An Informed Opinion On Psychiatric Medication And The Merits Of Cognitive Therapy As A Safer, More Effective Alternative

It is my personal opinion based off my own lived experirence that the agenda to medicate children with haste in the 90’s was a disastrous decision. I found in my own life that the medications were more of a problem than anything, and the system itself was entirely backwards. Much evidence has come out in recent years that contradicts the information told to parents like mine when I was younger. I write this article to evaluate two main concepts. The first point I aim to outline is that during early developmental years, counselling or therapy should be considered optimal compared to medication in many scenarios. The second point I hope to outline is that certain types of therapy in my opinion hold much more therapeutic value than traditional therapy. I hope to explain three practices, DBT, CBT, and EMDR therapies that I have used in the course of my own recovery from childhood trauma. I’ve previously written on my life experience, and for readers more curious about what experiences led me to advocate for something like DBT therapy, a link is at the end of this article. Not only do I believe these practices could replace medicine entirely for many people today, I also find the core skill set something that could be of use to anyone who has never experienced mental illness in their life.

       In the first publication listed in the sources section, professionals assess the clinical effects of prescribing antidepressants or drugs similar to adderal to young children. Surprisingly, nearly 30 years after the boom in childhood prescription it is clearly stated little is actually known how these drugs affect children. Clinical trials have shown over the years that there’s little way to tell if a prescription will be a cure-all. In some cases many antidepressants were shown to have no affect on the disorder, where others shown improvement. A 2004 study found that suicide rates actually increased in youth populations prescribed to SSRI’s as it was not correcting the underlying depression. Likewise, it was found that the suicide rate was at 4.7% when medication was combined with CBT therapy, 9.2% with SSRI alone, and 2.7% with a placebo.
       The same study notes how the prescription rates are on the rise as well as the age of prescription getting younger. In the U.S. 60% of prescriptions are given “off label” primarily due to a lack of research on their effects on children. The providers have to balance their duty to protect from ineffective treatments with their duty to try and improve their patients circumstances. Often this results in children receiving medications that have only been studied on adults. Where the brain is still developing through the adolescent years many professionals argue that medications can not only disrupt this process but also cause adverse effects not seen in adults. It is now being found that drugs like Ritalin, or SSRI’s given at a young age can desensitize the brain leading to worse symptoms or substance abuse.
       In the same journal the author talks a bit on studies that do validify the existence of mood disorders and depression in youth. It was found the rate of these disorders increased significantly between ages 15-18. During these years there are typically very large amounts of stress, and children are theorized to be at a point in brain development where they are susceptible to developing these issues in the absence of good coping skills. The effects of psychiatric drugs aren’t only harmful to children, they are now being shown to be counter-productive in adults also. If the only justification in giving them to children is piggy backed off the idea they are a panacea for adult mental illness I would argue many studies coming out should compel providers to rethink this system as a whole.

        In several of the links readers can find below, we also analyze data pertaining to these drugs as prescribed to adults. Psychiatric drug use over long periods of time is now shown to double suicide rates, induce worse physical and mental health symptoms, and can cause awful side effects. Some of these effects can include mania, hallucinations, psychosis, stroke, or even sudden death. There are many roads into the mental health system, and the list of side effects from most medications being prescribed is startling. The percentage of Americans currently taking psychiatric medications is unnecessarily high, and many began as kids. What often starts as a diagnosis of ADHD or Depression can evolve into much more serious issues over time as medication is introduced, and many cannot escape due to the cumulative effect of the medication. It is argued in one site by the Citizens Coalition on Human Rights that psychiatry is no more than pseudoscience. The doctor who created that presentation argues mental illnesses cannot be considered diseases because there is still not enough proof to establish many disorders are caused by chemical imbalances in the brain. He alleges that many disorders are developed and can be treated best through cognitive therapy practices. Readers can browse the links at the bottom for more information on the idea that psychiatric medications are toxic and could potentially be causing more mental illnesses than they treat. In the next paragraph we will look at CBT and DBT therapies and evaluate their merits in comparison to typical talk therapy.

       Before making my final comparison between talk therapy and the three methods described in my introduction we need to define and explain each of these things. First off we will be looking at CBT, or Cognitive Behavior Therapy which is a broad category which actually includes item 2, DBT, which I will describe second. I describe these types of therapy as proactive or interactive as they incorporate skills based training that aims to resolve root issues causing distress in addition to remedying issues presenting in the short term. In my segment on medications we saw how many in the mental health field feel it is more likely many issues prevalent in adulthood developed over time with a likely onset during adolescent years. What can start as low self esteem or increased energy can actually become trauma when treated improperly, and set young patients up to continually re-traumatize themselves repeatedly into their adult years. With the rise of attention to personality disorders we saw more studies done on treatments like CBT and DBT. This category of disorders has been known to stem from different forms of use and is typically unresponsive to psychiatric medication. Upon finding success with these intensive forms of therapy we are now seeing that extrapolated outward to the point that the study mention above noted that CBT actually reduced the suicide rate increase seen with SSRI prescriptions.
       CBT is often given on a short term basis and places an emphasis on what is termed cognitive distortions. By looking at patterns of flawed thinking patients are challenged to evaluate whats going on in their live in a systematic sense. Often one will be encouraged to first evaluate conditions in their life that are creating excessive stress as well as investigate how these situations are affecting their thoughts and emotions. When patients get to this phase, often they will find their thinking patterns to be both limiting growth as well as exponentiating their emotional upset. Through exercises done with a professional the patient works to reshape the way they think to return to a healthier way of approaching tough situations. The general idea behind CBT is that thoughts and perception influence behavior, and by changing these things we can also change our behavior for the better.
       DBT, or dialectical behavior therapy, employs a lot of the same ideas as CBT therapy due to it being a sort of evolution from the concept that was developed to help patients initially with borderline personality disorder. It was developed in the 1980’s by a woman named Marsha Linehan who saw all things in nature as a balance between opposing forces. She felt that change became possible when one force outweighed the other, that it was inevitable because all things are connected, and through integration of opposite forces one can actually achieve harmony. Linehan found that providers who were able to validate the patients actions through the context of their perception were also more able to encourage an openness to change. DBT is a very intensive method that will require patients to participate in weekly sessions with their therapist, weekly classes teaching the skill “modules”, and phone coaching.
       There are four modules taught in the classroom piece called mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. Within these modules patients will come to learn 12 core skills that they will then practice implementing in their individual sessions. Within this practice of dialectics we often see the opposing forces termed the emotional mind and logical mind, and patients will be working towards the ability to stay in the middle that’s termed wise mind. Through skills in these modules patients learn to reduce their emotional intensity as well as counter thinking errors to effect a balance between thought and emotion. This is often a very long term form of therapy where even after concluding the initial classroom section patients will work extensively with their providers to commit these skills to memory, so much so that they effectively replace previous ineffective coping skills. Ample research would still be required to say its a factual statement that DBT can be used for any disorder. At the same time though this is a method that can be curtailed to the individual, and the reason I advocate so much for it is because it has been wildly useful to me in all areas of my life.
        Thirdly EMDR, or Eye Movement Desensitization Reprocessing is a technique that I never used but has shown to be very successful in dealing with traumatic memories. My personal opinion is that many disorders may ultimately stem from varying degrees of trauma at a young age. Children who are bullied could potentially become depressed or overly angry later in life if they do not learn to cope with normal stressors effectively. Likewise children experiencing extreme physical or sexual abuse are well known to develop issues with their psyche. Where CBT and DBT are successful in addressing thinking errors, social skills and emotional regulation, EMDR is usually implemented to deal with memories of severe trauma that has been permanently affixed in a patients brain. Clinicians will instruct the patient to recall their traumatic memories and move their eyes along a fixed path. Its been found that this time of therapy has an incredibly high success rate as well in dealing with issues like PTSD.
The reason I advocate implementing one or all of these methods over the basic weekly talk therapy is that its essentially a band-aid. Though there is plenty of merit for seeking help on a regular basis with ones current issues, this method alone never for me proved to address the root causes of what I was experiencing. I found the combination of CBT and DBT so effective that not only was I able to taper off my medicine after my diagnosis was reversed, but I saw a complete reversal of my symptoms. I spent years being told that taking pills would make my suffering stop, that I would be happier, and I’d be able to participate in life effectively. This was never the case with medications, they only made matters worse for me and contributed to my lacking ability to cope with the hardships of life. What I found in these types of therapies versus basic talking was that I not only addressed what was happening, but why. I learned the ways my thoughts and emotions interact and over time became able to not only regulate how I felt, but became exponentially better managing my own behavior. Talk therapy always left me knowing I would have to continue this for the rest of my life, that what I was doing wasn’t actually correcting any issue, and in many ways felt like accepting defeat.
        When I finished the course section of DBT it was roughly 2 years time that I was being discharged entirely from mental health providers. Once I had learned the skills and moved into the “practice phase” I kept daily behavior logs and actually studied myself. I felt so empowered and capable by these methods that I actually took ownership for my mental health because for once, through validation, recovery seemed very feasible. I think these methods in many ways have taken into account the way disorders can occur naturally due to ones environment, and likewise have an equally natural solution. We cannot as a society afford to accept pills to numb the pain as the best option, nor can we settle for methods that really cannot offer the type of outcomes these three therapies do. As with all things, I’d say the first step would be to do an in depth clinical study. With children there are few studies as naturally most wouldn’t want to test pills on their children. With something like DBT or CBT there are no risks of harm, poisoning, or side effects, and it would be my stance that there are far less risks to do clinical studies to measure the effectiveness of Cognitive Therapies in adolescents. This alone wouldn’t give contrast to what effect the pills have on the same population, but studies could still substantiate the extent that these can eliminate disorders without use of psychiatric drugs. I make this point too because I have lived this, and know from at least my experience what worked or what didn’t. I’d love to see a world with a drastic reduction in mental illness and believe this is the road to that, and if even that proves impossible at least some may find a technique they hadn’t heard of that could help them in their life someday.

– Adam Rice

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