MENTAL HEALTH TREATMENTS
General Notes:
Mental Health treatments are as unique as the individual; what works for one person may not work for another person. Therapy sessions provide a safe and confidential environment in which to explore thoughts, feelings, and behaviors, and learn coping skills. Finding a therapist is as unique as the individual.
Psychotherapy:
Also known as “talk therapy,” psychotherapy helps a person discover unhealthy thought patterns and help them replace these unhealthy patterns with more healthy patterns. It also helps people learn healthy coping skills and to identify those situations that could activate symptoms.
• Cognitive Behavioral Therapy (CBT): In Cognitive Behavioral Therapy, a trained therapist helps the person to discover unhealthy thought patterns and how they can contribute to unwanted feelings and unhealthy behaviors. The goal is to help the person to identify situations that could activate their symptoms, and learn healthy coping skills.
• Dialectical Behavior Therapy (DBT): Based on CBT, DBT encourages people to accept uncomfortable thoughts, feelings, and behaviors. It helps to reduce dangerous behaviors in people who have mental health challenges, uses positive reinforcement, and focuses on the person’s strengths.
• Eye Movement Desensitization and Reprocessing Therapy (EMDR): Used to treat Post-traumatic Stress Disorder (PTSD), EMDR uses a combination of eye movements, traumatic memory recall, tapping, and muscle tones to replace negative feelings with positive feelings and reactions.
• Exposure Therapy: Exposure therapy is used to treat Post-traumatic Stress Disorder (PTSD), Obsessive-Compulsive Disorder (OCD), and phobias. In exposure therapy, the client learns how to avoid doing rituals, and how to control their anxiety by learning specific strategies to do so, then practice these strategies in a controlled and safe environment. There are two basic types of exposure therapy. One of the floods the person with large amounts of the stimulus that activates them and the other method presents increasing amounts of the stimulus to desensitize the person to the stimulus.
• Interpersonal Therapy: Interpersonal Therapy helps a person with their interactions with other people by improving their interpersonal skills. This therapy helps people identify negative patterns in interacting with others, for example, social isolation or aggression. It helps people to learn how to interpret social cues and interact with others positively.
• Mentalization Based Therapy (MBT): Commonly used to help a person who has Borderline Personality Disorder, this is a type of psychotherapy that teaches the important skill of mentalizing. Mentalizing is when a person is in tune with their own thoughts and feelings and speculates about the thoughts and feelings of other people. In the therapy, the therapist encourages the person to practice these skills, developing empathy for other people.
• Psychodynamic Psychotherapy: The goal of this therapy is to recognize negative feelings and behaviors, connect them to past negative experiences, and resolve them. The therapist uses open-ended questions to help the person to discover unconscious negative thoughts and feelings, and connect them to past events and unresolved feelings.
Psychosocial Treatments
• Psychoeducation: In psychoeducational, the person, family, and friends can learn about the person’s specific diagnosis, learn coping strategies, and problem-solving skills. Psychoeducation can help families recognize early relapse and reduce stress at home.
• Self-Help and Support Groups: These groups can help people learn about their mental health challenges and how to cope and problem-solve. Members of the group share their experiences in a safe and confidential environment and are usually consumer-run. Members can also share information and community resources.
• Psychosocial Rehabilitation: Psychosocial Rehabilitation helps teach the person the social skills needed to navigate the social environment with the least amount of professional help necessary. There are two intervention strategies: learning short-term coping skills to reduce stress and problem-solving skills to reduce future stress.
• Assertive Community Treatment (ACT): ACT is a 24/7 treatment model that involves a multidisciplinary team to work with the person experiencing mental health challenges. ACT team members help the person address every area of their life, including housing, employment, medication, therapy, or social inclusion. ACT is usually used for people transitioning out of the inpatient setting to community living who would still benefit from the 24/7 help and support
Medications
No discussion of treatment is complete without the mention of medications. Medications are helpful in addressing the biological contributors to mental health challenges and are prescribed by a Psychiatrist or an Advanced Registered Nurse Practitioner (Psychiatric Nurse Practitioner). The role of medications is to balance the brain chemistry that regulates emotions and thought patterns. There are several different kinds of medications and finding a medication that works is a process and a very individual process. What works for one person may not work for another.
• Antidepressants: Antidepressants are prescribed for Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD) Panic Disorder, some Eating Disorders, and Premenstrual Dysphoric Disorder (PMDD). Some “off-label” uses include Generalized Anxiety Disorder and some Eating Disorders. “Off label” means that the Federal Drug Administration (FDA) has not approved it for certain conditions. If your doctor uses an “off-label” medication, they should be able to justify the use of the medication.
• Antipsychotics: Antipsychotics work to balance dopamine and serotonin to improve thinking, mood, and behavior. These medications are commonly used to treat Schizophrenia. Most of the antipsychotics used today are known as second-generation antipsychotics or atypical antipsychotics.
• Mood Stabilizers: Commonly used to treat Bipolar Disorder (also known as Manic Depression), Mood Stabilizers work in the brain to improve mood. They can also be used as an “off-label” treatment for Depression, in combination with Antidepressants.
• Benzodiazepines: Used to treat anxiety, seizures, muscle spasms, alcohol withdrawal and is also given to people right before anesthesia. These medications can also be used to treat other conditions.
• Stimulants: Also known as amphetamines, mixed amphetamine salts, lisdexamfetamine, these medications are used to treat Attention Deficit Hyperactivity Disorder (ADHD). These medications are usually used in combination with non-medication treatments.
Other Less Common Treatments:
• Electroconvulsive Therapy (ECT): ECT is a medical procedure that delivers controlled electrical currents through the brain while the person is under general anesthesia. ECT is used as a last resort for treatment-resistant severe depression, depression with psychosis, and sometimes in treatment-resistant Bipolar Disorder.
• Transcranial Magnetic Stimulation (TMS): A procedure that creates magnetic fields to stimulate nerve cells in the brain to treat depression. The procedure does not require the use of general anesthesia and the person is awake for the entire 40-minute session. This usually requires several sessions to be effective. This should not be used for depression with psychosis, bipolar disorder, or for anyone who has a high risk of suicide.
• Vagus Nerve Stimulation (VNS): About the size of a stopwatch, VNS uses a pulse generator placed in the upper left side of the chest. The pulse generator uses electrical impulses to stimulate the vagus nerve, which influences mood and sleep. VNS is used to treat depression, but its use is highly controversial and is rarely used.
• Deep Brain Stimulation (DBS): Originally used to treat Parkinson’s Disease, DBS has been approved to treat Obsessive-Compulsive Disorder (OCD) and is being studied for use with Major Depression. This involves two electrodes surgically inserted deep in the brain and a pulse generator surgically placed in the chest.
Complementary Health Approaches:
Other therapies can supplement the treatment plan. These approaches include:
• Tai Chi
• Meditation
• Yoga
• Aerobic and Anaerobic Exercise
As always, check with your doctor first before beginning any new physical activity.
Possible Home Remedies and Helpful Lifestyle Changes:
• Stick with your treatment plan. Even if you are feeling well, keep attending therapy sessions and taking your medication. Your therapist can help you monitor your symptoms and help you catch early signs of relapse before the symptoms get out of control. Sometimes you can cope and other times you might need to call your doctor/psychiatrist and ask for help.
• Avoid alcohol and drugs. Alcohol and psychiatric medications don’t mix well. Ditto for street drugs. It’s just better to avoid them altogether. If you are addicted, talk to your doctor about getting help.
• Adopt a healthy lifestyle. Physical activity, a healthy diet, positive thinking, and a regular sleep schedule are all important to a person’s overall mental health. Determine your priorities and use a planner or calendar to keep track of your commitments. Don’t make important decisions when your symptoms are severe as you may not be thinking clearly. Wait until your symptoms are more under control and then revisit whatever it was you needed to make a decision on.
Support and Coping
• Learn about your condition. Your doctor or therapist can recommend educational materials for your review. Be sure to include family and friends so they know what you are dealing with and how they can help you.
• Join a support group. This is a safe environment where a group of people comes together to share experiences and ideas for coping with similar challenges.
• Keep connected with friends and family.
• Keep a journal. A journal is a safe space to explore thoughts, feelings, record symptoms, and any questions you might have for you doctor or therapist.
(Information adapted from the NAMI and Mayo Clinic websites)