Physical" Treatment (drugs) for a "Mental" Illness

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Hi,

Good question! Let's take a closer look at both the positive and negative implications.

RESPONSE:

1. What are the implications of using a "physical" treatment (drugs) for a "mental" illness (like depression or anxiety)?

The implications are both positive and negative. Positively, drug therapy controls some of the symptoms of mental ill, such as anti depressants controlling symptoms of depression, which improve the quality of life. The negative implications are the side effects associated with anti-depressants or other drugs and also, relying only on drug therapy and not dealing with the underlying or precipitating issues (e.g., emotional, social and psychological factors).

Antidepressants and anti-anxiety medications have serious negative implications for teenagers e.g., suicidal ideation, suicide attempts, suicide, and homicide). However, for other populations, such as for treating post-stroke depression, which is a serious disorder that can compromise the overall rehabilitative process, including speech-language treatment. Here, taking a drug that controls for depression symptoms greatly increases the person's change of recovery (http://jslhr.asha.org/cgi/content/abstract/34/2/325).

Therefore drug therapy for depression and anxiet disorders have positive implications, such as a return to normal functioning and a reported increase in the quality of life for people with major depression and post-stroke depression.

But are drugs really effective and worth taking, considering the side-effects of long term used of drugs? One study, for example, showed that while modern antidepressants do produce substantial improvements in depression, people receiving a placebo improved nearly as much as those receiving the drug. Only for the most severe depressions did drug show an advantage over placebo. The finding that placebo response is high in antidepressant trials is consistent with prior research (Joffe, Sokolov, & Streiner, 1996; Kirsch & Sapirstein, 1998; Kahn et al., 2000; Kirsch et al., 2002; Walsh et al., 2002, as cited in http://72.14.205.104/search?q=cache:-yfhg1_VwEIJ:www.cpa.ca/cpasite/userfiles/Documents/Effectiveness%2520of%2520antidepressant%2520medication.pdf+implications+of+drug+therapy+for+depression&hl=en&ct=clnk&cd=5&client=firefox-a).

Why do depressed people respond to placebos? The reasons behind the placebo response for depression are complex. Clearly, expecting that one is receiving a beneficial treatment is helpful. Depression is a disorder that is characterized by hopelessness for some patients (Abramson, Metalsky, & Alloy, 1989; Joiner et al., 2001 as cited in http://72.14.205.104/search?q=cache:-yfhg1_VwEIJ:www.cpa.ca/cpasite/userfiles/Documents/Effectiveness%2520of%2520antidepressant%2520medication.pdf+implications+of+drug+therapy+for+depression&hl=en&ct=clnk&cd=5&client=firefox-a). The very act of seeking help and receiving a treatment from an expert likely instills hope, which may spur improvement for some individuals. Therefore, perhaps the use of 'talk' therapy also instills hope and would be as helpful as the drug therapy, and without the side effects, especially related to long-term maintenance use of antidepressants and other drugs. The longer a person is on drug therapy, the more negative implications associated with the side-effects and more serious and likely the symptoms become permanent. However, major depression responds only to drug therapy and it is important ...