medications

Common mental illness medications fall into the following types.

Antipsychotics (Mainly prescribed to manage psychotic issues like schizophrenia)
Antidepressants (Used to treat depressive thoughts or anxiety)
Anti-anxiety/anti-panic medication (Prescribed for chronic anxiety and panic attacks)
Stimulants (Regulates disorganized thoughts of individuals with ADHD
Mood stabilizers (Stabilizes the mood of those with mental illnesses)

Who Can Prescribe Mental Health Medications?

Generally, only psychiatrists and psychiatric nurse practitioners can prescribe psychiatric medications due to the medical training they have gone through.

A few states allow psychologists to recommend a limited set of medications if they have taken courses in psychopharmacology.

The following factors will be considered when recommending mental health medications:

Genetics and family history
Lifestyle and environment
Other medicine that you’re taking
Experience with therapy
Dual diagnosis and co-occurring disorders
Symptoms experienced

Even if a group of individuals has the same mental illness, treatments and medications can differ based on the above factors.

Will You Lose Control When Taking Medications?

Psychiatric medications are like any other medication. Unlike heroin, they don’t create an artificial high, they simply help you feel like your usual self again. Therefore, you don’t have to worry about losing control in any way.

Will You Have to Depend on Medications in the Long-Term?

The duration of the treatment depends on how long you have been suffering and how serious the symptoms are. This goes for any medication — blood pressure, thyroid, antidepressants etc.

If you have a severe mental health condition, you may have to use the medication for about one year until the episode goes into complete remission. Subsequently, if the condition persists or comes back after pulling back on medication, you may need to continue the medication for longer.

Routine check-ins will help you and your doctor to stay connected. If your condition improves after medication and root causes are addressed through psychotherapy, your doctor may recommend the discontinuation of medications.

Mental Health Medication Side Effects

Like all medications, there are side effects that some may experience. Some physical side effects include dizziness, appetite changes, weight gain, sexual dysfunction, and sleep interference. On the emotional side, medications can drive mood swings, numbness, and disinterest in life.

A number of things such as genetics, ethnicity, and co-occurring disorders make it challenging for prescribers to determine possible side effects in advance. Pharmacogenetic testing enables providers to be more accurate, however, it is still not perfect, and it’s common for medication adjustments to be needed.

Typically, transient side effects go away after about two weeks, although weight gain or decreased libido might prevail longer. If adverse effects do not subside after the transient period, your doctor can prescribe comparable medications.

You can collaborate with your psychiatrist to weigh the medication’s risks and benefits and decide the next steps. In some cases, certain side effects may be tolerable if the benefit is significant.

Image for mental health medications comprehensive guide in 2021

Photo by Caroline Veronez on Unsplash

Do Pharmaceutical Companies Interfere?

For many years it was common for psychiatrists to be influenced by pharmaceutical companies based on existing partnerships. Things have changed, however, and most psychiatrists are careful to critically look at the requirement and decide on the best option for the patient.

Many regulations have been developed over the years to protect patients and limit the influence of drug providers. For example, according to the Physician Payments Sunshine Act, “Manufacturers of drugs must submit annual data on payments and transfers of value made to covered recipients.”

Your psychiatrist may prefer established drugs that have been around for a long time because of the proven reliability. Although you can opt for free trials on newer drugs, your insurance may or may not provide coverage.

Other Holistic Options to Consider

You may want to ensure that all other holistic options have been considered before taking psychiatric medications. Most providers will encourage these in conjunction with your treatment plan. These options may include:

Diet changes (Mediterranean diets, more fish, veggies, and fruits can help. We also recommend the UC Irvine weight-loss class)
Exercise (Research shows that exercise can help minimize mental health conditions like schizophrenia and bipolar disorder by increasing the adrenaline rush)
Therapy
Meditation (We recommend meditation apps like Headspace and Calm)
Yoga
Deep breathing (5–10 minutes of deep breathing as you begin and end your day)

Psychiatric Medications and Cultural Context

We have observed the stigma of mental health medications across a plethora of cultures, from individualist American cultures to collectivist Filipino cultures. Most individuals often worry about how taking medications may be perceived by society or their families. In the Asian culture, it’s typical for families to misunderstand the requirement for medications. We have a long way to go before we can normalize medication for mental health as we’ve done for other ailments.

We have often had families join sessions with patients so we can educate them about the importance of medications. We encourage patients to only share their treatment plans with those they know they will receive support from. We try to remind patients that medications will not define you, but will instead clear away the clouds that keep you from getting back to the life you want to be living.

Future of Mental Health Care

New medications continue to be introduced, but we’ve yet to see another wave of psychiatric medications like Zoloft, Prozac, and second-generation psychotics that were unveiled in the ’90s. Psychiatrists have found that newer doesn’t necessarily mean better, and will usually pass up newer options for older alternatives they know are effective and are less costly.

Historically, electroconvulsive therapy (ECT) has been a mainstay for treatment of severe, treatment-resistant depression, but Transcranial Magnetic Stimulation (TMS) is now a relatively new and more acceptable form of treatment due to less severe side effects, and no requirements to have someone transport the patient to the hospital for treatment. For insurances, TMS provides additional benefits, because payers understand the preventative nature of TMS and how it’s keeping patients from hospitalization and developing severe illnesses.

Other authorized treatments starting to be commonly used include hallucinogens and VR therapy. The FDA approved the use of Spravato (nasal ketamine) in 2019, thanks to the number of research studies that revealed its effectiveness on treatment-resistant depression. Secondly, although insurances have been and continue to be slow to cover treatment and costs are high, VR therapy has come a long way and is showing success in the treatment of performance anxiety and PTSD.

Clinical trials are underway for Psilocybin-assisted therapy. We’re hopeful that there will be more research on this in the future.

Though currently very expensive, we hope that pharmacogenomic testing will continue to advance. This testing of the body’s ability to metabolize medications allows providers to get a clearer picture of how patients will respond to medication treatment plans. This may someday minimize the trial-and-error aspect of selecting psychiatric medications.

Conclusion

Early treatment of any condition is key. The stigma or fear of medication can be debilitating. We hope that this article removes some of those worries and instills hope that relief and stability is available for you or your loved one.

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