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Wed Oct 03, 2007

The Need for a Balanced View of Psychotropic Medication

Psychotropic medication can be an invaluable component to the treament of depression and most psychological issues. However, it is important to have a balanced perspective about these medications. First, it is important to recognize that as Americans we are conditioned to want to "fix" or "get rid of" symptoms as quickly as possible. This view of alleviating suffering is certainly understandable, but is often incompatible with issues such as bereavement, where a sometimes lengthy healing process is needed.

Furthermore, the depressive symptoms that we wish to remove may be indicative of larger issues that need to be addressed. Very often, people come to me asking how they can continue to behave in ways that are beyond their emotional capabilities without feeling the negative psychological effects of doing so. For example, if someone starts a new job and finds themselves depressed after two months, the typical question is "What can I do to not feel this way?" instead of "Is this the right job for me?" My approach is simply to be as efficient as possible: If you have your hand on a hot stove and are feeling pain, then take your hand off of the stove instead of asking what I can do to help you numb the pain.

The psychological suffering at hand may in fact be a mechanism for telling us that we are not on the right track -- either something is missing and we need to seek it, or something is present and we need to eliminate it. By removing the depressive symptom with medication, we may lose the critical information needed to address a core issue in our lives. Because I am a Christian psychologist, I believe that many symptoms that arise for people in fact have their roots in deep, spiritual issues. If someone's depression is present due to a fear of a punishing God, then, as a staunch pragmatist, I would advocate grabbing that issue by the horns and addressing it, instead of effectively ignoring it by eliminating the depressive symptoms with pills.

Finally, it is important to be aware of the chicken-and-egg game associated with brain chemistry in mental illness. In American culture, issues such as depression are often seen as caused by a chemical imbalance in the brain. Although there is significant research evidence that demonstrates that chemical imbalances are indeed associated with psychological issues, this does not necessarily mean that they are the cause of them. If you slapped me in the face repeatedly for an hour and then measured my brain activity, it would likely exhibit a chemical imbalance associated with depression. But in this situation I am not depressed because of the chemical imbalance but because someone is slapping me. The cause of internal emotional imbalance is frequently external.

Please note that I am not recommending that people taking medication for depression or any other condition should stop doing so (and I would never recommend stopping any medication without consulting with the prescriber). I work with many clients that are dramatically helped by medication and I stand in awe of these improvements. Also, there are degrees of severity with depression and in many cases, particularly the more severe ones, I will absolutely recommend the use of medication. However, it is important to remember that the biological is only one of the many aspects of our complicated human issues, and medication is only one of the potential solutions for them.

posted at: 10:46 | path: /depression | link