Garrido 1 Holli Garrido Prof. Presnell Honors English 1103 30 Nov. 2011 Psychological Treatment: What do We Really Know?

Your head is aching. Bright lights hurt. Everything around you sounds loud and painful. Having a simple headache can ruin your day, until you take some Tylenol! Drug companies have somehow targeted what makes our head hurt so much, and manufactured a tiny tablet to make the pain stop. Simple enough. Now try and imagine that your head hurts, but instead of the sounds around you being too loud, you hear noises, voices, calls, that only you can hear. You cant stop them and you dont know what they are or why they are happening to you. For the life of a paranoid schizophrenic, there is no Tylenol tablet to make the voices go away. So what is there? If people are suffering from mental illnesses at this intensity, shouldnt there be a cure, or some plan of treatment so they can gain some relief? As long ago as 5000 BCE, people have been testing remedies to try and cure mental illness. What began as drilling holes in your skull above your ears, progressed to men traveling around Europe to remove stones of madness, and finally to a highly addictive and often lethal drug being handed out to patients called laudanum. Thankfully some progress has been made since then, but how exactly to treat an illness so that the results are significant and long lasting, if not permanent, is still a mystery. Lying down on a couch and opening up your thoughts to a therapist or opening a bottle of pills with a glass of water, these are two prominent attempts at treating psychological illnesses, but are they truly effective? My Own Encounter and My Best Friend Anxiety is a commonly heard term, and everyone can have anxious feelings from time to time. I wish I were one of these people, but my anxiety reigns prominent, ranging from a slight constant nagging in the back of my head to full blown panic attacks during which I have no control. Aside from gentle therapy, of which I havent been to in years, there isnt much to do for me, since I refuse to depend on relaxers or other drugs. Even if I had chosen otherwise, as Jeffrey Klugers article in Time magazine makes clear, drugs come with their own handful of symptoms. Mood stabilizers have been suggested to me come coupled with weight gain, vomiting, rashes, and sleepiness. Not exactly a fair trade for some panic attacks if you ask me. A far more severe problem than my own is that of my best friend, Luke, who has been dealing with depression and a possible diagnosis of bi-polar disorder, much like his father, a diagnosed bi-polar who committed suicide when Luke was seven years old. Luke is among the many who suffer from depression, as research conducted by Pim Cuijpers and others from their respective psychiatric departments verifies that depression is the fourth disorder worldwide in

Garrido 2 terms of disease burden. It is expected to be the disorder with the highest disease burden by 2030. This research also asserted the idea that therapy is more effective in treating patients with depression in primary care. Despite these facts anti-depressant medications are flying off the shelves. Kluger reminds us that these drugs may make you feel happier, but add some fatigue, reduced libido, and suicidal thoughts into the mix (55). Not exactly a fail-safe solution, so why isnt there one? With a new iPhone being released every six months, where are the new drugs or therapy methods that can help people like Luke and me? This lack of knowledge is prevalent and a major concern to those in the psychological community, and an even larger concern to the patients. Living on the Dark Side The year 1987 could be considered an important year, since this was when Prozac was approved as an antidepressant (Kluger 9). Why then is depression one of the most prominent mental illnesses found today and still growing? This overwhelming sadness that patients cant seem to escape or keep away,-often leads to suicide and other drastic measures. Research by Cuijpers has brought to light that patients put in primary care, especially those with less severe cases or early stages of depression, can be significantly helped by the therapy they receive there. When asked, the majority of the patients prefer therapy to other types of treatment. This is not so different from the way treatment for schizophrenia is being looked at in modern situations. International research studied by Kristin Cadenhead from the psychiatric department of the University of California at San Diego has shown that community outreach and knowledge regarding the symptoms of schizophrenia have been a success in raising awareness of the disease and treatment. While many other factors come into play when recognizing and diagnosing a case of schizophrenia, the suggested plan of action is to monitor the patient and offer therapy on a needs based approach (Cadenhead). Of those schizophrenia patients who received therapy, the majority of it was school or community support. This is a relatively new approach to treatment, but has proven to be nothing other than helpful so far. It is encouraging to see new ideas coming forth, especially to help what is probably the most severe psychological disorder of them all. But where does that leave depression, anxiety, and the rest of the mental problems? How are you Feeling? I find therapy to be a much more effective means of treatment, having been to therapy myself a handful of times and knowing that Luke prefers talking to his therapist than relying on his antidepressants. Sometimes the most complicated problems have simple solutions, like the truth of the medical model which states that when someone is ill, they seek care from others. This relationship holds true for any illness at any point in history and is proposed and made so obviously clear by Beth
Sigmund Freuds therapeutic couch, the idea that started the trend.

Garrido 3 G.Wildmans book on treating children in primary care. This model seems like common sense, so why is it so uncommon these days for people with an ill mind to seek help from another human or a therapist. We naturally crave attention from those around us, and what better than attention from someone whos career and feelings are completely dedicated to giving you and your problems the consideration they deserve. Horvath and Greenberg, two psychologists cited in Morley D. Glickens book on improving the effectiveness of the helping professionals, found research evidence to support the central role of the therapist to patient relationship in successful therapy. Other relationships come into play as well, whether it is the patients shared cultural beliefs, societal inequality or social support, or networks with the people around the patient (Wildman 247). What these factors have in common is that they all have to do with people, in particular the individuals that make up our surroundings and our day to day life. With humans playing such a huge factor, shouldnt a sick person seek help from another healthy and better off person, rather than a drug? Many psychologists think so, and I stand by that belief. Take Two Every Hour Over the years evidence has come forward to make clear the effects of prescription drugs, both what they are intended to do, and what they do besides that. There is a drug nowadays for just about any illness at any level of severity. From the early attempts at making prescription drugs to the modern day, there is no pill yet that is side effect free. The Victorian era saw the production of a drug called laudanum, a high octane mix of ethanol and opium that was given out as a painkiller, an antidepressant, and an antihysteric (Kluger 55). The modern day can see a whole chest of drug options, from sedatives to stimulants, mood stabilizers to antipsychotics. Each drug comes complete with its own list of side effects, ranging from simple fatigue to full out delusions. It looks like while one pill may cure your depression, it trades you for a whole
Are we becoming completely made up of the drugs we take?

collection of damaging symptoms; leaving the patient torn between suffering without medication, and suffering with the medication.

In the drug industry the lack of knowledge of psychological disorders shines through brighter than in any other area. Sure, a therapist may say the wrong thing or not help the patient along as quickly as they would like, but you dont leave your therapy session feeling dizzy and suffering chest pains. Of course a perfect drug is a lot more difficult to create. This much is known, but when the side effects list is longer than the list of cures, something needs to be done. The technology is out there, and with universities churning out more professionals than ever before, some figuring out needs to be done so that a medication can help a patient and nothing more. Understanding the brain and how it works, and then how to make a drug to remedy its

Garrido 4 problems since the demand for medication is not going away, and neither is the human brain and all the secrets it holds. Pop a Pill or Pay a Bill What psychological treatment comes down to is prescription drugs, or therapy. Between the research conducted by psychiatrists like Pim Cuijpers and Kim Cadenhead, to books published by professionals like Wildman and Glicken, the search for understanding and the results of what has been found already is all there. Although it is hard to ignore just how expensive therapy is, and how much more of it you need to be considered recovered or helped, more evidence suggests this is the better plan of action. Yet despite the harmful side effects, of which therapy has few, the drug route of therapy is growing and becoming an ever larger market. Drugs are cheaper, and leave the impression that they are working better because the results are immediate and require no conscious effort from the patient. Wildmans medical model is made even simpler, since care does not have to be sought out, but can be passed around in a bottle. Then again what happens when the drugs run out? Has the patient really made any sort of recovery? On the flip side of treatment what if a well-loved and understood therapist leaves the city, who else can the patient turn to for help? An even scarier thought is the prediction by APA (American Psychological Association) President Nick Cummings that in the next ten years half of todays therapists will be out of work due to a rise in drug popularity; though this does not mean that this will leave us to a world of drugs and drugs alone. Cummings also predicts that therapists and physicians will form group practices that provide patients with medical and emotional treatments rather than sticking to the routines of today (Glicken 197). New therapy will continue to evolve and build off of todays methods, hopefully fueled by an increase in knowledge. No doubt that drugs will continue to be manufactured and refined to include one less side effect. The world of treatment has been a hazy place for centuries, and continues to be a field of best guesses and high hopes of success. If concrete understanding can come to accompany these hopes, perhaps mental illness can finally be helped.

Garrido 5 Works Cited Cadenhead, Kristin, et al. NIH Public Access. PubMed Central. Treatment History in the Psychosis Prodrome: Characteristics of the North American Prodrome Longitudinal Study Cohort. 2010. Print. 7 Nov. 2011. Cuijpers, Pim, et al. The British Journal of General Practice. PubMed Central. PSYCHOLOGICAL TREATMENT OF DEPRESSION IN PRIMARY CARE: A META-ANALYSIS. Sweden: Department of Behavioural Sciences and Learning, 2009. Web. 7 Nov. 2011. Glicken, Morley D. Improving the Effectiveness of the Helping Professions. Thousand Oaks: Sage Publications, Inc., 2005. Print. Kluger, Jeffrey. "Medicine Chest for the Mind." Your Brain: A User's Guide. Time. 2011: 54-55. Print. Wildman, Beth G., and Terry Stancin. Treating Children's Psychosocial Problems in Primary Care. Scottsdale: Information Age Publishing Inc., 2004. Print. Picture Citations Therapeutic Couch http://www.google.com/imgres?imgurl=http://brainiedeal.files.wordpress.com/2010/01/ Drugs http://www.google.com/imgres?q=prescription+drugs&start=66&num=10&um=1&hl=en &biw=1366&bih=614&tbm=isch&tbnid=yThfH_KPBjRjnM:&imgrefurl

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Reflection on my Investigation My Idea and its Changes My initial plan was to conduct an investigation on how little understanding of treatment for mental illness there was, and why this is. Although as I did more and more research, I became more interested in different types of solutions for different diseases and why each type was used. My information began to be more of an exploration of therapy, drugs, and the benefits and faults of each, rather than the lack of understanding of these topics. I think the change was caused by the available information. It is hard to research psychological disorders without being pulled in by all the fascinating material out there. While the change occurred during the research, I dont think I realized this until I was writing my essay, and I found my energy going more towards exploring treatment and the thoughts surrounding it than anything else. The Direction of my Research My search began in the computer lab, as I filtered through hundreds of government documents, but those that I did find were relatively helpful. Since my investigation was psychology based, the articles I found were all in research format, and therefore pretty dry to read and tedious to pull information from without having to use the entire article. Also because these articles were mostly composed of the experiments and the details of the procedures, useable information was less than I had hoped. Following this search I checked out some books from the library, and thanks to the table of contents it was easier to narrow my search to fit my investigation, since both books were rather lengthy. The special brain related issue of Time magazine was by far the most vital source for my investigation, since it covered a range of topics and was written in an engaging manner. Most of the information on drugs and their side effects came from those articles, making it the most useful of all my sources for research. Sadly my primary source for which I tried to interview a psychologist at UNCC fell through, since she never responded to my multiple emails and I could not wait around. Id like to think the interview would have been helpful, but then again it may have made it difficult to organize her opinions on the subject and my own, so perhaps its for the better. Effects of my Research I was most surprised to find out so many things about therapy, aside from the general knowledge I already had. I think I was able to answer the majority of my ten questions, and those that I could not answer must not have been vital because I am satisfied with the information I gathered overall and the topics I was able to cover. My research did change my direction a little bit, gearing me more towards a detailed look at branches of treatment rather than knowledge of said treatment. However, the information I did find, both on therapy and on prescription drugs, was fascinating to me and I feel will stay with me throughout my life as a learner, writer, and most importantly a psychologist. Writing my Essay

Garrido 7 The talker headers helped immensely because I was able to have my information organized and planned out before I actually began writing. While I did not have to write a senior project in school, the papers I did write in my AP English courses helped me keep a formal and professional tone. I liked to mix facts with my own opinion, making the paper informative but also connecting it to my feelings and making it more personal for myself, and hopefully for my readers as well. Without the headers I would have been very lost and disorganized, so while that was the hardest part of the project, it made the rest much easier to complete and write well. Life as a Researcher This exploration is different from anything I have done in the past because when one writes a research paper, it is for the purpose of searching and compiling information to present or argue a topic. Everything is matter of fact and well organized. In this situation I was able to mix research with opinion, and while a search was still included it was not the sole makeup of the paper. For the first time I could use first person and include my thoughts and how the information affected me instead of just reporting it in my own manner. This is something I actually enjoyed and it made the paper easier to write. Life as a Learner As a learner and someone who will be digging through and gathering information on various topics for the rest of my life, I learned that the way an article is written really effects what I take away from it. It may be this way for a lot of people, but going into this investigation I figured that no matter where I found the information or the format it was in, it would at least relatively interest me. Such is not the case, and I discovered that when information is written in a looser and more casual fashion, such as a magazine article, it is a million times easier for me to be engaged in what Im reading and I absorb and remember the content better.