16. So Many Choices!

So far, you’ve learned a great deal about how to improve the quality of your mental health care: from setting expectations, to doing research, to improving your relationship and communication with your treatment providers. You’ve learned how to use your living treatment plan to avoid the many pitfalls that can so easily derail care.

You have the tools to master the process and logistics. It’s now time to explore the broad range of treatments and interventions available. What do they do? How do they work? What problems can each help with? How do you even begin to choose the treatments that are right for you? The remainder of the book tackles these questions.

There is a massive amount of material here and we’re only covering it in summary form. The sheer number of interventions available to treat mental illness creates a big challenge.1 Patients, family doctors, psychiatrists, psychologists, and counsellors—everyone finds it hard to keep track. New treatments and new ways of understanding old treatments are constantly appearing. It can be overwhelming. The good news is that, with so many more treatments, the chances of finding an effective one for you are higher than ever before.

If there’s one message we hope you’ve heard loud and clear, it’s that everyone is different. Your experience with mental illness is different from everyone else’s. Discovering the interventions that are relevant to and will work for you is very personal. You won’t find recipes here saying, “If you have depression, do X.” The interventions you incorporate into your living treatment plan will be those that make sense for you.

You’ll learn the importance of matching symptoms, causes, and treatments. The best treatment won’t help if it doesn’t address the causes underlying your illness. There may be no way to identify these causes—one of the reasons trial and error is needed. You’ll find the most natural, holistic treatments have far more in common with hardcore pharmaceuticals than you’d imagine. In mental health, you can accomplish the same thing in many different ways. There’s no magic here.

So, what sorts of interventions will we cover? We’ll start by looking at your physical health, which is deeply intertwined with your mental health. You’ll learn how some physical illnesses can bring on mental health symptoms or even increase the chance of developing a mental illness. We’ll look at various substances in your body such as vitamins and minerals that impact your mental health. We’ll discuss how to ensure deficiencies aren’t worsening your symptoms.

Next, we’ll look at lifestyle factors, including diet, exercise, sleep, alcohol, caffeine, tobacco, cannabis, and illicit drugs. We’ll explore the positive and negative effects these can have on your mental health. We’ll talk about vitamins, supplements, and other natural treatments used for mental health. We’ll try to separate fact from fiction.

We’ll then turn to the vast and varied collection of psychotherapies. These can have different roles in treatment. We’ll introduce the many different professionals who work in the field and suggest some approaches to find someone who’s right for you. We’ll talk about therapies that can provide practical, day-to-day support. We’ll also examine evidence-based psychotherapies, some widely applicable, some focused on particular mental illnesses. We’ll look at the challenges often associated with accessing individual or group therapy. We’ll also cover self-help and other resources that provide alternative ways to learn many techniques taught in therapy.

The remaining chapters deal with psychotropic medications, i.e., those for mental health, including antidepressants, mood stabilizers, and others. As compared to other mental health treatments, medications are more complicated and misunderstood. Given that, we’ll devote plenty of attention to the fundamentals. You’ll learn how they work, how they are chosen, how they can (and cannot) help, and why they’re frequently used. We fully appreciate that medications aren’t for everyone. We hope you can suspend any preconceived notions and approach this material with an open mind. We want you to make well-informed decisions about whether medications, like any other treatments, have a place in your living treatment plan.

We’ll look in some detail at antidepressants, which are the most frequently prescribed psychotropic medications. Building on that material, we’ll cover other categories of medications as well. We’ll talk about how medications are properly used, what to expect from them, how long they’ll take to work, and so on. We’ll discuss the smart way to try medications and how to avoid abandoning them prematurely. We’ll review managing side effects and special situations such as pregnancy.

Along the way, we’ll show you the common errors that we see all the time. Better you learn from other peoples’ mistakes than your own.

No Silver Bullet

If you read the in-depth article on our website that was mentioned under Lies, Damn Lies, and Evidence (in Paging Dr. Google), you know what we’re going to say here. For everyone else, pay attention!

No matter how many people say that a specific treatment will solve your particular problem, don’t believe them. Mental illness and its treatments are far too varied and affected by far too many factors. Current science can point you in the right direction but can’t make predictions. All the studies and evidence in the world can’t tell you what treatment will definitely work for you. Evidence can help guide your predictions. Trial and error, possibly lengthy, will almost certainly be needed to fully treat your illness.

Getting Started

The remaining chapters describe many different interventions. How do you begin to choose which belong in your living treatment plan? If you’re not sure, here’s one approach to consider:

1. First, we’re going to assume that you have at least a tentative diagnosis from your doctor or another mental health professional. If not, start there. We’ll also assume you’ve started your living treatment plan in your notebook or electronic gizmo. You’re ready to start trying things.

2. Next, make sure to read the following chapter, Just Enough Neuroscience. You’ll need this to understand both what various treatments can do and what they can’t do. This will also help you compare different treatments. It will save you from trying five similar solutions for a single problem. Instead, you could be trying a range of things, increasing the chances of finding those that work.

3. Read the chapter Your Physical Health, and then go see your doctor. Are there medical explanations for your symptoms that should be considered? A simple blood test could identify a problem with a quick solution. Better to start there rather than spending months in therapy or taking antidepressants with limited benefit.

4. Look through the Lifestyle Factors chapter. Are you unknowingly doing anything that might be making your mental health symptoms worse? Is there something you are able and willing to change that might help? Will any of these lifestyle factors affect how likely other treatments are to work?

5. Skim the chapters on the other treatments and add ideas that seem relevant to your living treatment plan. You’re not committing to them now. You’re highlighting them so you can read a bit more and possibly raise them with your care providers. As you’re skimming, ask yourself some questions. Does this treatment seem like it might be applicable or relevant to your situation? Might it be available to you? Is this something you might be interested in trying?