Mental Health Medication: Myth vs Reality

With the conversation on mental health slowly becoming less stigmatised, we join in to take a look at the medications being prescribed and how they work.

Mental health is already a deeply stigmatised issue, and discourse around the medication designed for it adds fuel to the fire. There are damaging misconceptions surrounding their usage, alongside a general lack of understanding of how they work. Here I will briefly explore how some of the most common medications for a variety of conditions work. In all cases, prescribed medication for mental health varies depending on the individual as a lot of these medications alter chemical balances in the brain, so what works for one person may not work for someone else.

Anti-depressants encompass a wide range of medications, with one of the most common and popular being Selective Serotonin Reuptake Inhibitors (SSRIs). Discovered by accident, SSRIs work by increasing the longevity of serotonin — a molecule generally associated with more positive emotions and sleep. By preventing its reabsorption by the brain, SSRIs help in the management of mood. However, serotonin uptake is only one aspect of depression, and SSRIs can take up to six weeks before they start to take effect.

Moreover, given that issues with serotonin is not the sole cause of depression, SSRIs do not always work for everyone; there are multiple types of anti-depressants, each with a different active ingredient which may work better for others. 

Anti-depressants are not addictive substances, however those with depression may become dependent on them, and so the transition off the drug is always a gradual process to allow your brain to adjust to the changes in the chemical balances small bits at a time. 

The most common anti-anxiety medications are benzodiazepines, which focus on the short-term treatment of the physical sensations associated with anxiety, such as trembling. For the treatment of panic disorder or social phobias, antidepressants are usually the most suitable treatments, as benzodiazepines are only for physical effects. Like anti-depressants, benzodiazepines only take effect after a few weeks and work in a similar manner to sedatives – they induce muscle relaxation through increasing the activity of the chemical Gamma Amino Butyric Acid (GABA) in the brain. Whilst it’s very effective in the short-term, the brain can get used to it and benzodiazepine may not always be appropriate – after a traumatic event, it can numb emotions that still need to be properly processed. 

Stimulants are used mainly in the treatment of ADHD, but sometimes can also be used in the treatment of depression. They work as a focusing agent by gradually increasing the levels of dopamine (a chemical associated with alertness and attention), allowing a person to concentrate better. There is a stigma surrounding stimulants that suggest they lead to drug abuse later in life, however, this is not supported by evidence and research has suggested the opposite is true, that stimulant usage makes drug abuse and dependence less likely to occur in the future. 

Antipsychotics are used in the treatment of any mental disorder in which there is a detachment from reality – such as schizophrenia, bipolar mania, and PTSD. They help to relieve the symptoms of these conditions, and whilst they take full effect up to six weeks in, major symptoms such as hallucinations can disappear within a few days. 

The newer antipsychotics are labelled atypical antipsychotics, and although the exact mechanisms of them are unknown, they are thought to work through blocking receptors to chemicals such as dopamine, allowing these chemicals to be restored to a regular balance. Older generation antipsychotics listed Tardive Dyskinesia (TD), a condition which affects muscle movement, as a side effect after long term usage. However, this rarely, if ever, occurs with new generation atypical antipsychotics. 

Of course this is just a general overview of some of the medications available for these conditions but there are many more options available. The highly changeable and personal nature of mental illnesses make the treatments prescribed also highly variable. It is also often the case that medications are best taken in conjunction with therapy (if it’s available and the therapist is suited to the individual’s lifestyle and needs) as it caters to individual situations and helps with behavioural management and the treatment of underlying causes. 

Furthermore, these medications are often not long-term treatments but coming off them must always be a gradual process under a medical professional’s guidance, as time is needed for the brain to adjust to the changing chemical balances.

With International Men’s Day around the corner and with it discussions about male suicide rates and mental health, understanding mental health medications is an important step in dismantling the stigma surrounding these areas. Let’s work to understand it together.

image source: Jamie Grill | Getty Images