TREATMENT
TALKING THERAPIES
Talking therapies can be used for a range of brain health and emotional challenges such as bipolar disorder, stress, anxiety and depression.
They involve talking with a trained therapist and may be:
- one-on-one;
- group;
- online;
- telephonic;
- family; or
- relationship sessions.
Many therapy techniques are used in conjunction with medication.
Questions could include:
- Why have you sought therapy?
- Tell me about yourself (personal history) and current situation?
- Do you have any symptoms? Anxiety, stress?
COUNSELLING
Counselling is one type of talking therapy.
A counsellor will help you to find ways to deal with emotional problems by helping you understand and work through these problems.
Your counsellor will help you to find ways to deal with specific issues you may have, by helping you work through and understand your problems in a positive way.
Counsellors are often trained to deal with specific areas such as relationships, families, grief or trauma. Professional counselling is confidential and non-judgmental.
Counsellors can help you deal with:
- A difficult life event, such as a relationship ending, bereavement or work stress
- Physical health conditions, such as infertility
- Addiction and substance abuse
- Family and school challenges
What to expect
Your first session will involve the counsellor getting to know how you typically cope with and think about the world around you, including possible threats and challenges.
Your counsellor will ask questions to gather this information and use this to help you find alternative ways of thinking about or coping with challenges you may currently be facing or may face in the future.
- It is best to be honest and open with your counsellor to get the most out of your sessions.
- Prepare for your session if possible so you can describe what brought you here.
- Ask questions about how it works and what the counselling process will be.
The aim of counselling is to help you overcome your problems or learn to cope with them in a helpful way. This is a team effort. Take an active part in the session, and you will find the counselling experience valuable. It is not a quick fix solution but it can be a successful tool toward resolving problems and feeling more in control of your yourself.
- A counsellor serves as a guide and may seldom give advice and almost never would strive to convince a client to do something. Instead, the counsellor helps you come to conclusions about any problems or issues you may have, and then may suggest ways or methods of helping with these issues.
My therapy journey: What to expect
CHOOSING A THERAPIST
When it feels like stress is getting the upper hand, consider getting professional help.
Where do you start?
Put first things first
• Identify the basic problem. Figure out (in general) why you want help. This gives you a clearer idea of the type of therapist that will best suit your needs.
• Decide if it is important for the therapist’s office to be near work, near your home, or in another convenient location.
• Consider your preferences for a therapist’s gender, age, ethnicity, religion, or affiliation with a clinic or counselling group. Remember, your comfort level is an important factor in the counselling process.
• Check with your health plan or medical aid.
• Find out what your plan or medical aid covers for therapy/counselling (amount paid per visit, number of visits per year, required counselling credentials or affiliations, diagnosis prior to payment).
Mental Health Treatment: 5 things your therapist wants you to know
INTERVIEW PROSPECTIVE THERAPISTS
Before you choose a therapist, ask some questions. Some therapists provide free or reduced-rate introductory sessions.
Here are some good questions to ask (it helps to take notes):
• What are your qualifications (degree, training, experience with your type of therapy)?
• How do you approach therapy (philosophy and methods)?
• How long do you think I’ll need therapy for (frequency and length of visits)?
• When are you available for appointments (days, evenings, weekends, emergencies)?
• What do you charge for a therapy session (billing, frequency, extended payment arrangements, medical aid claims)?
Points to remember
• You’ll simply be talking to someone about your problem, just like you consult other professionals for other areas of your life (your broker, your doctor, your mechanic, your religious leader).
• It helps to set goals with your therapist.
• Be realistic and don’t expect the therapist to ‘fix’ the problem. Your efforts are essential.
• You always have the right to change or terminate therapy if you think it is not working out.
COGNITIVE BEHAVIOURAL THERAPY (CBT)
CBT is a short-term talk therapy. It is time-sensitive, structured, goal-oriented and focused on the present.
MEDICATION
Medication is often used with therapy to treat brain health conditions like depression.
But psychiatric drugs don’t cure a brain health challenge. Rather, they can help reduce symptoms or help you cope better so that you are better able to work on your brain health. And not everyone needs to be on medication. Your treatment plan will depend on your needs.
Some things to remember
• Not everyone needs to be on medication.
• Most medications may take some time to become fully effective.
• How long you need to be on medication is based on your treatment plan.
• Medication may not work for you.
Being on medication depends on:
• your diagnosis
• your symptoms
• how severely the brain health condition affects you
PSYCHIATRIC MEDICATION
Types of Medication
ANTIDEPRESSANTS
ANTI-ANXIETY
ANTIDEPRESSANTS
Antidepressants are medications commonly used to treat depression.They work to balance some of the natural chemicals in our brains, ie by increasing levels of certain neurotransmitters, such as dopamine. By causing a change to your brain chemistry, antidepressants may lift your mood. They can help symptoms such as irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping. It may take several weeks for them to help. So it’s important to give them time to start working.
Antidepressants generally provide some relief of symptoms within one to two weeks; however, it may take six to eight weeks of treatment before the full effects are felt. There are several types of antidepressants. You and your doctor may have to try a few before finding what works best for you. To prevent relapse (another depressive episode), many doctors prescribe antidepressants to be taken for six months to a year.
Because each type of antidepressant works slightly differently, things like your age, symptoms, medical history and family history will help your doctor determine which antidepressant medication is best for you.
The most commonly used are:
• Selective serotonin reuptake inhibitors (SSRIs): SSRIs increase the amount of serotonin available to be used by the brain, eg Celexa, Cipramil, Cipralex, Prozac, Zoloft and Paxil.
• Norepinephrine and dopamine reuptake inhibitors (NDRIs): NDRIs increase the amount of these two neurotransmitters available to be used by the brain, eg Wellbutrin.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs increase the amount of these two neurotransmitters available to be used by the brain, eg Cymbalta and Effexor.
• Serotonin antagonist and reuptake inhibitors (SARIs): SARIs affect the amount of serotonin available to be used by the brain, eg Serzone and Trazodone.
To get the best results from an antidepressant:
It’s important to give the body time to adjust to the change.
Be patient
Once you and your doctor have selected an antidepressant, you may start to see improvement in a few weeks, but it may take six or more weeks for it to be fully effective. With some antidepressants, you can take the full dosage immediately. With others, you may need to gradually increase your dose. Talk to your doctor or therapist about coping with depression symptoms as you wait for the antidepressant to take effect.
Take your antidepressant consistently and at the correct dose
It is important to keep taking your medication, even if you feel better.
Don't stop taking an antidepressant without talking to your doctor first
Some antidepressants can cause significant withdrawal-like symptoms unless you slowly taper off your dose. Quitting suddenly may cause a sudden worsening of depression. When it is time to stop the medication, you doctor will help you slowly and safely decrease the dose.
Monitor your symptoms to see if they improve
For example, if the medication is supposed to help you sleep, lift your mood or lessen anxiety, pay careful attention to your symptoms to ensure that the medication is effective.
Minimise alcohol consumption
It reduces the effectiveness of antidepressants. Follow through with other treatment recommendations. Often, counselling is recommended to help you stay on your medications and to deal with the psychological problems associated with depression. Read the leaflet that comes with your medication, which will tell you whether you can consume alcohol and how much.
Ask questions
Talk to your doctor if you have concerns about your medication. There is no such thing as an ‘unwanted question’ when it comes to your health.
Try psychotherapy
In most cases, combining an antidepressant with talk therapy (psychotherapy) is more effective than taking an antidepressant alone. It can also help prevent your depression from returning once you’re feeling better.
Keep all your doctor appointments
whether you are feeling better or worse. The doctor will need to see you to monitor dosage, side effects and the effectiveness of the medication.
People don’t get addicted (or ‘hooked’) on these medications, but stopping them abruptly may also cause withdrawal symptoms such as anxiety and restlessness.
Side effects of antidepressants
Antidepressants may cause mild and short-term side effects, which usually occur in the first few weeks after commencing the medication. Side effects do not affect all people and many are temporary. Tell your doctor if you have any side effects.
Common side effects include:
• Dry mouth. Suck on ice, or unsweetened candy.
• Constipation. Eat more bran cereals, prunes, fruits, and vegetables; or try an over-the-counter (OTC) bulk stool softener such as lactulose.
• Bladder problems. Emptying your bladder may be somewhat difficult and your urine stream may not be as strong as usual. Call your doctor if you have any pain or severe problems with urination.
• Temporary blurred vision. If this occurs, it should pass quickly. Do not get new glasses. Talk to your doctor if problem persists.
• Dizziness. Rise from your bed or chair slowly.
• Sensitivity to the sun. Wear protective clothing and use sunscreen.
• Drowsiness. This will pass quickly, but do not drive or operate heavy equipment if feeling drowsy or sedated.
A final note ...
Explore options if it doesn’t work well. Sometimes your doctor will try a variety of antidepressants before finding the medication or combination of medications that work best for you. If you have bothersome side effects or no significant improvement in your symptoms after several weeks, talk to your doctor about changing the dose, trying a different antidepressant, or adding a second antidepressant or another medication. A medication combination may work better for you than a single antidepressant.
Medication for depression
ANXIOLYTICS
Anti-anxiety drugs are used to prevent and treat anxiety related to several brain health challenges.
They can help with sleep and feelings of fearfulness or nervousness.
These drugs tend to work rather quickly and can be addictive. Because of this, they’re usually only prescribed for short-term use.
They aren’t recommended for people with a history of substance misuse or addiction.
Anxiolytics are often combined with psychotherapy (talk therapy) or cognitive behavioural therapy.
BOOST YOUR KNOWLEDGE
Anxiolytics work by targeting key chemical messengers (neurotransmitters) in the brain. This is thought to help decrease abnormal excitability.
Primarily, anxiolytics are used to treat symptoms of anxiety disorders, including generalised anxiety disorder and social phobia.
Known as benzodiazepines, anxiolytics reduce symptoms of anxiety by increasing the action of a brain chemical called gamma-aminobutyric acid (GABA).
GABA is a chemical that nerve cells use to communicate with each other and it reduces brain activity. It is believed that excessive activity in the brain may lead to anxiety or other brain health challenges.
SELF CARE
There are many ways in which you can support yourself when you are experiencing a brain health challenge.
