Debunking and dispelling mental health myths.
MYTH: MENTAL ILLNESS IS CAUSED BY A PERSONAL WEAKNESS
Have you heard this one before? I have! Mental illness has NOTHING to do with being lazy or being weak. It is not a character flaw. Mental disorders are brought about by the interactions of different biological, psychological and social factors. These include genes, physical illness, injury, brain chemistry, family history of mental health problems as well as life experiences (trauma, history of abuse, job loss, loss of a loved one, separation, divorce etc). Seeking and accepting help is a sign of resilience and strength.
MYTH: IT IS IMPOSSIBLE TO GET OFF OF ANTIDEPRESSANTS BECAUSE OF WITHDRAWAL EFFECTS
I was recently asked: Do antidepressants create withdrawal symptoms when patients stop taking them? Do you feel pressured to taper off or keep a patient on antidepressants?
Some patients experience discontinuation symptoms when coming off of certain antidepressants. This is most common with antidepressants, such as Paxil, that have shorter half-lives, and in situations where an individual has been on an antidepressant for an extended period of time.
We also tend to see some discontinuation symptoms with some of the Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), such as Effexor XR. However, despite this, I have yet to encounter a situation where I am unable to terminate treatment with an antidepressant in a person who is clinically stable and in remission from depressive or anxiety symptoms.
The choice to discontinue antidepressants is influenced by an individual’s clinical state, his/her preference to discontinue, and the presence or absence of major life stressors. I have never felt pressured to continue or terminate antidepressant pharmacotherapy because of discontinuation symptoms.
For medications that have a tendency to cause some discomfort while discontinuing, I typically wean off of them slower, and have more frequent medication management appointments to monitor the effects and/or any change in clinical state. By doing this, I am better able to understand any positive or negative effects that my patient experiences while decreasing, and ultimately, discontinuing treatment with an antidepressant.
MYTH: I CAN’T DO ANYTHING FOR A PERSON SUFFERING WITH MENTAL HEALTH ISSUES
FALSE! If you know of individuals who struggle with mental health issues there are several things that you can do to be of support. Some supportive things include:
Encouraging them to seek professional care with a psychiatrist, therapist, or other health care provider.
Listening.
Providing moral support.
Asking them how they might need help.
When appropriate, contacting family members so that they are aware and can be of support as needed.
Encouraging them to utilize resources (and maybe helping them to figure out what resources are available).
Validating their experience.
As you can see, there are many things that you can do to help those who are struggling. As a psychiatrist, I love it when my patients have a strong support system. However, I always caution against the support system being “too involved“ such that their own mental health is negatively impacted. Please don’t feel like you have to fix or change the mental health of your loved ones. That is too great of a burden to carry alone!
Shivani Chopra, MD 