Improving the lives of mentally ill people – Beyond medication

Last Updated on Monday, 24 October 2011 07:20 Written by Natural Health Team Monday, 24 October 2011 07:20

Health Information about Improving the lives of mentally ill people – Beyond medication

IMPROVING THE LIVES OF MENTALLY ILL PEOPLE

 - BEYOND MEDICATION

Psychiatry is a unique speciality in medicine. It deals with the mind/psyche rather than the physic/body. Psychiatry is also the only branch of medicine that treats conduct and if necessary against the wish of the patient. In our country the mainstay of treatment of mental illness is still with pills/medicine alone, which is based on medical model. Psychiatrist tends to treat mentally ill people physically in the absence of any known physical pathology.

All over the world psychiatric services are rendering treatment based on an integrated model which takes care of the mentally ill person as a whole rather than treating the illness with medicine alone. The integrated model of treatment takes into accounts the individual psychological factors and socio-economic circumstances that have an impact on the mental health of mentally ill patients.

World Health Organization defines mental health as follows:

“Mental health is a state of well being in which the individual realises his/her abilities, can cope with normal life stresses, can work productively and fruitfully and is able to make a contribution to his/her community “

Can we restore the mental health as stated above with PILLS alone following the medical model of mental illness?

If we carry on with the medical model of mental health which locates problems solely in the individual then we will continue to ignore critical factors which influence mental health and well being.

Let us look into the following vignette.

Mrs.Suba is 44, married with four children. Her husband is an auto driver. She is warm, intelligent and caring homemaker living in a joint/extended family and coped well with life until ten years ago when she suffered with the first episode of depression following her first childbirth. Since then she had several admissions to psychiatric hospital. Her treatment consisted mainly of medication. She has been prescribed twenty different drugs and has been taking at least one or two of them since 10 yrs.

During her recent admission psychotherapy (talking therapy/ counselling) was offered to Suba to try and understand the background to and reasons for her depression. The psychiatrist who has been treating her for many years was not happy about this idea and agreed to it reluctantly. Suba also had mixed feeling about starting psychotherapy as she knew little about it and her family had been told that her depression is due to recurrent illness. But she gave a go. For the first time she opened up and talked about her feelings and the thoughts and incidences that precipitated depression. In the following sessions the psychotherapist continued to trace the roots of her depression. Therapist also looked into her childhood for the origin of her coping styles. Suba was able to work through and come to an acceptance of her past and ventilated the painful pent up feelings, which were inside her. Her feelings were not just dismissed or labelled. They were acknowledged and validated.

Suba slowly gained insight about the maladaptive thoughts and coping skills and started to make changes in her life with the support of the ongoing therapy.

As she was living in a joint family, her interaction with other members of the family was actually maintaining her depression in a way. She became aware of these and developed her interpersonal skills and worked towards bringing about changes in her family too.

She became a stronger person who could cope well with the normal life stresses and did not let them precipitate another episode of depression.

The psychotherapy gave us a way of understanding Suba’s depression as part of her whole person by understanding all her past and present experiences and relationships, rather than just as an unpleasant mental illness.

 Merely managing mental illness by containing the symptoms with medication is not the real recovery. It needs a change on a whole-person level with the help of combined effort through integrated model.

In a busy outpatient consultation, it is easier for psychiatrist to fall back on something they did know about i.e. medical-style treatment consisting of psychiatric assessment, diagnosis, biological investigations, medication and hospitalisation which ignores seeing the patient as a PERSON but only as an isolated phenomenon. This leaves the patient in the same situation and prevents from striving for change because the psychiatrist has defined the problem in such a way that the patient is prevented from realising that change is necessary. Moreover the psychiatrist is pushed to repeat the same because of the success in treating the previous episodes of illness with medication and make them reluctant to try psychotherapy.

The underlying message is that treating patients with PILLS/MEDICATION alone may be appropriate for any sort of physical illness but not for mental ill. Treating mentally ill person with medicines alone based of medical model is like treating the diseased tree with medicinal sprays and ignoring to strengthen the roots.

Find More Mental Health Articles

« Slim Fast Diet: the Perfect Plan for Your Healthy Life! | Missed Period and Missed Contraceptive Pill ? Two common Occurrences in a Woman’s Life »