Psychotherapies
Talk therapy (psychotherapy) is usually considered the first line of care in
helping a person with a mental illness. It is an important part of helping
individuals with a mental disorder achieve the highest level of functioning
possible. These interventions are therefore seen by some as being forms of
occupational therapy for people with mental illness. While medication can be
quite helpful in alleviating and preventing overt symptoms for many psychiatric
conditions, they do not address the many complex social and psychological issues
that can play a major role in how the person with such a disease functions at
work, at home, and in his or her relationships. For example, since about 60% of
people with bipolar disorder take less than 30% of their medications as
prescribed, any support that can promote compliance with treatment and otherwise
promote the health of individuals in the mentally disordered population is
valuable.
Psychotherapies that have been found to be effective in treating many mental
disorders include family focused therapy, psycho-education, cognitive therapy,
interpersonal therapy, and social rhythm therapy. Family focused therapy involves
education of family members about the disorder and how to help
(psycho-education), communication-enhancement training, and teaching family
members problem-solving skills training. Psycho-education services involve
teaching the person with the illness and their family members about the symptoms
of the sufferer, as well as any warning signs (for example, change in sleep pattern or
appetite, increased irritability) that the person is beginning to experience
another episode of the illness, when applicable. In cognitive behavioral
therapy, the mental-health professional works to help the person with a
psychiatric condition identify, challenge, and decrease negative thinking and
otherwise dysfunctional belief systems. The goal of interpersonal therapy tends
to be identifying and managing problems the sufferers of a mental illness may
have in their relationships with others. Social rhythm therapy encourages
stability of sleep-wake cycles, with the goal of preventing or alleviating the
sleep disturbances that may be associated with a psychiatric disorder.
Medications
Medications may play an important role in the treatment of a mental illness,
particularly when the symptoms are severe or do not adequately respond to
psychotherapy. For example, treatment of bipolar disorder with medications tends
to address two aspects: relieving already existing symptoms of mania or
depression and preventing symptoms from returning. Medications that are thought
to be particularly effective in treating manic and mixed symptoms include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel),
ziprasidone (Geodon), aripiprazole (Abilify), paliperidone (Invega), and asenapine (Saphis). These medications belong to a group of medications called
neuroleptics and are known for having the ability to work quickly compared to
many other psychiatric medications. As a group of medications, side effects that
occur most often include sleepiness, dizziness, and increased appetite. Weight
gain, which may be associated with higher blood sugar, higher lipid levels, and
sometimes increased levels of a hormone called prolactin may also occur.
Although older medications in this class that were not mentioned here are more
likely to cause muscle stiffness, shakiness, and very rarely uncoordinated muscle
twitches (tardive dyskinesia) that can be permanent, health-care practitioners
appropriately monitor the people they treat for these potential side effects as
well. Mood-stabilizer medications like lithium, divalproex (Depakote),
carbamazepine (Tegretol), and lamotrigine (Lamictal) can be useful in treating active
(acute) symptoms of manic or mixed episodes. These medications may take a bit
longer to work compared to the neuroleptic medications, and some (for example, lithium,
divalproex, and carbamazepine) require monitoring of medication blood levels.
Further, some of these medications can be associated with birth defects when
taken by pregnant women.
Antidepressant medications are the primary medical treatment for the anxiety
characterized by anxiety disorders, as well as the depressive symptoms of
depressive disorders and bipolar disorder. Examples of those medications that
are commonly prescribed for those purposes include serotonergic (SSRI)
medications like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil),
citalopram (Celexa), and escitalopram (Lexapro) and combination serotonergic/adrenergic medications (SNRIs) like venlafaxine (Effexor) and
duloxetine (Cymbalta), as well as buproprion (Wellbutrin), which is a
dopaminergic antidepressant.
Medications like clonazepam (Klonopin) and lorazepam (Ativan) from the
benzodiazepine group are often used to treat anxiety, particularly when it is
sudden and severe, as in panic attacks. Medications from the beta-blocker family
(for example, propranolol [Inderal]) are sometimes used to treat the physical
symptoms associated with anxiety as well.
Alzheimer's and other forms of dementia are often treated with medications
like memantine (Namenda), galantamine (Razadyne), donezepil (Aricept),
rivastigmine (Exelon), and tacrine (Cognex). These medications tend to slow the
progression of dementia, thereby helping sufferers of dementia remain functional
longer than they would without treatment.
Despite its stigmatized history, electroconvulsive therapy (ECT) can be a
viable treatment for people whose symptoms of depression, bipolar, or thought
disorder have inadequately responded to psychotherapies and a number of
medication trials. Although alternative
treatments for mood disorders like St. John's wort or ginkgo biloba are not
recognized standard care for bipolar disorder, as many as one-third of some
patients being treated for a mental illness use them.
http://www.medicinenet.com/mental_health_psychology/page5.htm
Aucun commentaire:
Enregistrer un commentaire