Healthy Chill Pills

Can We Have Less Medication for Anxiety?

Medication & psychotherapy works, but can we do better?

By Mark Banschick, MD

Healthy Chill PillsAnxiety is fundamentally intrusive, interfering with going to sleep, preoccupying you while driving and preventing you from concentrating on what needs to be done. For many adults and their kids anxiety is always there, and if not, it’s always on the verge of being there.

It’s exhausting, and people want relief.

We live in a pill obsessed culture, so the reflex is to think medication.

Yet, other options are out there, and they often work.

Medications have a time and a place, but a little caution is not a bad thing. Other treatments range the gamut from diet changes, to meditation, to exercise to talk therapy. In addition, some treatments are based on better habits of living that will continue to help you years after the anxiety has abated. Sounds like a win win to me.

Healthy Chill Pills: Can We Have Less Medication for Anxiety?

According to the National Institute of Health, anxiety disorders are the most common mental illness among Americans, with some estimates reaching 40 million people. It’s generally accepted that effective treatment for most anxiety combines medication and psychotherapy. And, I agree. These protocals work and I’ve used them for years. The issue at hand is whether we can do better.

At Issue: So, are drug interventions always needed?

A common trap that people get into with medications in general, and especially psychiatric ones, is thinking that a pill will end their suffering. This may be the case if the ailment has one simple cause, for example, if an improperly treated wound becomes infected by bacteria, an antibiotic can often clear the situation up quickly with minimal side effects. However, anxiety and other psychological issues are more complex, and the effects of medication are less fully understood. And, with all the breakthroughs of modern science, the functioning of the most important organ in our body, the brain, is still oftentimes a mystery.

Example: The placebo effect of psychiatric medications is very high. This means that taking medications does help, but often the effect is less because of the pharmacological action of the agent, and more about your mind “believing” that the pill will work. The message here is that what makes drugs work, may be more complicated than you think. In fact it may be because of the way you think.

Most medications prescribed for anxiety disorders can be characterized as either antidepressants or benzodiazepines. Benzodiazepines can cause a relatively quick calm and are much appreciated by patients who are panicky. The antidepressants work more slowly but maintain a blood level every day so they have the advantage of muting some anxiety throughout the day. Side effects are varied. It is easy to get hooked on benzodiazapines because they work so quickly and can be quite effective. The antidepressants have a wide range of side effects, from rare cardiac issues, to weight gain or loss, to night sweats and more. Fortunately, most of the side effects of these meds are relatively benign, but who wants to be on medication if they don’t have to?

And here is the rub. In our society, the doctors, the patients, the managed care companies, and medical industry all push medications. It’s the easiest and, sometimes, the least costly of interventions. But does that make it good treatment?

Good research has shown that medication, especially combined with treatment from a competent therapist, can often give a person what they need to start down the road to recovery. But in the long run, the best way to manage symptoms of anxiety isn’t with a drug that might induce dependence or have other side effects.


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