In mental health there is and has been a hot debate about the efficacy of medication to treat mental illness concerns. Most research and evidence shows the quality of the relationship between therapist and client is the most robust factor predicting change and improvement (studies here). Medication is rarely enough to cause real and positive change in someone struggling with mental illness; although a portion of the population, about 6% is diagnosed with severe and persistent mental illness (SPMI), the vast majority of those who are prescribed medication to treat mental illness are generally high functioning. While one in four adults will suffer from mental illness in a given year (which is a huge number – 25%?? Whoa!), we still have an enormous complex about being open and honest in our quest for recovery.
Our cultural ideal is rugged independence – we score higher on that dimension than any other country on earth. We look up to those who have made it on their own and pulled themselves up by their bootstraps. This ideal doesn’t hold up well for most of us in the human race; we need social connections to survive , we benefit from collective action (unions, suffrage, state government road maintenance) and most of us need help learning what we do before we can support ourselves – even those who don’t do college were most likely apprentices, learning from someone who knew what they were doing. Why wouldn’t mental health be the same?
Few mental illnesses require lifelong medication and maintenance; these are the SPMI, including Sczhizophrenia, Bipolar I Disorder and Major Depressive Disorder, recurrent. These disorders disrupt normal functioning and cause significant distress for those suffering from these illnesses as well as those around them. Major Depression isn’t just feeling sad and eating some ice cream after work; it’s not being able to move, not caring enough to shower, not having the energy to follow through on suicidal thoughts.
Beyond these, the most serious disorders, are significant mental illnesses of a potentially shorter duration. One can be in a depressive episode (lasting about 2 weeks) and need medication to break out of that period, but may not require lifelong medication maintenance. Obsessive disorders require extensive behavioral and cognitive therapy to replace harmful behavioral/thought patterns with more adaptive versions. Certain medications can help with correcting these patterns and in rebuilding receptors to prevent a return to maladaptive behavior.
Mental illness is just that – an illness. With the small exception of religious exemptions, we don’t chastise people for taking medication to cure their strep throat or to manage acid reflux. It’s time to stop shaming ourselves and others for trying to recover.