Your treatment depends on your particular mental illness, its severity and your life situation. Often a team approach is appropriate to make sure all of your psychiatric, medical and social needs are met. This is especially important with severe mental illnesses, such as schizophrenia.
Treatment teams
The team involved in your treatment may include your:
- Family or primary care doctor
- Psychiatrist, a medical doctor who diagnoses and treats mental illnesses
- Psychotherapist, such as a psychologist or a licensed counselor
- Pharmacist
- Social workers
- Family members
If you have a mild mental illness and your symptoms are well controlled, you may need treatment from only your primary care doctor, a psychiatrist or a psychotherapist.
Treatment options
Numerous treatments for mental illnesses are available. The particular treatment or treatments you'll need depends on the type of mental illness you have, the severity of your symptoms, and what you and your doctor think will work best for you. In many cases, a combination of treatments works best.
Medications
Although psychiatric medications don't cure mental illness, they can often significantly improve symptoms, whether you have depression, schizophrenia, an anxiety disorder or another condition. Psychiatric medications can also help make other treatments, such as psychotherapy, more effective.
Here's an overview of some of the most commonly used classes of prescription psychiatric medications:
- Antidepressant medications. Antidepressants are used to treat various types of depression and sometimes other conditions. Antidepressants can help improve such symptoms as sadness, hopelessness, lack of energy, difficulty concentrating and lack of interest in activities. Antidepressants are grouped by how they affect brain chemistry, and a number of different types are available. The most commonly prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and citalopram (Celexa). There also are numerous other types of antidepressants; the best one for you will depend on your particular situation and how your body responds to the medication.
- Mood-stabilizing medications. Mood stabilizers are most commonly used to treat bipolar disorder, which is characterized by alternating episodes of mania and depression. Mood-stabilizing medications include lithium (Lithobid), divalproex (Depakote), lamotrigine (Lamictal) and others. Sometimes mood-stabilizing medications are added to antidepressants to treat depression.
- Anti-anxiety medications. Anti-anxiety medications, as their name suggests, are used to treat anxiety disorders, such as generalized anxiety disorder and panic disorder. They may also be useful in helping reduce agitation and insomnia. These medications are typically fast acting, helping relieve symptoms in as little as 30 minutes. A major drawback, however, is that they have the potential to cause dependency. Anti-anxiety medications include alprazolam (Xanax), lorazepam (Ativan) and several others.
- Antipsychotic medications. Antipsychotic medications, also called neuroleptics, are typically used to treat psychotic disorders such as schizophrenia. Antipsychotic medications may also be used to treat bipolar disorders or added to antidepressants to treat depression. Antipsychotic medications include clozapine (Clozaril), olanzapine (Zyprexa) and others.
Psychotherapy
Psychotherapy is a general term for the process of treating mental illness by talking about your condition and related issues with a mental health provider. During psychotherapy, you learn about your condition and your moods, feelings, thoughts and behavior. Using the insights and knowledge you gain in psychotherapy, you can learn coping and stress-management skills. Psychotherapy often can be successfully completed in a few months, but in some cases, long-term treatment may be helpful. Psychotherapy can take place one on one, in a group or along with family members.
There are many specific types of psychotherapy, each with its own approach to improving your mental well-being. The type of psychotherapy that's right for you depends on your individual situation. Examples of psychotherapies include cognitive behavioral therapy (CBT), interpersonal therapy (IPT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT).
Brain-stimulation treatments
Brain-stimulation treatments are sometimes used for depression and some other mental health disorders. They are generally reserved for situations in which medications and psychotherapy haven't worked. They include:
- Electroconvulsive therapy (ECT). Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through your brain, deliberately triggering a brief seizure. This seems to cause changes in brain chemistry that can quickly reduce symptoms of certain mental illnesses, such as depression. Because it can provide significant improvements in symptoms more quickly than psychotherapy or medications, ECT may be the best treatment option in certain situations. Deciding whether electroconvulsive therapy is a good option for you or a loved one can be difficult. ECT can cause a number of side effects. Make sure you understand all the pros and cons.
- Transcranial magnetic stimulation. This approach uses powerful magnets to stimulate cells in the parts of your brain linked to emotions. This appears to relieve depression symptoms in some people.
- Vagus nerve stimulation. This procedure uses a small, battery-powered device (pulse generator) implanted in your upper chest. It connects with a wire to a nerve in your neck that leads to the brain (the vagus nerve). The pulse generator periodically stimulates the vagus nerve. Electrical signals then travel up the vagus nerve to the brain. This is thought to help relieve depression by stimulating brain cells.
- Deep brain stimulation. With this procedure, a pulse generator located in your upper chest sends electrical stimulation via wires to areas deep in your brain. This is thought to affect parts of the brain linked to mood, easing depression symptoms. It may also be helpful for obsessive-compulsive disorder. Because it involves brain surgery and chest surgery, this is considered a last-resort treatment.
Hospitalization and residential treatment programs
Sometimes mental illness becomes so severe that you require psychiatric hospitalization. Hospitalization is generally recommended when you aren't able to care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric hospitalization options include 24-hour inpatient care, partial or day hospitalization, or residential treatment, which offers a supportive place to live.
Substance abuse treatment
Substance abuse commonly occurs along with mental illness. Often it interferes with treatment and worsens mental illness. If you can't stop using drugs or alcohol on your own, you need treatment. Substance abuse treatments include:
- Psychological counseling, also called psychotherapy
- Medications, which may help ease withdrawal symptoms or reduce cravings
- Inpatient treatment such as withdrawal (detox) treatment
- Outpatient treatment programs, which require regular attendance for a set period of time
- Support groups or 12-step programs such as Alcoholics Anonymous (AA)
Participating in your own care
Be an active participant in your treatment. Working together, you and your doctor or mental health provider can decide which treatment options may be best for your situation, depending on your symptoms and their severity, your personal preferences, insurance coverage, side effects, and other factors. In some cases, a mental illness may be so severe that a doctor, loved one or guardian may need to guide your care until you're well enough to participate in decision making.
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