Treatment of people with medications when they present with issues related to their mood, motivation, sleep, stress, fears and doubts, worries and feelings should be based on their journey as individuals and not just physical signs and symptoms. Physical health can be seriously affected by poor emotional and mental wellbeing; however, management in these cases needs to be for the ‘whole person’ and not just systems and results.
We learn from others from a very young age, sometimes subconsciously and at other times willingly. Unpacking the impact of the environments, the dynamics of their friends and families, their habits and choices takes patience, a deep commitment and willingness for change and the challenges that come with it, along with affordability. Yes, unfortunately, the cost of finding professionals and support people who can facilitate this process can be quite high over the years.
Medication can play a significant role in facilitating this process, especially if people present with their emotional tanks depleted. If they’ve exhausted their energy in the chaos of their lives, just the desire to work on their healing and emotional rehabilitation is not going to be enough to help them.
Therapy will help them unpack their issues and learn new coping skills and strategies to help regulate and manage their behaviours and choices. And medication will be helpful to reduce the cognitive exhaustion and emotional fatigue. However, extreme caution needs to be observed with any medication, namely those that cause dependence like benzodiazepines, e.g., diazepam, oxazepam, alprazolam and sedatives and hypnotics, e.g., zolpidem, zopiclone, temazepam, nitrazepam etc. Some are recommended mood stabilisers, e.g., lamotrigine, lithium along with the usual classes like SSRIs (Selective Serotonin Reuptake Inhibitors), e.g., fluoxetine, sertraline, escitalopram, paroxetine and SNRIs (Selective and Norepinephrine Reuptake Inhibitors), e.g., venlafaxine, desvenlafaxine, that are most commonly used for treatment of anxiety and depression.
There are several other classes of medications that I have not mentioned here but the main point to understand is that if medications are started, we need to formulate a plan. The plan needs to entail understanding of the medications and their effects/interactions, duration and intensity of treatment and how they are beneficial as an adjunct to therapy.
A critical point here is to not fall into the trap of treating a medication-related issue with yet another medication and then another one. Polypharmacy is not only widespread but is extremely dangerous, and both practitioners and patients need to be fully aware of its implications.
Hence, the point of discussion is not that medications are bad and not recommended but that their role in every individual’s management plan needs to be discussed and re-evaluated continually without any judgement or biases by the patient and their treating and supportive team.
