Choosing the Best Mental Health Treatment Plan

Posted on January 3, 2014 by L. Chris Cannida

Do I take medication or should I talk it out? Which treatment is right for me? Whether it’s an effort to make a New Year’s commitment to self or because life has been so full of burden, attending to one’s emotional or psychological being is a good idea. But with the mass of information readily available via the internet, choosing the right path for dealing with these issues can be daunting. And face it, scary. Many people do not trust medications and others don’t buy into the idea that “just talking” to someone like a mental health professional would yield positive results. Many potential clients can’t shake the fear that they will be judged by the therapist after disclosing intimate details and vulnerabilities. Some are turned off by the idea of “getting treatment” – it can make us feel vulnerable to believe we need support in navigating our own emotions and decision-making. Some may have strongly-held religious or spiritual beliefs that create a disagreement or discomfort in taking medications. In certain cultures, allowing an “outside” person to know such intimate details of one’s life is seen as highly inappropriate. For many people, coping with life’s stresses can be done without the help of a professional. But for many others, it is a preference or becomes a necessity to involve helping professionals. And when all is said and done, one might question why both options are even available – surely there’s just one best way, right? If only it were that simple.

Simply put – because we are such complex creatures, sometimes both medications AND “talk therapy” are needed. And then again, not always. For certain situations, even more detailed options (other than medications and talking/counseling) are available. When trying to help clients understand their options and needs, I use an analogy of the ocean and a boat. Hopefully, you will find it useful in helping you make the important choice of how to utilize mental health treatment to better your quality of life. Let’s take a look at the 3 most common options for pursuing mental health (or behavioral health as it is sometimes called) treatment. Please know that these options (especially the ones involving medications) should always be discussed with your primary care physician or a psychiatrist (a physician specializing in medications for mental health issues) in order to proceed in the most medically responsible, and safest way, for you. And while these options certainly do not exhaust the choices one may have for addressing a particular need, my hope is that it is a starting point.

This analogy includes the following 2 pieces:

– the ocean which represents the chemistry inside your brain/body that is uniquely yours. It flows like no other.

– the boat you row – this represents your coping skills – those thoughts and behaviors that you use in order to deal with the daily and sometimes unique stresses and situations that you face each day.

First, imagine that you have excellent skills for rowing a boat. Your calm ocean allows you the chance to row across it to all destinations (good or at least tolerable) toward outcomes with which you can live. But, imagine that there is an unexplained storm in your ocean creating an upheaval that would capsize boats navigated by even the most skilled boatsmen. Until that storm is calmed no amount of rowing skill will allow you a desirable outcome. Sometimes for reasons too complex to explain here, we need our sea calmed. This is where taking certain medications may balance the chemistry inside you so that you can carry out the simplest of life functions (sleeping, working, making decisions) with the least amount of challenge. And all the rowing lessons in the world won’t help. Perhaps only medication prescribed by a physician will serve the need to calm your sea. In fact, there are various chemical combinations that nearly always require medication in order to create improvements, for instance, certain thought or mood disorders in severe conditions.

But what if, most of the time, your ocean appears calm (you’re able to carry out most of your major roles in life just fine), but you find yourself needing a few “rowing” lessons to navigate a particular situation (divorce, losing a job, recovering from abuse, making major decisions). This is where traditional “talk therapy” may be the answer. Perhaps you just need to empty the boat of painful thoughts and feelings that are flooding you and threatening to capsize your means of navigating life. “Talk therapy” is not just a comfortable or simple conversation with another person, although a skilled clinician can make it comfortable enough for most clients. It is structured by the licensed clinician (psychotherapist or counselor) in such a way that you can learn more effective ways to think and behave so that you can function in a manner befitting your life’s best interests. If you are fortunate enough to find a skilled therapist with whom you feel a great connection, these structured conversations may actually feel like dialogue with a trusted confidante. But know there is always the goal of teaching you the “rowing” skills you need to cross that body of water called life. With sufficient rowing skills, you may be just fine without medication.

There are some people challenged by the unfortunate combination of a storm in their sea of chemistry while also struggling to develop the thinking skills and actions that may be necessary to navigate the rough waters of stress and change that can come with even the most trauma-free life. For this group, a combination of medication and traditional talk therapy may be the best decision.

There is no blanket answer to the question of which treatment options are the best. Everyone’s chemistry and life situations are the same in some ways and yet different enough to warrant special consideration. If you’re faced with the decision of which way to turn – medication versus “talking” it out – you can visit a physician or licensed mental health therapist to discuss your options. In most all cases, there is a good fit for treatment that can help you gain the quality of life you seek or recover from challenging events in your past and present. Which one is right for you is always a talk worth having.

Note: The information provided in this article is not intended as a substitute for visiting face-to-face with a licensed medical or mental health professional.  Should you feel in need of professional assistance, please call 911 or visit your local emergency room or family primary care physician.

For more information on how to schedule an appointment with me in the Winston-Salem, NC area, you are welcome to visit my website at http://www.ccannida.com.

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Coping with the holiday seasons…

Posted on December 3, 2013 by L. Chris Cannida

The appointment book for my private practice is starting to fill up these days for one reason.  It’s December.   When first thinking about what I might use as a topic for this post, I (like many psychotherapists) instantly thought of offering tips for coping with holiday stress.  When I went to the search engine and typed “coping with the holidays” the number of hits that surfaced was 315,000,000.  Over 300 million hits for coping.  Let’s face it.  There is no shortage of information written about coping with the holiday season.  That’s because there’s no shortage of people feeling extra stress this time of year.  Yet many people will cower in the darkness of an emotional corner before reaching out for support.  This fact alone addresses one of the primary stresses we face – feeling isolated.  And that’s what I hope to address in this writing.

You are actually not so alone in feeling depressed, angry, and generally stressed during this time of year.  Yet, because the stigma attached to having these feelings is still so prominent,  the canvas of our emotions is painted with a large coat of shame.  And that shame is what isolates us even further.  The messages we receive from the media and other well-intentioned people can add to that shame by making us feel different or less than because we are not skipping around town filled with ‘joy’ and ‘holiday spirit’. It causes us to ask “What’s wrong with me?”  And if life has unfolded into a season of having no family or close friends to offer words of encouragment and companionship, that loneliness compounds our idea that we are inherently bad.

So, the first step in coping is to battle against the idea that no one else would understand how you feel or that confiding in someone would be a futile act.  It’s just not true.  You are definitely not alone.  Even making the simple comment “this time of year is always a bit rough for me” will typically bring words of empathy from many others.

That’s why I decided not to blog a cliche’ “20 Tips for Coping with the Holidays”.  Well, and for one other reason, too.  I’m not sure I could actually come up with 20 myself without just stealing them from other websites.  Even psychotherapists can experience stress during this time of year.  I will share, though, what I have discovered along the way over 30 of those years helping others (and myself) find solace in darker times.

– Talking to someone helps.  It just does.  The “chemistry” of our emotions must, what I call, finish itself once started, and somehow find release.  We are literally “chemical” beings and there are specific chemical reactions that occur creating our thoughts and emotions.  Once we begin a chain of thoughts that then lead to negative emotions, that chain reaction must run its course to an end.  How you cope along the way does determine 1) if the chain will be long and seemingly unending, and 2) if the end of that chain is devastating and destructive or if, somehow, a light for hope and new beginnings can exist.  Who you talk to can make a difference.  If you find yourself with no one earning your trust right now, choose a professional, like a psychotherapist or counselor.  If you’re employed and have any health insurance, see if your plan offers employee assistance programs where some of your counseling sessions would be free-of-charge.   If money is an issue in seeking professional support, perhaps you can find a church and talk to a clergyman.  Pastors, preachers, priests, chaplains – they’ll listen.  Some are quite gifted in caring for the human spirit and prefer this to “selling” religion.  If the idea of donning a church step doesn’t make sense to you, there may be a hospital in your area offering support groups or classes for this time of year.

Most importantly, if your shame has convinced you that you’re not worth the moments it might take someone to care for you, freeze right now, while reading this, yell STOP and read these next bolded words with the intent to believe them – it’s just not true.  Even if the dark clouds of loneliness, depression, anxiety, or shame have covered up any self-worth there might be, let someone help you clear the sky of your thoughts so you can once again realize there is worth in your existence.  These darker emotions may be symptoms of a deeper chemical reaction that does, in fact, need professional attention.  In the meantime, you can manage them with intent and determination.

– Do something. Anything, really. I have discovered that when I feel a lack of worth or purpose, my purpose can be found in doing even the smallest act. Like now, writing this blog and trying to help someone with my own experience. Even if I never know it’s actually helped, for the minutes it takes to write it down, I’m lifted out of a darker, more bleak state of mind. Volunteering at a soup kitchen for an hour, calling to check on a friend – anything, really, to lift yourself out of these moments that weigh us down.  Even if the “something” that you do is just for yourself (cleaning that long-neglected closet, planting a flower, reading a book), that behavior can change the course of your entire day.  Sometimes our purpose is to just be there for ourselves. It may be hard to believe, but there are times when our most important worth is in saving ourselves. Try not to get caught up in wondering the why of it all.  Just be, do, survive.

– Taking a Walk.  My own teenage son told me just this morning that he has discovered how “relaxing” a long walk can be.  He puts on his headphones, walks several miles, and says he can just tune out his stresses by listening to music.  It’s true.  Even if remedies or solutions to your stress cannot be easily solved, walking is a way to manage that “chemistry” that is churning inside you while you hold that stress over a period of time.  Bundle up, or even hit the local mall and just walk, walk, walk.  Slow or fast, doesn’t matter.  Think, or don’t think.  Walking, or any type of exercise/movement, has a way of unplugging us from our most painful thought processes.

– Random acts of anonymous kindness can do amazing things for the human spirit.  It doesn’t have to involve money or even lots of time.  If the person working the drive-through window at your local coffee shop has a gentle or uplifting tone of voice or pleasant demeanor – absorb that – pay attention to how their own efforts at pleasantness can ease your angst even just a bit and thaw out your frozen soul for that brief moment.  And then mention that to them.  I periodically offer a heartfelt “thank you” to a clerk in the store if I’m having a rough day – just a simple ‘thank you’ for being kind.  It reminds me that it’s possible to find and feel goodness in the midst of all the badness, or madness in the world.

– Prayer. Not your thing?  Then, skip this part and move on.  But, if it is something you’ve considered in the past, consider it again.  Not sure how to pray?  Not a worry.  It’s easy.  Go on that long walk I suggested (or sit comfortably somewhere) – and just quietly talk to God, your Higher Power, that Being to whom you would choose to pray.  Ask questions, scream, cry, shake your fist, tell a joke, or even just be silent paying attention to your own heartbeat or the rise and fall of your chest as you breathe.   The power of prayer (or some call it meditation or mindfulness) is in it’s intention.  If it’s your intention to calm yourself by turning inward (or ‘upward’ to a deity), it can have the same soothing effect.

I told you. I don’t have 20 tips.  Or even ten.  What I do have is the knowledge that you are not alone in your feelings during this season.  I do know that the kind of stress we feel deep down inside, the kind that attacks our sense of well-being, can be temporary and eventually managed with success.  If you find yourself angry or even slightly irritated, rather than hopeful, at the idea that you can feel better, that feeling alone can be a sign that it’s time to reach out and ask for support.  Until then, it’s okay, even necessary, to practice self-compassion – not only during the holiday season, but all year long.

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