I enjoyed your February Wellness series and appreciate the mental-health-support resources it provided. I would like to raise some points in relation to the Feb. 3 article, “Rethinking Mental Health.”
I am not a medical doctor, but a psychotherapist who works in the trenches helping individuals in trauma recovery. I also work with a substantial number of individuals who suffer from acute anxiety and depression.
I consider myself an integrative mental-health clinician who utilizes cutting-edge modalities that reach beyond traditional talk therapy (in terms of comprehensiveness, depth and effectiveness). I believe in the vast potential to heal oneself through cognitive restructuring, nutrition, exercise and healthy living.
Additionally, I practice yoga and have been teaching meditation and mindfulness for 25 years. I regularly employ these tools to treat anxiety, depression and chronic stress. It is extremely important to understand the role that stress plays in our lives. For example, there is substantial evidence that chronic stress plays a significant role in the development of depression and anxiety. Therefore, stress management tools are essential in treating such mood challenges.
I applaud those in the medical community who strive to look beyond the limits of Western medicine into allopathic arenas as acupuncture, homeopathy, herbal medicine, etc. And I am also from an extremely dedicated and bright medical family (which includes a highly respected neurosurgeon). I therefore have strong regard for the scientific method and the importance of the objective data it can provide.
While I agree that medications such as antidepressants have been grossly overprescribed, I do believe there is a place for medication in the treatment of brain disorders such as major clinical depression and bipolar disorder. I think one needs to exercise caution in order not to “throw the baby out with the bathwater.” Placebo or not, I have seen antidepressants and other psychotropic medication save lives and dramatically improve the lives of individuals suffering from severe brain disorders. I have seen psychotic homeless individuals receive psychoactive medications that turned their lives around when psychotherapy and holistic approaches were not available due to poverty.
I believe integrative medicine is our future. But for Robert Whitaker to definitely and categorically state that antidepressants “... and most of the other psychoactive drugs are not only ineffective but harmful,” is concerning and irresponsible in relation to those who stand to benefit from such medication treatment. (Whitaker's book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness, was cited in the story as contributing to Asheville psychiatrist Daniel Johnson's reconsideration of medication-based treatments.)
I clearly do not believe that medication is for everyone, or that it alone is the answer to treating mood disorders. At the same time, we cannot disregard the importance of its potential role in addressing the anatomy and chemistry of the brain in one suffering from a brain disorder. Why is treating the brain important? One of the consistent findings in neuroscience is that there are explicit negative changes in the chemistry and brain structure with brain disorders. Highly respected sources of research such as the National Institute for Mental Health and Johns Hopkins can inform us of advances in this growing field.
It is prudent and wise to look at the evidence provided by brain-imaging technologies such as MRIs or PET scans. For example, there is research that suggests that not treating major depressive disorder can cause cerebral damage. When severe, unrelenting depression (as in depression that persists for years) and other mood disorders are left untreated, nerve cell damage and brain shrinkage, also known as atrophy, can occur in specific areas of the brain. One area is the hippocampus, or the part associated with making and recalling memories. There can also be shrinkage in the frontal lobes associated with the ability to manage emotional reactions and preform executive functioning, such as the ability to focus and to perform execute tasks.
While there is controversy regarding the use of drugs such as antidepressants, if psychotropic medications work for some individuals with severe brain imbalances, then such an option that should remain on the table.
Additionally, there are a lot of very smart and dedicated researchers in the neuroscience community who are committed to researching brain disorders. There is ongoing investigation of different approaches, including new medication that might address chemical imbalances and promote nerve growth without the negative side effects of conventional antidepressants. I think it is worth keeping an open mind to the progressive possibilities that medical science may offer us in the future.
Martina is a licensed professional counselor and former hospice counselor who maintains a private practice in integrative psychotherapy. She offers a comprehensive and compassionate approach to promote wellness and facilitate the mind-body connection. She can be reached through www.martinabarnes.com.