Types of treatment

Various types of treatments are used to treat mental health problems
Types of treatment
Q

What are the different types of treatment?

A

As a first step in treatment, doctors do a thorough diagnosis. Based on the results of this diagnosis, they prescribe a specific treatment plan. For mild mental illness with controlled symptoms, treatment may be for a short period of time. For people with severe mental illnesses, a team of mental health professionals that primarily include psychiatrists, psychologists and psychiatric social workers, work together to provide appropriate treatment. Treatment can include one or a combination of the methods listed below.

Note: For any type of treatment, the person's willingness to take treatment helps in speedy recovery. Some disorders may be caused by a chemical imbalance in the brain; sometimes, the imbalance may be due to severe emotional turmoil. Empathy and emotional support from family and friends greatly helps the person through treatment and recovery.

Medication/Pharmacotherapy

Medication helps improve or control symptoms and promote recovery. In most cases, medication is considered the first line of treatment. The impact of medication depends on the severity of the illness, and on how the person's body responds to medication.

Some of the most commonly used psychiatric medications include:

  • Antidepressants: Medicines that are prescribed by a psychiatrist for relieving or controlling symptoms of  depression or anxiety. Antidepressants are not addictive and there is no dependency on them even when used for a long period of time.

  • Anti-anxiety medications:  Also known as tranquilizers, these medicines relieve anxiety, and hence are used to treat anxiety disorders. These medicines have a relaxing and calming effect and they also help reduce agitation and insomnia.

  • Mood-stabilizing medication: A psychiatric medicine and a mood stabilizer used to treat mood disorders.  They help balance certain neurotransmitters in the brain which control emotions and behavior. This medication is used to treat bipolar disorder and helps prevent the return of manic and depressive episodes in bipolar disorder. In some cases, this medication is also used to treat severe depression, or

    depression caused due to schizophrenia.

  • Antipsychotic medications: Also called neuroleptics or major tranquilizers, these are generally used to treat symptoms (hallucination, delusion, disordered thoughts, mood swing) of disorders such as schizophrenia. These medicines may also be used to treat bipolar disorder or severe depression.

Therapies

The aim of any therapy is to help people recover and improve their mental health and wellbeing. Some people may be prescribed medication and one type of therapy while others may be prescribed two therapies along with medication. The type of therapy depends on the severity of the illness and the person's physical and emotional condition.

Psychotherapy: A type of treatment where a medical expert (a psychiatrist or a clinical psychologist trained in psychotherapy) uses scientifically validated procedures to help people replace disordered and illogical thought process with positive, pragmatic, and logical thinking, combined with healthy habits to reinforce positive behavior.

The therapist encourages the person to speak about their symptoms and related issues, and helps them analyze and understand their moods, feelings, thought patterns and behavior. With this insight and understanding about oneself, the person is in a better position to learn how to cope with their condition and recover. There are various types of psychotherapies and there is no particular therapy that works for all illnesses.  

Cognitive Behavioral Therapy (CBT): This is a combination of two therapies: Cognitive Therapy (CT) and Behavioral Therapy (BT). Cognitive therapy focuses on a person's thoughts and beliefs and their influence on a person's mood and actions, and aims to change a person's thinking to be more adaptive and healthy. Behavioral therapy focuses on a person's actions and aims to change unhealthy behavior patterns.

CBT helps a person identify their existing problems and work at solving them. Both patient and therapist are actively involved in this process. The therapist helps the patient learn how to identify distorted or unhelpful thinking patterns, recognize and change inaccurate, irrational and meaningless beliefs, change behaviors accordingly, and improve their interpersonal relationships.

CBT is particularly helpful in patients who have an insight into their problems as the techniques used in CBT requires patients to be actively involved in the therapy process, which includes certain homework tasks like maintaining a mood diary, identifying dysfunctional thoughts and recording positive experiences.

CBT can be used to treat several mental illnesses such as depression, anxiety, eating disorder, and bipolar disorder.

Interpersonal Therapy (IPT): Intended to improve communication and the way a person interacts with other people. When a person's behavior is causing problems, IPT helps the person identify this problem and change their behavior. IPT may be used along with medication. Research indicates that the effectiveness of IPT depends on the severity of the illness and the patient's willingness to actively follow the therapy.

Family Therapy: Focuses on conducting therapy sessions for both the patient and their family members, and improving family relationships, which can support caregiving and the patient's recovery.

The therapist works with family members to identify family conflicts that could worsen the patient's illness. These problems are addressed and a solution is found with the initiative coming from the family members themselves.

The therapist educates the family members about their loved one’s illness and its symptoms. The therapist also helps the family recognize any critical or hostile attitude (which is unintentionally expressed due to the illness) towards their loved one and work on such negative behavior. At the same time, the therapist also highlights that fact that the patient's willingness to continue with the treatment and recover is vital along with family support and care. Family therapy also focuses on reducing any stress in family members, caused by prolonged caregiving.

Important: A combination of some of these therapies sometimes increases the effectiveness of the prescribed treatment. Also, there is a need to combine pharmacotherapy with psychotherapy in most cases. For example, for a condition such as mild depression, CBT along with supportive psychotherapy may yield good results, whereas for a more severe depression, a combination of pharmacotherapy (as a first line of treatment) with psychotherapy may work better. However for a psychotic illness, psychotherapy may not work at all and only medication may help.

Brain stimulation treatments

Brain stimulation treatment is used only when medication or psychotherapy has not shown any results. It is used to treat specific conditions after thorough medical evaluation, and after a panel of doctors come to a consensus that the patient would benefit from this treatment.

Important: The patient and their caregivers need to have a thorough understanding about these treatments and their side effects. The treatment is given only after the patient and the caregivers provide their consent.

Brain stimulation treatments include:

  • Electroconvulsive therapy (ECT): A therapy where electric current is passed through the brain, to treat symptoms of certain mental illnesses. Read more about why and when ECT is prescribed as a treatment. 

  • Transcranial Magnetic Stimulation (TMS): A procedure where magnetic fields are used to stimulate nerve cells in the brain to improve symptoms of some mental illnesses.

Q

How do I know if a specific treatment is beneficial?

A

Mental health professionals check the medical case history, analyze the symptoms, conduct tests and assessments and speak to family members to be able to diagnose the illness accurately and then decide on the type of treatment. The patient and caregivers are kept informed about the entire process. If the patient is in a condition where they can have discussions to understand how the treatment can help in recovery, they can do so. If not, it helps if the patient's family (caregivers) has sufficient knowledge about the specific illness and understands how it is treated, so that the doctor and the caregivers can be in agreement about the type of treatment.

Q

Can yoga be considered as a treatment for mental illness?

A

In the past decade, research has shown that yoga is effective as an additional treatment for various mental illnesses. To know more, read the interview with Dr. Shivarama Varambally, who explains the benefits of yoga as an additional treatment for mental illness.

Q

What are the side effects of psychiatric medication?

A

It is a well known fact that all medicines have side-effects. Some people may not feel the side-effects or they are able to manage them. Also, in case of psychiatric medicines, the side-effects are mentioned in the information sheet that is included with your medicine. Speak to your doctor and learn more about the side-effects and how to deal with them.

Some of the side-effects of psychiatric medication include:

  • Sleepiness and slowness

  • Weight gain

  • Possibility of developing diabetes

  • Fluctuation in blood pressure causing dizziness

  • Negative symptoms like poor motivation, lack of interest, and poor self care

You may want to think about the following important things:

  • The benefits of the medicine are more important than any minor side-effects.

  • It is best to take medication at the stipulated time, as advised by your doctor so that the medicines aid recovery.

  • Side-effects may stop after you regularly take the medicine for some time.

  • If you still experience side-effects and you are hesitant to continue medication, speak to your doctor. He or she may be able to lower your dose or change your medicine.

  • At any stage during the course of treatment, do not suddenly quit taking your medicine unless your doctor advises you to.

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