By John Shin, MD
Mental Illness is a serious medical condition that can be effectively treated. One out of every four Americans will have a diagnosable psychiatric illness. Patients with mental illness suffer from undue hardships and impairments in the social, occupational, and academic spheres of life. The good news is that psychiatric conditions can be treated and patients can improve with the appropriate treatment. Both therapy and the use of medications are effective choices for treatment. One or both treatment methods may be needed to treat the underlying psychiatric diagnosis. The focus on this article will be on the use of psychiatric medications, but therapy is also a very helpful intervention often needed to effectively treat mental illness.
The first step in any treatment for psychiatric condition is a very thorough assessment. We need to know what we are treating and the goals that are important for the patient, in order to determine the best course of action. There are times when therapy could be the recommended treatment. Other times, combined medication and therapy would be needed. There may be times that medications alone would be appropriate.
A good assessment would include a thorough description and history of the symptoms which are problematic for the patient. An understanding of any medical conditions, relevant family history, any drug or alcohol problems, psychological issues such as stressors, and social factors of a patient’s life, are all needed to be considered to ascertain the appropriate diagnosis and treatment recommendations. It is important to know the symptoms and diagnosis which are needed to be targeted, in order to determine which medications may be appropriate for the situation at hand. For instance, use of Prozac, a commonly used SSRI, might be appropriate for treatment for anxiety or depression, but it might not be effective in the treatment for Attention Deficit Hyperactivity Disorder.
A thorough discussion of the benefits, side-effects, indication, alternative treatments or consequence of no treatment should be entertained prior to use of medication. The impact of medication on breast-feeding and pregnancy effects should also be considered when applicable.
Once a medication is selected, the patient should be appropriately treated by a provider who has the expertise and experience in the use of psychiatric medications. This can be done by a primary care provider for some patients. However, for the more complicated and severe psychiatric illness, a psychiatrist or child psychiatrist would be the appropriate health care provider to manage the patient’s psychiatric medication.
Once a patient has done well for a period of time, a discussion of how long a patient should be treated with medication would need to be reviewed. For some conditions, such as treatment for first episode of depression, being on medication for at least 6-9 months after a patient has done well should be considered before tapering off medications. For patients with more severe psychiatric illness and recurrent symptoms, the patient may need to be on medication for several years, if not longer. Periodic evaluations for continued need of medications should be done.
Use of medications for psychiatric conditions can be very effective for the certain diagnoses, at the right dose, for the right period of time. A thorough assessment and appropriate follow-up are needed to ensure the patient receives the appropriate medications which are beneficial for the patient. The first step is to get help. Bottom line, treatment for mental illness is needed and effective. Behavioral Healthcare Associates, LLC has providers to meet the full array of comprehensive mental needs, therapeutic assessments and therapy services using a wide range of modalities including Evidenced Based Services, along with a Board-Certified Child, Adolescent, and General Psychiatrist for Psychiatric Medication Evaluations and Management. Contact 919-292-1464 for an appointment or further information.