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?