By Seth Lusk
When it comes to mental health resolutions, what I am referring to is the ability to maintain a desired state of performance in life, that is supported by the mental and emotional state of a person, to be able to live their life with fulfillment, and perform all necessary tasks to do so. This is a bit tricky to measure, because from person to person, the perceived ability to do so will vary, and how they are measuring it will vary. So, this is very subjective. But basically, we are looking for the ability of a person to either eliminate symptoms, or develop healthy coping skills that allow a person to live with healthy levels of symptoms that do not interfere with their ability to live a fulfilling life.
There is no “should” for mental health resolutions
I will say this up front. I am NOT here to say what anyone SHOULD do when it comes to treating their mental health. If you are having symptoms of poor mental health; ultimately it is your power, and choice to make the call on how you will handle it in a way that helps you create the life you want to be living. What I am here to talk about is what the date seems to show us when it comes to mental health resolutions, based on the methods of treatment that people seek when experiencing mental health issues.
Typically, when people are seeking mental health resolutions, they are faced with 2 major optional paths, that are then further broken down into MANY different options. These 2 major paths to mental health resolutions are therapy (meaning seeing a counselor, psychologist, therapist, or even coach), or there is the path of medication. And many people who stand at these crossroads begin to feel confused and maybe even overwhelmed with making a decision about the path forward to take.
I want to offer here, that there is in fact a 3rd path, and this is the path that the evidence, and myself tend to advocate for when it comes to seeking mental health resolutions. And this path is the path of combination treatment. This means that the person does not choose either therapy, or medication, but instead chooses a uniquely catered combination of BOTH.
What the data says about Mental Health Resolutions
The data in most research points to this path toward mental health resolutions to be the most fruitful. This means in terms of patients having fewer instances of future relapse into mental health issues AND increasing the amount of time that a person is deemed to be “in remission” from mental health issues. Which means that the person is not experiencing the symptoms of mental health disorder, or they are so minor that they are manageable with health coping skills and tools, and do not affect the person’s life.
When we talk about mental health resolutions, this is what the goal of treatment is. The goal is to get the person to a state of mental health where they are able to manage their life and mental health in a way that their life is not debilitated by the mental disorder. This does not necessarily mean that the person does not continue to go to therapy or take medication.
Let’s narrow the focus
So, let’s define what issues we are talking about that we are seeking mental health resolutions from. Most of the research in this area is done on disorders such as depression, anxiety, ADD/ADHD, and eating disorders. Though there is evidence that suggests that mental health resolutions for disorders such as schizophrenia, bipolar disorder, personality disorders, etc… are more favorable, and long-term with combination therapies (both medication and talk therapy).
A recent study coming out of Harvard took a look at the treatment of depression. They looked at mental health resolutions in patients who took medication, those who chose therapy, and those who decided on a combination. The results showed that 80% of patients who chose combination therapy, avoided a recurrence of a depressive episode. Only 57% of those who chose medication alone had zero recurrence.
When we talk about depression, there are some factors to consider when deciding on medication, or therapy or a combination of both. Mental health resolutions will vary depending on how severe the symptoms are at the time that treatment is begun. It is typically recommended that if symptoms are severe, that medication is started BEFORE talk therapy.
The same findings can be said with anxiety as well. The reason for this being that when a person is having severe symptoms, a certain amount of symptom relief is needed before talk therapy can be effective. So beginning with medication to return symptoms to a safe baseline before beginning talk therapy has its advantage.
Another study focusing on depression found that when patients were given medication for 16 weeks in one group, and another group only receiving cognitive therapy, that after 16 weeks, both groups saw similar relief from the symptoms of their depression. After this 16 week period both groups were withdrawn from treatment. What was observed at this point was that 76% of the group on medication relapsed into a depressive episode within the first year. 31% of the group receiving Cognitive therapy relapsed within the first year.
What can we take away here?
Now, the purpose of this paper is not to say if you should choose either medication or therapy. So, here is what we can take away from these results. Medication alone does not lead to the mental health resolutions that we desire. It appears that medication does relieve symptoms and does so effectively, and quickly.
Most of the research also shows that talk therapy, while the results seem to last longer after withdrawal from talk therapy, take longer to establish. And this is why I am advocating for combination therapy.
Most people who are at the point of asking for help with their depression or anxiety, are at a point where the symptoms are having a negative impact on their life. So, waiting around for months, so that talk therapy can begin to have an impact on symptoms, feels a bit undesirable.
On the other hand, having to take a medication that has some very undesirable side effects long term is not so appealing. But, not only this, the medication only helps with the symptoms while you take the medication. It does not treat the underlying cause. This means that when you stop taking the medication, the symptoms return at a very high rate. This is not the mental health resolutions we are looking for when seeking treatment.
What is desired with mental health resolution, typically, is quick relief of symptoms, and for that relief to last. Most people also want to know that at some point in time they can stop paying for relief from their symptoms and be able to manage them on their own without medication or paying for therapy. With combination therapy, both are achievable.
The Medication Trend
There is a trend for people to reach for medication as the solution for mental health issues. I know it has been proposed that this is simply because of people perceiving medication as being the “magic bullet” for mental health resolutions. The data does not support this though.
Most people reaching for medication are worried about side effects. They tend to also express many concerns of dependence on the medication. What this suggests is that people know that medication is not necessarily the most desired possibility for treatment. Yet, more people use it for treatment of their anxiety, or depression than people using therapy.
The reason why is a bit complex though. It has more to do with availability, and cost. I think that most people know that medication is not going to lead to the mental health resolutions that they desire. But, it is what they can access, and can afford.
Most medications for depression and anxiety, can be easily prescribed by a patient’s general physician. And most of these medications are covered by health insurance. So, we have the ease of access, since it is easy for most people to get an appointment with their GP. And when you combine that with the affordability of insurance covering the medication, we can begin to see why people seeking relief from the debilitating symptoms of anxiety and depression, reach for medication first.
But then why are they not utilizing therapy as well? And the answer to this gets to be just as complex and tricky.
The Issues with Therapy for Mental Health Resolutions
When we talk about therapy, we have several issues with people seeking this out for their mental health resolutions. Unlike medication, not every therapist can provide the same consistent result from patient to patient. And even if the therapist is well practiced, there will always be patients that will not feel comfortable with them, for varying reasons that are not the fault of the therapist or the patient.
Then, we have the issue of insurance. Most insurance will only cover certain types of therapy, if any at all. And, they will only cover therapy with certain therapists that fall within the network of the insurance company. This becomes problematic for patients when wanting to utilize therapy for their mental health outcomes. What if the type of therapy covered is not effective for their form of mental health issues? What if the therapists covered within their network do not work well with the patient? Medication becomes more and more convenient and enticing for a patient to choose when faced with these dilemmas.
Then, we have another issue. That issue being that access to these therapists, even if they are effective and covered by insurance, is limited. Therapists can only see a certain number of patients at a time and remain effective at their job. In some areas of the world, access to a therapist could have you sitting on a waiting list for months or years before even having a chance to sit in front of a therapist to talk. And, then you still don’t know if that therapist will be a match, or be able to effectively work with that specific patient.
This leads more and more patients to turn to medication alone for their desired mental health resolutions. Some may try to combine with therapy, and get frustrated, and give up. Some may not even try once they hear the hoops they will need to jump through to gain access to therapy. Meanwhile medication is there, affordable, and easy to access for them.
Can you see now why so many people are choosing the path of medication alone for their mental health resolutions? It is really an issue that we want to consider, and seek solutions for as a society. It is something we really want to push for solutions for. This issue is not going anywhere. The rates of mental health issues grow every year as we move further and further from lives that our bodies are designed to live, and pile more and more expectations on ourselves to live those lives in very inauthentic ways. We do not want to ignore this issue. The desire for effective mental health resolutions is here to stay for the foreseeable future.
The research points to combination therapy being the gold standard. I personally used this when I was battling with depression and anxiety myself. I was lucky. I was able to find a therapist in my insurance network that matched well with me, and was able to take me as a patient as soon as I needed the help. Not so many people are as lucky as me though.
So, for those of you out there beginning your journey into finding mental health resolutions; I want to encourage you. Do not feel shame around using medication to get relief from debilitating symptoms. I want to also encourage you to not give up hope on finding access to therapy to use in tandem with your medication. It REALLY IS worth it to utilize both. You will not only find relief from the symptoms with your medication, but find the tools to learn to manage those symptoms, and reduce them, medication-free by combining therapy with your treatment.
Mental health resolutions are about you having access to a mind that is clear, and healthy enough for you to show up in your life as the powerful creator that you are designed to be in your life. I want to encourage you to seek help and treatment if you are struggling to show up in your life due to mental health issues. It is nothing to feel shame around. It can happen to ANYONE, even the most mentally strong. Get yourself back on track in your life. You owe it to yourself to see what you are capable of when you seek solutions for both a health body, and mind.
RISE & THRIVE!
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