Psychotropics: Should You Be On Them And Are They Effective?
Updated December 19, 2018
Reviewer Cessel Boyd
The term psychotropics refers to all drugs that have an effect on your mind. You'll notice that description includes as in illegal drugs, as well as medically prescribed drugs. So, should you be on illegal drugs? Absolutely not. Should you be on medically prescribed drugs that happen to be classified as psychotropics?
The answer to that question is a little more complicated. Not only are there some very strong opinions on the use of psychotropic medication, but it also matters who is prescribing them and what they are being prescribed for.
Types Of Psychotropics
Just as there are unfortunately many different types of mental illnesses, there are dozens of medications that fall under the umbrella term "psychotropics." These psychotropic medications are used to treat a wide range of problems, including everything from ADHD to depression.
According to the National Institute of Mental Health (NIMH), psychotropics are categorized into a few main categories. These include anti-anxiety medications, antidepressants, antipsychotics, mood stabilizers, and stimulants. For the most part, these categories are pretty self-explanatory. Anti-anxiety medications are used to treat anxiety disorders; antipsychotics are primarily used to treat psychosis symptoms that manifest in people suffering from schizophrenia or mania related to bipolar disorder. However, the use of these medications does sometimes overlap, with antidepressants such as the generic drug Sertraline often used to help people struggling with anxiety and anxiety-related disorders.
Should you be on one of these medications? The answer depends on what type of condition you suffer from, its severity, and what other treatments are available to you.
Reasons Not To Take Psychotropics
An article in Psychology Today entitled "Treatment Compliance Issues in Mentally Ill Adults" describes some of the most common reasons people have for not taking prescribed psychotropic medication.
Side effects are a real concern. While not everyone who takes a psychotropic medication experiences negative side effects, some do. Side effects can be relatively harmless, like minor weight gain, or they can be extreme and life-threatening. The more serious side effects of certain medications include seizures or rigid or uncontrolled movement. Ironically, some of the worst side effects of psychotropic medications involve hallucinations or an increase of suicidal thoughts. When a person is experiencing severe side effects, it's pretty easy to understand why they would choose to discontinue taking the medication that is the cause of them.
Another common reason people stop taking medication for mental illness or avoid going on medication is one of the more unfortunate realities of mental illness. People with mental illness often don't realize or find it difficult to accept that they do have a mental illness. This is so common, in fact, that there is a term to describe it. According to the National Alliance on Mental Illness (NAMI), anosognosia refers to instances where a person is "unaware of their mental health condition." Anosognosia occurs particularly frequently in individuals with schizophrenia and bipolar disorders. It is difficult to accept treatment, whether in the form of medication or other methods if you're not convinced you have a problem. If you don't have a problem than it doesn't need to be fixed.
A related problem is when people are worried about what the medication will do to them. They aren't sure how to separate the mental illness from themselves, and they worry that in taking psychotropic medication they'll lose part of themselves that makes them who they are.
Addressing The Above Concerns
If the problem with the medication is unwanted side effects, then that is a concern that should be discussed with your doctor. There may be other medications that can be prescribed, or the dosage can be changed. Under no circumstances should you stop taking the medication without medical guidance. Aside from the potential return of the underlying condition, stopping a medication too suddenly can induce unpleasant and even harmful physical symptoms. Genetic testing can also help doctors decide what medications will be more effective based on the person's genetic disposition.
Anosognosia is a more difficult problem that requires delicate handling. Unless a person is a danger to themselves or others, an adult will not normally be forced to seek treatment involuntarily, whether that treatment includes psychotropic medication or not.
If someone is worried they'll lose some of their personality if they take medication, they should be encouraged to understand that they are a person apart from their mental illness. The purpose of the medication is not to suppress their nature and turn them into someone else. The purpose of the medication is to suppress the aspects of their mental illness that make it difficult for them to live a full life. Whether they decide to go the medication route or a more therapeutic approach, they will find that life after treatment is infinitely better than any supposed benefits that accompany their mental illness.
Do Psychotropics Work?
So do psychotropics work? The answer is yes - and no. Asking if psychotropics work is too broad a question. A lot depends on the type of mental illness, its severity, and why the drug is being prescribed. For instance, some people, including some in the mental health community, believe that psychotropics like antidepressants are overprescribed. They argue that for mild and moderate depression, psychotropic medications have little effect in comparison with other treatments.
In other cases, medicine is an integral component of treatment to help a person retain a stable life. For people with severe depression and other conditions, they can be a lifesaver. Often, the best way to approach mental illness is a combination of treatments. It's not an either/or, all or nothing proposition. Medication is not the only way to combat mental illness; it is only one of several tools in the toolbox.
Psychiatric medications can also be used as an important stop-gap treatment. When a person first seeks treatment, medicine may be prescribed to alleviate the worst of the symptoms, as part of a two-pronged plan of attack. How much and how long a person will be on medication is between them and their doctor. Counseling/Therapy can be the other prong.
That being said, for some people, medication has a certain attraction. Nowadays we have instant everything. It sometimes seems inconceivable to us that somethings still can't, or shouldn't, be fixed instantly. But medicine, with or without its drawbacks, is not magic. Medicine is still not usually an instant cure. Besides for the fact that many of these psychiatric medications take weeks to build up enough in a person's system to exhibit a noticeable effect, sometimes putting in the hard work of therapy is more effective in the long run.
Again, it all comes back to the facts of the individual case. Only a competent mental health professional should make these decisions, with your input.
Who Should Prescribe Psychotropics
Although theoretically, a regular primary care doctor can prescribe psychotropic medication. Psychiatric Nurse Practitioner or Psychiatric Physician Assistants also prescribe psychotropic medications and are considered on the same level as a psychiatrist when it comes to medication management of psychiatric disorders. There is a shortage of psychiatrists in some areas so subscribers should know that these other professionals can do just as good of a job.
The decision to go on psychotropic medication is one you will have to make with a trusted psychiatrist. Mental Health or Behavioral Health practitioner as above-mentioned practitioners can also provide the same services. Who can help you consider the pros and cons specific to you? Not all medications work the same for everyone. All medications have associated side effects, some more and more severe than others. Dosages differ. If you discuss your doubts with your doctor, he or she can assuage them, address them, or, when called for, help you find another way. Above all, if you are already taking a psychotropic medication, never ever go off it on your own without the approval of your doctor.
Concurrent treatment - seeing a psychiatrist to prescribe medication and a psychologist, therapist, or other mental health professional to work with you on the therapy side of things - is the best way forward for many people.
The treatment provided on this website does not and cannot include the prescription of drugs. But there is no reason you cannot seek help in more than one place. If you think that medication might be right for you, you should seek out an in-person mental health professional for formal diagnoses. You and your psychiatrist can then decide whether medication is necessary or warranted for you. At the same time, you can also learn more and explore therapy options here at https://www.betterhelp.com/start/. The mental health professionals who participate in Better Help are knowledgeable in their fields and qualified to use a variety of therapeutic techniques that may pertain to your situation.
Should you be on psychotropic medication? Some people swear by them; some people can't stand them. And some people take the best positions: the middle of the road. Everything in moderation.
Medication has its place. It can be an important weapon against mental illness. But it is not the only weapon. You can think about it like this: Medicine and therapy are like eating with utensils. Sometimes you need a knife and fork to eat in a mannerly fashion. Sometimes you can get away with using just a fork; rarely can you get away with using only a knife. It's up to you and your doctor to decide whether, in this example, psychotropics are the knife or the fork.