Drugs are not the only option

As a society, we’ve become heavily accustomed to cocktails of pills and synthetic substances to aid, replace and repair our body’s biochemical functioning. While pharmaceuticals can do a great job, particularly in assisting with managing symptoms, they only go so far. And the side effects aren’t always pretty. On their own, drugs simply can’t fix many of the underlying causes of psychological distress or mental health conditions, particularly the personal, social and systemic ones (if only it were that easy, right?).

However, pharmaceuticals are generally the first line of treatment for even the most common conditions including episodic depression and anxiety, and some behavioural issues. And scripts are dispensed at the stroke of a pen (or rather, a computer key these days). But it’s important to consider all of your feasible and available options before dosing.

If you’re looking for a well-established approach to dealing with common mental maladies, cognitive behavioural therapy (CBT) might be the go. It was founded in the 1960s by US psychologist Aaron Beck and is rooted in the field of psychoanalysis (famously developed by Sigmund Freud in the 1890s).

The treatment has had good success in helping people with managing and improving anxiety-related disorders and depression, gambling, substance use issues and eating disorders. It’s also proven to be effective for overcoming irrational fears or phobias (think: spiders, clowns and the dentist), as well as marital and relationship issues, and poor self-esteem.

CBT focuses on understanding, and gaining a sense of control, over your thoughts, beliefs and attitudes, to regulate your emotions and feelings. Sessions are about 30-60 minutes long, and take place over the course of several weeks (usually between eight and 20 sessions).

Personalised treatment plans are developed by the CBT therapist. They may incorporate: self-reported assessments of how you’re going; education and personal goal setting; learning and practising strategies, including different cognitive, behavioural; and mindfulness approaches. Homework can be expected and you may need to keep a diary to track your progress, challenges or triggering circumstances, and how you dealt with them.

Despite its success, one of the key issues with this kind of therapy is that it’s not particularly strengths-based, and is focused on the perceived deficits and dysfunctional thoughts or patterns of an individual. And it isn’t really suitable for addressing more complex mental health conditions, or for people with learning difficulties. CBT is also limited by the fact that it doesn’t address external causative factors.

But it’s a good idea to have a chat with your doctor, who can provide you with further advice about CBT and how it may help, particularly if you’re experiencing depression and anxiety. You may even qualify for Medicare rebates for sessions with some practitioners, or as part of a mental health plan completed by a general practitioner. If you haven’t already got a formal plan in place with your GP, it may be time to do so. Mental health plans can provide up to 20 Medicare rebated sessions with a psychologist, social worker or other appropriate allied health professional, with a referral from your doctor.

There are pros and cons, for any kind of medical, psychological or mental health intervention. So, please remember that when it comes to your own health and wellbeing, you have the right to be informed, and to choose.

It’s worth investigating your options — especially if the medications you’re taking or the approaches you’ve tried aren’t working for you anymore, which can happen as your body, circumstances and needs change. And keep in mind that not all therapies and treatments will resonate with you, and that’s absolutely OK too.

This article was first published in The West Australian in Renée Gardiner’s weekly column in Agenda, 11 September 2021.