Disadvantage of Taking Psychiatric Drugs

By Chee Fui Chau

The Psychiatric Drugs

Desiring optimal health, people frequently turn to drugs to alter their physical and mental health. Surveys show that many Americans regularly use some type of psychiatric medication such tranquilizers, sleeping pills, antipsychotic drugs and antidepressants. Easily obtained in today's market, these drugs are used to treat a wide variety of symptoms from anxiety and difficulty sleeping to decreased energy levels, disorientation and depression.

Although these are serious health issues, the treatment of these disorders is often misunderstood and abused. Not without consequence, the use of any mind-altering substance must be prepared by thorough research and careful evaluation.

Tranquilizers and Sleeping Pills

Today's hectic schedules and external pressures put great strain on the human body, often resulting in stress and agitation. Surveys show that 15.6% of people use tranquilizers to relieve anxiety. Of this percent, 39% use them daily, and 78% admitted to taking tranquilizers for more than a year. Most tranquilizers belong to a chemical family called benzodiazapines, although more common names include Valium, Librium, Xanax and Halcium. Sleeping pills, another common type of tranquilizers, include sedatives known as barbiturates, buspirone, Diphenhydramine, Hydrozyzine and Meprobamate.

Although confirming their popularity, studies question the efficacy of tranquilizers and sleeping pills. Evidence suggests that even the most potent tranquilizers are ineffective after periods of four months and sleeping pills have been shown to lose efficacy after only two to four weeks. In addition to limited performance, tranquilizers and sleeping pills can cause a multitude of side effects, such as low blood pressure, hip fracture, liver disease, allergies and breathing problems. Mind-altering effects include decreased mental functioning, forgetfulness, withdrawal syndrome and lack of coordination. Alarmingly, approximately 16,000 auto accidents each year are attributed to the use of psychoative drugs such as tranquilizers and sleeping pills.

Studies also shows that tranquilizers are unnecessary under most circumstances. In fact, in many studies, patients responded to placebos as well as they did to actual tranquilizers, proof that the therapeutic effects of tranquilizers don't merit their harmful effects. According to the World Health Organization (WHO), "anxiety is a normal response to stress, and only when it is severe and disabling should it lead to drug treatment."

Antipsychotic Drugs

Antipsychotics drugs are another example of treatment clouded by misconception and misdiagnosis. Although intended to treat only serious mental illness, such as schizophrenia, an estimated 750,000 people over the age of sixty-five regularly use antipsychotics drugs. This figure is alarming considering that approximately 92,000 people over the age of sixty five have been clinically diagnosed with schizophrenia. Experts believe that many people wrongly turn to antipsychotic drugs after experiencing symptoms similar to schizophrenia, such as hallucinations and confusion, when in many cases, these symptoms are side-effects induced by other drugs the consumers take regularly.

Adverse effects of antipsychotic drugs include nerve damage, tartive dyskinesia (difficulty in chewing or swallowing), loss of balance, muscular fatigue, delirium and Parkinson's disease. One study found that 36% of patients with drug-induced Parkinson's had been using antipsychotic drugs when diagnosed with the disease. Assuming that the patients had classic Parkinson's, doctors tried to treat the illness with another drugs, rather than stopping the antipsychotic drugs causing the symptoms.

Antidepressants

Although a very real illness, the cause and symptoms of depression are also frequently misunderstood. As with other mental disorders, many cases of depression are actually caused by drugs used to treat other ailments. Depression is associated with a long list of medications, including, barbiturates, tranquilizers, corticosteroids, diet drugs and painkillers. Other types of depression may be triggered by thyroid disorders, cancer, hepatitis or other form of illness. It is critical to define the underlying causes of the depression before administering treatment.

Adverse effects of antidepressants include low blood pressure, irregular heart rate, enlarged prostate, nausea, blurred vision, worsening of glaucoma, dry mouth, disorientation, loss of memory and fatigue. The safety and efficacy of an antidepressant can only be determined after obtaining both a careful and detailed history of the patient and a complete knowledge about the available medicines and their indications.

In Conclusion

The human mind is the body's powerhouse, the controller of both thought and action. For this reason, the brain must be carefully nurtured and protected from harmful substances. The science of nutritional immunology advocates a diet rich in phytochemicals, which help strengthen the body's defenses and prevent the need for serious medical treatment. Whether used to relieve simple stress or to treat a more serious mental disorder, psychiatric drugs can have a detrimental effect on both the physical and mental well-being of the body. Before consuming psychiatric drugs, it is imperative to consult a physician and conduct personal research to determine the necessity and consequences of the drugs in question. A willingness to do so may prevent critical health blunders and change minds for the better.

Articles provided by Chau Chee Fui who managed [http://healthnutrition4u.com]Health & Nutrition Articles website.

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Who's Who In Mental Health Service - GPs, Psychiatrists, Psychologists, CPNs And Allied Therapists

When a person is experiencing psychological or emotional difficulties (hereafter called “mental health problems”), they may well attend their GP. The GP will interview them and based on the nature and severity of the persons symptoms may either recommend treatment himself or refer the person on to a specialist. There can seem a bewildering array of such specialists, all with rather similar titles, and one can wonder as to why they’ve been referred to one specialist rather than another. In this article I give an outline of the qualifications, roles and typical working styles of these specialists. This may be of interest to anyone who is about to, or already seeing, these specialists.

The General Practitioner

Although not a mental health specialist, the GP is a common first contact for those with mental health problems. A GP is a doctor who possesses a medical degree (usually a five-year course) and has completed a one-year “pre-registration” period in a general hospital (six-months on a surgical ward and six-months on a medical ward as a “junior house officer”). Following this a GP has completed a number of six-month placements in various hospital-based specialities – typical choices include obstetrics and gynaecology, paediatrics, psychiatry and/or general medicine. Finally, a year is spent in general practice as a “GP registrar” under the supervision of a senior GP. During this period, most doctors will take examinations to obtain the professional qualification of the Royal College of General Practitioners (“Member of the Royal College of General Practitioners”, or MRCGP). Others qualifications, such as diplomas in child health, may also be obtained.

The GP is thus a doctor with a wide range of skills and experience, able to recognise and treat a multitude of conditions. Of course the necessity of this wide range of experience places limits on the depth of knowledge and skills that they can acquire. Therefore, if a patient’s condition is rare or, complicated, or particularly severe and requiring hospital-based treatment, then they will refer that patient on to a specialist.

Focusing on mental health problems it will be noted that whilst the majority of GP’s have completed a six-month placement in psychiatry, such a placement is not compulsory for GP’s. However, mental health problems are a common reason for attending the GP and, subsequently, GP’s tend to acquire a lot of experience “on the job”.

Most GP’s feel able to diagnose and treat the common mental health problems such as depression and anxiety. The treatments will typically consist of prescribing medication (such as antidepressants or anxiolytics) in the first instance. If these are ineffective, alternative medication may be tried, or they may refer the patient to a specialist. GP’s are more likely to refer a patient to a specialist immediately if their condition is severe, or they are suicidal, or they are experiencing “psychotic” symptoms such as hallucinations and delusions.

The Psychiatrist

This is a fully qualified doctor (possessing a medical degree plus one year pre-registration year in general hospital) who has specialised in the diagnosis and treatment of mental health problems. Most psychiatrists commence their psychiatric training immediately following their pre-registration year and so have limited experience in other areas of physical illness (although some have trained as GP’s and then switched to psychiatry at a later date). Psychiatric training typically consists of a three-year “basic” training followed by a three year “specialist training”. During basic training, the doctor (as a “Senior House Officer” or SHO) undertakes six-month placements in a variety of psychiatric specialities taken from a list such as; General Adult Psychiatry, Old Age Psychiatry (Psychogeriatrics), Child and Family Psychiatry, Forensic Psychiatry (the diagnosis and treatment of mentally ill offenders), Learning Disabilities and the Psychiatry of Addictions. During basic training, the doctor takes examinations to obtain the professional qualification of the Royal College of Psychiatrists (“Member of the Royal College of Psychiatrists” or MRCPsych).

After obtaining this qualification, the doctor undertakes a further three-year specialist-training placement as a “Specialist Registrar” or SpR. At this point the doctor chooses which area of psychiatry to specialise in – General Adult Psychiatry, Old Age Psychiatry etc – and his placements are selected appropriately. There are no further examinations, and following successful completion of this three-year period, the doctor receives a “Certificate of Completion of Specialist Training” or CCST. He can now be appointed as a Consultant Psychiatrist.

The above is a typical career path for a psychiatrist. However, there are an increasing number of job titles out with the SHO-SpR-Consultant rubric. These include such titles as “Staff Grade Psychiatrist” and “Associate Specialist in Psychiatry”. The doctors with these titles have varying qualifications and degrees of experience. Some may possess the MRCPsych but not the CCST (typically, these are the Associate Specialists); others may possess neither or only part of the MRCPsych (many Staff Grades).

Psychiatrists of any level or job title will have significant experience in the diagnosis and treatment of people with mental health difficulties, and all (unless themselves a consultant) will be supervised by a consultant.

Psychiatrists have particular skill in the diagnosis of mental health problems, and will generally be able to provide a more detailed diagnosis (i.e. what the condition is) and prognosis (i.e. how the condition changes over time and responds to treatment) than a GP. The psychiatrist is also in a better position to access other mental health specialists (such as Psychologists and Community Psychiatric Nurses or CPNs) when needed. They also have access to inpatient and day patient services for those with severe mental health problems.

The mainstay of treatment by a psychiatrist is, like with GP’s, medication. However, they will be more experienced and confident in prescribing from the entire range of psychiatric medications – some medications (such as the antipsychotic Clozapine) are only available under psychiatric supervision and others (such as the mood-stabiliser Lithium) are rarely prescribed by GP’s without consulting a psychiatrist first.

A psychiatrist, as a rule, does not offer “talking treatments” such as psychotherapy, cognitive therapy or counselling. The latter may be available “in-house” at the GP surgery – some surgeries employ a counsellor to whom they can refer directly.
Psychologists and allied mental health staff typically provide the more intensive talking therapies. Some senior mental health nurses and CPNs will have been trained in specific talking therapies. It is to a Psychologist or a trained nurse that a psychiatrist will refer a patient for talking therapy. These therapies are suitable for certain conditions and not for others – generally, conditions such as Schizophrenia and psychosis are less appropriate for these therapies than the less severe and more common conditions such as depression, anxiety, post-traumatic stress disorder, phobia(s) and addictions. In many cases, a patient will be prescribed both medication and a talking therapy – thus they may be seen by both a therapist and a psychiatrist over the course of their treatment.

The Psychologist

A qualified clinical psychologist is educated and trained to an impressive degree. In addition to a basic degree in Psychology (a three year course) they will also have completed a PhD (“Doctor of Philosophy” or “Doctorate”) – a further three-year course involving innovative and independent research in some aspect of psychology. They will also be formally trained in the assessment and treatment of psychological conditions, although with a more “psychological” slant than that of psychiatrists. Psychologists do not prescribe medication. They are able to offer a wide range of talking therapies to patients, although they typically specialise and become expert in one particular style of therapy. The therapies a particular psychologist will offer may vary from a colleague, but will usually be classifiable under the title of Psychotherapy (e.g. Analytic Psychotherapy, Transactional Analysis, Emotive therapy, Narrative therapy etc) or Cognitive Therapy (e.g. Cognitive Behavioural Therapy (CBT) or Neuro-Linguistic Programming (NLP) etc).

The Community Psychiatric Nurse (CPN)

These are mental health trained nurses that work in the community. They will have completed a two or three year training programme in mental health nursing – this leads to either a diploma or a degree, depending on the specific course. They are not usually “general trained”, meaning their experience of physical illness will be limited. Following completion of the course they will have spent a variable amount of time in placements on an inpatient psychiatric unit – this time can range from twelve months to several years. They can then apply to be a CPN – they are required to show a good knowledge and significant experience of mental health problems before being appointed.

CPNs are attached to Community Mental Health Teams and work closely with psychiatrists, psychologists and other staff. They offer support, advice and monitoring of patients in the community, usually visiting them at home. They can liaise with other mental health staff on behalf of the patient and investigate other support networks available (such as the mental health charities).

Some CPNs will be formally trained in one or more “talking therapies”, usually a cognitive therapy such as CBT (see “Allied Therapists” below).

“Allied” Therapists

Many “talking therapies” are offered by non-psychologists – for example, mental health nurses and mental health occupational therapists can undertake a training course in a cognitive therapy like CBT. After successful completion of the course, the nurse will be qualified and able to offer CBT to patients. The length and intensity of these courses can vary dramatically, depending on the type of therapy and the establishment providing the course. Some are intensive, full-time one or two week courses; others are part-time and can extend over months and years. Perhaps a typical course will be one or two days a week for two to three months. Formal educational qualifications are not necessary to undertake these courses, and they are open to “lay” people with little or no experience of the NHS mental health services. Of course this is not necessarily a problem - it may even be considered a positive point!

Some of those therapists thus qualified will offer their skills as part of their work in the NHS – for instance, a nurse or CPN may offer cognitive therapy to a patient that has been referred by a psychiatrist. Unfortunately this is relatively rare at the moment, presumably due to the reluctance of the NHS to pay for such training for their staff. As a result these therapies are more accessible on a private basis.

Summary

An individual with psychological difficulties will normally attend their GP in the first instance. The GP will usually have encountered similar problems with other patients and can offer a diagnosis and appropriate treatment. If the condition is unusual or particularly severe, the GP can refer the patient to a psychiatrist. The psychiatrist is able to access a wider range of treatments (medications and hospital care) and can, if necessary, recruit other mental health professionals to help the patient. This system perhaps works best with the severely mentally ill such as those with psychotic symptoms or who are suicidal.

The Mental Health Services in the NHS are generally less well suited to those with psychological problems of a less severe nature – the moderately depressed, the anxious, the phobic etc. The availability of “talking therapies” is limited in the NHS, with long waiting lists or even no provision at all in some areas. This appears to be due both to the cost of training staff appropriately and the time-intensive nature of these therapies.

For those with such conditions, the main option is to seek help outside the NHS. There are some voluntary organisations that offer free counselling for specific problems such as bereavement or marital/relationship difficulties, but more intensive therapies (such as CBT or NLP) are typically fee based. Your GP or local Community Mental Health Team may be able to recommend a local private therapist.

Karen is a mental health occupational therapist whose background is working in the NHS mental-health system. Karen practices privately in Hertfordshire, where she employs NLP and Hypnotherapy techniques to help people with emotional, psychological and behavioural problems. For more information about NLP, Herts visit http://www.karenhastings.co.uk

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