ON MENTAL ILLNESS: Treat Condition "Aggressively" but Don't Medicate Normal Problems

Jack Bragen
Friday August 02, 2019 - 03:09:00 PM

The following should not be taken as medical or psychiatric advice. It is derived from my personal experience only, and I am not a doctor. If you need medical, psychiatric, or any other advice, you must consult a licensed professional.


Recent medical philosophy pertaining to type 2 Diabetes entails "aggressive treatment," which means being rigorous with treatment to keep blood sugar at controlled levels. Doing this is said to minimize organ damage. This also may increase the diabetes patients' chances of progress toward needing less treatment and/or of the disease going into remission.

The above is analogous to schizophrenia treatment, in which many psychiatrists are in favor of high meds, so that the patient gets relief from her or his symptoms and has a better outcome.

Prescribing medication to treat the normal suffering that is intrinsic to "the human condition" should not usually be done. 


Some prescribing professionals (examples: a psychiatrist, a psychiatric nurse practitioner, or possibly a psychologist with an additional license to prescribe) over-medicate their patients, to the extent that side effects are unbearable, and functioning in a normal manner (to do simple things that most people would take for granted) is a near impossibility. Over-medicating creates a lot of restrictions in what a patient is able or unable to do. Some psychiatric medications, especially antipsychotics, create profound, severe limits on brain function. It took me years of being medicated to learn to work around these limits, and to adjust to side-effects. 

Yet, lack of adequate treatment for psychosis is worse. When a psychiatric consumer is medicated, some level of symptoms will persist. However, when under- or over-medicated, the condition isn't treated adequately, and symptoms will be worse. In some instances, a dosage of medication that is far too high could lead to more psychosis compared to taking a reasonable dosage. 

When a person has low-level symptoms of psychosis, they may be bothered by either negative or euphoric thoughts, and what I will call "messy thoughts." They may also suffer from poor decision-making ability. They may have delusional systems that develop despite being on meds. They may only have partial tracking of reality. 

Every person is different. Usually psychiatrists have to figure out what won't and will work for an individual by observing them for a period of months. Usually this is done through intermediaries, such as mental health staff in a day treatment program or during an inpatient stay. 

Inadequate meds can be a danger. And that's where the "aggressive" treatment comes in. One medication policy is to give a patient as much medication as she or he can safely tolerate. The idea is to get a devastating condition under control, so that the patient can get back to normal thinking and functioning. 

On medication, there may be some things we can't do. Yet, when adequately medicated, the damage caused from the brain overload of mania or psychosis, will be less. Additionally, if we can get back to syncing with basic reality, we have a chance at living under decent conditions. 

At some point after we get back to a normal mental state, we might look to medication to solve all our problems. This doesn't work. 

If we feel emotionally uncomfortable or overloaded, adding another medication is the answer only some of the time. We should be able to have some amount of emotions, whether pleasurable or painful. That is a sign of being normal. Yet, if emotions become so strong that the have the potential to destabilize us, we could consider asking for a pill. 

When emotions are so strong that we are unable to function normally, we probably aren't calm enough to look to mindfulness to fix that. The faculties that are used for mindfulness may not be available when emotions become too powerful. 

However, when we are grieving for a lost loved one, or if we are experiencing the emotional fallout of bad events, within limits we should feel these emotions. When the emotions snowball, and become a bottomless pit of pain from which we can't extricate ourselves, sometimes the solution is to seek a distraction, while other times we may need help from a counselor or psychiatrist. 

But we should not expect that medication will make our lives trouble free and easy. It never is, and that kind of expectation is in the realm of the promises of cult leaders. 

If the meds are doing their job, we are going to feel bad some of the time, but, also, we are going to feel good some of the time. If we never feel good, something is being done wrong. 


Jack Bragen's self-published books are available for purchase online.