Don E. Gibbons, Ph.D., NJ Licensed Psychologist #03513
This Blog is published for information and educational purposes only. No warranty, expressed or implied, is furnished with respect to the material contained in this Blog. The reader is urged to consult with his/her physician or a duly licensed mental health professional with respect to the treatment of any medical or psychological condition.

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Tuesday, March 25, 2014

Which is More Effective: Medication, Talk Therapy, or Hypnosis?


The short answer is, it depends upon the person and the circumstances. For example, a prison inmate with previously undiscovered bipolar disorder had driven his car into a tree while in a manic state, which resulted in the death of his girlfriend and his subsequent incarceration. He later said to me, "It's too bad that you have to come to jail to find out that you have a mental illness!" I agreed that he was unfortunately correct. ("Insanity" is a very difficult defense to use, even when it may be justified.) Later, when his meds had taken effect and he saw how effective they were, he told me, "The right medication, in the right dosage, will kick a**!" 

I told him that I had never heard it put so incisively before; but again I had to admit that he was right. Of course, many of the criticisms of "Big Pharma" for over-marketing psychotropic medication are probably valid. Research has shown that for many problems involving mild to moderate anxiety and or depression, a regular exercise program and, or talk therapy of the same length of time can be effective -- but certainly not for bipolar disorder!

However, medication is not without its drawbacks. It's a science to develop a new psychotropic medication but it's an art to use it, because no two people are exactly alike. Even after years of rigorous testing to gain approval for a prescription drug, a particular medication can have absolutely no effect on one person, work well for another, and put still another in the emergency room. (I've talked to more than one person in each group.). But after a medication has cleared all the hurdles to permit it to be prescribed, it can  be, and often is, prescribed for other purposes that it has not been approved for!

Because psychotropic medication can sometimes can take weeks to build up in your nervous system before you find out whether or not it is going to work, and because of the possibility of side effects just mentioned, prescribers often start a person on "baby" doses of a psychotropic medication and gradually increase the prescribed amount until a therapeutic level is atually reached. This often results in having to wait even longer to find out if a particular medication, or combination of them, is going to be effective.

No decision regarding whether to use or not to use psychotropic medication such as anti-depressants, anti-anxiety agents, or mood stabilizers, should be made without consulting an appropriately licensed professional who can prescribe such medication. But for those who respond poorly or adversely to psychotropic medication, hypnosis or talk therapy can be useful either as a booster or as an alternative. For example, a client whose depression appeared to be primarily rooted in family difficulties recently had been prescribed an anti-depressant by her family physician, but it was either not working or it had not kicked in yet. She was about to stop taking her medication, but I reminded her that some medication does take weeks to build up in one's body, sometimes the dosage needs to be adjusted, sometimes there are unpleasant side effects, which make it necessary to try another medication before finding just the right meds, either singly or in combination, which work for a particular individual.

She responded extremely well to hypnosis, however.  While she continued to see her physician, I suggested feelings of peace, happinesss, tranquility, and relaxation. Almost immediately her depression lifted, and we were free to begin the process of identifying goals and discovering the sources which would help to bring meaning and fulfillment into her life.

Was her change in mood due to hypnosis, or did her medication finally start to work?  Life is not an experimental laboratory; and with a live patient who desperately needs to get better, our goal is to get results, rather than identifying exactly what leads to what. The only thing we can be sure of at this point is that she was satisfied with the outcome.
 

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