Treatment of Mental Disorders
Wefigured
out it wasn’t depression after I had beentaking Prozac for about three months,”
recalls Chris Clark, a restaurant owner living in Memphis, Tennessee. Clark was
a junior in college when he was diagnosed with depression and prescribed the
antidepressant Prozac. “I had spent a semester locked in my dorm room, thinking
about killing myself and feeling horribly guilty about it.” But after taking
the Prozac: “Next thing I know, I’m in Mexico, trying to open a chain of
drive-thru gourmet French restaurants with some woman I met at a club in New
Orleans.
“It
seemed like a great idea at the time,” Clark muses, “despite the fact that
turning gourmet French cuisine into fast food is pretty much impossible.” After
he charged about $20,000 worth of restaurant equipment to his father’s credit
card, Clark reports, “my dad flew down, scooped me up, and deposited me directly
in the psych ward.” There, the doctors changed his diagnosis to bipolar
disorder—the mood disorder that makes people cycle between depression, mania,
and normalcy— and prescribed lithium, a mood stabilizer.
Unlike
antidepressants, which can trigger a manic episode in people with bipolar
disorder, mood stabilizers regulate both the highs and the lows of the
condition. “But man, I hated that lithium,” Clark recalls. “I felt totally out
of it.” Nevertheless, he took lithium through college, eventually graduating
with honors.
Once
on his own, though, Clark stopped taking his meds and within a year his mood
plummeted. He reached out to a psychologist but did not disclose his diagnosis
of bipolar disorder. “I think I was in denial.” he says. “Somehow, depression
was more acceptable to me than bipolar.” He also refused to take medications,
opting instead to try just talk therapy and exercise.
Two
marathons and one year of therapy later, Clark was feeling good—and then too
good. He stopped seeing his therapist, explaining that he was “cured.” He took
over a friend’s struggling restaurant and, suddenly needing only three hours of
sleep per night, threw all his energy into rescuing the business. Just as the
restaurant began to rebound, though, Clark took off for a month of partying in
Greece.
When
he followed the trip by splurging on a vintage Camaro, Clark’s friends
confronted him about his irresponsibility, but he didn’t listen. The restaurant
foundered. His girlfriend left him. He overdrew his bank account. Then came the
crash. “One morning, I just couldn’t get out of bed. After sleeping for 30
hours, and then hating myself for another 10, I had to confront the truth: I
have bipolar disorder, and I have to treat it, all the time, with everything
I’ve got.”
Clark
enlisted the help of a psychiatrist, who prescribed Lamictal, a medication that
for many people has fewer side effects than lithium. He returned to his
therapist, who helped him with his feelings of hopelessness. Through the
Depression and Bipolar Support Alliance he met people who understood his
problems. And he supplemented his running with adequate sleep, good nutrition,
and meditation to reduce stress.
Although
Clark has since opened a successful restaurant, he says, “My main job will
always be managing my mind.” The same is true for millions who struggle with
psychological disorders. As shows, people now have more and better options for
doing this job than ever before. Just as Clark relies on medication, talk
therapy, social support, and a healthy lifestyle to manage his bipolar
disorder, so do many people combine treatments to suit their individual needs.
The mind, after all, is a biological, psychological, and social achievement, so
mental health requires biological, psychological, and social balance.
Eariler
described a number of mental disorders that can cause extreme suffering and
disrupt people’s lives, making it hard to hold a job, sustain a relationship,
or, in some cases, manage the basics of day-to-day life. Because many factors
give rise to these disorders, the different approaches to treatment each have a
distinct focus. Practitioners who rely on psychological approaches employ
various kinds of psychotherapy. Others favor biomedical interventions such as
medications. Still others use an amalgam of psychological and biomedical
treatments. Do these treatments help? Are some better than others?
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